Why Physical Therapists Are Movement System Experts

By Eric Schoenberg

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Here’s What You Need To Know…

1. Physical Therapists are the experts in the movement system and their ability to be professionally identified as the go-to movement practitioners in the medical system with this movement based body system helps to solidify physical therapy’s place in the health care continuum.

2. Staking this claim helps physical therapists define their scope of practice differentiates the profession from chiropractors and strength coaches, and helps to improve public awareness to choose physical therapy as direct access providers.

3. As we age and our bodies change, so do our movement requirements and abilities. These changes allow for a great case to be made for physical therapists being lifespan practitioners and not just “as needed services” after an injury occurs. In an industry that is largely reactionary, the prevention of movement based impairments and injuries is the future.

4. Every profession has a language that eases communication and improves efficiency and results. The Movement System is the language that bridges physical therapy with strength and conditioning. The emergence of hybrid coaches and therapists who specialize in both sides of human movement is where the profession of physical therapy is headed.


Are Physical Therapists Ready To Be The Movement Experts?

The great Shirley Sahrmann and the faculty of the PT department at Washington University in St. Louis have been without question the most influential force in my professional growth. The philosophy and study of the Movement System is the foundation of my clinical and performance practice. Shirley’s unstoppable passion to define the scope of physical therapy as the experts of human movement is the inspiration to write this article. For more on Shirley Sahrmann and the Movement System, check out this video.

The good news is, every professional who is legitimate in the physical therapy and strength and conditioning fields is already talking about the importance of proper movement. Almost everything you read or hear over the past 5-10 years includes the concept of movement. This is awesome. The bad news is that the concept of movement is ill-defined. We have not defined our body of knowledge.

There are many inconsistencies in language, examination, interpretation, diagnosis, and intervention that make the topic difficult to advance and build on. So the question becomes: Is the profession of physical therapy moving further apart or closer together?

Aligning and Defining Our Allied Movement Professions

Similar to other industries like medicine, pharmaceuticals, and anything else that involves innovation, keeping an open mind and working together will be far more valuable in continuing to advance our fields. When someone discusses what a mechanic, accountant, lawyer, or doctor does, it is very recognizable and easily defined. This is not the case with the public perception of physical therapy or strength and conditioning.

In the big picture, the fields of physical therapy and strength and conditioning and personal training are still very young. The rapid growth has helped in establishing legitimacy, however we still have a long way to go. The common thread to unite our message is the Movement System.

In my facility, the use of consistent language, cueing, diagnosis, and program design has dramatically helped to bridge the physical therapy and training sides of our business. For example, an individual that presents with insufficient scapular upward rotation as their movement impairment diagnosis will not be cued “down and back” and be given scapular downward rotation and depression type exercises.

Instead, we will cue the athlete to get their shoulder blades “up and around” and program in wall slides, overhead carries, landmine presses, and half kneeling one arm bottoms up kettlebell presses, for example, to address their movement faults while still delivering a great training effect.

When asked for our “elevator pitch”, our answer should be,

“Physical Therapists are experts in human movement”

Any movement-related issue falls under our scope of practice. Owning a “system” of the body and positioning ourselves as experts puts us on par with other healthcare professionals and establishes a defined role in the health care continuum. With that said, this is no way implies that other professions (strength and conditioning, athletic training) don’t share in the identification with movement.

In fact, I am confident in saying that I have learned as much or more about movement from strength coaches than I have from physical therapists. It is absolutely critical that this concept of the Movement System crosses professions and the message to the public is consistent.

To Help Our Patients, We Must First Help The Industry

As I, along with many of you reading this article, wear multiple hats (physical therapist, strength coach, personal trainer, business owner, educator, etc), we need to be clear that the primary goal is and always will be to help make the person in front of us, aka our clients and patients, better. This is accomplished by our industries working together as a team on behalf of the client. This is not achieved by having pissing contests and turf wars over who has the best way to do something.

