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Why Rehabilitation and Fitness Should be Delivered in Parallel

By Dr. Charlie Weingroff, DPT, ATC, CSCS | Clinical Mentor at ActivCore

When someone requires physical rehabilitation, it indicates that one or more systems in the body wasn’t resilient to a stressor of some kind. The stressor could be an injury or disease. It could be too much exercise or the wrong exercise. Either the body was unable to fend off the stressor, or it was able to fend it off, but at a very high cost that isn’t desirable.

Traditionally, the way to become more resilient to those stressors is through a fitness strategy – intelligent stressors, intelligent exercise, intelligent nutrition, intelligent sleep, and intelligent decisions about when to engage in intense activities, whether they be physical or mental.

But there’s no reason why we can’t affect what led a person to be injured in the first place, and bring their systems back to minimum standards, using rehabilitation and fitness simultaneously. Unfortunately, most physical therapists don’t know how to deliver them in parallel.

Similarly, a fitness expert probably won’t have the skills or know the techniques required to manage a painful shoulder. For example, If the shoulder hurts and doesn’t move the way it’s supposed to move, there should be a rehabilitation lens at the shoulder. But the patient has another shoulder. And a trunk. And two legs. And a cardiopulmonary system. And an endocrine system. And so on.

All of them can be challenged intelligently at the same time by a physical therapist, who can evaluate the various systems and orthopedically, the joint systems of the body. A physical therapist will do things that don’t seem logical and make the patient say, “Why am I exercising my legs when my shoulder hurts?”

A physical therapist knows that the joints that do meet the minimum standard should be affected as aggressively as possible. When we engage in intelligent training in the joints that can sustain it, we create hormonal effects that that can help the tissue in the shoulder heal more quickly and reduce pain.

At the very least, when the shoulder is healed and meets minimum standards, we’re that much closer to engaging in a full fitness program, which is the ultimate solution to why the patient injured the shoulder in the first place. We don’t just want to make the shoulder feel better. We want to make sure the same injury doesn’t happen again.

Rehabilitation and fitness operate on the same highway, running parallel. But they’re in different lanes. The bucket you reach into for the techniques used to manage a painful shoulder is totally different than the bucket you reach into for the techniques used to treat a healthy leg.

One obstacle to a parallel approach is that people are willing to pay for fitness, but they’ve been conditioned to not pay for healthcare. They think they have to use their insurance.

We as physical therapists can change that. We need to explain to patients that they not only can receive fitness and rehabilitation services at the same time – in parallel – but they’re also likely to experience better outcomes as a result.

Dr. Charlie Weingroff serves as a clinical mentor for ActivCore. He is a Doctor of Physical Therapy, a Certified Athletic Trainer, and a Certified Strength and Conditioning Specialist. Dr. Weingroff is currently a Physical Therapist and Strength & Conditioning Coach at Drive 495 in Manhattan, NY and Fit For Life in Marlboro, NJ. He also is a member of the Nike Executive Performance Council and serves as the Physical Performance Lead and Head Strength & Conditioning Coach for the Canadian Men’s National Basketball Team. Prior to returning to his home of NJ, Dr. Weingroff was the Director of Physical Performance and Resiliency and Lead Physical Therapist for the United States Marines Corps Special Operations Command in Camp Lejeune, NC. He graduated from Ursinus College with a degree in Exercise and Sports Science in 1996, and went on to earn an MSPT in 1999 and DPT in 2010 from Rutgers University.

Beginning in 1998, Charlie spent 12 seasons of professional basketball, highlighted by his time as the Head Strength & Conditioning Coach and Assistant Athletic Trainer for the Philadelphia 76ers in the NBA. Among the highlights of his tenure in Philadelphia was being part of the medical staff that ranked 1st in the NBA in Player Missed Games in the 2005-06 season.

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