Have you ever met someone at a party and when you find out they are a physical therapist, your first thought is, “Oh yeah, you prescribe exercise to people!” If you ponder on that for a while you start to ask yourself, “Wait, how is that different from a personal trainer? Besides causing pain and assigning a ridiculous amount of exercises, what does a therapist do?” Society has misconceptions about physical therapy, some of which are unwittingly perpetuated by physical therapists who inappropriately use exercise in their own practice. Some of us, myself included, have been to therapy where all we did was exercise until we realized we could just do that at home.
The stereotype that a therapist just prescribes exercises is believed by most people, including some uninformed doctors. The largest components of physical therapy are the hands-on assessment, patient education, appropriate prescription of exercise, appropriate performance of exercise, and the healing touch that encourages overcoming barriers.
Imagine going to the doctor and getting 15-45 minutes of one-on-one time where they work with you hands on–overcoming your pain, answering your questions, and assessing your progression and continued limitations. That is what a Doctor of Physical Therapy (DPT) does.
Physical therapy has a purpose behind every exercise to create a specific change in the tissue according to what the tissue needs. Exercise is only a small component of physical therapy.
When I prescribe an exercise for a patient it is with the purpose that the exercise create a specific adaption in the body–rarely for muscle mass or expanding aerobic capacity. I explained in an earlier blog about diffusion, “Post Workout Soreness,” that the body heals with the exchange of nutrients and getting rid of waste products. Exercise speeds up this exchange. Most exercise in physical therapy is to prevent atrophy, maintain or improve range of motion, increase the rate of healing, decrease muscle tension, and improve coordination.
The biggest misconception I currently run into is that the prescribed exercise is a generic motion based off the idea that exercise does only 2 things: build muscle mass or increase your cardiopulmonary function and endurance. Exercise does so much more for the body than the two aforementioned benefits.
Physical therapists are not personal trainers; we rarely prescribe exercise to lose fat or increase large amounts of muscle mass. The sole purpose of exercise in physical therapy is to create optimal function.
I consider my smallest role to be the prescription of exercise. Like the dentist that encourages flossing and brushing, exercise is the adjunct to my intervention that will encourage healing and perpetuate change for permanent relief.