4 Common Mistakes That Physical Therapists Make

August 7, 2019

1. Not referring patients to others when necessary


Yes, I consider myself to be well educated and experienced in the field of physical therapy. But does that mean I know everything? Definitely not.


Many therapists only come to this realization over time as they gain experience in the field.


There are several key reasons why I might refer an athlete who has come to me for treatment to someone else.


  • Inability to specify the injured structure – although some clinical manual examinations can provide insight into what is going on structurally, it is impossible to detect the structure involved. In most cases the correct imaging studies will rule in one condition and rule out others with the correct clinical examination. Examples of this are wrist and foot fractures.
  • Different expertise needed – some physical conditions that mimic orthopedic or sports related conditions are ignored and missed by therapists.


A good example is the uncommon case of treating someone who has a systemic infection resulting in low back pain with the standard protocol to relieve lower back pain. This can be avoided completely by correctly taking the patient history and referring him/her to a specialist accordingly.

  • Although I am a strength and conditioning coach myself, connecting with the athlete’s strength and conditioning coaches and sports performance professionals is an integral part of my success treating athletes.


Doing so gives me more information about the athlete and the condition, training protocols that will be used in the future with the athlete that are essential to learn and test before the athlete resumes full activity, and overall good communication that will lead to trust between the athlete, coaches and therapist.


2. Not spending enough time questioning the client


Unfortunately, in some clinical settings engaging in long conversations during history taking is practically impossible.


The most important element of an initial visit is history taking, which must include a conversation between two human beings. This does take a lot of time, but it enables me as a therapist to form a hypothetical diagnosis, which I’ll be able to confirm later on. Even better, it enables me to better understand and get to know the athlete so I can help him/her in the long term by being able to pinpoint difficulties that may mask another potential condition or high injury risk activities.


One thing I always remind myself is that the difference between a good clinician and an average one is the ability to get as much useful information about the patient as possible. And that takes time. Don’t have enough time? Then you can expect errors, such as misdiagnosis that will lead to a negative treatment outcome in treatment.


3. Not being creative


Unfortunately, many therapists start and end their careers in a clinical sitting where they treat as many as 40 patients a day. This means that most of their treatments are based on the same techniques and approaches to save time and money, especially as it relates to working with health insurance companies.

I experienced this as well but quickly changed my approach by starting my own business to help athletes on an individual basis. This initially took sacrifice – but I quickly saw that this is the approach that results in the best outcomes.


Although evidence-based practice necessitates following the scientific basis, this doesn’t necessarily mean one way of doing things at work. As I view it, physical therapists should be limited only by their imagination. This is because physical therapy depends on many variables, especially in the sports performance world, and therefore creativity should be taught to reach the athlete’s specific goals as plans and protocols don’t always follow direct guidelines.


4. Not adhering to exercise science


I have been an athlete for as long as I can remember. I began swimming competitively at an early age. This experience led me to remain active as I grew up, to take part in several sports and to understand athletes’ minds and actions generally better than those who have never been involved in sports.


The combination of coming from an athletic background and being a strength and conditioning coach, understanding all the key concepts of training, is vital. Exercise and training in combination with the correct education must stressed more with athletes compared to the average Joe who comes for treatment.


Correctly applying exercise science in practice as it relates to athletes’ specific training protocols and progressions, and the ability to relate to their efforts will lead therapists not only to better outcomes but also to promoting longevity in their respective sports.


