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  • APTA Launches New Nutrition Webpage

    Yes, there's a role for the physical therapist (PT) in helping patients understand how nutrition affects function, but there are nuances to be considered and no shortage of factors that could affect just how to fulfill that role. Fortunately, there's now an APTA webpage that helps PTs navigate the issues.

    New to the APTA website: "Nutrition and Physical Therapy," a webpage with a collection of resources that delivers context for APTA's position that it's the role of PTs to "screen for and provide information on diet and nutritional issues to patients, clients, and the community"—within the bounds of the PT's scope of practice. That means, among other things, that PTs wishing to provide information on nutrition need to be certain that they're doing so in ways that are consistent with state licensing laws for both physical therapy and nutrition services, and assess whether this ability is within their personal scope of practice.

    The webpage provides factors to consider related to the PT's role in nutrition and diet, including additional certifications that may be required, use of the designation "nutritionist," and when to refer a patient or client to a specialist for nutritional education. Other resources on the page include links to dietary recommendations, a registered dietician nutritionist lookup, and information on how to pursue additional certifications.


    • We are not nutritionists! I think that is hard to make recommendations based upon that!

      Posted by Linda Boyle on 6/14/2017 5:31 PM

    • Thank you to the APTA for posting a progressive stance on nutrition and including nutrition as part of physical therapy scope of practice. This is a great step forward for the profession and for those with chronic disease!

      Posted by Joe Tatta on 6/14/2017 5:32 PM

    • Looking forward to good information on this topic.

      Posted by Kelly Comstock on 6/15/2017 1:26 AM

    • As an acute care therapist, I frequently try to encourage patients to eat and to eat foods to help them heal. The dietitian rarely has time to meet with patients but adds supplements where they are needed based on nursing communication.

      Posted by Maria Alfonso on 6/15/2017 7:48 AM

    • While we are not nutritionists, this aspect of health directly influences our patients ability to heal. Thanks APTA for bringing this to light!

      Posted by Dawn Harrison on 6/15/2017 2:20 PM

    • This website can be an important resource for therapists to learn about many aspects of nutrition, especially about the various new protocols that rely heavily on nutrition and are being used to help patients make unprecedented improvements. I am a physical therapist and certified Functional Medicine Health Coach with additional training in pediatric health coaching. I am also a patient who has used the Wahls Protocol myself as well as other lifestyle modifications to recover from chronic illness, and also other special diets for four of my children who were chronically ill. There are many very promising no or low risk, potentially high benefit, disease modifying therapies that can affect the functional and health outcomes of patients. The Bredesen and Wahls protocols are two examples. We are not nutritionists, however, we can play an important role in educating patients and supporting them if they chose to try these. The ideal situation is when the patient has access to a team including at least a physician, nutritionist and health coach with appropriate training. Therapists should know that patients can and are trying these protocols on their own, with good results. I’ve been in online support groups and seen the photos and videos posted, it is inspiring. Therapists with least a basic understanding of these protocols could serve as a helpful resource and support for patients, especially those who have more difficulty adjusting to significant diet and lifestyle changes. Research is emerging, and more is needed and is underway. The gift of possible hope through these promising treatments, especially for patients with conditions such as MS and Alzheimer’s, is precious. There are many drugs used regularly that have not shown this level of success and have serious side effects. The APTA Nutrition webpage is a wonderful way to begin to learn and share information about these new possibilities in treatment that can lead to more optimal functional and participatory outcomes in our patients.

      Posted by Donna DeSanto Ott on 6/15/2017 7:45 PM

    • Thank you APTA for taking a stance and providing resources. Teaching nutrition and providing learning experiences is an expectation of CAPTE and ss an educator in a DPT program it is nice to have more resources and support from the APTA. Keep up the great work!

