Physical therapy can span a broad spectrum, ranging from injury rehabilitation to injury prevention and even performance enhancement.
To truly help people get the most out of their bodies, we need to focus on all three of those areas.
But many of us don’t. And, if you’re one of them, I think you may be really missing the boat.
I’m not entirely sure why this happens, but if I had to guess, I think there may be two main thoughts holding us back:
- The vast majority of the physical therapy profession is focused on injury rehabilitation, which includes both our college curricula and most workplace settings, which is really limiting our potential to help people maximize their function and performance.
- We spend the majority of our time focusing on “function” and not “performance.”
Perhaps this is just terminology, but I know when I was in school and early in my career, “function” was people’s activities of daily living, and “performance” was sports.
Would you agree? That was my perception at least.
I couldn’t disagree with these definitions more. Here is how I would define them now:
- Function: Function is an activity. Sure, this could include things like bathing and getting dressed, but I would also say running, jumping, throwing, and playing a sport are also functions.
- Performance: Performance is how well you perform that function.
See what I mean? Just a simple tweak of the definition, and you can see these words in a different light.
“Performance” is not something reserved only for athletes. Everyone needs to perform.
We all need to perform at our best in whatever function we want our bodies to perform. This is probably the most crucial concept to understand, and one of the main things that people have said has helped them most after going through my Champion Performance Specialist course.
The Need for a Shift Towards Performance Physical Therapy
Here’s what I suspect is the most common vision of the performance spectrum to most physical therapists.
At any point in time, you have your baseline.
Most people then focus on either restoring or enhancing performance based on that baseline.
We sit back and wait for someone to get injured, then help them restore themselves back to their baseline.
Well, what if their baseline was poor? What if their baseline was part of the reason why they got injured in the first place?
If we just focus on restoring their function back to their baseline, we’re completely missing the boat on helping them optimize and enhance their performance.
I can’t help but think that this is one of the reasons why so many people have recurring injuries, chronic pain, and failed surgeries. Restoring people back to their baseline isn’t enough; we need to build their capacity and enhance their baseline.
As we all know, many things can predispose a person to injury, including weakness, mobility concerns, and imbalances. Consider this a reduction in capacity. An injury often occurs when the workload surpasses the person’s capacity.
There has been a recent uptick in criticism on social media that too many physical therapy interventions are either ineffective, transient in nature, or both.
Rightfully so.
But maybe it’s not the physical therapy treatments that are the concern, but rather the overall strategy?
Maybe we are focusing too much on just restoring people to their prior baseline, and not enough on building capacity, and eventually optimizing and enhancing performance?
Suppose you have limited shoulder range of motion overhead and experience pain in your shoulder every time you perform an overhead press in the gym. In that case, we can effectively reduce that pain through physical therapy.
But don’t you think that pain will likely return when they resume overhead pressing? We reduced their pain, restored them to their previous baseline (which wasn’t optimal), but we didn’t optimize their mobility overhead.
Their long-term outlook can’t be great, right?
The Goal of Performance Physical Therapy
The goal of performance physical therapy is to raise the capacity of the body, not just restore function.
If you haven’t seen it yet, you should watch our podcast episode discussing our vision of performance-based physical therapy.
It’s not enough to try to restore someone to their previous baseline. That’s “traditional” physical therapy if you ask me.
Performance physical therapy not only restores function but also works on optimizing and enhancing performance. That’s the key difference to me.
If you add optimizing performance to the spectrum, it could look like this:
But I still don’t think that’s enough; we can do better.
If you are working on restoring or enhancing performance, you should also focus on optimizing it. Realistically, there is an overlap between these concepts.
This changes our focus in a couple of ways:
- It shows that these concepts all overlap. We can restore and optimize performance, as well as enhance performance. Thinking of them as independent factors is not ideal
- It shifts our thought process from retrospective to prospective. When you know the endpoint isn’t just to restore their baseline, but also to optimize and hopefully enhance their performance, it changes your entire outlook on the injury rehabilitation process from day one.
Our Profession Needs Performance Physical Therapy
I have good news for you.
Physical therapists are really good at diagnosing and treating injuries. All of the assessment and diagnostic skills that allow physical therapists to evaluate and treat an injury can also be easily adapted to assess someone’s function and level of performance.
Think about it, what’s the difference between an evaluation of someone with an injury and someone who is healthy that wants to enhance their performance?
Special tests. That’s kinda it, right?
Special tests were designed to help diagnose a specific injury. If this special test, or cluster of tests, is positive, then you may have this injury.
But everything else, other than special tests, essentially evaluates someone’s level of function, right? Strength, mobility, balance, movement. These are all things that we can evaluate to help develop a complete performance therapy and training program for a person. We can then work on optimizing and enhancing each of those qualities.
How do you blend all this together? Treat the injury and optimize the body.
All it takes is a shift in your perspective.
How Do You Get Started?
If you’re interested in learning more about my approach to performance physical therapy, I recommend checking out my free online course, Introduction to Performance Therapy and Training.
When we started our facility at Champion PT and Performance, one of our biggest goals was to develop a simple system for our physical therapists and strength coaches to help people move and perform better.
My Introduction to Performance Therapy and Training program will teach you our 4-step system at Champion, ensuring you have everything you need to start helping people move and perform better.
Become a Champion Performance Specialist
For those who are ready to take the next step in their careers, my amazingly comprehensive Champion Performance Specialist course will teach you everything you need to know about restoring, optimizing, and enhancing performance.
This course is a career game-changer.
No more doubt, no more confusion, just a proven and simple system that you can start using right away.
I only open the doors to new enrollments at select times of the year for a limited number of new students.
