5 Lessons Learned From My First Year in Physical Therapy School
Estimated Reading Time: 7 minutes
My first year in physical therapy school is in the books.
I've spent thousands of hours in class, hundreds of hours in the library, and I've probably consumed enough coffee to fill a swimming pool.
But during that time, I had the opportunity to dissect an entire human body, I had the chance to observe some excellent clinicians, and I couldn't have asked for a better group of classmates.
I learned a lot this year academically, but perhaps the most important lessons I've learned transcend physical therapy and can be applied to much more.
Here are 5 things that I learned my first year of physical therapy school.
It Always Depends
Without a doubt, the phrase that I heard the most throughout school has been "it depends." It always depends.
When it comes to physical therapy, perhaps the most important thing to realize is that everybody is different. No 2 people are exactly alike and for that reason, no 2 patients can be treated exactly the same.
Sure, 2 patients can have the same diagnosis and there can be common patterns across diagnoses, but that's where the similarities end.
The mechanism of injury can be different. The irritability, quality, quantity, and location of pain may be different. The psychosocial factors influencing pain most likely will be different. The alleviating factors may be different. The patient's occupation, daily tasks, goals, and various other factors will be different. And most importantly to us as clinicians is that the treatment they need will be different.
You get the point.
Just like our parents told us when we were little – everyone is different. It's now more than ever that I truly grasp the magnitude of these differences that make us individuals.
Movement Is Medicine, We Should Know
What is the only medicine that can reduce the risk of diabetes, slow the progression of Parkinson disease, improve mood, quality of life, and increase your life span?
As "exercise scientists" and students of physical therapy, we're well versed in the benefits of exercise and movement. But it doesn't take a rocket—or exercise—scientist to realize that we need to move.
Our ancestors moved constantly – they moved to find food, to find shelter, to mate, and to survive. As humans, our bodies evolved to move. Movement helps circulate our blood, feed our cells, and forge the growth of our bones, muscles, tendons, etc.
Movement is life.
From the moment we're born (and even before that), we move. As infants we learn to move—rolling, crawling, and walking—so that we can explore our world. Being able to move gives us freedom. The day we stop moving or are unable to move, our life drastically changes.
Yet at this point in human history, we as a species are more sedentary than ever. What I've already come to notice in my short tenure as a physical therapy student is that when sedentary people feel pain, get achy, or even feel tired, they take it as a sign that they need to rest and avoid movement, when in fact, their aches, pains, and fatigue are consequences of their sedentary lifestyles. Contrary to popular belief, these people need to move more!
Before moving on (get it? – pun), I want to be clear: There is no "best way" to exercise and there is no one way to move, but the important thing is that we all stay active. We as physical therapists are crucial in educating our patients and our communities on proper movement, technique, and even in helping someone find what works best for them and their lifestyle. We're movement experts after all.
Progress Is Never Linear
Okay, I knew this before coming into school. But despite best efforts, progress is never linear. I think we all know this. But that doesn't make it any less important.
Having been immersed in all things physical therapy for the past year, I've learned about, observed, and experienced (rotator cuff impingement – fun stuff!) plenty of setbacks during the injury rehabilitation process. I was reminded time and time again that progress takes time, effort, dedication, and possibly most importantly to note, your progress is going to look like a really windy road map. Remember, that's okay!
From the patient's point of view, I realize how important it is to know that there will be ups and downs. Knowing that the road to recovery may be rocky gives patients solace each and every time that there is a setback.
As a future health care provider, I realize that it's imperative that physical therapists educate patients on the recovery process as well as offer support, reassurance, and encouragement along the way.
There will be bumps, there will be obstacles, and you may even trip and fall once or twice (or a hundred times), but as long as you never stop pushing forward, you're making progress and things WILL turn around.
Whether we're talking about us as students in the classroom or our future patients, we may not see results day-to-day, week-to-week, or even month-to-month, but with persistence, perseverance, grit, and a little bit of faith, progress is inevitable.
Words are powerful and when it comes to physical therapy, they matter a lot.
How a therapist communicates with their patients sets the foundation for how successful or unsuccessful treatment will be.
The complexity of the human body is beyond the scope of this blog, so I'll keep things simple. The mind is extremely powerful. Language and emotion is intimately tied to all facets of our cognition. Therefore, a person's beliefs and emotions significantly affect how they will respond to any given treatment or intervention.
It has been shown time and time again – the placebo is real. If someone believes that a treatment will make them feel better, then it is more likely to work for that person. Conversely, the nocebo is real as well. If a person has fear about their condition or is skeptical about a certain intervention, then that person is less likely to feel better.
This is where language comes in.
One of the many jobs of a physical therapist is to educate and empower patients. Physical therapists need to make patients feel comfortable, respected, and heard. By educating and empowering patients, physical therapists can minimize fear and maximize patient buy-in and, therefore, set their patients up for success.
While language is a powerful determinant of outcomes in physical therapy, it's also a powerful determinant of outcomes in life. The language we use with others influences how they will feel, react, and respond. Even more important, the language we use with ourselves deeply influences every aspect of our being, from neural circuitries to circulating hormones, all the way to our DNA; our words can literally alter who we are.
Choosing positive, empowering, and encouraging words has a profound effect on everyone, including yourself.
The More I Learn, the Less I Know
Almost a year ago to date, I came into physical therapy school as confident as could be.
I had spent the previous few years immersing myself in anatomy, physiology, motor learning, etc. I was extremely confident; at the time I thought that I knew everything.
Then school happened. I was humbled over and over and over again. School is tough and I quickly learned that I didn't know as much as I thought. In fact, the more I learn, the more I realize how little I actually know.
