Personal trainers have made great strides in propelling exercise from a pastime to a profession, from physical education to exercise science, and from humble home-based gyms to multimillion-dollar facilities. But today’s fitness enthusiasts are a different breed from those of previous years. They are more educated about the benefits of proper training mechanics. They want to work smarter, not harder. They want integrated, holistic workouts: core training and cross training. They want all of the gain and none of the pain.

In cases where there is pain—caused by an injury or a preexisting condition, for example—a personal trainer is limited by scope of practice in what he or she can do. In such cases, a pivotal professional relationship with a physical therapist is in order. Making a referral to a close allied health associate is a better alternative than turning clients away or, worse, attempting to “rehabilitate” them without the proper qualifications. With the clients’ best interests always in mind, a personal trainer and physical therapist alliance creates a safe, professional environment in which all parties benefit.

Case in Point

A working model of this concept exists at The Sporting Club One in San Diego. With 35,000 square feet of space dedicated to the betterment of its members, this elite facility doesn’t balk at improving the
experience. In addition to offering an
already expansive list of amenities, The Sporting Club One reaps valuable rewards from its partnership with Kate Grace Physical Therapy.

The relationship began in 1991 when Kate Grace, PT, relocated her business across the street from The Sporting Club One. Grace introduced herself by organizing monthly in-service presentations for the club’s personal training staff. The ongoing monthly sessions covered a wide
variety of topics. “In the beginning we started with each joint; then, as the trainers’ knowledge base grew, we covered anatomy, biomechanics and how to know if a client’s pain complaint was a red flag that needed medical attention,” Grace says.

Following these sessions, the trainers began choosing the topics themselves. Examples included how to avoid injuries when cycling, how to advise clients on work ergonomics and how to evaluate posture. Susannah Johnson-Cooper, fitness manager of The Sporting Club One, says Grace’s continuing education has taken her trainers to the next level. “These are the best and brightest trainers I’ve ever seen.” From a business perspective, she says, “it’s something that the clients recognize and appreciate.”

Mutual Benefits

As the two entities joined forces, a mutually exclusive and beneficial referral system emerged. Confident of Grace’s ability to address sports-related issues, the personal trainers asked her to assess particularly challenging dilemmas, such as a specific pain that wasn’t improving or movement restriction caused by poor posture. “It’s important that the trainer not wait too long, because the earlier it’s treated, the sooner it will be resolved,” says Grace.

Johnson-Cooper credits the ongoing training with providing her staff the courage and assertiveness to refer clients to physical therapy. “They’ve become adept at recognizing what’s within their scope of practice and what isn’t,” she says. “When they see severe mobility problems or long-term specific pain—particularly back, shoulder or knee injuries—they refer clients to Grace.” The Sporting Club One members are receptive to the referrals. “The club as a whole,” says Johnson-Cooper, “sets high standards. The members know we want to protect them; they know we want to provide them with the best of the best.”

Meanwhile, access to qualified trainers provides Grace and her small staff with a reliable resource to extend patients’ therapy into a lifelong fitness regimen. “After we’re done with rehab,” Grace says, “we take clients to the club and put them on a program. At least we’ve introduced them to the right way to do it. It’s never our intention to take [Club One members] out of training, but only to enhance what they are doing.”

Once clients leave physical therapy, the trainers refer to the therapists’ specific instructions and precautions before moving forward with a formal program. “Our referral system is based purely on mutual professional respect,” says Johnson-Cooper. “We allow Grace to use the facility when she needs to for care and referrals. She sends all post-therapy clients to us for continued health improvement. We get no-cost sports injury screenings for our members. Grace gets referrals from these screenings and free space in our newsletters to advertise.”

Building a Successful

For the physical therapist-personal trainer relationship to function, both parties must be open to making certain adjustments. It is important to have clearly defined roles. “First we get rid of the pain,” Grace says of her clinic, “then we hand them over to the trainers.” The trainers must also work strictly within their arena of professional authority. They adhere to industry guidelines on personal training scope of practice and refer clients to physical therapy when needed.

To combat preconceived notions of competitive rivalries between physical therapists and personal trainers, Grace conducts team-building sessions throughout the year that address communication skills, ways of handling stressful situations, customer service challenges, goal setting and other topics that affect team dynamics. At the outset of their collaboration, Grace recalls, trainers were concerned about losing clients to the more technical physical therapy staff. This fear quickly dissipated when the opposite outcome emerged and the trainers’ client base steadily increased.

From a physical therapist’s viewpoint, a potential challenge exists in dealing with various learning curves. Fortunately for Grace, The Sporting Club One already employed highly qualified staff members—many of whom had previous experience either working with physical therapists or studying physical therapy. “This was a great advantage,” Johnson-Cooper says of the transition. “They already knew the benefits of physical therapy and personal training and why each is important.”

Technology as a Training Tool

The critical element in this relationship is a shared desire to help clients reach their optimal training capacity. Both parties agree that the most common and overlooked source of training plateaus is poor posture. Grace explains the significance of this obstacle: “If an individual is mal-aligned and doing strength training, she is merely strengthening her mal-alignment. We have to get her back to a healthy baseline. Together with personal trainers, we can get clients where they want to be.”

Both personal trainers and physical therapists have a proclivity for trade tools. Some pieces of equipment, like the stability ball, began primarily as physical therapy tools and eventually found their way into personal training. Since both parties view postural issues as a primary training challenge, it makes sense that a new tool has surfaced to address this issue.

The Sporting Club One implemented the PostureRx system, a posture analysis and correction software system that uses a grid and plumb line and that Grace helped create. After a person’s data are entered into the programs, the software generates a series of corrective exercises, along with detailed descriptions, illustrations and formatted notes for future reference. PostureRx has proven instrumental in expanding personal trainers’ abilities. Most trainers are adept at identifying postural problems, but they don’t necessarily design the most effective corrective exercise programs. “It’s wrong to hand everyone the same exercises,” says Grace.

“If trainers can correct postural disorders,” states Johnson-Cooper, “they can take the clients back to ground level and then build them up to a much higher level. Trainers have been doing postural assessments for a long time. But we want to provide services that go above and beyond. PostureRx helps clients get healthier, feel better and work smarter. We are also able to charge extra for it, as we do with all of our advanced health assessment tools. The trainers who have used it have found it an important selling tool, as most people recognize how serious posture issues are and want help in correcting them.” Because The Sporting Club One’s members are predominantly aggressive in their approach to fitness, they are excited about the system’s potential.

Johnson-Cooper is optimistic that this type of collaboration will expand to other clubs. “At least,” qualifies the fitness manager, “to clubs striving for a higher standard.” The partnership, she adds, has been nothing but positive. “The biggest difference is the higher quality of customer service. Members are getting more. I definitely see this as a trend that will stick.”