We’re all working towards the same goal; to make healthier and stronger athletes that move better. I was having a conversation the other day regarding scope of practice with a physical therapist friend of mine and we starting talking about limits of our respective practice. This got me thinking about how these limits constrain our education within this field.
Within each discipline you will find a core unit of practitioners who are highly protective of their industry. For example, ATCs may tell strength coaches to stay away from doing “XYZ” because that is out of their scope. You also might find strength coaches telling PT’s that they need to stop implementing “ABC” regarding program design because ‘it’s their territory’.I will be the first to say that I completely understand and agree with the general standards of our scope of practice. Understand that the grey areas between the scopes are becoming ever more slimmer. There have been many times when I ‘use’ to personal train athletes that if they score poorly on the Functional Movement Screen, I referred them out. If that had positive indicators of pain doing “XYZ”, I’d refer. This just makes sense to me. I’m not an expert at physical therapy. I’m not an expert at diagnosing injuries. I’m not an expert nor can/should be, putting my hands on athletes with manual therapy. This is where the referring and scope of practice should be.
However, I think it’s in our industries best interest to UNDERSTAND what each practice does. I’m not going to go back to school to become an ATC or Physical Therapist but you can bet your buck that I’m reading textbooks and continuing education material regarding the topic. “Why”, might you ask? I believe having the understanding of each practice helps aid the athlete in all of our respective goals. We’re all here to make healthier and stronger athletes move better and more efficiently.
If I can understand what the ATC is looking for in injuries, I will be on the ball when I suspect an nagging injury or signs of “XYZ”. This doesn’t mean I’ll step outside of my scope of practice, but it does mean I’ll be quick to refer the athlete because of my education. Regarding physical therapy (something I’ve been extensively reading on lately), if I can understand the progressions the PT is doing with an injured athlete, I can efficiently and more safely begin developing strength training progressions and protocols that will help aid in the transition from an ATC, to a PT, to a strength coach.
I encourage you to not sell yourself short. If your a coach, or a PT or any other discipline; start reading other materials outside of your field. I’m not advocating to extend your practice outside of your scope, but rather gain an understanding of how each of our fields work towards the same positive goal. I’m still supporting becoming an absolute beast of knowledge within your own field, but to begin looking at other disciplines as a source to improve your own knowledge and the progress of our athletes.
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I certainly have mixed feelings about this topic. We each have our role… and our role is to perform our role to the best of our ability within the environment and resources at our disposal. Frankly, I don’t have time to read a ton of what a strength coach is doing nor do I necessarily care. I do read some stuff just so I have a feel for what is going on in your world, but it doesn’t affect or impact my clinical choices. As a physical therapist, I have a very, very broad population I treat (all ages, athletes, moms, workers, pre-surgery, post-surgery, balance problems, vertigo, neurological problems, all sorts of pain, healthy individuals, unhealthy individual with lots of comorbidities, individuals on all sorts of medications, individuals with cancer, individuals 5 years cancer free). I have to very quickly determine if the person is or isn’t a candidate for physical therapy services. I need to stay current on research on various tests and measures to know the reliability, the sensitivity, the specificity and the likelihood ratios to determine the strength of my clinical decision in determining what might be going on with the patient. I also need to understand the outcome tools I use well enough to know minimal clinically important differences to determine change in presentation. I also need to stay current on research indicating effectiveness of interventions. And the one topic I hate to stay current – reimbursement issues. Policies change more frequently that you can imagine. And then, of course, in this litigious society, unfortunately, I also need to be aware of those issues and take steps to reduce the likelihood of anyone suing me AND at the same time documenting in a manner that protects me in the event of a legal battle. Just so you know, the transition for most patients is from physical therapy to life. As you can see, I have enough reading to do to try to stay up in my own field AND outside of my own field on topics that will enhance my ability to be a better physical therapist. Strength and conditioning topics are very, very low on my “have to read” meter. More often than not, the patients presenting to me are the determining factor of what topics outside my direct field I search and read.Just thought I’d share. Your suggestion sounds good on paper, but in real life the suggestion isn’t going to help me excel at what I do nor assist patients in a manner that will benefit them during their time receiving physical therapy services.~Snippets
Snippets,You bring up many valid points and I agree wholeheartedly with what you are saying. Everyone has a very limited amount of time. Between continuing education within their own respective field, the ‘actual’ physical practice, clients, documentation, running a business, etc. It all consumes time that leaves very little for everything else. Even by saying that you read a little about our field (strength & conditioning), I think that is absolutely wonderful. You have an idea what we’re doing with our athletes and you have an understanding where we’re coming from. Perfect!I, however, do not think a lot of personal trainers, strength coaches or sport coaches don’t have a great deal of an understanding about what your field is doing. That is the issue I was suggesting with this post. I’m not advocating trainers or strength coaches to step outside of their scope, but if they have moments to learn from physical therapists, manual therapists, or ATCs, than I would encourage that. Whether it is clinics, reading materials, webinars, podcasts or classes, I think it all adds to creating a better ‘coach’.Perhaps there is a disconnect from strength coaches giving back to the physical therapy profession, because I feel like the flip side (Physical Therapists educating Coaches), have been absolutely tremendous. People like John Izzo, Gray Cook, Lee Burton, and Gary Gray to name a few, have been absolutely giving to the strength and conditioning industry with their wealth of knowledge.I think the differences between us two is probably mostly a differences in demographics. The very limited exposure I have with the physical therapy world is through the medium of an athlete. I also realize that athletes make up a small percentage of your total practice. However, as a strength coach, most of the emphasis in these posts will be through the lens of creating better athletes. This is most certainly a flaw with the post, not identifying the target demographic I intended on writing about.I appreciate your comments and thoughtfulness.If there is anything I can do please don’t hesitate to e-mail me!- Adam
Let me know where you land… if you stay in the East Lansing area, I could keep you in mind for instances where patients are interested in your area of expertise. I am basically in the same locality. ~Snippets