Instructor Sarah Hughes, PT, DPT, OCS, CF - L2 sat down with The Pelvic Rehab Report to answer a couple of questions about treating the Crossfit and weightlifting community. Dr. Hughes earned a BS in exercise science from Gonzaga University and a DPT from the University of Washington.
Sarah's specialties include dance medicine, the CrossFit and weightlifting athlete, and conditions of the hip and pelvis such as femoroacetabular impingement and labral tears. She began coaching other PTs who wanted to start their own practices in 2017 and co-founded Full Draw Consulting with her partner Dr. Kate Blankshain.
What are three things you wish you knew when you first started treating the athletic community?
First, I wish that I had had the confidence to treat these athletes the way I saw fit earlier in my career. For a long time, I felt weird treating CrossFit athletes in the clinics I worked in because I felt that my peers were judging me. My colleagues (and many PTs at the time) were wary about the sport and believed it was dangerous for patients. This is a viewpoint I am working to change in our profession.
Secondly, I wish I knew more about how to scale movements in a way that is relevant to the patients and the stimulus they are striving for. For example, if a patient wants to be able to do kipping pull-ups in a workout, giving them banded strict pull-ups as a substitute is not the only option. What about the metabolic conditioning part of the equation? What about looking at the volume and how that is impacting the tissue of concern? This is a big topic that we discuss in my course.
And finally, I wish I knew that being an effective therapist for these athletes does not mean being the top athlete in the gym. In fact, just as with coaching, you do not have to be a great athlete to be a great PT. Again, this is something that I want to change as far too few physical therapists are comfortable treating these or advertising that they treat these athletes because they are not Crossfit athletes (or are not ELITE Crossfit athletes) themselves.
What lesson have you learned in a course, from an instructor, or from a colleague or mentor that has stayed with you?
One important lesson that has stayed with me came from a colleague in Seattle who started her business a year before I started mine. She told me that I needed to listen to my gut when it came to treating these athletes. She reminded me that my experience with CrossFit as a sport, as an athlete, as a coach, and as a PT put me in a position to be an expert on how to help these folks. What I did not need was to allow other physical therapists to sway my thinking and cause me to doubt myself by insisting that we should not be condoning the sport. TRUST YOUR GUT. If you think you are doing what is right for the patients, you are. You might not be right for every patient and that is OK! I am certainly not the right therapist for everyone, but I am indeed right for the community I serve.
When it comes to Crossfit and Weightlifting, opinions are divided among Physical Therapists and other clinicians. In this half-day, remote continuing education course, instructor Sarah Haran PT, DPT, OCS, CF-L2 looks at the realities and myths related to Crossfit and high-level weight-lifting with the goal of answering “how can we meet these athletes where they are in order to keep them healthy, happy and performing in the sport they love?"
This course reviews the history and style of Crossfit exercise and Weightlifting, as well as examines the role that therapists must play for these athletes. Labs will introduce and practice the movements of Crossfit and Weightlifting, discussing the points of performance for each movement. Practitioners will learn how to speak the language of the athlete and will experience what the movement feels like so that they may help their client to break it down into its components for a sport-specific rehab progression.
The goal of this course is to provide a realistic breakdown of what these athletes are doing on a daily basis and to help remove the stigma that this type of exercise is bad for our patients. It will be important to examine the holes in training for these athletes as well as where we are lacking as therapists in our ability to help these individuals. We will also discuss mindset and cultural issues such as the use of exercise gear (i.e. straps or a weightlifting belt), body image, and the concept of "lifestyle fitness". Finally, we will discuss marketing our practices to these patients.