TrainSMART is What Physical Therapy Should Be

TrainSMART is What Physical Therapy Should Be

“TrainSMART Personal Fitness is what physical therapy should be but, cannot be due to our healthcare system, low reimbursements, and companies that prioritize profits over patient outcomes!” The majority of our clients come to us because they’re in pain and they’ve tried to get help. They have met with anywhere from 3 to 8 different medical practitioners. They’ve met with primary care physicians, orthopedic surgeons, physical therapists, chiropractors, massage therapists, acupuncturists, energy healers, and in some cases anyone they could find to try to get out of pain. They have decided they really don’t want to have surgery! They didn't give up and continued to search until they found us!

TrainSMART Personal Fitness is medicine, healthcare, and physical therapy.

We have to be! We have no choice! We have to be because our healthcare system, physical therapists, and sports medicine practitioners are failing us miserably! The academic programs that are training these practitioners are also failing us miserably! They create a lot of robots who have lost their humanism or in a way it was beaten out of them. It wasn’t our intention to be medicine. We intended to be Strength Coaches or what many refer to as Personal Trainers. When I started in my profession, we were taught by Functional Movement Systems (FMS) when a client has pain, REFER OUT! That’s what we did, and it worked… for a while. As time went on, the paradigm shifted, a lot. We were taught that when a client is in pain, we ready need to understand it and figure out how to get them out of pain because generally speaking, we could no longer depend on the practitioners we were referring out to. Functional Movement Systems was invaluable in helping us here.

We also started attending the same Continuing Education Programs as Physical Therapists and Chiropractors. We did more than that. We learned from, went to dinner with, became friends with, collaborated with, and even taught with some of the finest thought leaders in the world in the fields of Strength Training (Personal Training), Physical Therapy, Sports Medicine, Performance Training etc… It took time. It was expensive. It took commitment but, we had to catch up, and we did.

In 2017 and in 2018 Dr. Michael Geraci from Geraci Spine and Sports who is one of my best friends, mentors, and the person who has had the biggest influence in my career brough in Dr. Craig Liebenson to teach two – three day Courses on the “Prague School of Athletic Development.” The courses were among the best I have ever taken because Craig has spent decades traveling the world and learning from the best minds in the history of sports medicine. This included Vladimir Janda, Dr. Stuart McGill, Annie O’Connor, Pavel Kolar, and many others. Over the 48 hours of classroom time he taught us the most important principles and methods that he learned in his career. Two things that really caught my attention are the following:

When the course started, the very first thing he did was he asked the audience of approximately 130 students (vast majority were physical therapists) “Are there were any Personal Trainers in the audience?” Of course, my team and I who were the only Personal Trainers there, raised our hands. He went on to say, “We need to learn from the Personal Trainers because they’re doing a way better job of getting people out of pain than we are!” Wow! What a statement from a man who has written textbooks that are used in Sports Medicine academic programs throughout the country. He also stated, “If you can tell the difference between what a Physical Therapist and a Chiropractor are doing then, somebody is doing something wrong!” Wow! These are profound statements that changed our perspective and may change yours as well! I would like to take it 1-Step further and say in large part “If you can tell the difference between what a Physical Therapist, Chiropractor, and Strength Coach are doing then, somebody is doing something wrong!” I’m well aware of the fact that Strength Coaches cannot due manual therapy and I do believe there is real value in that! That’s why we have a manual therapist on staff and partner with outstanding manual therapists in the area. To give you some perspective on my belief system, I believe there are 4 main components of physical therapy.  They are listed here in order of importance:

1. History, Assessment, & Diagnosis
2. Functional Strength Training
3. Physical Therapy / Corrective Exercises
4. Manual Therapy – think of it as something like medical customized massage

Of these I firmly believe that History, Assessment, & Diagnosis is hands down the most important, requires the most skill, and is the rarest skill to find. In NY State, to my knowledge, Physical Therapist are not allowed to diagnose. Physical Therapists are not taught Functional Strength Training in a meaningful way as part of their education. In my experience, they are woefully uneducated in Functional Strength Training. In my professional opinion and I feel comfortable in saying that Dr. Craig Liebenson’s would agree with me, after History, Assessment, & Diagnosis, Functional Strength Training is the most important component.  One of the biggest things that Liebenson taught us is that you can almost fix any joint pain by helping somebody to be stronger in the right areas.  For example, if somebody has Low Back Pain if you can help them to achieve Core Endurance and Stability and Activate their Glutes they are most likely going to feel a lot better.  If somebody has knee pain the same applies in a very real way.  The idea is that we want to put the tension on the muscles not the joints and we have to train the brain (nervous system) and body to do that!  If somebody has shoulder pain if we can build up their posterior torso (lats, scapulae, shoulder blades, traps), core, and make sure they have proper hip mobility that's most likely going to go along way into taking that shoulder pain away.  I'm oversimplifying but, you get the point!

I will also state that almost every single one of the best physical therapists that I’ve had the pleasure of learning from and with are either leaving the profession altogether or starting cash practices that don’t accept insurance. This is primarily because of what I stated earlier which is low reimbursements, our healthcare systems, seeing multiple patients at once, being bogged down in record keeping , and companies that prioritize profits over patient outcomes.

To build on that, it is my understanding the most profitable physical therapy company in Buffalo who I believe has the most locations actually hires new physical therapists on a probationary period in which they are pushed and tracked on how many times they can get a patient to keep coming in. Now think of that for a minute! You would think their job is to get you out of pain as soon as possible but, their performance is being measured not on how quickly they can get you (a patient) out of pain but, on how many times and how long they can keep a patient coming. It’s a conflict of interest! Again, prioritizing profits instead of what’s in the best interest of you, the patient.

I was also informed that this same company made some claims based on internal research regarding outcomes that were completely false! They admitted that they only included clients who were doing well in their “research” and not the patients who didn’t feel well and were not progressing.  So they biased the results.  Pathetic but, not surprising.  I feel like randomly choosing a therapist is like buying a lottery ticket, Good Luck!

Sometimes some physical therapists snicker at us a bit because they say that we cheated by bringing in “experts” when we needed help to get a client better. They only make my point stronger! I believe they’re frustrated because in their business model they simply can’t get help when they need it because it’s not profitable. They don’t have time to do it. They don’t even think about it or realize it’s an option. They’re too afraid to say, I’ve done everything that I know, and it didn’t work so now I’m going to bring in somebody else who knows things that I don’t know. They’re embarrassed! We’re not embarrassed because IT'S NOT ABOUT US!  IT'S ABOUT YOU (our client)! I couldn’t care less who gets the credit for getting the client better, out of pain, and accomplishing their goals! I only care that they get better! That’s my job! That’s why they come to see us! That’s probably why we have the most 5-Star Reviews of any fitness company in the history of Western New York. Many of these reviews are from doctors, physical therapists, medical practitioners, etc…

I don’t necessarily believe that we’re smarter than everybody else but, I do adamantly believe that WE CARE MORE AND TRY HARDER!  That makes all the difference in the world! PEOPLE WHO CARE MORE AND TRY HARDER GET BETTER RESULTS!  Walter Brown who is a friend, someone I greatly respect and have learned a lot from over the years taught us to treat with our heart and our hands. I would like to take that 1-Step further! I pray just about every morning I go to work: “Our Father, please help me to treat our clients with your heart, your hands, your love, and your healing which is so much greater than mine!” I believe it!