The Educated Therapist

Let’s face it. Most physical therapists aren’t winning any sales and marketing awards. Most of us have don’t have a business background and typically enter this profession based on a love of health, exercise and helping others. In school, we don’t really have time to cover anything beyond examination and treatment of our soon-to-be patients. We graduate, enter the world of health and wellness as practitioners of physical therapy, and soon realize the competition is fierce. In San Francisco, a city with something for everyone, there are individuals providing health and wellness services that seem in direct competition with everything we offer. There are personal trainers, massage therapists, Muscle Activation Therapists, Sports Therapists, Neurokinetic Therapists, Core Activation Therapists, and more. Have you ever stopped to consider who is best trained to help you heal? While these practitioners may indeed be skilled at the services they offer, based on our level of education and training, physical therapists are in a league of our own.

The other day, I had a pleasant conversation with a gentleman who was interested in learning more about the field of physical therapy. A seemingly intelligent man, he’d also had personal experience as a recent physical therapy patient. At some point in our conversation, he stopped me and asked, “Do you have to have some sort of certificate to be a physical therapist?” My jaw dropped.  It was then and there I realized how physical therapists have done such a terrible job of informing the public of what we do, what we can offer, and why we should be considered the practitioners of choice for musculoskeletal health.

So here’s what you should know: physical therapists go to school for 7-8 years. This includes 4 years of undergraduate education, heavily based in science (physics, chemistry, microbiology, exercise physiology, etc.), and 3-4 years of graduate-level education. Students graduating from physical therapy programs in the United States today earn a Doctor of Physical Therapy. The first Doctorate program in Physical Therapy was started in 1993 at Creighton University in Nebraska and, as of 2015, all accredited and developing physical therapist programs are DPT programs. Often part of a medical school, PT programs teach physical therapy examination and treatment, as well as courses in Anatomy, Neuroanatomy, Pathology, Pharmacology, Radiology and Differential Diagnosis (how I determine if a symptom may be something more serious—and outside of my scope of practice—than run-of-the-mill back pain). In fact, when I attended UCSF in the early 2000’s, the physical therapy students were the only students who performed full cadaveric dissections. Other programs used the cadavers we spent our first foggy summer in San Francisco dissecting. It was also the start of our collaboration with the first year medical students, where we 2nd year PT students helped teach the medical students musculoskeletal anatomy. Most recently, residencies and fellowships after graduation have grown in popularity to provide advanced training for physical therapy school graduates.

Beyond our formal education, physical therapists are licensed by the state in which we practice and are held to a high level of professional conduct that includes requirements for continuing education every year. Most courses are held on the weekends and many physical therapists travel great distances to take courses of interest. This year alone, PT’s from TherapydiaSF will take courses in San Francisco, San Diego, Montana, and Las Vegas. Some physical therapists also opt to enhance their degree and training by completing board certification in different areas of practice, including Orthopaedics, Pediatrics, Women’s Health, Neurology and 4 other areas of specialty practice.

The next time someone suggests physical therapy, please consider our extensive training and education and know that we have the education, expertise and dedication to help you work, play and move without pain.

 

 

TRX

This 55-minute class provides an effective total-body workout using TRX® Suspension Training straps. TRX® uses clients body weight to improve core strength and stability, increase muscular endurance and work the body in all planes of movement. Adjusting body position allows users to change the resistance of an exercise and control how challenging the workout is. The 6-week series is designed as a progressive class that will introduce new and more challenging movements each week.  Class size is limited to 6 for individualized attention and is appropriate for all fitness levels.

6-week series: $150

Space is limited!  To sign up, please call 415.765.1502 or email: hello@therapydiasf.com.

TRX

This 55-minute class provides an effective total-body workout using TRX® Suspension Training straps. TRX® uses clients body weight to improve core strength and stability, increase muscular endurance and work the body in all planes of movement. Adjusting body position allows users to change the resistance of an exercise and control how challenging the workout is. The 6-week series is designed as a progressive class that will introduce new and more challenging movements each week.  Class size is limited to 6 for individualized attention and is appropriate for all fitness levels.

6-week series: $150

Space is limited!  To sign up, please call 415.765.1502 or email: hello@therapydiasf.com.

TRX

This 55-minute class provides an effective total-body workout using TRX® Suspension Training straps. TRX® uses clients body weight to improve core strength and stability, increase muscular endurance and work the body in all planes of movement. Adjusting body position allows users to change the resistance of an exercise and control how challenging the workout is. The 6-week series is designed as a progressive class that will introduce new and more challenging movements each week.  Class size is limited to 6 for individualized attention and is appropriate for all fitness levels.

6-week series: $150

Space is limited!  To sign up, please call 415.765.1502 or email: hello@therapydiasf.com.

TRX

This 55-minute class provides an effective total-body workout using TRX® Suspension Training straps. TRX® uses clients body weight to improve core strength and stability, increase muscular endurance and work the body in all planes of movement. Adjusting body position allows users to change the resistance of an exercise and control how challenging the workout is. The 6-week series is designed as a progressive class that will introduce new and more challenging movements each week.  Class size is limited to 6 for individualized attention and is appropriate for all fitness levels.

