How to Integrate Nutrition in PT Practice

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, CNPT, NSCA-CPT, Cert-DN

Many physical therapists (PTs) seeking continuing education courses for manual therapy, specialized modalities, and new exercises, feel comfortable with the content before enrolling in the course. Afterall, most PTs had exposure to some, if not all, of these concepts in PT school and in practice. But what about nutrition training?

Like medical doctors the majority of DPTs today and nearly all of the graduate PTs with MS and BS degrees received little to no education in nutrition. Understandably this lack of knowledge leaves a riff in clinical practice and a desire to learn more to help a patient.

So, let’s dive into some ways for physical therapists to integrate PT into their practice. 

#1 Get The Basics

Understanding the basic components of nutrition is a must. Many clinicians think they must enroll in advanced online courses for supplementation, specialized dieti...

By: Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, CNPT, NSCA-CPT, Cert-DN

I know, I said it. And you are wondering why in the heck a physical therapist, personal trainer, and strength coach would ever say such a thing?!

A few years ago a group of researchers published a wonderful editorial piece in the British Journal of Sports Medicine. Titled It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet, the article stirred the pot and highlighted important data on weight loss.

The literature highlighted how many sports medicine, physio, and personal training professional are biased to exercise as the main mode for weight loss. Furthermore, the authors came out and boldly stated that physical activity does not promote weight loss. That's right, physical activity does not promote weight loss.

If these researchers are right, then why is the American Physical Therapy Association (APTA) hanging their professional "hat" on PTs promoting physical activity...

Unless you have been living under a rock the last 5 years, the gluten free movement has produced massive shifts in product lines, menus, and people. Gluten, a protein, found in wheat has been around for thousands of years. How did it go from an essential food, in some areas of the world, to a eschewed substance of inflammation and disease?

Let us start first with facts: gluten allergies occur in less than 1% of the population. Those allergic can have skin rashes, intense gut pain, diarrhea, weight loss, and malnutrition. A researcher studying children in Belgium after World War II saw these findings in young kids after their country went from near famine to feasting on pounds of bread. Shortly after, the substance gluten was isolated and taken out of their diets to improve the kids' symptoms: it worked and so started the investigations that lead to celiac disease.

Celiacs disease is an inflammatory bowel disease due to gluten. The gold standard diagnostic test is a gut biopsy. Celiac...

Insurance physical therapy at your hospital or local clinic is steeped in tradition: find the one problem, focus on it, and fix it. The services are reimbursed based on a fee-for-service model. The more care the more payment that is given, regardless of outcomes or future setbacks. Physical therapist (PT) education skews also towards the model of problem-based learning, exam, and intervention. Lost in the mix of the insurance and educational maelstrom is the patient: what other issues are lurking, how do they address the "whole" patient and not just the one body part or pain, and how can they continue living healthy and happy?

Fortunately a new model of PT practice emerged. The Health-Focused Therapy Model (HFPTM) promotes PTs to recommend notions like smoking cessation, regular physical activity, and even nutrition, when/where appropriate. Researchers at the University of Alabama at Birmingham produced the new model which hopes to only enhance what PTs currently offer.

Learn about o...

Which is better and what is turmeric and curcumin?

Turmeric is root much like ginger. I can be ground up and used as delicious spice. It is often used in Indian dishes and has been linked to a reduction in inflammation, diseases, and possibly improved longevity. What's the potential activity compound in turmeric? Curcumin.

Curcumin is refined and processed from tumeric. One gram of turmeric may only contain 0.02 grams of tumeric! That's not much. Some studies highlight the benefits of using supplemented tumeric, such as improvement in arthritis, inflammatory bowel diseases, and rheumatoid conditions; however, other studies still highlight the perk of turmeric root. Other compounds in the turmeric may be responsible.

It may be best to stick with the whole root of turmeric, even though studies are highlighting the benefits of curcumin. For one, turmeric is cheaper than curcumin. Second, turmeric is processed in order to get turmeric, so other compounds that may be beneficial are extr...

Physical therapists (PTs) are movement experts that help patients with Parkinson's regain function, activities, and engage better in life. Parkinson's disease (PD) affects the smoothness and ability to initiate movement. PTs can offer a myriad of exercises, activities, balance training, and walking interventions with decent results. The disease is usually be progressive, although intense exercise can delay this progression. What if PTs could offer an even greater edge for the patients to "beat" PD?

An early trial showed that a plant-based diet was able to lower the patients Hoyen-Yahr stage (https://www.ncbi.nlm.nih.gov/pubmed/21535916).   Research has also begun to show that eating certain plant-based foods rich in nicotine containing compounds, like sweet peppers, may be important to preventing PD (see our other posts on this topic). Another review study highlighted the benefits of plant nutrients in improving or ameliorating neurodegeneration and chronic inflammation (https://www.s...

A California judge ruled that some stores must label coffee as potential cancer-causing because it contains a compound known as acrylamide (https://www.yahoo.com/news/apnewsbreak-california-judge-coffee-needs-212748202.html).

The unfortunate reality in this situation is that the defendants of the case, the coffee industry, did not have an opportunity to really express the potential health benefits of coffee. Research shows that coffee is a strong antioxidant, reducing the risk of some neurological decline and Parkinson's, as well as promoting GI motility, which may reduce the risk of gut cancer. Large epidemiology studies show that coffee may even reduce the risk of death by roughly 6-15%, with consumption up to 6 cups per day.

As such, does coffee really cause cancer from acrylamide?

Very unlikely. If there is any industry the California government and lawyers should be attacking it would be the potato chip and French fry manufacturers. Potato chips and french fries have the larg...

Nutrition has long been a subject of much health discussions. Headlines are a buzz with the next diet fad or study linking food to causing or stopping chronic diseases. PTs help patients through these tough times of chronic disease and pain, only to miss the impact food has on patients.

Dr Wells will be rolling out a book for showing the connection between food and pain, arthritis, surgical healing, and heart disease.  The continuing education courses, on the site you are on, has been developed to help PTs counsel patients and improve their lives.

Stay in the loop at: https://www.facebook.com/nutritionPT/

Learn about our online courses:

There is much more to be found in our evidenced-based, board-approved online continuing education courses for physical therapists.

Enroll today and progress through our 3 course sequence starting with nutrition basics, then the assessment/prescription process, and finally a specialty focus on select populations and specialized nutrition topics. Com...

More than 80% of older adults over the age of 65 have some form of osteoarthritis, also more commonly known as arthritis. In fact,  arthritis has more than doubled in the last 50 years! How did we get to this point? Is it just a matter of better Imaging or are we actually seeing a change within our bony structures? More importantly what can we do to prevent the continual growth of osteoarthritis within our population?

The answer lies within several studies that were published recently. Epidemiologists and researchers going back and measuring our skeletons of our ancestors have shown that physical exercise and activity have been a integral part of our lifestyle and bodies. With modern technology and changes to our lifestyle we have become less agrarian and less active. As a consequence our bones and bodies have changed. We have gained a little bit more weight, or joints have not gotten used to not being used, and we suffer from other ailments related to changes within our diet. In a st...