What is Physical Therapy?

Do you ever get asked that question?  Do you have a quick and easy way to respond?  How about this – “A physical therapist can help you achieve and maintain mobility and quality of life without surgery or prescription medication”?  Or “Physical therapists apply research and proven techniques to help people get back in motion”?  What do you typically say? 

Our Marketing Director has often suggested that if you poll a dozen people on the street about what a chiropractor or podiatrist or massage therapist does, you’ll probably get pretty consistent – and relatively accurate – responses.  But if you ask them what a Physical Therapist does, you’ll likely get very different and oftentimes incorrect answers.  Our profession has a long history and has changed so many lives in so many positive ways, but is still elusive to most Americans.  The American Physical Therapy Association (APTA) wants to change that.

In February, APTA rolled out a new branding Campaign called “Move Forward.”   The website and accompanying materials for the campaign not only explain what physical therapists do and how they work with patients, but also how to find a PT in your area.  It provides impressive statistics about the successes of therapy and even outlines some FAQs. 

I encourage you to use this resource – and continue to check in as the campaign is further developed in the future – to help educate your patients and the general public on our profession.  As we work toward fulfilling APTA’s Vision 2020, we all need resources to be comprehensive, clear, and consistent in our message about who we are and what we do.  If we are truly autonomous practitioners and expect patients to think of us as a first point of contact for musculoskeletal issues, we need to educate our population and make the definitions of “physical therapy” not only common in the world of healthcare but also in our greater cultural conversations. 

 

Athletic Trainers in TAI

Director of Athletic Training, Chelsey Franz, tapes an athlete at the National Girls U16 Fast Pitch Tournament

A few TAI clinics have a certified Athletic Trainer (AT) on staff or work closely with ATs in some capacity, but one clinic – TAI-Valley Physical Therapy  in Keizer, OR – maintains a unique and comprehensive AT program in which they provide AT services for all of the Salem-Keizer high schools in the district.  I asked Chelsey Franz, MS, ATC, our Athletic Training Program Director, to shed some light on the work of Athletic Trainers and our program in Oregon. 

What is an Athletic Trainer?

A certified athletic trainer (AT) is a highly skilled and nationally certified health care provider. Working with physicians and other allied health professionals, ATs specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses that occur in athletes and the physically active. Certified Athletic Trainers have, at minimum, a bachelor’s degree, usually in athletic training. ATs study human anatomy and physiology, rehabilitation, biomechanics, exercise physiology, athletic training, nutrition, health and sport psychology. Athletic Trainers undergo extensive training in both clinical and professional settings. An AT’s primary responsibilities are injury prevention, reduction of further injury by administering immediate care, development and implementation of rehabilitation programs, and development of appropriate policies, including return-to-play. 

TAI’s AT Program in Salem-Keizer

The Salem-Keizer School District (SKSD) implemented use of athletic trainers at the 6A high schools in the Salem-Keizer area 13 years ago. It began as a community outreach program with services contracted through Salem Hospital. In 2005, the SKSD contract was awarded to TAI-Valley PT Keizer and we have been running this program ever since.  Currently, we employ 6 regular-time ATs, and 4 on-call ATs, to work in and with the schools during the school year.  A fifth on-call AT directs the program. 

Athletic trainers work at the schools an average of 25 hrs/wk over the course of the school year. Due to demands of different sports, an AT usually averages more hours in the fall and less in the winter and spring. Average start time is 2-2:30 pm (when school gets out) and end time is dependent on home activities. If possible (given the constraints of the contract), an AT will cover all home sporting events to be on the field with the athletes. An AT will travel with varsity football and often times with playoff games.  Most ATs carry a second job in addition to the AT role. Three of our ATs are full time teachers, two others work in the school setting, one is a rehab director and another is a PTA. 

Our AT program implements four core offerings with the student athletes – a Concussion management/return to play program, PEP (Prevent Injury, Enhance Performance) program, SAM (speed/agility/mobility) program, low-cost sports physicals.  We are additionally utilized in a PTAT program, assisting patients who have completed PT but still desire continued workouts/conditioning. 

Our program serves thousands of student-athletes in the local community and provides cost savings by avoiding unnecessary trips to urgent care clinics, ERs, doctor offices and rehab clinics.  The TAI-Valley PT clinics offer 3 free visits to student athletes.

