Rehabilitation With a Personal Trainer vs. Physical Therapy

When tackling your fitness goals, its important to know your body. Are you looking to improve your fitness level or do you have some injury or pain that you need to heal? Your fitness goals will determine whether you see a personal trainer or a physical therapist. Learn the difference between training with both from this article posted on Livestrong.com and written by Nick Ng. For more questions, call our studio at 619-756-7500!

Rehabilitation With a Personal Trainer vs. Physical Therapy
Personal trainer. Photo Credit Creatas Images/Creatas/Getty Images

Personal fitness trainers design exercise programs and help their clients execute them to maintain or improve health, while physical therapists diagnose, treat and manage pain, injuries and diseases. Fitness trainers often encounter clients with existing difficulties, such as severe back pain and diabetes, and plan activities that blur the line between fitness and medicine. When a problem is beyond their expertise, trainers must refer clients to a proper rehabilitation professional, such as a physical therapist.

Therapist Education and Qualifications

Rehabilitation With a Personal Trainer vs. Physical Therapy
Physical therapist. Photo Credit Jupiterimages/Creatas/Getty Images

Physical therapists must have at least a master’s degree in physical therapy, kinesiology, sports medicine or a similar field. If your bachelor’s degree is not exercise related, you need to complete prerequisites as mandated by a university before applying for the physical therapy program. Physical therapists must also be licensed by the state they practice in, pass the National Physical Therapy Examination and fulfill state requirements such as jurisprudence exams, according to the Bureau of Labor Statistics. They must also take continuing education courses to keep their practice updated to maintain their license.

Trainer Education and Qualifications

Rehabilitation With a Personal Trainer vs. Physical Therapy
Sports Medicine is a degree for therapists. Photo Credit Hemera Technologies/AbleStock.com/Getty Images

The profession of personal training does not have an educational standard and is self-regulated. Trainers can have a master’s degree in biomechanics with five years of experience working at a clinical and athletic setting, or simply a weekend certification with no experience. However, personal trainers should have a minimum of a bachelor’s degree in exercise science or a related field as well as an accredited certification that extends their academic knowledge, such as PTA Global or the National Academy of Sports Medicine. They should also be CPR and first-aid certified.

Scope of Practice

Rehabilitation With a Personal Trainer vs. Physical Therapy
Physical therapists works with injured patients. Photo Credit Hemera Technologies/AbleStock.com/Getty Images

Physical therapists diagnose, treat and rehabilitate patients who have an injury or disease that limits their movement. Their job is to help patients move independently, alleviate pain and prevent disability. They often work with patients with joint and muscle pain, multiple sclerosis, arthritis, cerebral palsy, stroke, spina bifida and post-surgical conditions.

Besides designing exercise programs, personal trainers also coach clients to a healthier and more active lifestyle, help prevent injuries and help clients follow through with their physician’s or physical therapist’s advice. They also screen movement patterns to ensure that clients can move well without pain or severe limitations. Trainers may not recommend diets or supplements, unless they are registered dietitians.

Expert Insight

Rehabilitation With a Personal Trainer vs. Physical Therapy
Personal trainer with client at gym. Photo Credit Chris Clinton/Digital Vision/Getty Images

A personal trainer may perform the work of a physical therapist only if he is a licensed physical therapists also. This hybrid professional may work with a patient with back pain and a high school football player who wishes to gain muscle size and speed.

Some personal training certification agencies provide a clinical exercise certification for trainers who have little or no experience or qualifications in the rehabilitation field. When in doubt, choose a physical therapist over a personal trainer for rehabilitation services.

Myths and Misconceptions: Muscle Soreness

Is it good to be sore after workouts? Check out this ACE Fit article to see if you may be over-doing it. Then come see us at San Diego Sports Physical Therapy for some great rehabilitation exercises to get you back on track. 619-756-7500

There is a common misconception that muscle soreness through exercise is inevitable and necessary to see results. For many, soreness acts as an indicator of a great workout. But this is a shortsighted view of exercise benefits and can have detrimental effects in the long run.

To clarify, this is not about the minor muscle stiffness that can be felt the day after a workout. This is about excessive soreness—the kind of soreness that lasts for a few days, has you avoiding stairs and dreading everyday activities such as putting on pants, getting in and out of a car, and even sneezing. Some people actually strive to experience this. And while a little soreness is safe and may motivate even the most sensitive among us, when it crosses the line toward debilitating movement, your body is telling you that you went too far.

