In this week’s Q&A we interviewed Dr. Teddy Willsey PT, DPT, CSCS. Teddy is a writer, speaker, and educator in the field of strength and conditioning and sports rehabilitation. He covers the entire spectrum of physical preparation from rehabilitation to high level performance. Dr. Willsey holds a Doctorate of Physical Therapy from Old Dominion University, and a Bachelor of Science in Exercise Science from the University of Pittsburgh.
Question: In your opinion as a DPT, where do you see room for growth in traditional rehab and physical therapy?
Teddy: There are a lot of physical therapists that do an inadequate job of integrating strength & conditioning principles into their treatment and following an evidence based practice approach. It all starts with education: there is not enough emphasis placed on the importance of progressive resistance exercise. Many athletes and older adults alike in rehabilitation settings are chronically underloaded in PT when they should be building strength and robustness that can be protective towards future injury. Fortunately for me, my bias towards strength & conditioning lines up nearly perfectly with what the evidence tells us about how people get better and stay better.
Question: How important is it to have a proper assessment, or checkpoints during the rehabilitation process?
Teddy: It is extremely important to have an assessment and ability to track objective measurables over time. Objective data can help to predict readiness and motivate athletes or facilitate client buy-in as well. Furthermore, objective data is necessary for an intervention to be properly researched and scientifically vetted.
The initial assessment creates the first plan of care, but the ability to adjust and progress rehab is more important than any one single assessment or checkpoint. High quality rehabilitation should use a progressive set of checkpoints that evolve over time to mimic real life or sport demands.
One of the questions students and young professionals always ask is, “how do you know when they are ready to do X or Y.” The answer lies in the checkpoints and mini assessments happening everyday while you’re working together.
Question: Many look at rehabilitation and training in two different buckets. You call yourself a “strength coach therapist,” so how would you describe the relationship between training and rehab?
Teddy: The goal of rehabilitation and training are the same: build resiliency, make people harder to break. The principles are the same: progressive overload and specific adaptations to imposed demands. The difference is the starting point.
Question: Understanding previous injury history with an individual is imperative to preventing future issues. How do you address previous injuries during the rehab, or training process?
Teddy: Previous injury history should is first addressed through a thorough history and health background. Once we have an idea of all previous issues to consider, we will look at them more closely in the physical exam and movement portion of the assessment. If anything seems off, we’ll address it. It’s not uncommon for old injuries to resurface when people get hurt and are forced into a detrained state for a long period of time. We try to avoid this from happening altogether by training the rest of the body in any way possible during rehab.
Question: Many athletes are told to rest for extended periods of time following an injury before beginning to train again. How long after injury should athletes wait to start training again?
Teddy: There is almost never a need to fully rest and literally do nothing. I have yet to see an injured athlete that I couldn’t figure out some way to challenge in the gym. One of the most important differentiating factors of my approach to rehabilitation is continuing to train around the injury as much as possible. Detraining and disuse atrophy can lead to a injury-reinjury cycle. The all too familiar example: athlete comes back from a knee injury, sprains their ankle, pulls their hamstring, etc. within the first few weeks back. The best way to avoid this common occurrence is to not rest and to challenge the athlete more similar to how a strength coach would during the return to sport phase.
Question: Staying up on research can be daunting as a busy practitioner. Where do you look for quality content, and what are your recommendations on staying up to date with current research?
Teddy: There are a lot of high quality practitioners who post articles on instagram, twitter, and facebook. I post at least 1-2 articles a month on my story as I read them. Leverage your social media relationships and follows to make you smarter. There are also some apps out there now, like Read by QXMD that allow you to follow specific topics or journals. There are some continuing education subscription services as well that are well worth the nominal investment. For example, I write for a journal review publication called Physio Network. We send out monthly issues with 12 article reviews.
Question: What can we expect from you in 2019? Any big events?
Teddy: I am continuing to teach continuing Ed. courses, so I’ll probably be doing 4-5 courses in 2019. My next few are in Krakow, Poland in January, Salt Lake City in February, and Toronto in April. I have some plans to speak at a few larger events as well and I’m working on a 1-day course in NYC this spring as well. I also launched an awesome strength & conditioning based training program, Citizen Athletics, last September. We offer online training in 4-week blocks through our app with videos for all the exercises. Besides all that, I’ll just be creating content, writing, running my PT practice here in Maryland, and trying to spend every free moment I have outdoors soaking up the sun!
Follow Teddy on instagram (@strengthcoachtherapy) and twitter (@teddywillsey). Also find him on the web at teddywillsey.com and healthyballer.com.