Do you have to be "sporty" to be a good physical therapist?

[NATO]

Do you have to be "sporty" to be a good physical therapist? I've been reading some of the older threads tonight and noticed that many posters were either athletes in school (or currently a "gym rat" so to speak), are friends with a lot of "sporty" people, place sports or run in their free time, or all of the above.

I'm interested in PT because I love the idea of helping someone get stronger again after a traumatic event. I would never consider myself an athlete. In high school and college, I never participated in an after school sport. All of my after school activities involved clubs. I was one of the last few people to get selected when making up dodge ball teams. I go to the gym a few times a week for one hour per session....that's about as physical as I get (for now). I can get into better shape, lose some body fat, and tone up a lot more, but I'm average body/size at best.

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[leon24]

Hi NATO, although there do seem to be many PTs that enjoy exercise related activities; there are just as many as you say "average" individuals when it comes to fitness and athletics. When I did my shadowing I saw as many out of shape PTs as in-shape PTs. I do think it helps a PT to be in reasonable shape to a. remind yourself what exercise is like so you can relate to the patient and b. to show the patient that you take care about yourself, which gives you that little extra bit of credibility pertaining to exercising and getting healthier. But one does not NEED to be sporty to become a PT imho.

 

[jesspt]

Do you have to be "sporty" to be a good physical therapist? I've been reading some of the older threads tonight and noticed that many posters were either athletes in school (or currently a "gym rat" so to speak), are friends with a lot of "sporty" people, place sports or run in their free time, or all of the above.

I'm interested in PT because I love the idea of helping someone get stronger again after a traumatic event. I would never consider myself an athlete. In high school and college, I never participated in an after school sport. All of my after school activities involved clubs. I was one of the last few people to get selected when making up dodge ball teams. I go to the gym a few times a week for one hour per session....that's about as physical as I get (for now). I can get into better shape, lose some body fat, and tone up a lot more, but I'm average body/size at best.

Being "sporty" doesn't matter a lick. Now, being able to perform critical reasoning is another matter.

So, long story short: Active body - not necessary. Active mind - crucial.

 

[goyo1010]

Simple answer?

No.

 

[markelmarcel]

The only "sport" I'm good at is one that involves a bike that physically doesn't go anywhere (indoor cycling)

Good answers from all!

 

[Fiveoboy11]

Leading an active and healthy lifestyle is important. People who have no interest or history doing exercise in any form probably should seek a different profession.

 

[jesspt]

Leading an active and healthy lifestyle is important. People who have no interest or history doing exercise in any form probably should seek a different profession.

Look at it this way. Almost all of our patients come to us because they are in pain. Some of them have seen 3 or 4 providers already, without any relief. If you are able to reduce their pain, they won't care if you weigh 400 lbs and don't know the difference between a baseball glove and a cesta. They'll be grateful, and tell their friends, relatives, acquaintances about you.

A "healthy' lifestyle doesn't hurt, but it is fairly relative. I'm more slender than most of my patients, and I run 3-4 times per week, but I also drink around 4-5 cups of coffee a day and probably have at least one glass of wine 4-5 nights a week. Some folks, including some of my patients, call that unhealthy. I call it survival.

 

[Fiveoboy11]

Look at it this way. Almost all of our patients come to us because they are in pain. Some of them have seen 3 or 4 providers already, without any relief. If you are able to reduce their pain, they won't care if you weigh 400 lbs and don't know the difference between a baseball glove and a cesta. They'll be grateful, and tell their friends, relatives, acquaintances about you.

A "healthy' lifestyle doesn't hurt, but it is fairly relative. I'm more slender than most of my patients, and I run 3-4 times per week, but I also drink around 4-5 cups of coffee a day and probably have at least one glass of wine 4-5 nights a week. Some folks, including some of my patients, call that unhealthy. I call it survival.

Agreed. Patient's are looking for someone who they can be comfortable with and relate to. They don't care about how muscular or in shape you are. However, IMO PT's with a history of participation in exercise make for better clinician's. There are some things that we teach or know that need to be learned from a different perspective.