The Science
In short, all muscle soreness is a result of microscopic tears that take place through workouts, followed by swelling as part of the repair and rebuilding process. This may sound like a violent way to treat your body, but it is a necessary process to stimulate changes that improve strength and fitness. But how much is enough? To answer this accurately, lets look at the available research and remove any anecdotal biases from the equation.

Cause and Effect
Many people argue in favor of soreness because they have experienced positive results and associate soreness with the results. But soreness does not necessarily equate with a cause and effect for the improvements. In fact, there is no scientific evidence that proves soreness gets better results. While there is a lack of research in this specific area, there is no shortage of research indicating that progressive challenges are responsible for improving fitness. The question then becomes, can we progress effectively without soreness? And the answer is a resounding YES.

Consider world-class athletes. No athlete, after falling short in competition, has ever said, “I should have trained to be more sore.” Yes, athletes do sometimes experience sore muscles from training. But it is neither the purpose nor the target of their training. In fact, workouts are often modified for athletes if they are experiencing excessive soreness. The measuring stick used to track success for an athlete has nothing to do with the level of soreness derived from day-to-day training and everything to do with the longer-term outcome of their training program and competition goals. In fact, too much soreness will negatively impact training and competition.

Overload
To improve fitness, it is true that an “overload” is required. This means you need to apply a challenge that is greater than what your body is accustomed to. However, this “overload” can be applied aggressively or it can be applied gradually. Many assume the more aggressively you overload, the faster you will see results. But the body is more complex than that and pain is its way of telling us to slow down with the overload.

Law of Diminishing Returns
Most improvements follow a basic premise of “the more you put in, the more you’ll get out.” However, there is a tipping point that suggests a certain level of extra work does not yield any additional benefits. In short, it means you are working overtime and not getting paid for it. This can be illustrated through the concept of exercise dosage. Much like medical prescriptions, too high of a dose does not provide additional benefits nor increase the speed of benefits. Additionally, repeated “overdosing” can invite negative consequences. Extreme soreness is often just that—an “overdose” to the body.

Why it is Important to Avoid Muscle Soreness?
The Hot Iron syndrome…
Most kids only need to touch a hot iron once. If you simply don’t like to feel pain, soreness is more likely to be a deterrent to exercise, not a motivator. In fact, it may be a subconscious reason it is so difficult to start up or get back to that first workout after a layoff.

Fitness should make everyday life easier, not harder…
Extreme soreness naturally alters choices for activity outside of workouts. If your weekly leg workout leaves you feeling sore for three days, and you choose escalators over stairs, it defeats the functional purpose of being more fit.

Tighten up those muscles…
This phrase, which is often used to describe a positive outcome, may literally mean “tighten” in this case. Consistent states of soreness can easily reduce range of motion and lead to permanent changes to your movement patterns.

Overtraining and overuse injuries…
Overtraining and overuse injuries take time to develop. Unfortunately, by the time they are noticed, you are too deep to reverse the process quickly. Aiming for and achieving soreness week in and week out is inviting either or both.

Distraction from more important goals of exercise…
Exercise and fitness success needs to have a far more sophisticated evaluation tool than the level of soreness. By aiming for soreness in the short term, we may be ignoring the true measurements of success for exercise, such as fitness, strength, functionality and longevity, among others.

How to Avoid Muscle Soreness and Still Achieve Great Results
Avoiding soreness is not the same as avoiding high intensities. High intensities and maximum effort can be reached through sensible and progressive overloading strategies. You just don’t want to start there. Gradual progressions are very effective and are a far more reasonable and comfortable way to improve fitness and reduce short- and long-term risks. This can be accomplished by understanding your current levels of fitness and strength, and applying small and frequent increases in intensities and volume according to where you are now—not the level you someday hope to reach.

Remember, fitness is built. It is not injected. Build it wisely…

By Christopher McGrath

Chris McGrath, M.S., is the founder of Movement First, a New York City-based, health and fitness education, consulting and training organization. With more than 20 years of fitness and coaching experience, McGrath specializes in a variety of training modalities including sports performance, injury prevention, post-rehabilitation and lifestyle/wellness coaching. McGrath is a Senior Fitness Consultant to the American Council on Exercise and has established himself as an international fitness expert.

The Yoga Injury Debate

If you do yoga, do you experience any injuries? Come see us at San Diego Sports Physical Therapy to get back on track,

To yoga or not to yoga seems to be a common question for individuals. The debate is heating up in both trade and consumer publications, each explaining various relevant perceptions. The controversial topic has had the yoga community and advocates in upheaval about the negative perceptions that some have about yoga.

Although yoga has many advanced “acrobatic-like” qualities, classes offered in most health-club settings do not promote or practice advanced postures. In addition, yoga, like any other form of exercise or athletic pursuit, can pose a risk of injury. Awareness, acceptance and proper training are the keys to preventing injury.