6-week series: $150

Space is limited!  To sign up, please call 415.765.1502 or email: hello@therapydiasf.com.

TRX

This 55-minute class provides an effective total-body workout using TRX® Suspension Training straps. TRX® uses clients body weight to improve core strength and stability, increase muscular endurance and work the body in all planes of movement. Adjusting body position allows users to change the resistance of an exercise and control how challenging the workout is. The 6-week series is designed as a progressive class that will introduce new and more challenging movements each week.  Class size is limited to 6 for individualized attention and is appropriate for all fitness levels.

6-week series: $150

Space is limited!  To sign up, please call 415.765.1502 or email: hello@therapydiasf.com.

TRX

This 55-minute class provides an effective total-body workout using TRX® Suspension Training straps. TRX® uses clients body weight to improve core strength and stability, increase muscular endurance and work the body in all planes of movement. Adjusting body position allows users to change the resistance of an exercise and control how challenging the workout is. The 6-week series is designed as a progressive class that will introduce new and more challenging movements each week.  Class size is limited to 6 for individualized attention and is appropriate for all fitness levels.

6-week series: $150

Space is limited!  To sign up, please call 415.765.1502 or email: hello@therapydiasf.com.

Eat Healthy: Smart Nutrition Strategies for the New Year

Start your year off right with Nutritionist Bethany Pianca, RDN.

In this one-hour interactive workshop, Bethany will discuss why past resolutions may not have worked and help you develop a plan to succeed at this year’s goals.

Cost: free

The Holidays: A Time of Love, Laughter and Overeating

You know the scene, you swear you’re going to have just one drink at a holiday party, and the next thing you know you’ve lost count and have a killer headache the next morning. Or maybe you show up to the party thinking there will be dinner only to find out they are only serving apps, so you start taking down every bacon-wrapped scallop in sight. Or perhaps your Aunt Margaret swears you’ve lost too much weight and starts handing you a snack every time you walk by. Or hey, maybe it’s just the holidays and you only get this food once a year, so you cram as much as you can onto that plate…and then make a second trip. The holiday season is packed full of healthy eating obstacles (some more fun than others!). If you want to stay healthy through the holidays without adding “lose holiday weight gain” to your New Year’s resolution list, it takes a bit of planning and mindfulness, and we’ll tackle some of the big ones here.

Booze

Without a doubt, the biggest contributor to holiday weight gain is all the extra alcohol consumed throughout the season. We see friends and family we haven’t seen in a while, and every occasion seems like a real good reason to celebrate. Not to mention in addition to the beer, wine, and regular cocktails, eggnog, hot toddy’s, and mulled wine make their way onto the menu this time of year, and hey, it’s been a while since you’ve had one! Here are some tips to keep holding the reins on your alcohol intake:

  • Give yourself a weekly allotment for alcohol and plan it out. If you have several events in one week, decide ahead of time where you would like to spend your “booze dollars”. If you find yourself having trouble sticking to it, you might need to make some events alcohol-free.
  • Keep track – a serving of wine is 5 ounces, which is less than half of most wine glasses. If you fill it up to the top, that’s two drinks. If someone comes around and tops off your glass, count it as another drink. We frequently have the equivalent of 6 drinks in one night, thinking we only had two.
  • Watch the higher calorie drinks – eggnog, cider, and most mixed drinks have a lot of extra calories in addition to the alcohol. If you need to have one for the season, keep it to just one.

Hors d’oeuvres

These tasty little morsels seem so innocent, but do a lot of damage. Typically crowd-pleasing fare, these items tend to be mini-calorie bombs, and if you show up hungry one after another will slide right down, adding up to more than a meal’s worth of calories…before you even get to dinner. So what can you do?

  • If you know the party will be appetizers only, make sure you eat a small healthy meal before you go. This will take the edge off any alcohol you have, and prevent you from stalking the waiters circulating the apps.
  • Only try 1-3 appetizers, and only if they look worth it – the point is for you to get a small taste of an amazing dish, not to substitute for a meal.
  • If it’s a dinner party, try having a small snack with protein beforehand so you can hold out until dinnertime.

Buffets

Buffets are a popular, convenient way to serve dinner, and are generally a healthy-eating nightmare, especially if it’s a potluck. It’s as though someone thought of every food you were trying to avoid and put it all on one table. You’re sure to see at least a few of these this holiday season.

  • Take a tour of the buffet before you get in line. See what’s available and decide ahead of time what you want to put on your plate.
  • Only fill up one dinner plate, and only go through the line once. No, you cannot start stacking the food vertically to get more to fit.
  • Try only small portions of the heavier items and fill most of your plate with the healthier options.

Family

This section could take up its own blog post, or even its own book, and could probably be co-authored by a psychotherapist, but we don’t have room for that here, so we’ll only cover the basics!

