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Physical Therapy

Is Physical Therapy right for me?

Have you ever felt like things moved too slowly, that you got bored fairly quickly and/or that you just weren't challenged enough? Well, I have. I had spent a number of years doing "jobs" that neither fit my general philosophy of life nor held my real interest. It is pretty much inevitable that we are going to have to work for a living, so I finally decided to look into a "career" that seriously fulfilled my needs.

Physical therapy offers so many challenges and opportunities there isn't even the slightest chance of finding yourself complacent about what you're doing. Even if you someday feel like you have any area of this vast field of health care wired (which I guarantee could never happen), your educational background has provided you with enough knowledge to modify and transfer your skills into different areas. Physical therapists are required to take continuing educational courses that to advance the knowledge base in their current area of practice, or to help steer them toward another direction.

You need to ask yourself if you have a high level of desire to help others. There are two things that really get to me about what I do: first, to see a person return to function, or a sport or activity for which they have a passion, and second, to actually have that client/patient tell me how grateful they are. We all need and appreciate this kind of feedback. Although intangible, this "reward benefit" is what keeps me coming back for more.

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What kind of jobs can I get after college?

If you find yourself drawn toward the field of physical therapy you'll find the opportunities endless. Determine what area might interest you the most and go for it! Many therapists chose to work in pediatrics, with kids that suffer from musculoskeletal developmental impairments, or in areas that specialize in cerebral palsy, muscular dystrophy, cystic fibrosis, or coordination disorders. This is an extremely challenging and rewarding area.

Geriatric physical therapy is becoming an increasingly popular field of practice as we consider the implications of the aging population of "baby boomers." From working with the frail and institutionalized elderly to working with the healthy elderly to stay fit, or the older athlete, this age group makes up a significant percentage of the growing American population. By definition, the "older" athlete may only be in his or her forties, and is still considered to be geriatric.

Are sports your thing? Consider working in a sports-oriented orthopedic clinic. If you are one of the chosen few, you may even land a position as a physical therapist for a professional team. Orthopedic physical therapy in and of itself offers up many challenges, from evaluations where you play detective in an effort to pinpoint the problem, to devising an effective treatment plan or therapeutic exercise program to attain your goals.

Other areas that aren't heard about that much, but which I think test our skills even more include working with spinal cord injuries, traumatic head injuries, neurological rehabilitation, strokes, wound care, cardiopulmonary physical therapy, and working with cancer patients.

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What courses do I need to take?

These days, most of the physical therapy programs are offering degrees at the master's level. This requires an undergraduate degree in science, usually biology, which provides the student the prerequisites needed to apply to the program. Once accepted into the program, prepare yourself for total immersion in the world of physical therapy. I won't kid you, it is a demanding program that will require many of your waking moments. Keep your eye on the goal and your nose to the grindstone because once you graduate, the world is yours. The independence found from being a "professional" is well worth the effort. You'll be able to get employment anywhere in the world! This beats having a regular old "job" any day.

Below, I have listed some of the prerequisites for the undergraduate major and postgraduate courses required. This is not a complete list, but it will give you an idea of the direction you'll be traveling if physical therapy becomes your choice of career.

Prerequisites for the Physical Therapy Major
English
Courses in Arts and Humanities
Intro to Biology
General Chemistry
Intro to Psychology
Intro to College Physics
Anatomy for Paramedical Personnel
Mechanics of Human Physiology
Public Speaking: Fundamentals
Orientation to Physical Therapy

Postgraduate Courses
Medical Sciences
Rehabilitation Procedures
Intro to Patient Care Technique
Applied Movement Science
Theory and Techniques: Massage
Clinical Evaluation
Anatomy for Physical Therapy
Psychological Aspects of Disability
Intro to Manual Therapy
Soft Tissue Treatment/Joint Mobilization
Abnormal Psychology
Industrial Rehab/Occupational Medicine
Muscle Function in Health and Disease
Gerontology
Therapeutic Exercise: Mobility, Strength
Strategies for Early Intervention
Therapeutic Exercise: Tests, Measurements
Advanced Pediatrics Assessment
Electrotherapy and Electrodiagnosis
Advanced Applied Anatomy
Neuroscience for Physical Therapy
Clinical Kinesiology
Sports Physical Therapy
Patient Education Techniques
Cardiopulmonary Physical Therapy
Teaching Experience in Physical Therapy

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Key Words-What is a Physical Therapy major expected to know?