What Causes Yoga Injury?

Injuries occur for a wide variety of reasons; in some cases, the cause may be unknown. Injuries may occur on the point of action, while other ailments creep up over time, with no explainable cause as to why the pain or injury occurred.

Some individuals argue that specific yoga poses cause injury due to a joint’s vulnerability in the pose, while others believe advanced postures are the primary cause of injuries.

While there is no single cause of yoga injuries, here are some common reasons why they often occur:

-Pushing beyond one’s physical capabilities to more advanced postures
-Forcing the body to stretch beyond one’s flexibility level
-Not being mentally prepared, or stable, for advanced postures
-Striving for perfection in poses

The Flexibility Spectrum

The occasional yoga participant potentially faces the greatest risk of injury due to a restricted range of motion in the joints. When there is a lack of mobility, other joints may try to compensate, which may result in overstraining, overuse or injury.

On the other hand, many yoga instructors may have experienced injuries due to having a highly flexible body. Having muscles that are too lax or flexible may make the individual more likely to overstretch the ligaments and tendons.

Ideally, one should be located near the center of the flexibility.

Personal Flexibility Awareness

Every body is gifted with a natural ability. Just as athletes are “born” with genetic gifts that, along with considerable training, enable them to excel in their sports, some individuals are naturally more flexible than others. In addition, some individuals who have practiced yoga, gymnastics or dancing from a young age are flexible and strong enough to perform advanced postures in their adult years.

Individuals who start a yoga practice after the age of 30 may or may not progress to advanced postures. It can sometimes take years to get the mind and/or body in an advanced state. Progressing yoga poses is similar to progressing traditional exercises, requiring one to build a solid foundation before moving toward the advanced state.

Wanting to look and perform like others in class, however, can increase the risk of moving beyond one’s current flexibility.

Acceptance of One’s Ability

Mass marketing yoga advertisements show yogis effortlessly performing beautiful postures. This makes us strive to or become curious about how to perform these poses. Generally, this is the point where we force ourselves to move, bend or stretch beyond our capability.

In yoga, this is called the ego—the driving force that wants to shine and succeed, or the voice that tells us we are not good or strong enough. Yoga instructors and attendees need to step off their mat and analyze their abilities and embrace their strengths. Acceptance is what keeps us satisfied in our practice and trusting ourselves on when to progress a given posture.

For example, a person may have a lack in spinal extension, which can make back-bending postures challenging, especially advanced spinal extension movements. However, this person may have exceptional wrist and forearm strength to perform beautiful inversions. This does not mean she has to avoid backbends; rather, she must understand and accept her limits and capabilities without forcing the spine into a foreign position.

What Comes First—the Fear or the Posture?

When progressing to advanced postures, many yoga instructors promote overcoming physical fear through advanced postures. For example, if someone has had wrist issues and a fear of re-injuring that joint or a fear of falling, one can perform a handstand (with or without wall support) to overcome the fear. Although this notion is successful for some, it poses another question of whether or not an advanced posture should be the driving force to overcome fear.

In yoga, as in many other sports, one must truly train the mind and be confident in one’s ability before progressing to advanced states. A baseball pitcher or tennis player must be mentally sound and visualize that perfect pitch or serve. If an athlete doubts his or her abilities, the majority of the time that pitch or serve will be unsuccessful or erratic. The same concept applies in yoga.

When performing a handstand, if one thinks, “I can’t do this. I don’t want to fall. I’m scared,” he or she is not mentally prepared yet. When the mind flutters, the physical body may weaken or fall, which can result in strain or injury.

Final Thoughts

Though some individuals have been seriously injured in yoga, it is best for practitioners to instruct various levels of yoga poses when working with the general population. Many yoga poses are not appropriate for everyone and instructors should understand which higher-risk asanas should be modified.

Neither the student nor the instructor should fear yoga. Education and awareness are essential for those who want to perform to perfection or advanced postures. Many students have that driving force to push forward, but it is through clear communication that we can educate them about the potential risks.

With various body types and mixed-level classes, the requirements are higher for instructors to know the anatomy and potential risks of each pose. When in doubt, teach the basic and common poses, such as Warriors, downward facing dog and balance poses.

References

American Academy of Orthopaedic Surgeons (AAOS) (2012). Yoga Injury Prevention.

Kerr, Z. et al. (2010). Epidemiology of weight training-related injuries presenting to United States emergency departments, 1990 to 2007.The American Journal of Sports Medicine, 38, 765- 771.