It's safe to say that I have a new appreciation for learning. I especially have a new appreciation for the type of knowledge that only experience can afford.
This past year of school has grounded me, but at the same time, it has lit a fire. I absolutely can't wait to get out in the clinic and mess up.
You read that right – I can't wait to make mistakes.
Don't get me wrong, I would love nothing more than to knock it out of the park and be a perfect clinician. But the reality is even the best clinicians make mistakes, and mistakes, in my opinion, provide the best opportunity to learn.
The opportunity to learn is what I'm excited for—I'm hungry. Hungry to learn more, help more, and to be better each and every day.
As I sit at my computer writing this blog "my palms are sweaty, my knees are weak, and my arms are heavy, there's vomit on my sweater already, mom's spaghetti…." (Shout-out to Eminem.)
But in all seriousness, I am absolutely pumped to work on my craft and develop my skill as a future professional and a physical therapist. And whatever it is you may be striving to achieve, I hope you are too!
"The separation of talent and skill is one of the greatest misunderstood concepts for people who are trying to excel, who have dreams, who want to do things. Talent you have naturally. Skill is only developed by hours and hours and hours of beating on your craft."
– Will Smith
My Drexel University and I.
Joe Rinaldi, SPT, attends Drexel University. You can find Joe on Instagram at: @joe_flofit.
The Sustainable Mind-Set
Estimated Reading Time: 5 minutes
I have wanted to write an article like this ever since I listened to Ryan Smith, PT, DPT, on the Knowbodies Podcast, and read articles by Cruz Romero, PT, DPT, and Alexis Morgan, SPT, respectively. I couldn't find the words until recently, though.
I was on a routine run through my community and it just came to me. I had been searching for a term to explain what I have needed for a while, and that is a sustainable mind-set.
This article is for those students who, like Cruz, have experienced imposter syndrome. For those students who feel that relaxing is a sign of weakness. For those students who are constantly coming up with their next big idea.
This article is for me because I wrote about not wanting to be in this exact scenario in one of my first blog articles.
I did not want to take on too many things in addition to school work, where I felt that I was not giving my full attention to anything. But here I am. So let's get into what drove me to seek some help.
Like most new things in my life, I came into physical therapy school with the unbridled enthusiasm of a Labrador. I wanted to consume everything I could about physical therapy. I had hundreds of project ideas from day 1, while also wanting to be the best physical therapist I possibly could be, who could do anything right out the gate.
What started out as enthusiasm, slowly turned into unmanageable stress. That stress caused me to wake up at 3:30 am and start working on my different ideas. There were times when I didn't sleep, I just kept plugging away.
My schoolwork never really suffered or was the cause of this stress, but school became a burden nonetheless. I soon became angry and frustrated with everything about school—classmates, professors, everything.
Physical therapy school. THE THING I HAVE SPENT YEARS TRYING TO GET INTO! And when that anger burned off, all I felt was apathy toward everything around me. I would just stare into nothing on my bed before school, and floated in and out of classes until I got home to do nothing again. I barely ate because somehow I thought that food was too much effort. For the last 2 years, this cycle cropped into my life numerous times until I finally sought some help, but more on that later.
Because at the core of these cycles were 2 salient points that I discovered about myself: I had unrealistic expectations, and my emotions were largely unchecked.
The former point is fairly straightforward: I thought that I could complete every project perfectly and to my complete satisfaction. But the latter point was a more interesting revelation to me because it wasn't just my anger and depression that went unchecked, but my happiness as well. There were days when I really WAS able to complete 10 different tasks in a day. It was a lot of fun just letting my mind go and operate at such a high-energy state. But when I was too tired to function at this level, I felt guilty and I would begin to swing the other way. Overall, I just felt unstable and all over the map.
I eventually sought help.
At Regis University, we are fortunate enough to have counseling services included in our student fees, so I sat down with someone every other week to verbalize everything I was feeling.
For me, seeing a therapist, an impartial third-party, allowed me to finally release some of the thoughts that I was having. I needed an outlet. At the same time, I began to tweak certain things in my life.
For one thing, I started limiting each project to just an hour a day and stopped working promptly at 10:00 pm.
I also stopped having a to-do list a mile long. Something that really started to help was instead of erasing something off of my to-do list, I now put a check mark next to it. It was so easy for me to forget how much I actually accomplished in a day, and to see how productive I was actually helped me relax before going to bed.
Instead of making vague goals, I now try to make specific things to accomplish that day, so when I have completed it, I move on. Vague goals gave me a sense of emptiness where I would spend 2-3 hours on a single project, trying to finish it all at once. Now I feel more satisfied that I accomplish something in a day, rather than stressing out that I didn't do everything.
Just doing these little things have helped me tremendously in my day-to-day life.
I think it is also important to note that I haven't scaled back my involvement in projects or have become less driven, but rather have changed how I have looked at them.
My classmates and I volunteering at a local half marathon.
Instead of trying to rush to the finish, I now enjoy the process of my work.
Therapy was a way for me to snap out of my unmanageable stress, but the tweaks above have really created a more sustainable mind-set for me.
Tim Ferriss recently gave a Ted Talk on something similar and I highly recommend watching it, along with the recent APTA Student Assembly #XchangeSA talk on emotions.
A few of my classmates and I.
Ultimately, we know our own emotional well-being ties directly into patient care. Someone once told me that we need to take care of ourselves so that we can take care of our patients. That was the spark that finally enabled me to seek the help that I needed. Because we all need help, in some way, so I need to make sure that I am functioning at my very best to ensure my patients can eventually do the same.
Ryan Bourdo, SPT, is a third-year student at Regis University in Colorado. You can reach Ryan at email@example.com, @ryanbourdo on Twitter, and visit his website at: www.ryanbourdo.com.