Introducing myself...and asking for career input

[DavidY]

Hello, all!

My name is, obviously, David, I have been a lurker for some time, enjoying the stimulating conversations on this forum. I can't say I've digested it all yet, but I am interested in learning more. I am a injury prevention/post rehab focused personal trainer and currently a health coach (sort of a preventative health/injury prevention guy for a large company), working on the next step in my career.

Sometimes I have difficulty in letting go of my 'mesodermalist' perspective, which was inculcated for years within two degrees in exercise science/rehabilitation sciences, but this site has been a huge corrective.

I hope to contribute more over the coming months, as I am trying to transition into a more pain-focused field.

I figure that I would combine my introduction with bouncing my current career dilemma off of whomever is interested in giving their two cents. :teeth:

My goal was originally to be a physical therapist, but the combination of financial concerns, job changes, and having to work full time through undergrad and my master's while not making a lot of money, has left me with a rather mediocre undergraduate GPA and some debt. Since most PT programs I have encountered seem care mostly for how well one could study for Chemistry and Physics, cumulative undergrad GPA and not much else (that's fine, this is their criteria), I am struggling with how to do what I love, which is helping a person resolve pain and poor function.

My goal is really to help people generally, and particularly those who have some pain (via manual methods and exercise) and I am also in love with the science of the body and how it works, so whichever option unites these causes is an interest.
A specific goal would be to have my own business/practice around rehabilitation, diet, and health.
I love the assessment process, and (trying to) figure things out for each person, or helping them figure it out.

So, long story long (I apologize for that), I find myself with post 9-11 GI bill money to use on SOME educational program, and there are two options with which I am currently presented :


1) An MSAT (athletic training) program, which would allow me to learn how to do a proper orthopedic assessment and some systems review, more on therapeutic exercise and modalities, and allow me at least a foot into the clinic...so basically content that I love...but would require that I probably not make much money for two years, could not pay down much debt, and would require some fancy footwork in paying for it (though most of it would be paid without more debt).

OR

2) I could just continue working FT while obtaining a massage therapy license, and just use the money on a nutrition degree or something that I could do (mostly) online. This would give me broader capacities in nutrition, some manual techniques, but without the more medically based training in assessment and exercise rehabilitation.

So, I guess my questions would be: If you were me, what would you do?

Is there a way to combine proper assessment education, manual therapy, exercise rehab, some dietary/health interventions, into either career field (AT or MT)?

Can some of it be done with continuing education, or does one's degree trump all?

Okay, sorry for the length and the autobiography, but I figured I'd get straight shooting from this group. :teeth: I honestly am at a point where one day I want to be an AT, another it's an MT/nutritionist/personal trainer, it's driving me nuts. I need some objective input to help break my cycle of thought.

Thanks for anyone who is willing to chip in, and nice to meet everyone!

[DavidY]

Hello, all!

My name is, obviously, David, I have been a lurker for some time, enjoying the stimulating conversations on this forum. I can't say I've digested it all yet, but I am interested in learning more. I am a injury prevention/post rehab focused personal trainer and currently a health coach (sort of a preventative health/injury prevention guy for a large company), working on the next step in my career.

Sometimes I have difficulty in letting go of my 'mesodermalist' perspective, which was inculcated for years within two degrees in exercise science/rehabilitation sciences, but this site has been a huge corrective.

I hope to contribute more over the coming months, as I am trying to transition into a more pain-focused field.

I figure that I would combine my introduction with bouncing my current career dilemma off of whomever is interested in giving their two cents. :teeth:

My goal was originally to be a physical therapist, but the combination of financial concerns, job changes, and having to work full time through undergrad and my master's while not making a lot of money, has left me with a rather mediocre undergraduate GPA and some debt. Since most PT programs I have encountered seem care mostly for how well one could study for Chemistry and Physics, cumulative undergrad GPA and not much else (that's fine, this is their criteria), I am struggling with how to do what I love, which is helping a person resolve pain and poor function.

My goal is really to help people generally, and particularly those who have some pain (via manual methods and exercise) and I am also in love with the science of the body and how it works, so whichever option unites these causes is an interest.
A specific goal would be to have my own business/practice around rehabilitation, diet, and health.
I love the assessment process, and (trying to) figure things out for each person, or helping them figure it out.

So, long story long (I apologize for that), I find myself with post 9-11 GI bill money to use on SOME educational program, and there are two options with which I am currently presented :


1) An MSAT (athletic training) program, which would allow me to learn how to do a proper orthopedic assessment and some systems review, more on therapeutic exercise and modalities, and allow me at least a foot into the clinic...so basically content that I love...but would require that I probably not make much money for two years, could not pay down much debt, and would require some fancy footwork in paying for it (though most of it would be paid without more debt).