All fields of study come with terminology that is often exclusive to that particular field. Some words may be used in other fields but may have different meanings. Simply put, in order to have a clearer understanding of your chosen field of study, in this case physical therapy, there are some key words you should be aware of. Here are just a few of them.

Anatomy
The structure of the body, its muscles, bones, tendons, ligaments, etc. As you can imagine, this is a pretty important thing for a therapist to know if he or she is going to work with it in order to fix it.

Musculoskeletal System
The combination of the muscles and the skeleton and the way they move together and attach to each other. (You'll find that lots of words in the medical field run together like this).

Biomechanics
This is the science of how internal and external forces affect the function of the musculoskeletal system. For example, knowing how a muscle moves and/or, understanding all the parts of a normal walking pattern.

Orthopedics
This area deals with restoring health and function to the body's musculoskeletal system.

Rehabilitation
Restoring the patient's ability to function just like, or nearly like, they had before their injury.

This list could go on and on and on (kind of like that little bunny), and in time, you'll become familiar with many more terms and their use. Correct use of medical terminology helps professionals to communicate clearly, concisely and quickly.

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Core Skills: What is a Physical Therapy major expected to be good at?

Evaluation
This is very important. This is where we gather all of the pieces of the puzzle and do the necessary detective work to figure out, as best as we can, what is wrong with our patient. This information comes from the doctor's diagnosis, the patients themselves, and from the special tests we perform. Practice and experience teaches us the best questions to ask and the best tests to use in order to make as accurate an evaluation as possible.

Documentation
This means writing down, or "charting," what the patient says, what we do to them, what we think about their progress (or lack of it), and what our continued plan is going to be. In today's health care environment, it is important to be good at this, and it's also important to be brief yet thorough so we don't spend our whole day writing about our patients instead of treating them.

Treatment Plan
Once we think we know what's wrong, we need a plan so the patient can get better. This includes what kinds of "hands-on" treatments we plan to use, plus the exercises or activities we want them to practice as a home program. This is very important.

Myofascial Release
This is a form a massage. There are a number of different methods of massage that all designed for different purposes. Sometimes the therapist may need to perform "deep tissue massage" to get out a muscle spasm, and other times they may need to do "soft tissue mobilization" to make a muscle longer so the person has better movement, or range of motion.

Education
This can't be stressed enough. It doesn't matter how good of an evaluation or treatment plan you've got, or how well you can rub out a tight muscle if you can't educate your client. As therapists, we have to be able to teach the client about what is wrong with them so that they can help us help them. The more they know and understand about their condition the better. You will also teach them how to progress in their home program‹it will pay dividends.

Motivation
In my opinion, our ability to motivate is a must. Motivation "empowers" the client to take responsibility for his or her own recovery. There are 168 hours in a week; as therapists, we will only see our clients for a maximum of three of those. What they do with the rest of that time is obviously very important to their rehab.

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The Voice of Experience

Learn from seniors who have been down the road ahead of you. Here is one senior's candid reflection on life as a Physical Therapy major:

I. Why did you choose your major?: There were a number of reasons for choosing physical therapy. It helps me to feel good about myself by helping others in need. It offers diversity and many challenges. I like the amount of time I am allowed to spend with patients (this isn't always the case with some of the other health care professions). It is a profession that gives me the independence I need, in terms of where in the country (or the world) I choose to work. And last, but not least, it provides for a comfortable living.

2. How did this major meet your expectations?: All of the effort and hard work that went into getting my degree pays for itself every time a client leaves the office telling me what a difference I have made in his or her life. It goes deeper than just returning them to function. Hopefully, I have inspired a slight change in their lifestyle to help them take better care of themselves so that they may have a better quality of life in their later years. I also find myself challenged on a daily basis, always thinking about the problem at hand and of ways to modify the treatment plan for better results.

3. What disappointed you about this major?: I won't kid you‹sometimes people just don't want to get better. I'm the first to admit that I have a hard time understanding this. Some folks use injury as an excuse for not working, or to gain sympathy, or for a multitude of other reasons. As odd as it seems to me, it's a reality I keep trying to come to terms with.