August 12, 2024
Cupping therapy is an ancient technique that has been integrated into modern physical therapy to help alleviate pain, reduce inflammation, and enhance overall recovery. In my practice, I use cupping as part of a holistic approach to treat muscle tightness, improve blood flow, and accelerate the healing process. How Cupping Works: Cupping involves placing specialized cups on the skin to create suction. This suction helps to lift the skin and underlying tissues, promoting increased circulation to the affected area. The improved blood flow aids in reducing muscle tension, breaking up scar tissue, and encouraging the body’s natural healing processes. Benefits of Cupping Therapy: – Pain Relief: Cupping can help reduce muscle soreness and pain by releasing tightness and promoting relaxation. – Enhanced Recovery: By improving blood circulation, cupping accelerates the removal of metabolic waste from tissues, leading to quicker recovery times. – Flexibility and Mobility: Regular cupping sessions can improve joint and muscle flexibility, making it an excellent addition to your rehabilitation or performance enhancement program. What to Expect: During a cupping session, you may feel a pulling or stretching sensation as the cups create suction. It’s normal to experience some mild bruising or redness at the treatment sites, which typically fades within a few days. I ensure that each session is tailored to your specific needs, targeting areas that will most benefit from the therapy.
August 10, 2024
Blood Flow Restriction Training (BFRT) is a rehabilitation technique used to enhance muscle strength and growth by applying a cuff to partially restrict blood flow to a muscle during exercise. This method allows patients to gain the benefits of muscle hypertrophy and strength gains using low-intensity exercises. In physical therapy BFRT is particularly advantageous in settings where patients are recovering from injuries or surgeries, as it reduces the mechanical load on joints and tissues, minimizing the risk of re-injury.  The benefits and advantages of BFRT include: Muscle Strength and Growth : BFRT promotes muscle hypertrophy and strength gains even with low-intensity exercise, which is crucial for patients who cannot engage in high-intensity workouts. Accelerated Recovery : By enabling effective training at lower intensities, BFRT helps maintain muscle mass and strength during periods of limited mobility, aiding faster recovery. Reduced Joint and Tissue Stress : BFRT allows for significant muscle engagement without the high loads that could strain joints and soft tissues, making it suitable for patients with orthopedic issues or those recovering from surgeries. Versatility : BFRT can be applied to various body parts and adapted to different exercise modalities, making it a flexible tool in a therapist’s toolkit. Enhanced Safety : The low-intensity nature of exercises performed with BFRT reduces the risk of overtraining and injury, providing a safer rehabilitation option for patients at different fitness levels.
August 10, 2024
Force plates are a valuable tool in physical therapy, offering a range of benefits that enhance the quality of care and outcomes for patients. Here’s a detailed explanation of their advantages: – Objective Data Collection Force plates provide objective, quantitative data on ground reaction forces, which are essential for understanding how a patient’s body interacts with the ground during various activities. This data is critical for accurately assessing biomechanical performance and movement patterns, such as gait, balance, and jump dynamics. Unlike subjective assessments, force plates offer precise measurements, which lead to more accurate diagnoses and treatment plans. – Enhanced Assessment and Diagnosis With the detailed information force plates provide, physical therapists can identify subtle imbalances and asymmetries that might not be visible to the naked eye. For example, discrepancies in how much force each leg produces can indicate underlying issues, such as muscle weakness, joint instability, or improper technique. Early detection of these issues allows for timely intervention, potentially preventing more severe injuries. – Personalized Treatment Planning The data from force plates enables the creation of highly individualized rehabilitation and training programs. By understanding a patient’s specific movement deficiencies, therapists can tailor exercises and interventions to target these areas. This personalized approach increases the effectiveness of therapy, as interventions are specifically designed to address the patient’s unique biomechanical profile. – Progress Tracking and Outcome Measurement Force plates facilitate the objective tracking of a patient’s progress over time. By regularly assessing changes in force production, symmetry, and other key metrics, therapists can evaluate the effectiveness of treatment interventions. This ability to measure outcomes quantitatively helps in refining treatment plans and ensures that patients are making measurable improvements. – Injury Mitigation and Performance Enhancement For athletes and active individuals, force plates are particularly valuable for optimizing performance and preventing injuries. By analyzing the forces involved in specific sports movements, therapists can identify risky movement patterns that may predispose an athlete to injury. Interventions can then be designed to correct these patterns, enhance performance, and reduce the risk of future injuries. – Comprehensive Documentation and Communication The data collected from force plates can be documented and shared with other healthcare providers, coaches, or trainers, fostering a collaborative approach to patient care. This comprehensive documentation supports a continuum of care, ensuring that all parties involved have a clear understanding of the patient’s condition and progress. – Patient Education and Engagement Visual and numerical data from force plates can be a powerful tool in educating patients about their condition. When patients see the objective data, such as force distribution and asymmetries, they often gain a better understanding of their issues and the rationale behind their treatment plan. This understanding can enhance patient compliance and engagement in their rehabilitation process. Incorporating force plates into physical therapy practice elevates the standard of care by providing precise, objective data that enhances assessment accuracy, personalizes treatment plans, and tracks progress. This technology not only aids in injury prevention and performance enhancement but also fosters better communication and education, ultimately leading to improved patient outcomes.