OR

2) I could just continue working FT while obtaining a massage therapy license, and just use the money on a nutrition degree or something that I could do (mostly) online. This would give me broader capacities in nutrition, some manual techniques, but without the more medically based training in assessment and exercise rehabilitation.

So, I guess my questions would be: If you were me, what would you do?

Is there a way to combine proper assessment education, manual therapy, exercise rehab, some dietary/health interventions, into either career field (AT or MT)?

Can some of it be done with continuing education, or does one's degree trump all?

Okay, sorry for the length and the autobiography, but I figured I'd get straight shooting from this group. :teeth: I honestly am at a point where one day I want to be an AT, another it's an MT/nutritionist/personal trainer, it's driving me nuts. I need some objective input to help break my cycle of thought.

Thanks for anyone who is willing to chip in, and nice to meet everyone!

Now that I have had a chance to think, I am regretting all of this detail.

I guess, could someone provide for me the pros and cons of MT vs. AT, as you see it, as regards working with those in pain /preventing pain/ career prospects?

Thanks

[Keith]

Welcome aboard, David.

I have PMd someone to chime in here who may offer some input.

Respectfully,
Keith

[Johnny_Nada]

In my state an AT is a tech in the clinic, provides on field coverage for football team's practices and games. They commonly have another part time job to make ends meet. A few operate at universities. This would be best case scenario.

[DavidY]

Welcome aboard, David.

I have PMd someone to chime in here who may offer some input.

Respectfully,
Keith

Thanks!

[DavidY]

In my state an AT is a tech in the clinic, provides on field coverage for football team's practices and games. They commonly have another part time job to make ends meet. A few operate at universities. This would be best case scenario.

Thanks, Johnny. Understood, not the best paying field. In VA they have a little more freedom, in industrial environments, the military, etc.

But you're right, the average reimbursement is not great in the clinical capacity.

[Johnny_Nada]

From a massage therapy standpoint they operate no different than a hairdresser. Some rent space within a massage therapy clinic from the owner and others open up their own shop.

[Matthew Danziger]

Welcome aboard, David.

I have PMd someone to chime in here who may offer some input.

Respectfully,
Keith

Hi David, I'm the someone Keith asked to chime in. As perspective I'm a LMT/CPT combo, though I've let my trainer certification lapse for what that's worth. Time to write my certifying body a letter.

I don't have an answer for you, but I think you may be best served figuring out what it is you really want to do first. From there, what kind of education best suits that goal? I think you're aware of what different education contains to some degree, but perhaps should consider what that educations gets you. ATCs often work in rehab clinics, while LMTs are rare exceptions. If you'd be happy to work for yourself, it may not make as much of a difference, though the scope of practice would almost certainly be different. Can a MT where you're located legally (or ethically) offer exercise advice? What about discussing nutrition? If not, perhaps that throws a wrench in your plans.

Something I'd also like to stress is that formal training in a medical setting cannot be replaced with continuing education, and (for the most part) this is not available through massage therapy education. That doesn't mean medical education is going to be 100% evidence-based. We certainly see that's not the case across PT, ATC, MD, etc. However, fields like massage therapy, chiropractic, osteopathy, etc very rarely have clinical hours working with the truly ill or infirmed.

All of this might seem like I'm coming down hard on massage therapy, but if I thought it was useless I wouldn't keep doing it. I get to offer compassionate informed touch to people in need. I frequently use this to start a conversation on how their experience is multi-factorial and there is much more to be considered. By earning their trust, I can even sometimes get people to trust that their body is stronger than they once thought. As a result, some have (without any verbal input from me) canceled appointments for imaging and reconsidered surgery.

I'm of the very firm opinion we need people like those we find here on SomaSimple at every level and in every profession to truly change the health care landscape, so wherever you end up, it will be a good choice.

[DavidY]

Hi David, I'm the someone Keith asked to chime in. As perspective I'm a LMT/CPT combo, though I've let my trainer certification lapse for what that's worth. Time to write my certifying body a letter.

I don't have an answer for you, but I think you may be best served figuring out what it is you really want to do first. From there, what kind of education best suits that goal? I think you're aware of what different education contains to some degree, but perhaps should consider what that educations gets you. ATCs often work in rehab clinics, while LMTs are rare exceptions. If you'd be happy to work for yourself, it may not make as much of a difference, though the scope of practice would almost certainly be different. Can a MT where you're located legally (or ethically) offer exercise advice? What about discussing nutrition? If not, perhaps that throws a wrench in your plans.