For more information on this program, visit our website.

Hillsboro PT and Sports Education and Injury Prevention

Several of our therapists have created strong outreach programs which extend their skills and services beyond the clinic walls. I was inspired by one recent program developed at our Hillsboro PT clinic in the Portland metro area. They are a Certified Clinical Site for Cincinnati SportsMedicine Research and Education Foundation and their SportsMetrics program. Hillsboro Director Tim Brinker, PT, OCS, FAAOMPT and his team have started a lecture and on-field training series with the soccer players and parents of FC Portland Academy. The first presentation was conducted in February for about 150 young female players and it focused on ACL (anterior cruciate ligament ) injuries. The same format presentation will be repeated for about 150 male players later this month.

Presentation highlights include:

• Statistics on female athletes and ACL injuries (e.g. Did you know that 1 in 100 female high school athletes and 1 in 10 female collegiate athletes will sustain an ACL injury and that female athletes are 4-6 times more likely to sustain a non-contact ACL injury than males?!)
• ACL injury overview, including a discussion of pertinent anatomy and function and, in this case, biomechanical and developmental contributions to ACL tears in women and what you can and cannot change about these contributions
• Review of the PEP Program, a dynamic warm up program that has been proven to decrease non-contact ACL injury in female athletes by 2-4x
• On-field training and education on Sportsmetrics WIPP Training (Warm-up for Injury Prevention and Performance)

• Overview of the SportsMetrics program where the athletes are evaluated to determine if they are at high risk of developing a non-contact ACL injury. This is done through SIT (Sports Injury Test) and video analysis.  For those athletes who are high risk or are returning from a knee surgery to sport, two different SportMetrics programs are offered: a 6-week group training session or a Return to Sport program, which have been shown to reduce the incidence of serious knee ligament injury by 80%.

Not only will Tim and his therapist team continue to work with these athletes, but he is leading a group of TAI therapists through a 2009 Sports Education and Injury Prevention program where clinics throughout the company will offer lecture demonstrations to young athletes in their communities in Soccer, Baseball, Athletic First Aid, Cycling, Running, and Speed and Quickness among other things. Not only is this kind of work timely and relevant (e.g. I have heard a number of stories on NPR in the last several months that point to the seriousness of injury in young athletes and the importance of proper attention and training to prevent injury), but it also points to our continued efforts to use our skills as musculoskeletal experts to make a positive difference in people’s lives.

If you are interested in finding out more about this programming, contact me or email Tim Brinker at tbrinker@taiweb.com.

Golf Performance Program

Several TAI therapists are TPI Certified Golf Fitness Instructors through the Titleist Performance Institute (TPI). TPI is a PGA and LPGA approved golf specific training program.  Clients who visit one of our instructors for a golf performance assessment go through, among other things, a biomechanical evaluation and develop of a custom exercise program to optimize swing results while minimizing risk of injury.

Our instructors are physical therapists and avid golfers so they not only have an interest in the sport, but an expertise in evaluating and treating biomechanical injuries and issues. Jeff Houser, DPT – a therapist at our Seattle Physical Therapy clinic and one of our TPI instructors – has highlighted some of the program’s features:

• Initial evaluation (60-minute scheduled appointment) of your physical ability as it relates to the golf swing. This 13-point physical evaluation allows the instructor to identify potential weaknesses or mobility limitations that can create erroneous swing patterns, which could be detrimental to your body. This evaluation is both for the golfer in pain, as well as the non-painful golfer who wants to maximize his or her potential by increasing their swing efficiency.

• Videotaping of your swing to identify major swing errors that may be creating your pain. There is also the option of working with a golf professional (through TPI) for a more complete diagnosis of swing faults and ideal corrections.

• Development of a Golf Performance Fitness Program. This is another 60-minute appointment where the therapist instructor and client review the findings from the above to then develop a specific exercise program to address weaknesses or mobility restrictions.

• Access to MyTPI.com, a site where you can view your swing, your personalized exercise program, and all progressions that are made, as well as get tips from the leaders in golf fitness at the Titleist Performance Institute. This is a home based program that will usually run over the course of 16 weeks.

More information on this golf performance program and other tips for active golfers will be found in the upcoming edition of Therapeutic Outlook, TAI’s bi-annual magazine that covers issues in PT, health, and wellness. You can receive your free issues in hard copy or via email. Thanks for reading!

