- Physical Therapists who are exercise forward are being called “glorified personal trainers”
- This stems from the idea that “skilled” therapy is mainly derived from hands on care that personal trainers aren’t legally allowed to use
- The value gained from earning the title of Physical Therapist (in whatever capacity) comes from the expert understanding of the musculoskeletal system
- Exercise and physical activity act in a dose dependent manner
There is an unfortunate trend in the physical therapy world that occurs to physical therapists that are exercise forward or heavily use active interventions over passive ones. They get called “glorified personal trainers” as a way of denigrating their means of practice, insinuating that leaving out the passive interventions like manual therapy and modalities somehow makes them less of physical therapists.
To say the same thing differently, these physical therapists seem to be insinuating that the mere inclusion of manual therapy and modalities are what makes physical therapists, physical therapists.
The issue that I take here is that everyone seems to be missing the point of what makes you a physical therapist: the expert and advanced understanding of how the musculoskeletal system works, in both a well functioning and symptomatic or injured state.
The tens if not hundreds of thousands of dollars spent on a doctorate of level of education is not won or lost because massage is or isn’t included in the plan of care. There is no deterioration of value of the degree because someone chooses to prioritize physical activity and exercise in their plans of care or not.
In fact, I want to make the argument that being in the glorified personal trainer camp in the physical therapy world has a more robust effect on patient health than not being in that camp. It’s no secret that there is a dose dependent response to physical activity, in both resistance and aerobic training.
What this means in the equation of health is that the more physical activity you put into the front end of the equation, the more health comes out of the back end (to a point).
If we continue to pull on this thread, we can see how prioritizing things other than physical activity, like manual therapy or modalities, would lead to putting less physical activity into the equation, simply due to the nature of session length and frequency that patients see their physical therapists in the most common setting. It’s not that your hands on or passive care doesn’t have a place in rehab, its just that prioritizing is putting less physical activity in the front end of that equation
With the additional understanding that physical activity can modify symptoms just as well as any other intervention, it begs the question, why wouldn’t you prioritize physical activity and exercise as a treatment approach.
Simply put, if anything is going to help with symptoms, why not use something with as robust of a secondary effect as exercise?