Something I'd also like to stress is that formal training in a medical setting cannot be replaced with continuing education, and (for the most part) this is not available through massage therapy education. That doesn't mean medical education is going to be 100% evidence-based. We certainly see that's not the case across PT, ATC, MD, etc. However, fields like massage therapy, chiropractic, osteopathy, etc very rarely have clinical hours working with the truly ill or infirmed.

All of this might seem like I'm coming down hard on massage therapy, but if I thought it was useless I wouldn't keep doing it. I get to offer compassionate informed touch to people in need. I frequently use this to start a conversation on how their experience is multi-factorial and there is much more to be considered. By earning their trust, I can even sometimes get people to trust that their body is stronger than they once thought. As a result, some have (without any verbal input from me) canceled appointments for imaging and reconsidered surgery.

I'm of the very firm opinion we need people like those we find here on SomaSimple at every level and in every profession to truly change the health care landscape, so wherever you end up, it will be a good choice.

Matthew,

Great insights, and thank you for your time on that.

To answer your question, in Virginia almost anyone can offer nutrition advice, thought medical nutrition therapy, and the titles 'nutritionist' or 'dietitian' are restricted to the credentialed. I have been a personal trainer for years, so I could do the exercise portion.

I guess I am wondering where the line is - I know people see MT's for minor aches/pains, so are you, personally, able to offer a kind of massage+exercise service?

I hear you on the continuing ed point - they now they have things like 'orthopedic massage,' and 'orthopedic manual therapy' courses (taught by MT's and chiros, usually, so there's that). :embarasse

http://www.learnmuscles.com/COMT_skillset.html
http://www.omeri.com/education/certification/

So it makes it a little tougher to compare options when piecing together a prospective career/business in rehab or post-rehab, at least at first glance.

The only point I might contend (partly with myself because I mostly agree with you) is the value of continuing education. I wonder if less-than-perfect continuing ed beats the often rushed, cram-it-into-your-head-ASAP models of most universities...particularly when what one learned in a university is probably partly obsolete after 5 years or so, in the sciences.

And you're right that it's tough to beat working with real patients in pain.

Anyway, I am verbalizing my own internal struggle. Your points are taken and I thank you for your perspective, which is a great one to have given your current role .

Hope you have a great day!

[Barrett Dorko]

David,

You could just ignore the complaints, or tell your client that it's expected, the pain is "weakness leaving the body," or something, well, just about anything else. The public doesn't know any better, and the context you create (including your smile) is more important than anything you "do.".

I wonder how many are "deadmen" before they even get here?

Matthew's is the best advice.

[DavidY]

David,

You could just ignore the complaints, or tell your client that it's expected, the pain is "weakness leaving the body," or something, well, just about anything else. The public doesn't know any better, and the context you create (including your smile) is more important than anything you "do.".

I wonder how many are "deadmen" before they even get here?

Matthew's is the best advice.

A bit sarcastic, which I appreciate. Understandable given what you all deal with regularly in putting up with we who are working at 'crossing the chasm.'

Just know that I do respect the voices on this forum, which is why I brought my concerns here.

Thanks for the advice about the advice.

P.S. Is 'simple touch' a course available to MT's and/or ATC's? Or just PT's?

[Barrett Dorko]

All these are welcome. Nothing is scheduled currently.

It's not "simple touch" by the way.

[DavidY]

All these are welcome. Nothing is scheduled currently.

It's not "simple touch" by the way.

Oh, for Pete's sake. Sorry about that. This is why coffee was invented.

I'll keep my eyes open, regardless of whichever field I choose. Take care.

[Matthew Danziger]

To answer your question, in Virginia almost anyone can offer nutrition advice, thought medical nutrition therapy, and the titles 'nutritionist' or 'dietitian' are restricted to the credentialed. I have been a personal trainer for years, so I could do the exercise portion.

I'm in New York and the same is generally true of nutrition advice, however even so nutritional advice is not covered under my scope of practice as a LMT. I would have to double check to see if it's explicitly forbidden, but in either case I would be acting outside of my SOP to discuss such matters while practicing massage therapy or if someone has sought me out for those purposes.

I guess I am wondering where the line is - I know people see MT's for minor aches/pains, so are you, personally, able to offer a kind of massage+exercise service?

I tend to give very general exercise advice unless I've found something particularly helpful for someone within our time together that I think they can replicate with a little know how. Sometimes I will offer instruction on something simple like a stretch, a Feldenkrais/Somatics movement, or what Cory Blickenstaff has called Edgework. I do not demonstrate any movements with additional load or undertake any resistance training.

