Who Ya Gunna Call?
An easy guide to determine when to see a doctor, physical therapist, or personal trainer for your specific needs.
In the healthcare field, there are many weird Venn diagram-esque overlaps with different health care providers and fitness professionals. It’s one of the reasons that it can be so confusing to healthcare consumers about where to enter into the fitness, health and rehab process. Who do you see if you have an acute injury?
Your primary care doctor
Your physical therapist
Your chiropractor
Your personal trainer
Your massage therapist
You can end up with the same responses when asking “How do I prevent re-injury?” or “How can I get started in an exercise program?” The reality is that it is confusing, and it does depend on many factors, but each of the health care practitioners listed above knows their own scopes of practice and will know the best way for you to enter the system.
Here’s my advice for who to use when.
When to See Your Doctor First
It never hurts to start with an MD, but there are definitely a couple of clear-cut scenarios when it’s best to see your doctor first. Some of those clear-cut scenarios are if you have been in an accident; had any kind of trauma; have symptoms that don’t change (increase or decrease) with movement; have symptoms radiating into your arms, legs, face, chest; or have any known diagnoses or comorbidities.
Even if you have had a diagnosis like diabetes under control for years, it’s good to see a doctor first for a couple of reasons. Not only can they help monitor your progress to see if metrics like your BMI or blood sugar levels change with an exercise program, but they can also screen and assess for any underlying conditions (just to be on the preventative side). My motto is that it never hurts to be on the safe side, and if I have a patient that’s going to be seeing me through direct access, I think it’s good to have recent baseline measurements for patients with comorbidities.
When to See Your Physical Therapist First
I just alluded to this above, but physical therapists in many states have direct access, meaning that you can see a physical therapist first or directly after an injury without requiring a referral from a doctor. This is a wonderful tool for so many patients. For example, common musculoskeletal overuse injuries like Achilles tendonitis and plantar fasciitis improve greatly with physical therapy. The earlier a patient gets physical therapy, the quicker improvements can be made.
Physical therapy also really helps chronic muscular conditions, such as the very common neck and back pain diagnoses with techniques like trigger point dry needling, active release techniques, cupping, instrument-assisted soft tissue mobilization, therapeutic exercise progressions and activity modification.
When we see these patients first for treatment, we can potentially lessen the patients prescribed opioid medications, lessen utilization of unnecessary imaging (x-rays, MRI) and lessen unnecessary surgery.
Now, patients don’t need physical therapy forever. Physical therapists usually get their patients to 80-100% back to their normal activities and give the patients a good game plan of continuing exercises and activity modification to get that last bit better and stay better! And that’s where personal training can be so great for patients after they finish up with physical therapy - they help our patients stay motivated, stay on track, and continue to make gains and meet their fitness and health goals after an injury.
When to See a Personal Trainer
I frequently hear people say that they want to be “healed” or “fixed”. In reality, most people in pain aren’t fixed or cured, but more treated for their pain and taught how to prevent future injury. A personal trainer is a wonderful and transitory member of the healthcare field in taking a person from a patient (with the connotation that the person is suffering) to a healthcare consumer who has an active and meaningful role in their health and fitness.
Speaking from experience, Marie Peaslee is an asset to physical therapists, because she spent years working in a physical therapy clinic! She really has an understanding of how patients transition from being in severe pain with less function to being ready to get started with an exercise program. It's a huge asset for a physical therapist to have someone like Marie because she speaks the language that we use in the clinic and knows how to utilize it with her patients.
I can call Marie and say, “Mrs. Jones” really wants to work on her core strength and needs more core stability. She still is slightly limited and painful with end-range hip flexion, so she might need modifications with activities like squats and lunges and more hip mobility exercises.” Marie can take this information to create an individualized exercise program for her clients while understanding their past injury history and considerations.
This is invaluable and it’s important for clients to understand this difference too. If you’re coming off an injury:
Ask your physical therapist for recommendations of any personal trainers they frequently work with.
Make sure your personal trainer knows your goals, limitations, and areas you had been working on improving in physical therapy.
To wrap it up, we all know that exercise is medicine and that is the end-goal for many people. Exercise has a myriad of health benefits, and personal trainers are incredibly well-versed in helping their clients meet all of their health and fitness objectives. I hope this helps shed some light on the best way to choose a healthcare provider.
Katie Peaslee Talamo, DPT is the owner of Louisiana Concierge Physical Therapy and has been a practicing physical therapist for seven years. Katie is passionate about educating her patients and her community with the goal of effectively and efficiently getting patients out of pain, and keeping them out of pain. You can follow her on Instagram, Facebook or contact her at Katie@LouisianaConciergePhysicalTherapy.com