Fairwood Physical Therapy and the GRAVITY SYSTEM®

General wellness programming is an exciting trend in outpatient physical therapy nowadays. Well designed and executed programs can not only draw new potential patients to a clinic, but can also keep patients healthy and active in the clinic even after therapy discharge. Several of our practices have endeavored upon various wellness and fitness programs in the last few years. In July 2007, our Fairwood Physical Therapy clinic in Renton, WA began offering GRAVITY classes. I recently connected with Jeannette Baker, NASM, CPT, a personal trainer who teaches the classes at Fairwood PT and asked her to explain the GRAVITY program and share some of its successes…

Lori: How does the GRAVITY program work?

Jeannette: The classes are taught mostly using a machine system called Gravity. If you’re familiar with the Total Gym that sells for home use . . . the Gravity machines are similar but a little more versatile and built for a health club/physical therapy environment. You can read more about the system on their website. The classes work using your muscles to lift a variable portion of your body weight and focus a lot on core strength as we build muscle strength, cardio endurance, and flexibility. During the course of the classes we also do some complementary exercises off of the machines to work on balance and core strength as well. Sometimes the classes are a total body workout and sometimes we spend a session focusing on a specific area of the body. I try to tailor the classes to each participant.

Lori: How many people at a time participate in a GRAVITY class?

Jeannette: We have a maximum of 4 participants in any given session so there is LOTS of one-on-one attention. The small classes also allow the participants to get to know one-another and have lots of fun! I have some clients that have been with me for 4 sessions now and thoroughly love the program!  The other instructors and I are constantly working to find new and fun things to do with the classes on the machines so that we don’t get bored too

Lori: So how long is a session?

Jeannette: We have our program structured in 10-week sessions – either coming twice a week for 30 minutes each time or once a week for an hour. We also do offer drop-in sessions (as space allows) but the pre-requisite for that is either having gone through our program once already or having a personal training session first with me on the machines so that you know the ins and outs of the machines (working on them, adjusting the machines, knowing some of the moves, etc) when you drop in. I also do individual personal training sessions with people. The group classes are offered in the early morning hours, evening hours, and on the weekends.

Lori: What benefit have you seen this program have on the participants? and for the clinic?

Jeannette: The initial measurable benefit that I have seen from the clients is their drop in body calculation figures . . . body fat, measurements, weight, blood pressure, etc. (All are measured at the start and end of each 10-week program – we’ve seen some amazing changes!) But far more impacting than those numbers has been the increase in self esteem that I have seen in each client.  At the start of the program many of the clients are pretty quiet and timid about the exercises and the levels that they push themselves. However, after they get through a few weeks of classes, a few “test days”, and some “workout pains”. . . they start to see their hard work pay off and become hungry for more and learn to enjoy the journey along the way. They learn how to push themselves appropriately, how to deal with and overcome minor setbacks in their program, and become proud and confident about the person they are. Just this last weekend I had a client come off the machine with a grin ear-to-ear after doing a set of pull-ups at an incline level 8 (the machines progress from level 1-8). She told me the first week she doubted that she would ever be able to even accomplish the exercise on a level 3; and now in her second session she has already made it to level 8! She then giggled and said “I know you’ll find a new way to challenge me on it though!” The clients also use the time we have together as a basis for a change in their overall lifestyle. We help the clients develop short and long-term goals at the start of their time with us. Many choose to adopt additional workout activities or healthy eating patterns in addition to our program to help them reach that goal. We provide knowledge and support to help them meet their goals.

As for the benefits to the clinic, the program creates more opportunities for the clinic to touch the community and promote healthy and active lifestyles. The classes are also quite often a bridge for clients between physical therapy (as a patient) and a safe new workout lifestyle. Clients who join the program feel that they are still in the safe and supportive environment of the physical therapy office that they have become familiar with, but are learning how to help themselves stay healthy on their own. I am able to provide my background knowledge from my personal training certification as well as interact with the therapists in the clinic to design a safe and effective program for the individuals. Some PT patients have witnessed the fun classes happening during their treatment times and have also been excited to work through their PT time and be released to join in the program – hopefully providing a good goal to help motivate their progress as well.

Jeannette Baker and two GRAVITY clients