Full disclosure - I'm a previous wt room buff, competitive powerlifter and marathoner. Now I stick to hiking and walking my dog.

 

[Shelby029]

Sporty? No. Interested in fitness? Yes. I would think that the reason there are more "sporty" PT's is because a lot of what PT is revolves around rehabilitating the muscles, which includes exercise. Much of a PT's day they spend talking about and helping patients do specific exercises. You need to like the subject enough to be thinking about and advocating healthy lifestyles. Now that doesn't mean you have to be a gym buff though.

 

[DrDre2001]

Being "sporty" and loving sports and athletics is a reason why I am interested in a PT's work.

But it says nothing about whether or not I will be a good PT.

 

[unlikeall]

"sporty", not necessarily but I do believe you have to have a god knowledge about different variety of outdoor activities. you will get a lot of people who want to return to sports, and even the older population who play stuff like golf or even bowl. a good knowledge will help you helpthe patient to return to those activities.

 

[EndersDrift]

Sorry but in my mind yes you do. Maybe not 'sporty' though, that might be an overstatement but you do have to be healthy and have good posture. I, and I'm willing to bet nobody here, would take weight loss advice from an obese personal trainer. So why would you take advice about physical therapy from someone that wasn't healthy.

 

[aggiecjg11]

I agree with EndersDrift. So far in my program the faculty has really harped on staying in shape for a number of reasons. No, a patient might not be open to exercise advice from an overweight PT, but beyond that, you need to have the strength in order to safely do transfers without hurting your back (or the patient)! If you look at the overall population, a lot of our patients are going to be heavy-set, especially in the acute care setting. So to answer the question, I think it helps to be athletic because maybe exercising will come more naturally to you. And for all my fellow girl SPT/PTs out there, don't be shy about the weight room! Get in there and build bone density so you can practice safely for a long time!

 

[A Burly Man]

Hey what is the definition of Exercise and what is one of the major conerstones in PT?

The answer to the 2nd question is EXERCISE!

Here I cut and pasted this text from the APTA website:

Physical therapy positively influences an individual's overall health, wellness, and fitness by providing services that positively impact physical fitness. Improving an individual's level of physical fitness can prevent, remediate, improve, maintain, slow the decline of, or lower the risk of impairments, functional limitations, and disabilities.

Has anyone heard the phrase "Practice what you Preach or Teach" ?

I believe the body follows whever the mind leads it however if the body is not fit for the journey how can the mind proceed forward?

 

[jesspt]

I believe the body follows whever the mind leads it however if the body is not fit for the journey how can the mind proceed forward?

This sounds like total new age garbage. What does this even mean?

 

[jesspt]

Sorry but in my mind yes you do. Maybe not 'sporty' though, that might be an overstatement but you do have to be healthy and have good posture. I, and I'm willing to bet nobody here, would take weight loss advice from an obese personal trainer. So why would you take advice about physical therapy from someone that wasn't healthy.

And why is my posture so important to my ability to effectively treat patients?

 

[unlikeall]

Technically posture is very important. As Therapist we are role models for our patients. We have to practice what we preach or who is going to take us seriously??? also posture can effect everything you do in life. Horrible posture leads to musculoskeletal problems, tight muscles, weak muscles etc. So how can I provide proper intervention techniques( if needed) if I am not in proper health??

 

[jesspt]

Technically posture is very important. As Therapist we are role models for our patients. We have to practice what we preach or who is going to take us seriously??? also posture can effect everything you do in life. Horrible posture leads to musculoskeletal problems, tight muscles, weak muscles etc. So how can I provide proper intervention techniques( if needed) if I am not in proper health??

I'd love to see some data showing that poor posture leads to musculoskeletal problems.

 

[PTisfun]

I agree completely with jesspt's early post. PT is 'practiced' from the neck up....in other words, your clinical decision making is by FAR the most important thing to move our profession forward. Being able to complete all of your job duties (i.e., having sufficient strength and mobility) is important of course for your own, as well as for patients' safety, but 'sporty' is wholly unnecessary.