There are many philosophies or “groups” in the physical therapy profession from PNF, Bobath, Maitland, McKenzie, NDT and others to newer tribes – SFMA, PRI, etc.   There are some brilliant minds that subscribe to one or many of these philosophies. The best in our business blend information from all of these to form their own “unique” treatment philosophy. This is all positive and important for our professional development. For more on why the Movement System should be important to your clients and patience, check out this video.

We have to remember to “keep the goal the goal”. More specifically, if a client’s goal is to deadlift 500lbs, they have to lift heavy. That doesn’t mean that positional breathing drills and foam rolling aren’t critical, But, at the end of the day, we are not building world class “breathers” or professional “straight leg raisers”

Instead, we need to use these tools to develop strong, powerful, and resilient athletes. I see too many good physical therapists and strength coaches being too micro with their thinking and programming. Let’s continue to focus on developing our clinical reasoning skills to make decisions on the individual in front of us and not just plug them into a formula and see what spits out. The Movement System makes it easy to do this.

Forget About Labels and Brands & Start Being The Movement Systems Guy

The great part is that all of these philosophies have movement at the core of their approach.   However, the challenge is they all have their own language, diagnoses, protocols, and treatments. So we tend to label ourselves as “SFMA guys” or “PRI guys” instead of branding ourselves as Movement Experts. It is at best confusing within our own profession and at worst unexplainable to the general public (our patients) and the medical profession as a whole.

In the article “The Human Movement System: Our Professional Identity” in the Physical Therapy Journal (PTJ) published in March, 2014, Shirley Sahrmann essentially summarized her life’s work (50+ years) and mission in driving the Movement System. It is a must-read for all PTs and S & C professionals.

The turning point came in 2013 when the House of Delegates of the APTA (American Physical Therapy Association) passed a resolution that stated, “The physical therapy profession will transform society by optimizing movement to improve health and participation in life.” The adoption of this new vision statement unflinchingly affirms that movement is indeed the essence of physical therapy. It is now time to take this vision from the government buildings and put it into practice in our clinics and gyms.

It’s Not About The Tools, It’s About The Toolbox

I spent the first eight years of my career taking courses and developing “tools” to help my patients get better. I felt like I was having success, but looking back, I realize I had some good tools, but no toolbox.

I had no foundation to keep everything together and organized. The skills I had were individually effective, but were not working together. Then my business partners introduced me to Shirley Sahrmann and the Movement System and everything literally fell into place and made sense. This was the system that put evaluation, treatment, manual techniques, strength and conditioning, posture, breathing, etc. together in a simple and user friendly manner.

We should not be naïve to the fact that building your own “unique system” helps to differentiate you from the masses and serves as a profit center for your business. Being a business owner myself, it would not be advisable to try to look and feel like everyone else and simply blend in. In fact, I think it is just the opposite. Once we establish a universal Movement System, then we can niche to specific populations under that umbrella. I think you need to have a “box” before you can think outside the box.

If you are an avid reader of DrJohnRusin.com, then you are at the top of your profession. For that reason, you have likely already determined your niche and have a following. For that reason, it is our collective responsibility to continue to help move the fields of physical therapy and strength and conditioning forward.

Here are five simple actions steps to move the Movement System forward as the foundation of your patient and client management while successfully blending the specialties of physical therapy and strength and strength and conditioning together.

#1 Master The Movement System

Learn the Movement System cold. Take a course and/or read the books and familiarize yourself with the Movement System Impairment Diagnoses. This is the first step, and should not be overlooked.

#2 Speak The Language of Movement

Document and communicate using these specific categories of diagnoses to help create consistency throughout our profession. If we all start speaking the same language, our profession can be unified and grow as a strong front.

#3 Start Adding To The Movement System

Recognize that a standardized language and diagnostic classification system is not a finished product by any means. Consider being a part of the solution through participation. This can be done by responding in the comments section of this article or reaching out to me directly. Also, consider participating through the APTA and getting more involved.