4. What has challenged you the most about this major?: No two people are the same‹even if they have the same diagnosis. The challenge starts as soon as I begin to deal with differences in personalities, pain tolerances, degrees of injury, outlooks (is the glass half empty or half full?), levels of activity, lifestyles, etc. For some reason I always remember a saying: a student is only as good as his or her teacher. Therefore, I accept the challenge and assume the responsibility to make sure the client receives the best care I can give.

5. How has this major prepared you to get a job that you'll love?: Take a look back at the coursework required to get a degree in physical therapy and you'll notice that few stones are left unturned. We learn how to treat all age groups and different diagnoses. We cover psychology, education, and we learn how to tape, wrap, and make casts. We learn how to preserve the dignity of our clients while we are working on them, and how to treat them with respect. We were further put to the test and received first-hand experience at several one-week and three six-week clinical affiliations. The program tests your knowledge and skills with a mock board examination in preparation for the real thing. Trust me, they cover all the bases.

6. What do you know now, as a senior, that you wish someone had told you about this major three years ago? What advice would you give a student just entering this major?: I happen to believe it doesn't matter what someone tells us, or what advice he or she might give‹most of us are "hard of hearing" when it comes to advice. When I was told I'd be in class eight to ten to twelve hours a day (and then there was the homework thing), I suppose I heard it, but I couldn't actually feel it. It was a demanding undertaking! I missed out on two ski trips and two vacations with my family, plus I sacrificed almost every weekend of fun because of the demands of the program.
Even though this advice may fall on "deaf ears," I would offer the following: 1) no matter what grade you are in now, learn and understand your stuff‹it will help to ease the stress of an already stressful program; 2) volunteer or get a part-time job as an aide in a physical therapy clinic‹this will provide invaluable experience plus it will help you decide if this is a career that will be fulfilling to your personal needs and goals; 3) try volunteering in as many different clinical settings as you can (aquatics, hospitals, private-practice clinics, in pediatrics, a nursing home), just anywhere that there are physical therapists; 4) be prepared to put aside a large part of your current social life‹you will have a new group of friends, your classmates, with whom you can commiserate, and; 5) always keep the goal in sight. If you decide that physical therapy is the field for you, be confident and work hard to make it your reality‹it's worth it.

Get Connected!

To seek support for your college experiences, and to get a head start on your career, use these links to get connected by learning more about organizations in your discipline. By joining and participating in the professional conversation around the country, you can learn beyond the boundaries of your program. Many of these organizations offer scholarships and awards that can also help you to grow and succeed in your field of study!

Student organizations

Physical therapy clubs are commonly seen at universities that offer physical therapy programs. This allows for pre-physical therapy majors to gather to discuss topics related to their intended field including coursework, career opportunities, volunteer experiences, etc. The club I belonged to often invited one or more of the physical therapy students or one of the faculty members to speak about current issues and the direction physical therapy was taking. It's a nice first step as you enter into the world of physical therapy.

Professional organizations

American Physical Therapy Association
APTA is a national organization established to advance the practice of physical therapy, as well as promote research and education in the field. It also interacts with the government and legislative bodies to make sure that physical therapists are recognized as a valuable part of the patients' rehabilitation. It represents over 75,000 members!
Each state has it's own chapter of the APTA that addresses specifics from legislative issues at the state level to career resources and job openings to updates regarding special interest groups, etc. They provide links to the state legislature, member benefits, and product information.

The Federation of State Boards of Physical Therapy
The Federation was established to "protect the public by providing service and leadership that promote safe and competent physical therapy practice." They are also responsible for the development and administration of the National Physical Therapy Examinations.

Global Organizations
Many countries throughout the world have established organizations that are similar in goal and mission to the APTA. These organizations are most easily accessed through the Internet via

www.rehabworld.com/rwlib.htm
Physical Therapy Library by PT World

Get Informed!

The world of medicine, and more specifically, the world of physical therapy, has a plethora of resources in this information age. From peer-reviewed literature to practical hints and "pearls" from those that have gone before us, there is a wide array of materials to further our practice and to enhance our skills and our knowledge. Below, I have listed some of the more prominent and widely subscribed to journals and magazines available. These, in addition to the web sites provided above, will definitely provide an incoming stream of information we just might have a difficult time in keeping up with.

