Dr. Pat Allen is a collaborative physician. Her patients, she believes, will be her best partners in providing diagnostic information—as long as they are asked the right questions. She also believes in consulting with the best medical minds on issues that require specialization or unique clinical experience.

 Today, to explain the considerable difference in credentials between a physical therapist and a personal trainer, she calls on the expertise of Evelyn Hecht, a licensed physical therapist with a private practice in New York City.


Dear Dr. Pat:

I injured my knee playing soccer with my teenagers. I am reasonably fit, but I twisted the ankle in an unexpected turn. I was fine until the next day; then I had constant pain on the inside of my knee. It was reasonably well controlled with over-the-counter ibuprofen every six hours for a week. I never had any swelling, so I thought this would get better with time. But after I stopped the ibuprofen, the pain seemed worse than at the start of my injury.

My personal trainer, with whom I have worked out for years, suggested that I stop all weight-bearing exercise and begin to work on strengthening the muscles around my knee. He assured me that he had worked with many athletes who’d had a similar problem, and that in a month I would be back to my regular physical activity. 

The problem did not get better. I wondered if I should see a physical therapist; a friend of mine sees one for joint issues and thinks she is great. What is the difference between a physical therapist and a personal trainer?  Do I need a doctor’s referral in order to be evaluated by a physical therapist?


Dear Joan:

So glad that you are continuing to stay in shape and that you are enjoying healthy outdoor athletic activity with your adolescent children. Your questions are common ones that many people are interested in: “Who should I see first when I have a musculo-skeletal injury? What is the difference between a personal trainer who oversees an exercise program and a licensed physical therapist?”

The nature of the injury to the medial aspect of your knee should direct you first to an orthopedist or a physician who specializes in joint injuries. Either may then direct you to a reputable licensed physical therapist, who should have years of education and training in the evaluation and treatment of pain syndromes and joint injuries. While under New York law patients may see a physical therapist without a referral from a physician, I would suggest that in your case you be evaluated first by a doctor, who may order imaging tests to determine if there has been any structural damage that would have an impact on the treatment program.

I have asked licensed physical therapist Evelyn Hecht, president of EMH Physical Therapy, to discuss your questions in more detail.

               Dr. Patricia Allen


Physical Therapist, Personal Trainer—What’s the Difference?
By Evelyn Hecht, PT, ATC

Dear Joan:

Physical Therapists (PTs) are healthcare providers who have a minimum of seven years of medical education/training and have passed their State Education Department licensing exam in order to practice the profession of physical therapy.  PTs examine and treat a wide range of ailments, including neck/back pain, sports injuries, arthritis, burns, heart disease, post-op surgery of shoulders/hips/knees, sciatica, stroke, and trauma.

Personal trainers do not have physical therapists’ seven years of educational requirements, their scope of medical knowledge, and the months of “hands on” clinical internships they have served in hospitals, rehab centers, and private practices. Also, PTs receive a license from the State Education Department.  Most personal trainers receive a certificate after passing a written test given by the company/organization offering such programs. One organization offers 75 hours of study and direct-contact education (which is great, but very rare). Many certificate programs are self-study online courses with no direct-contact training. One online program offers a self-study personal training certification for $69.95. Some fitness centers require their personal trainers to attend their in-house training programs to improve their skills.


What a Physical Therapy Knows

Anatomical knowledge is the framework upon which PTs understand physiological processes, evaluate pathology and trauma, and design the best intervention strategies for optimum recovery and function. Accordingly, the student PT studies or receives—

•human anatomy and movement sciences; this includes dissecting a human cadaver to appreciate alignment and position of nerves, muscles, and bones

• basic medical sciences, biomechanics, neuroanatomy, pathology, mechanics of injury, and the theory/practice of physical therapy

• rehabilitative procedures such as manual therapies, therapeutic exercises, use of modalities, sports training, balance, and coordination

• hands-on experience through a number of eight-week clinical internships.

Objective tests and measurements for multiple diagnoses are taught and practiced. These tests are used as benchmarks to report improvement during physical therapy and to help motivate patients to continue with therapy, if needed, and perform their home exercises.

In Short—

Personal trainers help healthy clients attain improved fitness; they should refer any injured client to a PT for guidance and treatment. PTs refer their discharged patients to gyms/personal trainers once their patients are fully rehabilitated.


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