Do You Need Physical Therapy or Personal Training?
Who can Help you Meet your Travel Goals
Perhaps the big trip you have been wanting to take is on hold because you are not confident in your mobility. Maybe you notice you are losing your balance more easily or have had a recent fall and are concerned you will have another. Is lifting and carrying your luggage becoming a barrier to travel? These are just some responses that I as a physical therapist hear when asking older adults what they like to do/what they would like to return to. “I love traveling but…”. Let’s talk about improving your fitness for travel!
Decreasing strength, endurance, and balance are tied to aging. Declines in these areas affect all aspects of your life. More demanding activities like traveling will be early signs to you that things are changing. Ready for some good news about improving your fitness for travel? We can improve our strength, stamina and balance at any age!
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Relevant Research Studies and Reviews
- How can strength training build healthier bodies as we age? Research Highlights from the NIH. This is a good place to start, especially if you do not want to dive into the literature below.
- Interventions to Prevent Falls in Community-Dwelling Older Adults: A Systematic Review for the U.S. Preventive Services Task Force
- Improving Physical Function and Performance With Progressive Resistance Strength Training in Older Adults: A Cochrane Review
- Muscle Mass and Strength Gains Following Resistance Exercise Training in Older Adults 65-75 Years and Older Adults Above 85 Years
Great! We can improve our strength, stamina and balance which make us hesitant to travel, but how? In this post, I cover differences between a physical therapist and a personal trainer, when you should see one or the other and when you should see both. If a personal trainer is not an option, we will also cover how your physical therapist can help you set up a successful exercise routine for you to do independently.
Note: If you have had a recent medical procedure, significant health event, or are not regularly physically active, check with your physician before starting with a physical therapist or personal trainer.
Physical Therapy
As a physical therapist, I am often asked if someone can see a physical therapist if they do not have pain. The answer is YES! You qualify for physical therapy services when there is a musculoskeletal or neurological reason why your activity level is declining or there are activities that you can no longer do. Perhaps, you are unable to lift your 20lb suitcase but you could a year ago. You used to stand for an hour in a museum but now search for a seat after 10 minutes because your legs feel tired or weak. Maybe you enjoy walking in your neighborhood but fear after a recent fall is preventing you from trying again. These are all reasons to see a physical therapist and your insurance should cover it.
Physical therapists address why these limitations are occurring. Reasons can include strength, balance, endurance declines, compensatory movement patterns, pain, stiffness, etc. The two of you will then develop a plan to address these limitations. As you improve, your exercise program will evolve, working to meet your goals.
Most insurances will cover physical therapy as long as there is evidence of functional progress. For example, you can now stand 20 minutes instead of 10 or can now lift a 10lb bag. Some insurance will only cover a handful of sessions to build a comprehensive exercise program for you to do independently. That same insurance will often later cover additional physical therapy under two conditions. The first is if you need to increase the challenge of your exercise program because you are improving. The other is if your activity level is declining without physical therapy. There is a lot of variability in what each insurance plan covers. Call your insurance provider to learn about these specifics.
Qualifications
A physical therapist will also be able to take your past movement history and any current aches/pains, comormidities and other health diagnoses into account. This is perhaps one of the largest distinctions between physical therapists and personal trainers. Physical therapists have medical training (a three year graduate program, leading to a Doctor of Physical Therapy degree). In the U.S, physical therapists but also must pass the National Physical Therapy Exam to become a licensed physical therapist. Physical therapists can complete a residency program and/or become board certified in a specific field of physical therapy. Examples include geriatrics, neurology and orthopedics. Visit the American Physical Therapy Associations’ Choose PT website to learn more about physical therapy and to help you find a physical therapist.
Personal Training
Certified personal trainers will design a plan with you to improve your strength, flexibility and stamina for improving your fitness for travel depending on your goals. Do you not qualify for physical therapy based on the information above? If so, seeing a personal trainer is likely a good step.
Finding a personal trainer that focuses on working with older adults or is recommended by your health care provider or friends/family can be a good place to start. Some personal trainers will be able to give you modifications based on compensations you make. They may also be able to provide alternative exercises if you tell them something hurts/doesn’t work for you. If you have pain/stiffness/balance difficulties, you may want to start with physical therapy. That way, you can learn your parameters and good modification options for you. That way, when you see a personal trainer, you already know what exercises/motions you should avoid.
Qualifications
Personal trainers have no medical training and do not need to complete any specific education except to pass an exam to be a certified personal trainer. Education and skill levels of personal trainers vary widely. It would be unfair to not give credit to the majority of personal trainers who take relevant coursework, study anatomy and continue learning. They should, however, not give you medical advice or address how to help you with an injury. It is important to see a medical provider first if you have health concerns, new pain, balance difficulties or joint stiffness/swelling. Personal trainers should recommend you see a physical therapist or your physician when appropriate.
*A note about nutrition: Diet can affect how we build muscle, our energy levels, etc that are very important when you are trying to improve your mobility. Nutrition is out of my wheel house as a physical therapist but some personal trainers provide nutritional advice/meal planning as part of their services. If this is important to you, my recommendation would be that you see a registered dietitian nutritionist (RDN). They have a Master’s degree and pass the RDN exam. RDNs can help you to ensure what you eat is helping you meet your activity goals. They will also take into considerations any relevant medical history including diabetes and autoimmune disorders. They will likely request your physician to order bloodwork so that they can make even more informed, personalized recommendations for you.
Moving from Physical Therapy to Personal Training
When should you move from physical therapy to personal training? Here are two quick answers. One – when you feel ready. Two – when you no longer meet your insurance’s criteria for physical therapy. Make sure your physical therapist knows that seeing a trainer or that returning/starting at a gym is a goal. Depending on what your limitations are, your physical therapist may recommend that you start with a trainer while you are still in physical therapy, either working on other areas of the body or keeping your general conditioning going while recovering from an injury.
Your physical therapist should be willing to communicate with your trainer about what they would like you to focus on or to avoid during training sessions. Personal trainers should abide by this. Ideally, this communication between the two would continue. As you continue to improve, your physical therapist should communicate with your trainer with your consent or through you to clear you to increase intensity of exercise, resume specific exercises that may have not been appropriate prior, etc. Having the two communicating can help your goal of improving fitness for travel faster!
Other Ways for Improving your Fitness for Travel
If you will not be seeing a personal trainer, let your physical therapist know you would like to work on an overall fitness program to help you to continue towards your travel goals. They will spend one or two sessions with you providing a full body routine to help you to continue strengthening, improving balance, walking further, etc. Most people go to physical therapy and use their medical insurance. If so, you likely would only be able to be seen for a couple visits once you have reached this point. There is also usually an option to pay as an individual instead of through your insurance which would provide much more flexibility. Speak with them about this as each individual’s case will vary.
If a personal trainer or a gym/home routine does not interest you, it does not mean you should stop activity! It is still important to maintain, if not continue improve on, what you have achieved in physical therapy. Once you have started improving your fitness for travel, you will need to continue with some activity. Your physical therapist can suggest alternatives such as Yoga, Pilates, Tai Chi, Swimming, etc based on your interests and what your physical therapist thinks will benefit you most.
I hope this has helped minimize confusion of who to see for improving your fitness for travel!
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