#4 Embrace New Approaches

If we stay open minded and work together, we can organize our philosophies and ideas into one unified system that represents the field of physical therapy. This would and should encompass the dozens of evaluation and treatment approaches that currently exist.

#5 Utilize Mentors and Continue Learning

Lastly, I have been invited and put in a position to have a voice and a “seat at the table” to play a role in making some real change in championing the Movement System. Please do not hesitate to reach out to me with thoughts and ideas that you would like me to bring forward at the Movement Summit this December.

The Time For Unified Change In Movement Is Now

In life and in business, the establishment of organized systems improves efficiency and growth. Right now, our fields have a lot of valuable information and ideas “scattered all over the desk”. It is time to do a better job collecting this information and putting our heads together to create a more uniform approach – The Movement System.


About The Author

eric shoenberg

Eric Schoenberg is a Physical Therapist and CSCS located in Massachusetts. He is co-owner of Momentum Physical Therapy and Performance Training which is one of 12 Washington University (St. Louis) distance fellowship locations offering a 1 year post-doctoral clinical fellowship program in the Diagnosis and Management of Movement Impairment Syndromes. He has had the privilege of working and collaborating with and learning from many industry leaders in physical therapy, strength and conditioning, and medicine.

Eric is honored to have been invited by the APTA to participate in the 1st annual Human Movement System Summit in Alexandria, VA in December 2016. The Summit will bring together thought leaders in the physical therapy profession to develop roadmaps for integrating the human movement system in practice, education, research, leadership, and advocacy.

Visit Eric on his website: Momentum Physical Therapy and Performance Training

Follow him on Twitter: @PTMomentum

And feel free to reach out to Eric at eric@momentumpt.com

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8 Comments

  1. Rp June 3, 2016 at 6:57 pm - Reply

    The APTA vision statement that was passed by the HOD is misquoted. Otherwise, excellent article.

  2. Taiis June 5, 2016 at 4:07 am - Reply

    Great article. do you think movement systems can also be applied to other movement fields like yoga and Pilates?

    • Eric June 14, 2016 at 12:35 pm - Reply

      @Taiis: Movement is Movement. The more familiar you are with a particular practice, sport, activity, etc., the better. Our ability to apply movement principles to any activity is what sets us apart and goes a long way in reducing injury and improving performance.

  3. Eric June 14, 2016 at 12:32 pm - Reply

    @Matt Sremba – Not sure how the Movement System is “dangerous”. Also, I would argue that functional anatomy and applied physiology – which are the basis of the Movement System approach – is science?

    • Matt Sremba July 9, 2016 at 2:23 pm - Reply

      Eric,

      Thanks for your response. Can we further this conversation with a public debate. Wash U would be a great location 🙂 We will explicitly prove why the HMS is ‘unscientific’ and dangerous. One thing for sure, debate is part of the scientific process. Also, did you get a chance to listen to our podcast?

      Look forward to partnering to further the conversation,
      Matt

  4. Tyler Paturel June 14, 2016 at 12:34 pm - Reply

    As a global continuum of young to old, and non-active populations, physiotherapists may be choice. In terms of people looking to gain as much function and movement/injury prevention/strength and conditioning/overall quality of life, I would argue that a Certified Athletic Therapist (Canada) or Certified Athletic Trainer (USA) are not ready to be movement experts, they ARE movement experts! This is signified by the amount of ATs working with active populations throughout north America from professional athletes to post cancer rehab.

    • Eric June 14, 2016 at 12:40 pm - Reply

      Thanks for reading Tyler. The point of the article is not to debate which profession is better. It is more to push the concept of Movement to the forefront and identify and motivate the profession of physical therapy to continue moving in this direction. If you feel you and your colleagues are doing a good job, then keep going. A collaborative approach from all disciplines is the best way to support our patients and clients. There are a lot of people claiming to be “experts in human movement” who don’t have the chops to label themselves as that. Appreciate the comment.

  5. Muzzamil June 15, 2016 at 11:28 am - Reply

    Some other great Info. Thanks Again Dr. John.

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