October is National Physical Therapy Month!

How great of our local YMCA to recognize the amazing benefits of physical therapy!

Oh, wait… they meant personal training

I don’t know why I get my panties in a wad about the misuse of my profession’s abbreviation. Except that I do. That’s because there’s a big difference between a personal trainer and a physical therapist. 

Physical therapists earn a bachelor’s degree before they ever go to graduate school. My master’s program was 3 years long. The entry-level degree now is a Doctor of Physical Therapy, and most of these programs are 3.5 years. Once you finish your degree, you must sit for and pass a test to earn your license to practice physical therapy. 

Currently, there are no national or state regulatory bodies that monitor the personal training industry. Your average personal trainer attends a weekend class or studies online and takes a test to earn a certification, with the only requirement typically that you are a high school graduate. It’s not the same as the schooling a physical therapist goes through to earn an advanced degree. 

That being said, I know some excellent personal trainers that know their field extremely well and have college degrees to back it up. But without much regulation of this industry, programs to certify personal trainers vary greatly in content, scientific background, and quality, and is reflected in the competency of the trainer.

I worked in a gym back in the late 90’s after I graduated from PT school. I was a personal trainer as I waited to take my boards. I can tell you that some of our trainers were competent, others were not. 

One of the trainers I worked with claimed that her two years of pre-med coursework in undergrad were equivalent to my post-graduate degree. And, no, she did not earn a degree of any kind. Sigh. I took the same classes in my first two years of college, too. Most college graduates do. 

But let me tell you a better example. We had a trainer who would instruct her clients to find their target heart rate, then try to achieve this with each cardio workout. I ended up having one of her clients in one of my intro to exercise classes. He asked me why he couldn’t reach this magical number. 

The answer to this question required a bit more investigation. I asked him if he had high blood pressure, which he did, and if he took medication for this, which he did. One of these was a beta blocker, which artificially lowers your heart rate to reduce the workload on your heart. So this poor guy was huffing and puffing away on the treadmill, never reaching that target heart rate. 

To correct this trainer’s lack of inquiry, I educated the client about the effects of this medication and what to do instead. I may have prevented a major medical event for him. All it took was a more thorough questioning of his medical history and a basic understanding of how certain classes of medications work. 

I teach my patients about rate of perceived exertion, or RPE, instead of target heart rate. It’s a much better way to gauge the effort of exercise. Here’s why:

  • First of all, it’s far less complicated. 
  • Second of all, folks tend to take a carotid pulse, which I feel is a bit risky. You never know if you will throw a clot this way. 
  • And third, the heart rate sensors on cardio equipment are rarely accurate. 
  • As a clinician, I tend to sit and chat with my patients when they are doing activities aimed at improving their cardiopulmonary endurance. That way, I can gauge their RPE while also monitoring their vital signs.

I also tried to educate our personal training staff about this, detailing the issue in our communication book and even explaining the concept of RPE. The response I received? “You suck.” Awesome. Not only were some of our staff incompetent, but also extremely unprofessional. I was so grateful to pass my boards and get my first job as a physical therapist. 

Several years later, I was working out at a new gym. I saw all of these employees walking around with shirts emblazoned with “PT” on the back. So, I asked, “Are all of these staff members physical therapists?” knowing that they were not. The staff member I conversed with confirmed that these were personal trainers. I explained the issue with this and how hard I worked to earn that designation. She seemed unfazed, merely shrugging her shoulders and carrying on with her day. I was less than impressed. 

So, beware if you interact with a “PT” at the gym. You are probably not talking to a physical therapist with an advanced degree. You are more likely to encounter someone with only a certification in personal training instead. As I said, there are some great personal trainers and personal training programs, but not all are created equal, and not all personal trainers have a related college degree or the professional curiosity to back up their methods. It’s really important as a consumer to understand the difference. Only a physical therapist can call themselves a PT. 

Happy Physical Therapy Month to my fellow PT’s!


This is not an attack on my friends who are competent personal trainers. It is, however, commentary on the misuse of my profession’s designated abbreviation.

If you are looking to get on track with an exercise program and don’t have many medical complications, especially involving cardiopulmonary systems, a competent personal trainer can be helpful for your needs. But if you are injured or have medical issues which need to be considered with activity, you should consult your doctor, and a physical therapist may be just the medical professional you need to help you. 

As always, I hope you all are safe and healthy.

Published by annecreates

I am a physical therapist, wife, mom, runner, artist, and vegan. I'm passionate about helping others find wellness, speaking about the human experience, and in fighting for social justice. Assistant Coach for the Sports Backers Marathon Training Team. Current ambassador for: Boco Gear, SaltStick, SPIbelt, Goodr, Noxgear, and Switch4Good.

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