An Exercise What?

In Uncategorized by Alicia Bonney

An exercise what? This is usually the question I get once someone learns of my title. And when I say that I am a personal trainer for people with chronic medical conditions, it is almost always followed by, “Why didn’t you become a physical therapist?” 

It can be hard sometimes to determine which healthcare provider to see and when. If you are experiencing back pain, for example, do you make an appointment to see an orthopaedist? A chiropractor? An acupuncturist? Physical therapist? Exercise physiologist? Maybe you go to your primary care doctor and have him or her direct you. Before you become overwhelmed with this list—to which other professionals can easily be added—consider that we have multiple options in other fields that may seem to overlap as well. Can I give you an example? The food industry is one. There are fast food restaurants, fine dining restaurants, buffets, cafes, bars, food trucks, supermarkets, etc. You probably wouldn’t order wine at a McDonalds drive-thru, and you probably don’t expect to be seated and served dinner at Stop & Shop. While any of these establishments can help to solve a hunger problem, the one you choose depends on your particular needs. Likewise, any of these health professionals I mentioned may be able to help your back pain. Who you see depends on what is causing the underlying problem and which approach offers the best solution for you. Unfortunately our healthcare system is not always methodical; many healthcare providers operate within silos, assiduously working their best practices all while unaware of what their collegues are doing across the aisle. Patients can get lost in the noncommunication, so this is my attempt to provide a small bit of clarification. 

According to the American Physical Therapy Association, physical therapists are licensed professionals who help patients restore mobility, reduce pain, and prevent disability (2019). They may work with patients to prevent surgery or rehabilitate them post-operation. Physical therapists offer mechanical traction; manual techniques; and therapeutic exercises for posture, neuromuscular re-education, coordination, and balance (APTA, 2019). Therapists are required to receive a bachelor’s degree or complete a number of classes before entering a three-year doctor of physical therapy (DPT) program. Once completed, they must pass a licensing exam to practice within their state.

According to the American Society of Exercise Physiologists, exercise physiologists are fitness professionals who specialize in the body’s metabolic response to physical activity (2018). They may use exercise as a means to enhance athletic performance and improve health, prevent or manage injuries, and help care for chronic conditions—mostly cardiovascular and pulmonary disorders. Exercise physiologists receive instruction in metabolic and stress testing which allow them to use heart rhythms, blood pressure, and oxygen consumption to determine fitness level and develop highly specific exercise protocols for athletic and clinical populations (Bureau of Labor Statistics, 2018). Physiologists are required to have a minimum of a bachelor’s degree in exercise physiology, exercise science, or kinesiology. They can be credentialed through the American College of Sports Medicine as certified exercise physiologists or registered clinical exercise physiologists (ACSM, 2019). They may also take a board exam to be certified under the American Society for Exercise Physiologists. 

I know it still may be a lot to understand and sort out, especially as it relates to your particular situation or that of someone you know. There is a scope of practice that healthcare providers should follow. It means that I can’t—legally and professionally—offer treatment that I am not authorized to give. So while I can help to strengthen a person’s knees before an operation, I cannot play physical therapist to rehabilitate him or her in the first few months following their surgery. I can, however, pick up where that therapist has left off to help this person continue to make progress and return to sports or other daily activities. I encourage you to do a bit of homework, ask questions, and seek advice from credible professionals to help inform your decision to engage in a treatment program. The person for you will listen, explain, provide answers, make a referral if necessary, and welcome other opinions because he or she will know that it is all about you.

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