      Posted by Kim on 6/16/2017 10:25 AM

    • Linda, you are right that we are not nutritionists but we have an opportunity and ability to counsel patients about how their diets and other lifestyle habits can affect their health. Also, it seems like our physician teammates similarly could learn some more about nutrition. https://www.ncbi.nlm.nih.gov/pubmed/26234947 That being said both physicians and PTs can help our patients by giving basic advice to our patients. In my state, all health care professions can give advice about nutrition (We are just not allowed to say we are going to cure a disease with nutrition). I think anything we can do to help our patients within our scope of practice should be something we seek to learn more about and educate our patients. Two more minutes of a joint mobilization will likely be less helpful to a patient in 1 year than a patient who is slightly more active and eats slightly healthier because we took the two minutes to educate them about basic nutrition and healthy lifestyle.

      Posted by Ryan on 6/16/2017 2:24 PM

    • Nutrition is the foundation of healing, recovery, performance, energy etc... Patients in need of development of specific eating plans should be referred to licensed dietitians . We can definitely be more proactive in providing general education on the pros and cons of certain foods and always add a disclaimer to" consult with your physician if your on prescribed medications, being treated for diagnosed ailments and have any medical history of concern or allergies. " People suffer from poor recovery, prolonged or chronic inflammation , body pains, lack of energy, sleeplessness, obesity, dizziness etc... that correlate with poor nutrition. Although we don't assess that correlation we can offer information and resource tools to steer them in a better direction for recovery.

      Posted by Matthew St.Aimee on 6/18/2017 9:32 AM

    • "Dietitians examine their role in the practice of Physical Therapy" How does that headline set with all the PTs out there?? Not very well I imagine! I agree that it is helpful for PTs to have s basic understanding of Nutrtion, just as dietitians/ RDs have a basic understanding of anatomy, and while my job as a dietitian may seem easy, and yes, there is a huge shortage of Dietitians, that doesn't mean that PTs should do my job. And the "recommendation" to refer to "a specialist for Nutrition Education", that would be an RD. I am married to a PT and we both respect each other's expertise. It would be nice if other health professionals did also.

      Posted by Ann Lentell, MS, RD on 6/20/2017 7:57 PM

    • Ann, I understand your concern about PT's overstepping their role in educating their patients regarding nutrition but I believe your quote, "Dietitians examine their role in the practice of Physical Therapy" is not the same analogy as the title of this article. A more similar analogy would be "Dieticians examine their role in educating their patients in the importance of exercise." I believe most if not all PT's would applaud dietitians who encourage their patients to include exercise in their daily routine. Specific diets as in specific exercise programs should be left to the specialists "within our scope of practice" but as for more general wellness information we as health care providers should be working as a team to improve the overall health of our communities.

      Posted by Gretchen Largusa on 6/25/2017 3:03 AM

    • I have encouraged patients to eat a caloric deficit for weight loss but to always inform their physician of diet changes with appropriate referral to a dietitian for a complete diet assessment. Actually performing diet consults or recommending specific changes is prohibited in most states (like here in Alabama).

      Posted by Matt Kellum, DPT on 7/7/2017 10:20 AM

    • Chiropractors advertise for "Physiotherapy" after only taking 6 credits which teaches them the very basics of our profession. In addition they advertise "Wellness and nutrition" after only taking a 3 credit course and actually counsel people on nutrition. Who is holding them accountable on playing physical therapists and nutritionists?

      Posted by Blerim Dibra on 7/7/2017 10:23 AM

    • Our primary objective should be in changing our practice act and removing us from the anxillary category. Trying to spread to thin with other services that cross turfs without securing a strong position in the hiearchy of healthcare delivery is not going to help us in the long run. Fighting for dry needling which wasnt recognized by insurance companies caused enemies with the Accupuncture group. Doing the same with nutrition will lead to enemies with the nutrition and dietitian groups. Meanwhile Chiroprators can play any role they chose to do so without any resistance given to them due to the fact that they have positioned themselfs correctly in the eyes of the insurance companies and legislative level by being united and having 100% membership in their own association. Its dissaponting to look at our data of membership and participation. We largely outnumber them and yet we are left in the stone age. What is it going to take to wake up and evolve??