 

[A Burly Man]

Sorry I thought I was on a Physical Therapy forum conversing withindividuals that actually are concerned about their overall Health. Sporty isnot the debate I was concerned with as much as the statements given from it.Yes I read the title.

You mean OLD AGE. My philosophical words don't ring a rhyme to all peopleand that’s OK. It’s for deep thinkers!

I don't understand how one can truly explain specific positions let aloneshow a patient without drawing from their own experiences. My example: PelvicTilt. Has anyone attempted to instruct a decondtioned 50 year old through thismovement either standing or supine? (I want to know who says this is easy todo). I work at an orthopedic clinic dealing with patients that have LBP, fusions,radiculopathy, and herniations. Do you think modalities (e-stim, ultra-sound,heat) will fix the problem? My personality might help the patient with theprocess but it cannot fix them. I generally implement a lumbar stabilityprogram for most with restrictions catered to that person’s diagnosis. I haveno proof and need no proof for adjusting and helping with a person's posture.My only evidence is the multiple patients that have thanked me for eliminatingthe pain they had by the use of exercise and correcting their posture.

So if I am using a protocol (aussie method) and implementing a certainposition (posture) that is more effective than their present state why would Inot implement the same practice to prevent these occurrences.

Question Jess..... Have you worked with an 75-85 year old deconditioned patient?If so how can you relate what you learned from them and apply it to a 20 yearold patient?

Being that the mind and critical thinking/reasoning are important I assume you can give a good explanationto this question....

 

[jesspt]

Sorry I thought I was on a Physical Therapy forum conversing withindividuals that actually are concerned about their overall Health. You are on a physical therapy forum. From your statement, I can't tell if you assumed I was concerned with my health, or that of my patients. Sporty isnot the debate I was concerned with as much as the statements given from it.Yes I read the title.

You mean OLD AGE. I have no idea why this statement is here. Did anything that I or any of the previous posters said indicate that we we being age specific with our posts? My philosophical words don't ring a rhyme to all peopleand that’s OK. It’s for deep thinkers! It sounds to me like something a snake oil salesman would say. But, perhaps I'm just not thinking deeply enough...

I don't understand how one can truly explain specific positions let aloneshow a patient without drawing from their own experiences. My example: PelvicTilt. Has anyone attempted to instruct a decondtioned 50 year old through thismovement either standing or supine? Yes, I have.(I want to know who says this is easy todo) It often times is not. . I work at an orthopedic clinic dealing with patients that have LBP, fusions,radiculopathy, and herniations. As do I. Do you think modalities (e-stim, ultra-sound,heat) will fix the problem? Nope. If you look at some of my past posts, you'll see that I'm no proponenet of modalities. My personality might help the patient with theprocess but it cannot fix them. What does this mean? I generally implement a lumbar stabilityprogram for most (Even though we have very limited data on the efficacy of such programs? Even the Ausies work is fairly limited here.) with restrictions catered to that person’s diagnosis. I haveno proof and need no proof for adjusting and helping with a person's posture.My only evidence is the multiple patients that have thanked me for eliminatingthe pain they had (This is exactly what John Barnes, of a straight chiropractor, or a blood letter, or a witch doctor would say. "I need no evidence - subjective report of some success from some of my patients is enough.") by the use of exercise and correcting their posture.

So if I am using a protocol (aussie method) and implementing a certainposition (posture) that is more effective than their present state why would Inot implement the same practice to prevent these occurrences. As far as I know, we have one study that indicates a reduced recurrence rate of LBP when treating patients with transverse abdominis re-education exercises, with a fairly small sample size, but also with a fairly significant effect size. I too, use these type of exercises often near the end of a patient's course of therapy. I typically ignore posture, as the data regarding it's clinical utility is essentially non-existent, and we have virtually no good research indicating even a correlation between posture and LBP, let alone research that shows cause and effect between the two. But, should a patient have significant reduction in pain with a given posture or position, I utilize this in my treatment plan.

