PT vs PT – Hurt or Injured?
Physical therapy is typically associated with injury. Personal training is typically associated with health and wellness. The only similarity most people could find with these two fields is their abbreviation. This is an outdated and misguided understanding of both professions. Here are some tips to finding the right personal trainer or physiotherapist, and also how to determine which professional is the best choice for you.
Most of my clients are already hurt if not injured when they come to see me for the first time. This may be surprising, so let’s first distinguish the difference of being hurt and being injured. Being injured is a state of being where significant muscular, skeletal, or connective tissue damage has occurred and daily movement/function is significantly affected or restricted. Being hurt is when one of the aforementioned ailments only modifies the way you move/function. Let’s use lower/mid back pain as our example. Back pain is the most frequently treated ailment that physical therapists see, and back pain could be due to many different causes. A back injury could be a recently herniated disc, fractured vertebrae, or a severe muscular strain. A hurt back could be on and off tightness/soreness after driving or sitting for long periods of time, or a mildly strained muscle. A herniated disc injury will ruin you if you lift or bend too quickly, and conversely overactive lats/lower erectors that cause lower back tightness could be tolerated without any damage the spine. If a client is seriously injured and I am not familiar with the particular area, I will refer them to a physiotherapist or doctor for further treatment.
My responsibility to my client as a personal trainer is to listen to their wants and goals, and then to create a functional, reasonable, and sustainable exercise program for them. This program should feature flexibility and balance (both proprioceptive and postural) as the upmost priority. Too many trainers let their clients dictate the session out of the fear that the client will fire them if they don’t deliver results. This is a very true and real fear for the trainer. I would also not see much value if I didn’t get results after investing my time, money, and effort. There are, however, many ways to achieve a common goal. It is quite possible to achieve my client’s goals while simultaneously addressing my own needs for them. It is also my responsibility to communicate effectively how improved posture will improve aesthetics, and why sitting on a machine training in a single plane of motion is not nearly as effective (or challenging) as using our own body weight until the movement is mastered in all directions. A positive clue to look for is whether or not your trainer puts you through a movement assessment before creating an exercise program. If a client is seriously injured and I am not familiar with the particular injury, I will refer them to a physiotherapist or doctor for further treatment.
A physiotherapist has a responsibility to educate their client on how the entire body affects their isolated injury, and to create a functional, reasonable, and sustainable exercise/flexibility program. A properly trained physiotherapist will spend enough time working on the specific injury that is troubling the client, and will also allow time to work on the other root causes for the injury. Let’s use an injury to an extremity far away from the core as our example. Shin splints are very common in Boston, due to the amount of runners in and around the city. A shin splint is caused by overactive calve muscles, and underactive shin muscles (in a nutshell). This muscular imbalance can also be linked to the hamstrings, quads, glutes, hip flexors, hip add and abductors, lower back, lats etc. These possible imbalances should be properly assessed, diagnosed, and treated by the physiotherapist. If the therapist only focused on the area of discomfort, that client would probably be returning later with either the same problem or with another related injury (hamstring strain). Once the client has achieved success and is no longer injured, the physiotherapist should refer them to a competent personal trainer who can continue their progress and prevent any further damage
In summary, a great trainer will assess, diagnose, and prescribe like a physiotherapist, and a great physiotherapist will be able to comprehend and motivate like a personal trainer. Both of these professionals should know when to reach out beyond their scope of practice ask for help when help is needed.