      Posted by Blerim Dibra on 7/7/2017 10:40 AM

    • Excellent! Nutrition is so important in what we do. I am thrilled it is being discussed and our role in this topic.

      Posted by Gale Hazeltine on 7/7/2017 11:25 AM

    • I am grateful that the APTA is clarifying this important aspect of taking care of the WHOLE person we call "patient"!!! Just because I might recommend a healthier diet or food choice to someone does not mean I am taking over, or taking on, the role of the dietitian. I happen to have two certifications in nutrition and therefore DO have knowledge to share in this arena. I still cannot call myself a nutritionist nor a dietitian and never do. As others have stated, we all need to be working as a team and stop being threatened by what other professionals do and see the PATIENT AS PRIORITY. It is the over specialization of medicine that has gotten us to this place of DYS-ease in our system and our culture. I agree with Gretchen Largusa that I would not be upset or threatened if I discovered that a dietitian had recommended exercise to a patient as long as they left the prescribing of the specifics to the appropriate professional.

      Posted by Dr. Beth Rini Scott, PT, DPT on 7/7/2017 12:15 PM

    • Holy Smokes! Finally! This is awesome! I have been preaching the importance of this for years! Now the questions are: Will this become part of a Plan of Care? And if so, how will nutrition education be delivered by a PTA? What about within a PTA curriculum? A lot to think about, but I think we all saw this coming with the mention of Nutrition in the newest CAPTE standards for education. Thank you APTA!

      Posted by Cody T on 7/7/2017 1:20 PM

    • Anyone who treats injuries should realize that nutrition is at least 50% of the process or more. We do not heal anything. We influence the body to heal damaged tissues so we can restore function. Without proper nutrition to work with in the body, the injured area will NOT heal. While I ALWAYS advocate good nutrition to all my patients, I don't counsel them on their diet. That is beyond the scope of what we do as physical therapists. Having a good nutritionist to refer them to is advised.

      Posted by Richard McGuire on 7/7/2017 1:24 PM

    • I have worked with a PT in an sports med clinic and he was one of my best sources of referrals. I also knew enough A/P to know when muscular/joint pain might benefit from a PT eval. In fact, Dr. Gabe Brooks and I have spoken together at PT conferences on scope of practice and educational background. Providing anticipatory guidance on healthy eating via My Plate or the Athletes Plate (USOC) is wonderful and I wish all professionals would do this. However, ordering labs, recommending supplements and medical nutrition therapy are truly scope of practice issues. Medical nutrition therapy is the domain of the RD. I can tell patients to exercise but not how to rehab an ACL. I would humbly suggest that PTs become a source of referrals for RDs and vice versa

      Posted by Roberta Anding on 7/7/2017 3:51 PM

    • I love this! Let thy food be thy Medicine.

      Posted by Diane on 7/7/2017 4:07 PM

    • The more ways we can develop our profession the better off we will be. The more ways we can educate our patients and community about what we do as therapist, the more valuable our roles will become.

      Posted by Taiis on 7/7/2017 6:30 PM

    • Agree with others. This is a great idea! Thank you for the support! As clinicians we should avoid feeling like "someone is trying to do my job" or "they should respect my title" when it comes to patient care, the goal should be to maximize the resources for our patients. I greatly appreciate other clinicians discussing importance of exercise and I have always discussed basic nutrition suggestions, weight management considerations and encourage smoking cessation programs as well as communicate with patient phycician. I have a list of local resources, including dieticians ready to provide. We all have lots of responsibilities, we don't want to fully represent any other roles, but starting a conversation is important. K.P. PTA (3 states)