Question Jess..... Have you worked with an 75-85 year old deconditioned patient? Yes. If so how can you relate what you learned from them and apply it to a 20 yearold patient? I'm not really sure what you are asking here. Are will still talking about LBP? Or do you wish me to make generalizations about the similarities, or dissimilarities of rehabbing a 75 year old with a 20 year old. And if it's the latter, I'm not sure how this is applicable to the general discussion here. But, I'll attempt to answer your question in general terms - I use my experience with the 75 year old, as well as my experience with all of my previous patients, in conjunction with the current best evidence as I know it, and the considerations of the patient in front of me, to drive my treatment interventions, much like how David Sackett described evidenced based medicine. Do you have a better way of describing how your experience with the older population has helped you in treating a more youthful patient demographic? Or are you relying on more deep thoughts and new age musings?

Being that the mind (Mine, or the patient's, or both?)and critical thinking/reasoning are important I assume you can give a good explanationto this question.... (see the above re: my clinical reasoning)

Burly, Your post was a bi free association, so perhaps I'm interpreting it incorrectly, but some of your statements rub me the wrong way, particularly the point about the only evidence you need is that of your patients thanking you. Our profession doesn't need that. Hell your patients don't need that. I think they would be better served by someone who cares more about practicing as an evidence/science based clinician than he does about patient gratitude. I'm hoping you respond with a logical post, but won't be holding my breath...

 

[A Burly Man]

You are on a physical therapy forum. From yourstatement, I can't tell if you assumed I was concerned with my health, or thatof my patients. I hope you'reconcerned with both.
I have no idea why this statement is here. Didanything that I or any of the previous posters said indicate that we being agespecific with our posts it sounds to me like something a snake oil salesmanwould say. But, perhaps I'm just not thinking deeply enough...Exactly. It's not New Age its old wise words. Both the body and mind are cohesive,they work as a unit. How do you optimize your whole body if in which you do nottrain both…figure it out.
Nope. If you look at some of my past posts, you'llsee that I'm no proponenet of modalities.What does this mean?(Even though we have very limited data on theefficacy of such programs? Even the Ausies work is fairly limited here.) I am confused? You believe in treatment with an EBP but you stated:
So, long story short: Active body - not necessary. Active mind - crucial.

Does this quote only pertain to practicing PT's and not patients?

(This is exactly what John Barnes, of a straightchiropractor, or a blood letter, or a witch doctor would say. "I need noevidence - subjective report of some success from some of my patients isenough.") My words were written in haste and I stand corrected. All licensed physical therapist graduate under the same accredited principles. This means I learned from research and practice! By no means do I relate my patient'sgratitude to the efficacy of posture or my capabilities. I did not mention inany regard that I do not care about research or an evidence/scientific basedpractice. Research in PT has only been included since the early 1920's and I am not talking about Hippocrates and his practice. The current research and data can and will change just like most fields of science and research. Meaning what we say today is not an end all solution. In actuality there is researchbeing conducted about posture and decrease of LBP.
http://www.ncbi.nlm.nih.gov/pubmed/21380982
I also work with a professor that is researching cervical posture/TMD in which she foundno significant effect from correcting posture.

