Things I learned in physical therapy school so far

[blowdpanis]

So, as an attempt to have something approximating a decent profession, I enrolled earlier in the year in a DPT (doctor of physical therapy) program at a local university. The quality of education so far has been mostly good, but I have seen troubling signs on the horizon, which are coming to fruition in the very lamest of advice you can imagine.

For example, these are just things I learned today...

* A 240 lb bench press represents a level of force to the shoulder that will invariably do permanent damage, and is apparently a world-class effort. An instructor reflected how he'd never go over 15 or 20 lb dumbbells. Also, you should not bench below 90 degrees at the shoulder joint, as it causes "way too much stress" on the anterior capsule, glenohumeral ligaments etc. Worth pointing out here that a bench was demo'd with the imaginary bar seemingly traveling to the upper chest/throat.

* Walking lunges with 20 lb dumbbells represent a level of loading to the knee that it was "never meant to handle." A suggestion was made to try only 5 lb dumbbells from now on to the female classmate who was reporting anterior knee pain.

* A deep squat is a ~1/3 squat, and should only be done by the healthiest of populations.

I honestly don't get it. There has been an emphasis on the value of research in forming our opinions, but where is the research to substantiate any of the above? Is there ANY evidence that the absolute risks of progressive loading in somewhat sane form in basic, barbell exercise is particularly more problematic than almost any recreational sport/activity that they could name? I have not run across this evidence (ever), but they certainly act as if it not only exists, but exists in abundance.

How do people so obviously educated on the basics of anatomy and physiology come to these conclusions? It's like they've never, ever heard of olympic weightlifting, powerlifting, or any other strength sport, or have ever interacted with the various communities of People Who Enjoy Lifting Heavy things and sought their insight into what tends to cause problems in the long run. It's as if that entire body of data simply does not exist, and In the Beginning, the original Physical Therapist invented resistance training with restricted range of motion and dumbbells that never exceeded 20 lbs.

It's honestly disheartening, because I am incurring a rather large debt to be taught by people who seem impressively clueless on how to exercise in a way that might actually increase somebody's strength in a meaningful way. I am not proclaiming to be an expert by any stretch of the imagination, but I do think I have some familiarity with the available research on resistance training, and have been doing this stuff for a while. I can't help but feel I'm being taught by people whom I'd never, ever seek advice from in a gym for free, yet am paying them many thousands of dollars to get that same advice in school.

[Mark Rippetoe]

See post #6 in this thread: http://www.startingstrength.com/reso...ad.php?t=13633

And he wonders why I scoff. It never ceases to amaze me how both physical therapy and conventional exercise "science" (which is derived from physical therapy) so thoroughly and completely ignore the empirical evidence of 100 years of competitive lifting. It is as if no one has actually squatted or deadlifted over 405, or bench 300, or pressed their bodyweight. How do they think these lifts are trained for? What would happen if you showed your PT teacher a video of Bolton's 1008? Would he think it was a cartoon?

[stronger]

See post #6 in this thread: http://www.startingstrength.com/reso...ad.php?t=13633

And he wonders why I scoff. It never ceases to amaze me how both physical therapy and conventional exercise "science" (which is derived from physical therapy) so thoroughly and completely ignore the empirical evidence of 100 years of competitive lifting.

more like ignoring hundreds of thousands of years of human existence, all of which required the species exert forces in excess of a bench press preformed with

15 or 20 lb dumbbells

. It's basically like saying carrying two gallons of milk to your car is likely injurious to your physical structure

[Polynomial]

It's basically like saying carrying two gallons of milk to your car is likely injurious to your physical structure

Nobody can drink that much milk in a month, much less carry it to his/her car!!

[Christopher]

Well, maybe this is your chance to try to make a difference from within a misinformed community. Somebody's gotta do it.

[tdwaffle15]

It's basically like saying carrying two gallons of milk to your car is likely injurious to your physical structure

Which in addition to being silly is inefficient, since you'd have to return to the market in two days.

[Raleighwood]

So, as an attempt to have something approximating a decent profession, I enrolled earlier in the year in a DPT (doctor of physical therapy) program at a local university. The quality of education so far has been mostly good, but I have seen troubling signs on the horizon, which are coming to fruition in the very lamest of advice you can imagine.

I am applying to DPT school next fall... I am also a big believer in better living through heavy barbell strength training.

Hopefully you and I can both help catalyze, even if only on a small scale, a movement towards more practical strength training within the PT industry.

Perhaps the issue lies in that PT's are trained and geared towards rehab, rather than strength training. Rip said it himself that being committed to becoming stronger requires an acceptance and acknowledgment of future injury.

This requirement for future injury, in order to reach your max strength levels, is counterproductive to a PT's mission of healing and therapy. I am not saying one is better than the other; simply that they each have goals that conflict in certain regards.

You wouldn't go see a PT to figure out how to maximize your bench press, just like you wouldn't see a CSCS immediately after a hip replacement.

The examples you listed are obviously bad statements made by your professors. No one person is the utmost authority on all topics. A DPT may know how to rehab a torn ACL, but he probably doesn't know the best way to get your squat past 400 lbs.

Maybe the problem lies in that when educating the PT's, a conservative approach is taken in order to prevent bad exercise prescription to rehab clients.

I've had people tell me many times that Physicians, PT's, Chiro's, even a few Personal Trainers say never to do a full back squat because it will tear up your knees. We know they are wrong. I mainly think that they shy away from riskier lifts to minimize liability and potential for injury.

As with most things in life, you should take everything with a grain of salt and base decisions off a mixture of gut experience and empirical evidence.

[jtorres3]

Oh shit... Today I was carrying some dog food up my stiars and my whole fucking body exploded from the massive effort. I guess humans just werent designed to do it. Then, my granny fell down and she needed some help up, I told the old lady that even attempting to lift something as heavy as her could result in permanent damage to my body.

Seriously, I have a degree in exercise science. Nearly 70% of my graduating class went on to PT school. I will never trust PTs in general because I know what a group of retarded shits my class was, and they will be PTs in only a few years!!

[tnumrych]

I considered enrolling into a DPT program myself after realizing that a MS in Strength & Conditioning entitled me to the same wage as a NASM weekend certified trainer. It is quite disheartening to find that six years of combined schooling in human movement is basically useless. It is In fear of exactly the type of garbage blowdpanis describes I have not pulled the trigger on going the DPT route.

[loseyourname]

If I was in the class, I'd definitely ask for a citation and expect my textbooks to provide citations to primary sources (basic and applied research). Unless they've actually stress-tested the joints of population samples of trained and untrained individuals, I can't think of how they would have a basis for making these claims other than conjecture.

The thing is, I can't imagine, without even looking at their research (if they have any), that they would ever be able to stress test human joints. It's obviously unethical to load the joints of test subjects to the point of injuring them and nobody would ever volunteer to do that. I'd at least demand to know on what basis they're guessing.