  • Stress – is there a lot of tension at your holiday gatherings? Meditation and therapy are more productive solutions, but in the interest of time, try this quick fix: instead of eating to drown your sorrows or avoid talking to someone, bring a large plate of pre-cut veggies to share as hors devours. When you’re feeling frustrated, grab a small plateful of veggies – the crunch will help get your aggravation out and keep your mouth full so you don’t have to talk!
  • The pushers – the ones pushing high-calorie although made-with-love food. Quick fix: small portions, big fanfare. “This is so delicious! You’re such a fantastic cook! No, I can’t fit anymore, I’m so full. It’s so good, but I also want to save room for XYZ too, I wouldn’t want to miss that!”
  • Look for healthier recipes of old favorite foods. If your family resists, stick to a serving the size of a ping-pong ball. The first 3 bites are where you get all the taste and flavor, after that your taste buds become accustomed to the food and you spend the rest of the time trying to “chase the taste”.
  • Bring your own healthy dish so you know there is something there you can fill your plate with.

The holidays should be a jubilant time of year, where you enjoy the company of friends and loved ones. Although everyone has different ways of celebrating during the holiday season, we hit on some common pitfalls here that frequently trip people up. There are certainly challenges we didn’t cover here. If you need a little help figuring out how to enjoy the holidays without damaging your waistline, head on down to see your friendly neighborhood Registered Dietitian. You can get your own customized plan that still allows you to have fun! Happy Holidays!  Bethany is seeing clients at TherapydiaSF, located on Maiden Lane in downtown San Francisco.

Fit as a…fiddle?

run-rehab-featured

 

Body image has been a hot topic over the past several years. Recently, many companies have run advertising campaigns to promote healthy body types in reaction to the extremely thin models who have been so prevalent in the media.

The recent video of dancer Misty Copeland has had a huge impact on the dance world and has made us think about the concept of an ideal dancer’s body.  I remember not too long ago, when “athletic body type” was considered a euphemism for “thick” or “heavyset.”  I hope you agree that while Misty is certainly athletic, she is neither thick nor heavyset.

Beyond the notion of an ideal body type, I’ve recently been thinking about the concept of fitness. I blame this partly on recently reading The Sports Gene by David Epstein, and also having just returned from a continuing education class filled with practitioners who each work with a different clientele, including college athletes, golfers, yoga practitioners, and the general population, some more active than others.   As I thought about the baseball pitchers, cyclists, runners, and CrossFit participants with whom we each work, I could easily identify ways they are fit, but I also thought of areas where they may be deficient.  I began to wonder about fitness.

When someone is decribed as “fit”, what does that really mean?  Does it mean the same thing to everyone?  There are different dictionary definitions of fitness, some of which brought a smile to my face:

1. The condition of being physically fit and healthy (I’m going to need a little more here…).

2.  Good health or physical condition, especially as the result of exercise and proper nutrition (ok, we may be getting somewhere…).

3.  The capacity of an organism to survive and transmit its genotype to reproductive offspring as compared to competing organisms (well….I bet you know plenty of people who have the capacity to transmit their genotype to reproductive offspring who you would not call fit).

So, we’re back to the drawing board with defining fitness.

Is a body builder with bulging biceps and massive quads more fit than a marathon runner?

Is Tiger Woods more fit than Serena Williams or Michael Phelps?

What does it mean to be fit?  Ah…what I would do to take a camera out onto the streets of San Francisco and ask people this question (stay tuned…).

As we think about each of the athletes and their respective sports, it quickly becomes clear that fitness is hard to define and describe.  While the bodybuilder might have larger muscles that allow him to lift heavy weights, the marathon runner would certainly show greater cardiovascular endurance across those 26.2 miles.  Tiger Woods and Serena Williams both demonstrate amazing muscular development and precise hand-eye coordination, but if he had to run around the golf course like she does the tennis court, could Tiger keep up with Serena?  Michael loves the game of golf and, like Tiger, has an amazingly strong core, yet I wouldn’t want either one of them representing the other’s sport in competition.

This is an important topic to me both personally and in my work with athletes of all ages, skill levels, shapes and sizes.  To me, there is no one definition of fitness.  I believe that fitness is a balanced combination of strength, stability, balance, flexibility, and endurance…and maybe even mindfulness.  What the general population thinks of as an ideal of fitness may actually be a person who excels in the sport in which they train, but has severe and potentially harmful imbalances in some of the categories mentioned above.  The fittest people with whom I work are those who enjoy a variety of exercise and sporting activities.  These are the folks who are rarely in our studio for treatment, except for the occasional tune up after having changed their routine. Often, the people who appear most physically fit are those who are plagued with injuries related to imbalances in overall fitness.

I’ve learned that there is no one ideal body type just as there may be different ideas of fitness.  I encourage my clients to be successful in their rehab and develop and improve their fitness by recommending a three key steps:

1. Move well and move often.

2. Find something you enjoy doing.

3. Mix up your routine—your body will thank you for it.

So, what does fitness mean to you?

And, in case you were wondering where “Fit as a fiddle” came from…