As a Medical Exercise professional you will work with a wide range of clients when you open your practice. You will clients with neurological disorders (multiple sclerosis, Parkinson's and CVA), cardiovascular conditions (hypertension, myocardial infarcts, coronary bypasses) and musculoskeletal disorders (total hip and knee replacements, disc herniations and meniscal tears). These are just some of the conditions you will work with in your practice.
Clients will also seek your services to correct postural and muscular imbalances and/or to improve strength, endurance or flexibility around a joint. With all clients, complete a thorough medical history interview BEFORE initiating any assessment procedures or exercise programming.
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Medical exercise professionals must effectively manage the “BIG 6”. These six conditions are major contributors to the skyrocketing health care costs we see across the globe. The “BIG 6” include:
The costs of managing these conditions is the primary reason every medical exercise professional should learn to manage these conditions. If you focus on these six conditions you can build a strong practice.
The majority of clients referred to medical exercise training (MET) are there due to “residual functional deficits”. As we have mentioned in previous blog posts, over the last 25 years the reimbursement for rehabilitation services has diminished. As a result physical therapy patients are discharged earlier. We saw trend starting in the early 1990’s. This prompted us to develop the “Medical Exercise Specialist” certification. Insurance reimbursement for physical therapy is now roughly half of what it was in the 90’s. With patients being discharged earlier, we estimate roughly 80% of those discharged from physical therapy have functional deficits and need a safe and effective exercise program to enhance their level of function at work, at home or with sports. FUNCTION is the driving factor for medical exercise training!
The function wheel above identifies the nine key elements of human function. These elements may be...
Do doctors understand the importance of MET and how to use it?
No, physicians will not understand medical exercise training (MET) but don't let this be a deterrent. Most physicians realize exercise is beneficial for their patients but as far as prescribing specifics with exercise, such as activities, frequency, duration and progression, they wont know how. But they aren't trainerd to know exercise. Physicians are trained to diagnose and treat disease. In learning to treat disease, they perform surgery, write prescriptions; read x-rays; and interpret diagnostic tests...exercise prescription is not part of the standard medical school curriculum.
But their defense - which would you prefer? You go to the emergency room at 2 in the morning with a sick child. Would you want the physician to have the ability to interpret the diagnostic test(s) to determine your child's illness and the best course of treatment or do you want a physician that understands exercise...
Medical exercise training and corrective exercise are growing rapidly. It’s important to make sure both concepts are used appropriately. Many clients may report pain and discomfort to their fitness professional. In many instances, the immediate response is to think of an exercise to manage the discomfort. Obviously, the personal trainer, corrective exercise specialist or medical exercise professional cannot diagnose. But there should be some process to determine if the client should seek medical care.
In the corrective execise realm the response may be to put the client through a screening to determine what exercise will manage the discomfort or the accompanying muscular imbalance. We need to start thinking beyond muscular and postural imbalances as the source of client pain and discomfort. In many cases, these non-muscular/postural sources of discomfort are not considered by the corrective exercise specialist or personal trainer.
In the METI – Medical Exercise...
Clients are leaving physical or occupational therapy earlier and with greater limitations such as weakness, lack of endurance, etc. This is not the fault of the physical or occupational therapists, its the changes in insurance reimbursement for rehabilitation. As a result the medical exercise professional is seeing clients with greater ‘residual functional deficits”. These deficits limit client function and are the primary reason for the growth in medical exercise training since 1994 when we offered the first Medical Exercise Specialist workshop and certification.
The job of the Medical Exercise Specialist is shifting toward identifying and developing an exercise program to improve these “residual functional deficits”. These deficits may be in range of motion, strength, endurance, balance, power, etc. The function wheel below identifies the key components of function. Your job as the medical exercise professional is to deal with these deficits.
The...
So you want to build a medical exercise practice? You completed the Medical Exercise Specialist (MES) or Post Rehab Conditioning Specialist (PRCS) certification but now what? Which physician or physical therapist should you approach first? What should you say to physicians and therapists? What will medical professionals want for referring clients? How should you explain medical exercise training (MET)? Will doctors accept you as a Medical Exercise Specialist? How do you build credibility to obtain referrals?
GROWTH….this is the stage every medical exercise professionals wants to get to as quickly as possible, This is where everyone wants be. A growing, thriving practice with referrals coming in and high revenue is the goal. Only 10% of medical exercise professionals get to this stage. This stage is the most elusive and difficult to reach for a number of reasons.
By the time you get to this stage you have a SPECIALIZATION and you passed through the MANAGEMENT stage so you can produce positive functional outcomes for your clients; you have learned the APPLICATION of the skills you learned in the MES or PRCS workshops from which you established a strong FOUNDATION. So now its on to GROWTH. Without passing through the previous four stages, you wouldnt be here. GROWTH can only come from passing through the other four. This is the same in every profession. You can’t shortcut it….you’ve got to do the work and put in the time. But it’s great because now you...
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