A New Model for Predictive Medicine Practitioners: Physical Therapists


Suffering an orthopedic injury can be devastating. It can preclude us from athletic competition or force us to take time off work, not to mention the added strain it puts on completing normal daily tasks while partially immobilized or in pain. Regardless if surgery is required, a physical therapy rehabilitation program is usually prescribed to aid recovery. Say hello to countless hours of sweat, pain, and foul language (primarily in the form inner monologue, often directed toward the therapist that you are certain is trying to tear your limbs from your body, but occasionally a choice expletive might just slip out in frustration or exhaustion). Well, not necessarily, says Caitlin Kelly, who recently blogged about what she felt was the unsuspecting upside of physical therapy-- the healing power of the friendships formed during the sessions. Day after day, through all the pain and suffering, she got to know and relate to other patients, and maybe even more importantly, developed an open-communication relationship with her therapists. Ultimately, the injury healed, and the unforeseen personal bonds persisted long after the pain subsided.

Aside from their good interpersonal skills, physical therapists seem to have a knack for treating the person, not just the condition. Every patient has different questions, concerns, strengths, and weaknesses, making it nearly impossible to have a canned treatment program that will work in every situation. I've had the fortunate experience of working with some really great physical therapists over the years, and not only do I believe they were instrumental in helping me recover from injury, I believe they prevented future injuries from occurring by preemptively addressing other issues. For example, at one point I was chronically pulling the same hamstring. While not career ending, or severe in the grand scheme of sports injuries, it still prevented me from competing. No matter how much hamstring stretching/strengthening I did, I couldn't shake the problem. It wasn't until my physical therapist told me that I need to address the tightness in my hip flexors that I was able to prevent the injury from occurring. At first, this made no sense to me. Why would stretching a muscle on the front of my leg help prevent an injury on the back of my leg? They explained that tightness in the hip flexor could be negatively impacting my stride, and leading to the hamstring pull.

Physical therapists are an excellent model of the new-wave health practitioner, since custom treatments that address the patient's past, present, and (potential) future health, together with an open dialogue between the health provider and patient, are the heart and soul of personalized medicine. We've been bugging physicians to do these things for a while, and it's refreshing to see a health practitioner that's already got it under control.

Recently I had a great conversation with some friends and colleagues who brought up an interesting point: the experiences I had with my physical therapists, they've had with other health practitioners -- massage and acupuncture therapists, yoga instructors, dietitians, and personal trainers. Predictive medicine will require our own team of health practitioners, only a few of which are physicians. There are many people who can aid our quest to stay healthy, and implementing our own Decision Trees will require tapping into all of these resources.