      Posted by KP on 7/7/2017 7:22 PM

    • Ann, i understand where you re coming from. As an outpatient PT, I ask every one of my patients what they had for breakfast. It's something so simple but it sparks a conversation about healthy eating between me and my patients. Although the most dietary education I received was a grad elective, this is more or equilivent to even some medical doctors! If a teacher in elementary school can (and should) promote healthy eating, why can't I? For special dietary concerns or GI issues, I always refer to their MD or registered dietitian. Let us stop the obesity epidemic from all directions!! Respectfully, Chelsea Hayes, DPT, OCS

      Posted by Chelsea on 7/7/2017 10:04 PM

    • This is the most uplifting and hopeful news I've read this week! Recognition that we are what we eat and how we fuel determines how we develop and heal is long overdue. In my outpatient pediatric practice I regularly point families toward current research in healthy nutrition related to functional development and performance. I recognize and discuss the relationship between pro inflammatory foods, constipation/gut health and stiffness/joint pain, lethargy, and sensory motor function. I am up front with families that PT alone will likely help their child however to achieve the most effective response, I invite them to begin the journey of learning about nutrition and cooking. I refer to specialists as appropriate for allergy testing, GI function, nutritionists and practitioners with functional medicine training ( MD, DO, DC, ND etc). Often parents need "permission" to buck our cultural influences of high sugar and processed food. No one needs a degree to decide to eat Real Food. Empowered families realize better health and wellbeing is in their grasp and work more effectively with their medical team.

      Posted by Barbara DeMatteo PT on 7/8/2017 10:22 AM

    • Thank you APTA for addressing this important (and long missing facet) of PT practice. We cannot except our patients to improve if we do not emphasize the important connection between what they eat and how well they can move. There is an abundance of evidence available that links osteoarthritis and nutritional habits and intake (I teach a 5 hour CE on it for starters), so if we are leaving out this important element of discussing nutritional resources and educating patients about the important connections - we aren't doing our job as PT's. From a systems-based approach, this is just plain common sense, and if PT's are to become front-line healthcare providers that see folks across the lifespan, nutrition must be a part of the conversation. And for those who have a stance against this, this has nothing to do with overstepping boundaries in scope, and everything to do with inclusion of nutrition experts and dietitians in the conversation about health and well-being. Nutrition must have a seat at the table in a multidisciplinary team approach to optimizing health and wellness. Finally, one area I'd like to see APTA speak up in the same way - is mindfulness practices and integrative therapies. They, like nutrition, play an incredibly important role in affecting neuroendocrine health and pain perception - which again - is a basic building block of affecting movement across the lifespan. Let's continue to move forward proactively as a profession, which means coming out of our silos to work together toward optimizing America's health, Ginger Garner DPT, ATC, PYT

      Posted by Ginger Garner -> >HU_<O on 7/9/2017 7:06 AM

    • PT s are not nutritionists indeed but we have exceptional coaching skills. please refer to my article on linked in. I have successfully added coaching into my practice and am doing coaching full time now. Think about how hard it can be to rehab an overweight and unhealthy patient. It is often 2 steps forward , one step back. If we use a structured approach to get their weight under control and teach them lifestyle and lifelong habits, we not only improve their lives and mobility, we can actually save their lives.! Don't set you yourself short! There are tools out there and I have applied them successfully. I can help you establish this great program in your practice without increasing your overhead.

      Posted by Dominique Kohlenberger on 7/9/2017 8:22 PM

    • As a PT w/ an advanced degree in holistic nutrition I'm glad to see out profession addressing this important and impactful area. Obviously each PT will have a diff comfort level but this resource will be valuable to maintaining consistent and accurate info for pts. Thnx

