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Advice For Aspiring Performance Oriented Physical Therapists

The educational constraints influencing physical preparation and physical therapy have led many professionals to question the delineation between the two disciplines.  As mentioned previously on this blog, the boundary between these fields is often more political than practical.  Outside of very specialized situations like high-level track and field and competitive strength sports, physical therapists need to delve into the performance realm to adequately prepare patients for discharge.  Similarly, inpatient and acute postoperative circumstances notwithstanding, performance specialists are often unable to avoid navigating in clinical waters.  Pain is typically regarded as the line that differentiates the performance and the clinical worlds.  However, it is simply unrealistic to expect every hard-training athlete to see a clinician whenever the pain threshold is crossed.  What that line should be is beyond the scope of this post but the point is that the unavoidable overlap between professions had led to the emergence of the performance-based clinician concept.

Aspiring performance-oriented physical therapists must recognize that their interest deserves no more focus in entry-level DPT curricula than any other specialization.  These programs are designed to prepare graduates for the licensure exam and create generalists who can work safely in any setting.  Specialization is up to you.  Consequently, don’t expect to get all the answers you’re looking for in a formal academic setting.  There are simply too many learning objectives to cover to cater to students whose emphasis is not very representative of the profession as a whole.  That doesn’t mean, however, that there aren’t things students can do to expedite a career in clinical physical preparation.  Here are a few:

    1. Get your ATC in undergrad if your school offers it.  That way even if you don’t pursue any additional post-graduate education you will still have a medical credential.  Moreover, many of the strength coaches in professional sports are required to be ATCs.
    2. If you decide to apply to physical therapy school, attend the least expensive one that admits you.  DPT programs are essentially teaching the same curriculum with the goal of making you a generalist, not a specialist.  Ultimately, you’re looking for a license that affords you the professional autonomy to do the things you learn on your own.  There is no reason to accumulate 250k in debt at a private school if you can achieve the same end state somewhere else for a third the money.  Physical therapists are still not paid like “doctors” upon graduation so there remains a mismatch between cost of tuition and earning potential.
    3. Select a program that allows you to set up your own clinical affiliations This criterion should be a deal breaker.  The real learning occurs during internships.  Most programs do not have relationships with professionals who integrate performance training into their clinical practice.
    4. Begin taking continuing education courses as a student.  Many of these courses offer student discounts.  Additionally, the right courses will help you to better identify the outdated aspects of entry-level curriculums, which can be slow to keep pace with current evidence.  Continuing education courses can be pricey which is another reason to attend a less expensive DPT program.
    5. Get your CSCS if you anticipate ever working in a setting that requires it.  The process of studying for the CSCS will not make you a competent physical preparation coach (just as passing the boards doesn’t make one a competent PT) but it remains the standard in the field.
    6. Intern at a trusted physical preparation facility if time permits The focus during your PT school internships needs to be biased towards the clinical end of the spectrum no matter who your clinical instructor.  Concentrating on the performance end of the spectrum for a few weeks will broaden your perspective.