Magazines and Trade Journals

www.apta.org
PT Journal and Magazine of Physical Therapy

www.physsportsmed.com
The Physician & Sports Medicine

www.biomech.com
Biomechanics

www.archives-pmr.org
Archives of Physical Medicine and Rehabilitation

www.humankinetics.com
Journal of Sport Rehabilitation

Research journals and Academic Publications

New Zealand Journal of Physiotherapy
JAMA
Orthopedics Today
The New England Journal of Medicine
Journal of Back & Musculoskeletal Rehabilitation
Journal of Orthopedic Surgery and Related Subjects

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Physical Therapy in Depth!

This is the place to deepen your knowledge of the field. Whether you are a graduating senior, or still deciding if you want to major in Physical Therapy, you'll find here a more detailed overview of the field.

What Is Physical Therapy?

Physical therapy is a dynamic, caring profession. It is primarily concerned with helping to resolve musculoskeletal problems and returning the client to better health. It combines passive modalities (e.g., heat/cold therapy, ultrasound, electrical stimulation, massage, and joint mobilizations) with therapeutic exercise to rehabilitate the body. Therapeutic exercise includes stretching, strengthening, and improving muscle balance as well as postural re-education.

Physical therapy is utilized to help get the patient back to their active lives as quickly as possible. Therapy is aimed at reducing pain, increasing flexibility and range of motion, building strength, and improving function.

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History and Background

It never fails, start talking history and the ancient Greeks and Romans had it or did it first. This is also the case with physical therapy. Early Greek and Roman writings refer to the use of the same physical agents we use today, such as hot packs and ice. Even the ancient Chinese, Persians and Egyptians talk about the beneficial effects of sun and water as well as exercise and massage.

In the latter part of the nineteenth century and the early part of the twentieth century, American orthopedic surgeons began to train young women graduates of physical-education schools to care for patients in doctors' offices and in hospitals. But the most notable beginnings of physical therapy occurred in 1916 when a severe epidemic of poliomyelitis struck New York and New England. In those days they were known as "reconstruction aides" and they treated thousands of patients.

The first formal physical therapy school was established at Walter Reed Army Hospital in Washington, D.C., after the outbreak of World War I. Fourteen more schools were soon established and approximately 800 graduates were utilized in military service.

After World War II physical therapy became increasingly utilized for patient care. This can be directly related to the impressive results obtained in treating the many men and women injured in battle and industry during WWII and the Korean and Vietnam Wars. Equally impressive results were obtained treating our aging population.

Physical Therapy Today
Since it's inception, there had been a shortage of qualified physical therapists. Physical therapists had a wide choice of jobs and were able to demand their setting and salary. That is, until approximately 1998 when the supply and demand for physical therapists pretty much balanced out. Naturally, supply and demand depends on location. For example, some communities have physical therapy programs as well as physical therapy assistant programs within close proximity to each other. In this instance, the supply would outweigh the demand and subsequently, there would be fewer jobs available. It might be a good idea to assess the need for physical therapist services in your own community while considering the possibility of relocation.

A demand continues to exist for the "qualified" therapist in many communities across the nation and abroad. Sources report that the need for physical therapists is expected to grow faster than average for all occupations through 2008. Furthermore, the demand should continue to rise due to the growing number of individuals with disabilities or limited function, the increasing elderly population, and the baby-boom generation, which is entering the prime age for heart attacks and strokes. Younger people are also beginning to need physical therapy as technological advances save the lives of a larger portion of newborns with severe birth defects. Medical developments will likely allow for more trauma victims to survive, again indicating a growing need for rehab specialists. We are also noticing that more and more employers are using physical therapists to evaluate work sites, develop exercise programs, and teach safe work habits to employees in the hope of reducing injuries and their costs. In addition, our nations' widespread interest in promoting health should also increase the demand for physical therapy services.