      Posted by chris on 7/10/2017 10:52 AM

    • I see the why, but I don't see the rationale for pursuing this role in healthcare as a PT. My spouse is an amazing dietitian, and seeing what it takes to properly use experience and practical knowledge to counsel and advise clients firsthand. We are jumping into an entirely too simplistic view of what it takes to produce a meaningful change. Giving advice and proper counsel on medical nutrition and dietary change is not a practice area we use frequent enough to be masters of sufficiently to provide better than most internet content would provide. I for one wouldn't feel right about charging pt education code or billing for that as service unless I was sure I could follow it up with more depth that is meant to effectively facilitate a meaningful change in that clients condition. Let's stick with what we are well trained to provide and have regular experience providing. Greg Redmond, DPT

      Posted by Gregory Redmond on 7/10/2017 11:44 AM

    • I am very happy to see that the APTA is recognizing the huge importance of good nutrition and so many people including doctors and other health professionals, unfortunately do not have enough training or knowledge in this area. I also used to think that I was eating healthy but in reality I really had no idea what that really meant. I am very passionate about implementing a more holistic approach and love the functional medicine approach. I would love to meet more like minded physical therapists and would love to some day work in a clinic with other physical therapists that "get it" using this holistic approach. Therefore if anyone is already doing this, I would love to chat! I love Joe Tatta's,(DPT) podcast (The Healing Pain Podcast) and book (Heal Your Pain Now) and would love to eventually do Chris Kresser's Adapt program. Dallas Hartwig (co-creator of the Whole 30 Book and Program) is also a PT. We can make a big impact in so many lives and I would love to meet for PT's that feel this way also.

      Posted by Heather on 7/10/2017 3:14 PM

    • This is wonderful!!!! I have been asking and researching to find answers to my questions about sharing nutritional "advice" for my families. It is an aspect of caring for the "whole" person that HAS to be considered. We make such an impact already in our patient's lives, just think how greater that can be if we address a more holistic approach, with healing the body, nutrition, food is thy medicine, natural means of healing, etc.....I work in pediatrics and see how poor nutrition effects these kiddos!!! I would also like to connect to other like minded PT's who "get it" using this holistic approach like Heather mentioned in her comment. Heather feel free to email me! kelleymn99@hotmail.com I will check out some of the resources you shared as well. We can make such an impact when we join together to do this. :)

      Posted by Kelley Johannes, DPT on 7/11/2017 10:06 PM

    • We may not be nutritionists but we all realize how important nutrition is to our patients. We are also not pharmacists but we also can relate to how important antibiotics and pain medication can be. If our population can benefit, we should have a working knowledge of what can help them heal. Thank you for this very important resource.

      Posted by Karen Michella, DPT on 7/19/2017 2:26 PM

    • How about we focus on educating the world about our expertise on things that we are specifically trained to do rather than trying to be everything to everyone? One of the commenters mentioned that chiros have no restriction as to what they do. Shouldn't they? shouldn't we? How about some restraint with the practice expansion and let my mother's neighbor realize that when her knee hurts, maybe a trip to the PT would be a good FIRST step, rather than having PT clinics start popping up with a full line of herbal supplements to help with bladder flow, baldness, depression, and skin care. Its a fine line and a slippery slope to quackland.

      Posted by Tom Reeves on 7/24/2017 9:08 AM

    • Why does th APTA endorse the government nutrition guidelines when the scientific evidence clearly supports dairy to be unhealthy and disease causing, and supports a vegan diet as the most disease-preventing and healthiest diet?

      Posted by Nancy Harrison -> ?JTcBF on 7/25/2017 2:47 PM

    • I think it is great that we are addressing nutrition. It is nearly impossible to separate exercise and nutrition, healing and nutrition, and health and nutrition. I think we often run into roadblocks that could be addressed with some basic nutritional education/advice. On the other hand, I think that before we start giving advice we better have additional education on what we are doing. You wouldn't manipulate someone without sufficient training, dry needle without sufficient training or perform some other skilled treatment without thorough knowledge of what we are doing. I do believe that if we are giving out information we need to make sure that we are using the same format that we do when prescribing exercise. We need to make sure that our recommendations are solidly based on evidence and true science not on documentaries, personal bias, or conspiracy theory. I would like to see some good continuing education course for physical therapists on this subject and if anybody knows of any I would love to hear what is out there.