http://blog.az-tmj.com/2011/09/23/head-and-cervical-posture-in-patients-with-temporomandibular-disorders/
All this info is relatively new and I am aware that it will take several years and many studiesto validate the benefits of biomechanical posture. I realize there is no singleposition that we could say is neutral, there are too many variables to define such a thing. That's like asking what is normal. That being said, should I not consider it a coincidence that 3 current patients: a dentist, ophthalmologist, and a computer programmer are all being treated for shoulder impingement. What is the most common position (posture) these patients are in? It is a position where their shoulders blades (scapula) are significantly protracted for more than 8 hours daily. Do I need research to make an assumption that there underlying problem could be from posture and deconditioned muscles? Do I let them protract theirs houlders blades while performing Int/Ext rotation of the humerus?NO.
As far asI know, we have one study that indicates a reduced recurrence rate of LBP whentreating patients with transverse abdominis re-education exercises, with afairly small sample size, but also with a fairly significant effect size. Itoo, use these type of exercises often near the end of a patient's course oftherapy. I typically ignore posture, asthe data regarding it's clinical utility is essentially non-existent, and wehave virtually no good research indicating even a correlation between postureand LBP, let alone research that shows cause and effect between the two. But,should a patient have significant reduction in pain with a given posture orposition, I utilize this in my treatment plan. So which is it do you ignore or use postural re-education?
I'm not really sure what you are asking here. Arewill still talking about LBP? No I am not. Or do you wish me tomake generalizations about the similarities, or dissimilarities of rehabbing a 75 year old with a20 year old. And if it's the latter, I'm not sure how this is applicable to thegeneral discussion here. The underlying principle is that we can learn from our patients and their current situation to provide information andeducation to others in hopes to prevent a similar outcome. But, I'll attempt to answer your question in generalterms - I use my experience with the 75 year old, as well as my experience withall of my previous patients, in conjunction with the current best evidence as Iknow it, and the considerations of the patient in front of me, to drive mytreatment interventions, much like how David Sackettdescribed evidenced based medicine. Do you have a better way of describing howyour experience with the older population has helped you in treating a moreyouthful patient demographic? Or are you relying on more deepthoughts and new age musings? In part I rely on deep thoughts which have substance! This last question was food for thought and I did mean a generalization.

Although research may not provide any specific answer yet about posture and its effects, it is my responsibility to pursue and not ignore the different plans of treatment that are available or have yet been discovered and proven. Creating plans of treatment are orchestrated by research and keeping an open mind.
Thanks for your response and insight and sorry for rubbing you.

 

[unlikeall]

jesspt, so ur telling me that excess kyphosis and rounded shoulders (i.e. horrible posture) could not lead to weaker back muscles and a tight pec minor?? and ur telling me that a very tight pec minor could not limit shoulder flexion?? seems like an MS problem to me

 

[jesspt]

jesspt, so ur telling me that excess kyphosis and rounded shoulders (i.e. horrible posture) could not lead to weaker back muscles and a tight pec minor?? and ur telling me that a very tight pec minor could not limit shoulder flexion?? seems like an MS problem to me

Nope. But, I am imagining that you're talking about an extreme case, perhaps a more elderly patient with a fixed kyphosis, possible wedging of the thoracic vertebrae, etc. It has been my experience that most therapists who implicate poor posture as a cause of neck or back pain are more typically referring to the average american, who may sit with roudned shoulders, a reduced lumbar lordosis nad a posterior pelvic tilt, a.k.a. "slouching." And, I think that this type of posture has almost nothing to do with the neck or back pain of the patients who come to see a physical therapist.

Look at my example in this way. Look around at your fellow classmates as they sit through a class, or your fellow co-workers if you are a practicing therapist. As we sit, nearly all of us obtain a posture that is something other than what Florence Kendall told us is "proper" or "ideal." Yet, how many of those people have neck or back pain that they would consider is significant? A recent survey from the NIH shows that the prevalence of LBP that lasted at least one whole day was 26%. This brings up several important questions:

• If nearly everyone has posture that is less than optimal, and poor posture is such a dominant cause of LBP, shouldn't we be seeing much higher rates of prevalence?
• The survey asks the respondents if they had LBP that lasted at least a whole day within the last three months. So, some of the respondents had back pain that resolved after one day. Do you think their posture, a position that they obtain, automatically, typically without conscious thought, changed that quickly?
• If posture is such a big player as a cause of LBP, then how come, even after researching it for decades, we have so little data that even indicates that it is correlated with spinal pain, let alone a causative factor?

I will attach some articles for all to consider.

 

[PTisfun]

Jesspt...Much thanks for the occupational sitting and LBP systematic review. I believe that paper will be a valuable exercise in evidence based practice critical appraisal.