Advice from a Physical Therapy Professor

What can a student expect during the course of study?
The master of physical therapy degree is an entry-level professional degree program. Most programs are two-and-one-half to three years in length, full-time. All programs incorporate both classroom and clinical education components. Students study the basic biological sciences of advanced human anatomy, physiology, and exercise physiology. They study the clinical or medical sciences of pathology, pharmacology, radiology, psychology; and they study the professional science and art of physical therapy‹the evaluation and management of patients/clients with musculoskeletal, neurologic, cardiopulmonary, and multiple-system involvement. Students will learn how to work with clients across the continuum of care, acute/inpatient/outpatient/home health, wellness environments, and will work with all age group clients. Students will also discuss professional issues associated with health care delivery, administration, service to disadvantaged populations, and the integration of physical therapy into the entire health care and service delivery system within this country and worldwide. Most programs offer and require some sort of clinical research component. Finally, students will participate in at least twenty-four to thirty weeks of full-time clinical internships in a variety of physical therapy settings including acute care, outpatient, and rehabilitation settings. Many will also have clinical education opportunities in home health, pediatrics, geriatrics, wellness centers and other environments.

Students prepare for this graduate program of study by taking a substantial number of science prerequisites at the undergraduate level, including chemistry, physics, anatomy, physiology, microbiology, abnormal psychology, and statistics. Most programs require that students enter with a bachelor's degree though many permit that degree to be in any major as long as prerequisite courses and volunteer experiences are all fulfilled. Letters of recommendation are also often required of the applicant.

What are the characteristics of a successful student?
The successful physical therapy student loves to study science, particularly the biological and medical sciences, and are successful students in these areas. They enthusiastically commit to a full-time education process for two-and-one-half to three years that incorporates thirty to forty hours per week in class and substantial outside reading, research, and study time. They respect people of all backgrounds, and are genuinely interested in the values and opportunities important to their clients. They are enthusiastic teachers, and revel in the opportunity to work in groups and collaborate to problem solve. They are interested in the role that clinical research plays in the advancement of the physical therapy profession. They communicate effectively verbally, and in writing. They are responsible for themselves and to their patients and colleagues. They are committed to health and wellness in their own lives, and promote these values among their peer groups, colleagues, and clients. They are supportive of their fellow students.

What are some of the challenges facing this field?
One of the greatest challenges of the field today is the preparation to deliver physical therapy services to all in need within the financial and time constraints imposed by the current health care regulatory and delivery systems. Third parties have exerted extreme influence, often not in the best interest of the patient but in the best interest of the bottom line, and have restricted the opportunity for delivery of effective physical therapy services to clients.

The second challenge is to meet the expanding health care and wellness needs of the population across all age and socioeconomic realms as we begin the twenty-first century. Physical therapists will become an entry point into the health care system for clients, and will need to be professionally prepared to take on the responsibility of an entry-point professional. The move to the clinical doctorate (DPT) degree over the next fifteen years is one way that the profession is preparing to meet the advanced responsibilities of the physical therapist.

What makes this field exciting to you personally, and why do you love what you do?
The challenges of the field are ever-changing. The unique and diverse people that we serve are an endless source of challenge and satisfaction. The rewards of restoring an individual to health, or to maximal, albeit, different levels of function are the best. The ability to offer solace and comfort to the elderly, the debilitated, and the terminally ill is restorative to me. The challenge to educate the population on wellness and responsibility for one's own health is energizing.

Any student interested in physical therapy should visit the American Physical Therapy Association's web site at www.apta.org. Also, students interested in the master of physical therapy program at Eastern WashingtonUniversity can visit our web site directly at http://www.ewu.edu/pt/ or may contact me at meryl.gersh@mail.ewu.edu.

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Links and Resources

Physical Therapy Scholarships

www.ambucs.com
Ambucs offers scholarships to students in their junior or senior year in a bachelor's degree program, or a graduate program leading to a master's or a doctoral degree. Approximately $225,000 is awarded annually.

Mary McMillan Scholarships are offered in the amount of $5,000 each are available from the APTA foundation for doctoral students in their first or second semesters.

March of Dimes along with Kmart Corporation are investing a $25,000 scholarship for one high-school student looking for a career in health care.

www.fastweb.com
www.scholaraid.studentadvantage.com
www.collegeboard.com
www.collegenet.com
www.srnexpress.com

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