      Posted by Chris Marean on 8/4/2017 11:03 AM

    • I strongly believe everyone in the healthcare sector, especially those concerned with preventative medicine, should be educated and informed on the current state of evidence in nutrition. It is important to note that even physicians have a limited scope of education in nutrition (roughly less than 10 hours in medical school), and it is important that all health providers be up to date in this topic. Chronic diseases, such as diabetes and heart disease, impact the function and lives of the vast majority of our patients, and we know that diet and lifestyle are very much associated with chronic disease progression. Therefore, diet cannot simply be overlooked or deferred to others, when it is very much a reality and contributing factor to chronic diseases that we see every day in our patients. We should, as in other respects, as an evidence-based field align ourselves with the literature over the industry. I do appreciate that the APTA has included as resources non-profits that provide evidence-based information on nutrition, including the Physicians Committee for Responsible Medicine and NutritionFacts.org.

      Posted by Richard Benes -> CITc<O on 8/5/2017 2:14 PM

    • It is imperative for us as a "conservative discipline" to understand and appropriately advise patients with effective objective nutritional counsel and lifestyle management. When we walk into the food store, we are walking into a pharmacy. "The future of medicine is prevention through nutrition." - Leroy Hood MD, PhD (human genome project). The science is undeniable; inflammation and oxidative stress have been identified as the root of most chronic disease. I believe our future in the medical model will be the integration of functional alternative medicines. In the future DPT students should complete residencies, certification in their respective fields and the 4th year should be a very comprehensive understanding of nutrition and how to most effectively provide patients with nutritional counsel as an adjunct to their treatments. We can't out-exercise a poor diet, nor can we expect optimal outcomes when proinflammatory lifestyles are contributory to chronic disease states. "Let food be thy medicine and medicine be thy food." - Hippocrates

      Posted by Rocco Gervasi on 8/29/2017 6:25 PM

    • I agree that RD's are the experts in nutrition for disease. They have a comprehensive background that involves coaching for habitual and psychological connections that often make it hard for an individual to make a change in their nutrition even when it makes sense. I do however believe that we can positively impact our patients when indicated for nutritional advice that can help facilitate the healing of surgical wounds, musculskeletal inflammatory disorders, bone fracture healing, muscle and tendon tear healing. How many times do we get confronted by a chronic smoker who has a slow healing surgical wound or surgical repair. Smoking cessation is a part of poor nutrition that's included in our initial evaluation questions. Diseases involving sytems should always be referred to a RD and physician for possible nutrition involvement. Physical Therapist have to maintain a role in their scope of practice but it's a no brainer that if a patient reports a poor diet impacting their physiological progress that we can suggest some basic tips to improve their awareness in addition to giving recommendations to consult with a licensed dietitian and physician.

      Posted by Matthew St.Aimee on 1/14/2018 7:31 PM

    • Thank you APTA! We have got to be the change we want to see in the world. I'm proud to be part of a professional organization that understands the important role of good nutrition in peoples lives. We can stop this insanity one stalk of broccoli at a time! Anyone interested in hearing the latest research should check out Nutritionfacts.org!

      Posted by Lisbeth Weinheimer -> >HV]CL on 2/23/2018 11:24 PM

    • Nutrition education was part of my training. I provide nutrition counseling to patient's regularly to those who are open to it. Reducing systemic inflammation through nutrition is getting to the root cause of disease. We are educated in medication and know precautions and side effects so why shouldn't we know the same about micro and macro nutrients? Thank you APTA!

      Posted by Martha Sharkey on 5/26/2018 5:44 PM

    • Is there a certification in nutrition that you know of? Actually, I am looking for two different ones. If you, please share their website. Thank you!!

      Posted by Sharon Fair on 5/6/2020 9:04 AM

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