I would likely be covered under my SOP to offer some degree of home exercise advice, however the prescription of specific exercise is not covered, nor (in my opinion) should it be. If I wanted to do that, I would have to end the massage therapy session and then start over wearing a different professional hat. At that point I can offer personal training, but if the person in front of me is there for pain relief, I would then be blurring a different line.

I hear you on the continuing ed point - they now they have things like 'orthopedic massage,' and 'orthopedic manual therapy' courses (taught by MT's and chiros, usually, so there's that). :embarasse

http://www.learnmuscles.com/COMT_skillset.html
http://www.omeri.com/education/certification/

So it makes it a little tougher to compare options when piecing together a prospective career/business in rehab or post-rehab, at least at first glance.

The only point I might contend (partly with myself because I mostly agree with you) is the value of continuing education. I wonder if less-than-perfect continuing ed beats the often rushed, cram-it-into-your-head-ASAP models of most universities...particularly when what one learned in a university is probably partly obsolete after 5 years or so, in the sciences.

And you're right that it's tough to beat working with real patients in pain.

OMERI (which you've linked above) is run by Whitney Lowe, and I have nothing but nice things to say about my interactions with him. He's demonstrated a willingness to change that is uncommon and admirable. Despite my fond feelings toward the person, I still find a great deal of his content to be very outdated or incomplete. I can't tell you how this compares to a university based program, but I will tell you that university level core sciences can make a big impact on how people think about different subjects.

Anyway, I am verbalizing my own internal struggle. Your points are taken and I thank you for your perspective, which is a great one to have given your current role .

Hope you have a great day!

I struggle with my own future a good deal too. Everyone seems convinced I have to go on to do other things and maybe they're right or maybe not. For now I'm very happy to try to help those who are willing to take it.

[Gregory]

Hi David,

What is the scope of massage therapy in your region? Here in New York, massage therapy includes a large range of touch modalities, most of which are arguably not "massage." I am currently attending massage school. I practice a form of "touch therapy" that is not really massage, but is technically shoved under the umbrella of massage therapy. Here is NY's definition of massage therapy:
http://www.op.nysed.gov/prof/mt/article155.htm#def
§ 7801. Definition of practice of massage therapy.
The practice of the profession of massage therapy is defined as engaging in applying a scientific system of activity to the muscular structure of the human body by means of stroking, kneading, tapping and vibrating with the hands or vibrators for the purpose of improving muscle tone and circulation.

And here are further guidelines on scope of practice. Notice how it ranges from physical to mental, from skin to deeper structures, from scientific to vitalistic (pseudo-scientific and anti-scientific), and from massage to other touch modalities:
http://www.op.nysed.gov/prof/mt/
Massage therapists are licensed health professionals who apply a variety of scientifically developed massage techniques to the soft tissue of the body to improve muscle tone and circulation.
Massage therapists work to enhance well-being, reduce the physical and mental effects of stress and tension, prevent disease, and restore health.
Massage therapists use many different massage techniques and methods. These include the following, among others:
Swedish medical massage
Shiatsu
Connective Tissue Massage
Amma
Neuromuscular Massage
Tuina
Reflexology
Acupressure
Polarity Therapy

As you can see, contradictions and hypocrisy are written into the law. While it forces you to get a massage therapy license to touch clients, it also gives you the freedom to practice many different forms of touch therapy that might have very little in common with massage. My school even teaches "forming a ki ball in and around the client," which sounds to me like they are including non-touch in massage therapy, by attempting to affect peripersonal space and beyond.

Massage school has been a dreadful deluge of misinformation and militant defense of ignorance. I need to spend just as much time researching plausible information on my own outside class as I do studying class content. In other words, I have to study double to do damage control. That might not be much different in other manual therapy professions, but the massage therapy teachers I've encountered seem to be especially steeped in doubtful information. With adequate drive to self-educate, however, there is no need to follow in their unfortunate footsteps. I think there is much that can be salvaged from a massage therapy license, which is why I chose it.

I mainly use very light skin contact to catalyze ideomotion (non-conscious non-volitional movement). I also use passive skin contact such as skin stretch. Occasionally I'll go as far as to use oscillations. I don't prescribe "exercises." I just touch the client to help them stop restricting their own reflexive movement. For home care, I tell clients something like: unassisted ideomotion has been helpful for me. Aside from assessing red/yellow/green flag pathologies, I think the most important checkpoint is asking clients if their complaints respond to movement/change of position. If yes, they might be helped by touch that targets abnormal neurodynamics, and that is what I provide.

Good luck and please let us know what you decide.