As movement professionals, there is often a gap - and even a disconnect - between physical therapy and personal training. In this 2-part interview series between Progressive Personal Training and MVMT Physical Therapy, we start to bridge the gap and discuss a number of topics that lie at the heart of our specialties. Antonio Sini and James Camastra from PPT and Mark Lusk from MVMT each asked the other four questions. Part One takes two questions from each. The following is from our conversation. Enjoy!
Question 1 - Hydration
James (JC), from PPT: How much does hydration play a role in dysfunction?
Mark (ML), from MVMT: Awesome question! OK, let’s geek out a bit here. Fascia is a connective soft tissue that invests everything in the body, creating a fascial “web”. There are areas where one unit of fascia is continuous with the next unit, like cars of a train (shout out to Thomas Meyers, author of Anatomy Trains!). There are other areas where these fascial planes create an interface at an angle, or even a direct overlap. These interfaces should work together, yet still “glide and slide” over each other. A main component of fascia is called “ground substance” and contains GAGs (glycosaminoglycans) which attract water. In instances of injury, inflammation and/or dehydration, “adhesions” or “cross-links” are created in this intricate web. Ida Rolf, the creator of the myofascial (deep massage) technique, often explained it as a shirt or sweater that has been tucked in too tightly (hold your shirt down and see how it limits your arm movement in reaching up). If a body is chronically dehydrated (and not moving well or fully), these cross-links and adhesions will form, restricting our movement.
Question 2 - Personal Philosophy
ML: The two of you have an impressive combined experience: How does your approach differ from other personal trainers?
JC: Generally, I’ve always felt like someone who doesn’t follow. I don’t adhere to anyone’s particular view or system, just science and practice. I like to be smart and progressive rather than traditional. I’m quite particular on how things are done and in tune with the variations any exercise may have, much more so than most trainers. While this is true, I like the clients to move, keep going, don’t stop to make adjustments, make them as you continue on. With all that said, there are only little ways that my approach differs from others. Though, these little ways are frequent and consistent. One example is terminal knee and hip extension:
I teach “finishing the move”, especially with lunges, squats and associated exercises. I want to see the hip and knees fully extend to straight. Often clients will remain slightly flexed at one or both joints. I tell them this tension, adaptive shortening perhaps, is or could be a or part of their problem. Terminal knee and hip extension is important.
When doing standing upper body exercises I tell clients to keep their knees straight, not flexed. Doing these exercises with soft/bent knees is learned and not how we function. I say things like, “when you are in your kitchen cutting onions or on line at the bank your knees are straight”.
Similarly, straight is strong and supportive. Bending, although appropriate, is a sign of weakness or difficulty. When catching and throwing a light medicine ball on one leg with a straight knee. If the knee bends it’s a sign of weakness or difficulty. If it’s easy, the client will be able to do the exercise with a straight knee. If it’s difficult, they will absorb the energy of the ball with the hip and knee in addition to the core and arm.
Shuffling, running lateral, in a crouched position is learned. It’s interesting the first time I ask a client to shuffle, often they immediately squat down and go. This is not natural and learned. Rather, I believe, we would do this upright, fully extending the knees and hips. I preach this. There are certain sports, basketball in particular, where it makes sense to shuffle low.
Antonio Sini (AS), from PPT: James and I are a good team. When it comes to designing client’s programs, James is very structured and detailed. His workouts are fundamentally sounds in their approach to reaching client goals quickly and efficiently through strength, balance and coordination. I too follow these principles but like to include other components of health and wellness; breathing, hydration, sleep, recovery and flexibility are all important. What separates us from the rest is that we work together as a team and use all these principles to give our client’s great workouts and better their lives.
Question 3 - Career Path
AS: How did your past as a professional dancer influence your path to physical therapist?
ML: I sustained a few injuries as a dancer. About two weeks after I graduated college with my BFA in Dance, I ruptured my left ACL while rehearsing a show. It was a traumatic moment in my young life and career. However, I had physical therapy before and after surgery with two excellent, yet very different PTs. The knowledge and skills PTs demonstrated fascinated me and stuck in my brain as a potential future career, for when the time came to transition away from dancing. Plus, as a dancer, we spend most of our training in a mirror - watching a teacher or choreographer, critiquing ourselves, watching others. Our “eye for movement” is really a learned skill, a byproduct of our physical training.
As someone who has always been (unconventionally) athletic and artistic, physical therapy has been a rather logical progression for me. Plus, I get to work with people 1:1, and I love that part of the healing process.
Question 4 - Managing Expectations
ML: How do you manage unrealistic expectations of your clients?
AS: It’s important to stay the course with a client’s program and keep detailed information so you can show progress. If you show these clients real and positive results early on, it helps when you have a conversation about expectations later.
JC: Very circumstantial. Some clients you need to just nod your head OK, OK. Over time, I like to gain the confidence of a client and put them on a more realistic track.
That’s it for today’s chat. Check in for Part 2 as we continue to discuss our personal and professional influences!
Mark M Lusk, DPT, OCS, CFMT