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.