We’ve all heard of cross-training right? Perhaps you’ve educated your patients about it – or even incorporated some cross-training into your own fitness routine. (I’m looking at you runners!). But have you ever considered cross-training when it comes to your physical therapy practice?
As PTs, we typically find our niche over time. I see a little bit of everything where I work, but I would still say I fall into more of an ortho niche. The longer we’re in the game, the more we find ourselves spending time with certain kinds of patients – whether by chance or by choice. Eventually, we reach the point where most of us will say I’m a ____ PT (insert ortho, geriatric, neuro, pediatric, pelvic, etc. etc.).
Finding our niche usually results in us focusing on what we know, like, or are comfortable with. Most of the continuing ed and expertise we gain will likely center around whatever “kind” of PT we identify with. I mean it makes sense – learn more stuff related to the area you spend the most time in. Some people even get REALLY specialized to very very specific types of patients. There’s nothing wrong with being an expert. In fact, I think it’s great. However, I want to make a case for cross-training in our PT skills as well.
Cross-Training Will Help Your Patients
For starters, cross-training will help our patients by making us better PTs. If we’re being honest, we should be thinking outside of just our niche on the regular. We may call ourselves a “sports PT”, a “neuro PT”, or a “peds PT” or whatever, but there’s a lot of cross over in all areas of PT.
For example, often in sports PT a patient returning to sport must do some proprioceptive work before returning to play – that’s neuro. Many high level athletes are plenty strong and have full ROM but they still have pain. Soooo what do you work on then? Well a lot of the time it’s neuro-redu, muscle activation patterns, again proprioception – all very neuro-based ideas.
Looking at it from a different lens, a stroke patient may make some pretty significant muscle compensations when walking. For example, circumduction of the hip or hyperextension of the knee are common ones. While sometimes these are unavoidable in order to complete a functional task, if we’re not thinking about how these compensations may affect someone orthopedically, we’re doing the patient a disservice. In the case of multiple trauma the goal is to get the patient to complete functional tasks. However can we use treatments traditionally considered orthopedic or sports to maintain muscle mass while things heal?
I think in some ways PTs are becoming more and more siloed into our areas of practice. This is both good and bad in my opinion. It’s a double edged sword because I think we need experts and sometimes being too much of a generalist can be inefficient, but patients don’t always fit neatly into a category.
As a PT who spends most of her time in outpatient ortho I can attest to this. I’ve had ortho post-ops who also have a neurological condition like MS or Parkinson’s. In those moments I’m glad I was one of those “thought I’d do neuro rehab and ended up liking outpatient” student PTs.
Another situation I’ve been in is working with adults who have developmental delays or intellectual disabilities. A lot of the time it’s like working with kids. In those moments I wish I had more peds experience.
Thanks to friends in the pelvic floor world, I’m starting to learn there is also a lot of cross over between pelvic floor PT and general ortho. Several times I’ve been in situations where I wish I had some more pelvic floor knowledge. The little bit of cross-training I’ve done in this area has already helped a ton and I plan to do more.
Cross-Training Will Help YOU
Not only will cross-training help your patients, but it will also help YOU. When patients do good, we also tend to be a little happier. I don’t know a single PT who’s happy when their patients aren’t progressing. Having more tools in our box to support patients can reduce frustration and help prevent burnout.
Sometimes burnout comes from monotony. The very first blog post I ever wrote was about burnout. In that blog post I dedicate a section to why learning new things can help with it. I know a couple PTs who will purposefully take continuing ed classes a little outside of their niche – just because it interests them and helps keep things fresh.
Cross-training can be good for career opportunities as well. You’re in a niche right now, but you may decide one day it’s time for something new. You may move and have to find a new employer. There’s a lot of reasons why one day you may not have the same job you do now. Having education and experience in multiple areas will make you MUCH more marketable. This can open doors for your career you might not have had otherwise.
Lastly, cross-training may result in you broadening your expertise. You may cross train in some other area of PT and find you actually really enjoy it! It may be something totally different or something adjacent to the niche you work in now. However, you’ll never know if you want to swim until you dip your toes in the water! So if there’s something that even kind of interests you, I say go for it. You’ll never know how much you really like it or what it could turn into.
How to Start Cross Training
Just like with any new workout program, the hardest part is getting started. Think about what you would tell your patients. First, you’d probably tell them “everyone starts somewhere”. If you’re not sure where to begin, think of a patient on your current caseload that you might be able to treat better if you dabbled in some PT cross training. For example, I recently found myself treating a series of CVA patients. These definitely aren’t the bulk of my caseload, but our inpatient rehab has been really busy lately and many of those patients come back for outpatient therapy. This prompted me into taking a CVA continuing education class.
And you know what? IT WAS GREAT. I have tons of new ideas for my neuro patients. There were also things I learned that I’ll try with my ortho population as well and it was nice to take something different than the courses I usually gravitate to. If you’re looking for a great CVA course, I highly recommend the CSRS certification course. It was super well organized and the instructors were great.
You could also brainstorm what areas would best compliment your current niche. Think not quite your niche, but adjacent. Again, I’m primarily ortho, but I get a fair amount of women postpartum with back, hip, or leg pain. Coincidence? Sure, maybe sometimes. But having at least some women’s and pelvic health knowledge would definitely help in those situations.
The other piece of advice I’ll give you (and probably one you’ve given to patients before) is to start with small achievable goals. Again we’re cross training, not trying to switch our expertise. Becoming an expert doesn’t happen overnight anyways. Start with the basics. Don’t take a course better suited for someone who has years of training or experience in that area. I started my women’s health education by taking a short free webinar. It was the perfect amount of new information – enough to get some basics AND leave me wanting more. Now I’m looking at taking a longer beginner’s level course.
So start small and just dip your toes in the water. If you find you like it and it’s helpful THEN you can dive in.
What do you think about PT crossing-training? Do you see some benefits or do you think everyone should just stay in their lane? Have you had an experience with PT cross-training?? What niche do you work in now and what did you cross train in?? All thoughts and experiences are welcome in the comments section! 🙂 If you missed the last post on treating subacromial pain, you can check that out here. To get more PT Page content make sure hit the subscribe button below and follow on Instagram @the_pt_page!
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