Working as a physical therapist can be a rewarding experience.  After becoming a physical therapist, you have the opportunity to help people regain mobility and reclaim independence every single day.  You have the ability to change someone who may be uncomfortable in their current physical condition, maybe even in great pain.  In my opinion, this is such a fantastic service to be able to provide and extremely rewarding.  

Working as a personal trainer, I have encountered so many people who have come to me after going through a physical therapy program.  The main underlying problem I hear is that they are still in pain. Why, I ask.....why?  So, I start asking them questions and these are the responses that I hear most.  

One, my insurance would not cover my visits anymore so I stopped going.  After I hear this first response I then follow up with a second question.  How long did you go for?  I get answers across the board but the similarity between them all is that they did go for a good period of time ranging from 3 months- 1 year.  So, why aren't they any better?  I follow with another question. What did they have you doing at physical therapy?  The answer, usually very vague and not clear as to what they were actually doing.  So, for homework after our first session, I ask them to bring in their sheets from physical therapy and see what actual exercises they had them doing.  Our next session arrives and I check out these papers, usually all wrinkled with copies that have repeated pages in no real organization whatsoever.  I take a look and ask them to do a particular exercise in correct form.  Two things here, the first being that they don't know the name or how to demonstrate the exercise and two, if they do then it rarely is being done in the correct way to recruit the proper muscles or functional pattern.  

So, what is the disconnect here?  What is the main underlying problem of why people are not getting results through physical therapist?  The answer, ACCOUNTABILITY.

In order for accountability to work, 2 very crucial things must happen

1.  The physical therapist must be a good coach.  

2.  The patient must adhere to the program. 

You see, much like personal training, physical therapy sessions are done 1-3 times per week generally depending on the necessity of the program.  The problem here lies in the fact that they are not with their coaches the other days of the week.  Now if a patient is with you 1 day a week and by themselves 6 days, what is going to make them stick to the plan?  To be a good coach, you need to teach your clients properly and then follow up with a way to make your clients adhere to the program which brings me to my next point.  Without consistency and adherence to the program, a physical therapist( or coach) does not know if they need to adjust their program or not.  So in order for this to work both the coach and patient must be working on a team in order to accomplish the desired goals.  This requires effort and communication on both sides.  

Clients come to you for good reason.  They don't know how to fix or improve a particular problem or they have particular goals that they can't accomplish on their own.  I think that the problem with physical therapy is not that physical therapists don't know what they are doing but the fact that they show you exercises and things to improve your situation and then you go away with no real supervision or accountability until your next session.  Furthermore, I don't think enough time is spent during the session to discuss "how" and "why" they are doing a particular exercise and the reason they are doing it this way. I am not saying to go into an anatomy lesson here but just give some simple feedback in a way a client can understand.  The majority of people out there are going to fail because of the fact they don't remember how to do the exercise, don't do it properly b/c of lack of effort or knowledge, and/or just don't have enough motivation or time to get it done on their own.  The result.......little to no improvements. This is why people are failing at these minimal exercises that take 15-20 minutes a day to complete. 

Physical therapy, like personal training, needs an accountability system to check in or communicate with clients on a daily basis to make sure they are getting these exercises done.  Without that, adherence to a particular program is going to be sidetracked and no further improvements are going to be made for these patients.  The system does not need to be complicated and I am not going to go into how to implement these so-called systems.  Everyone has their own way of doing things, different styles,  and different ideas.  Choose whatever way works for you or your company and find a way to keep clients understanding, accountable, and on track.