There may be confusion between the roles of a physical therapist and a personal trainer; even the letters at the end of our names are very similar (PT for physical therapist and CPT for certified personal trainer). And to be honest, there is some overlap between the two professions. When you have an injury or are experiencing pain or a loss of body function, I highly recommend starting your healing journey with a visit to your local physical therapy clinic. Especially if the issue you want to fix is diastasis abdominals recti.
Now I’m NOT saying that a personal trainer can’t help you heal this condition. What I AM saying is that personal trainers do not have the same training in movement dysfunctions that a physical therapist has to be able to both diagnose and recommend rehabilitation exercises to heal diastasis recti. And that’s not to say that personal trainers aren’t smart or don’t research - some of my close friends are really awesome personal trainers. But I have experienced many personal trainers on the internet and in gyms giving the wrong advice to people after an injury or when trying to fix their “mummy tummy.”
Let’s take a look at the differences between a personal trainer and a physical therapist.
Personal Trainers
According to the American College of Sports Medicine (ACSM), an ACSM-certified personal trainer (CPT) “ works with apparently healthy individuals and those with health challenges who can exercise independently to enhance quality of life, improve health-related physical fitness, performance, manage health risk, and promote lasting health behavior change.” The key words there are “apparently healthy individuals.”
Women with diastasis recti are not in a healthy state! Women whose abdominals are split and whose core is not working properly have a movement dysfunction. These women simply don’t have “weak abs” - diastasis recti is a body dysfunction!
Under the ACSM’s definition, the CPT should conduct pre-participation health screenings, and assess an individual's fitness level and body composition. The CPT also should facilitate motivation to participate in regular fitness and be able to develop a safe and effective fitness program to help an individual reach their fitness goals. A CPT is the perfect person to help you meet your fitness goals. A PT needs to step in when everyday function goals need to be met.
A personal trainer’s responsibility is to recognize when to refer to a physical therapist or other healthcare professional (such as an occupational therapist, physician, or dietitian).
Physical Therapists:
According to the APTA (American Physical Therapy Association), “Physical Therapists are movement experts. They are licensed doctors who examine, diagnose, and treat movement dysfunction.
According to the Texas Board Of Physical Therapy, “Physical therapy means a form of healthcare that prevents, identifies, corrects, or alleviates acute or prolonged movement dysfunction or pain of anatomic or physiologic origin.”
As part of the diagnostic process, physical therapists take a thorough medical and movement history as well as assess movement, posture, functional limitations, and balance to diagnose and create an effective treatment plan to correct and prevent movement dysfunctions to restore normal function.
While the two professions are both geared at meeting your health and fitness goals, read on to understand who you should see to guide you in your healing of abdominal separation:
Physical therapists are trained in analyzing and assessing posture and movements.
Anyone can learn to assess for DRA (here’s my video explaining the detailed functional way to assess for DRA!). You can even Google some exercises on how to fix DRA (but I caution that these exercises aren’t personalized or even proper exercises for healing DRA). But that doesn’t mean that a personal trainer understands how this condition impacts or is impacted by the rest of the body.
A physical therapist is specially trained to assess dysfunctions and how they relate to the rest of the body. In doing so, they can take a holistic approach to care. Diastasis recti occurs from the imbalances in pressures in the abdominal cavity, which includes the pelvic floor muscles. Seeing a specialized pelvic floor physical therapist for healing your abdominal separation means they can assess your pelvic floor muscles through an internal exam to prescribe personalized exercises to heal.
Personal Trainers are not medically trained and cannot evaluate and diagnose
Personal trainers take courses related to personal training and must pass a certification exam to become certified personal trainers. However, they do not gain the depth of knowledge physical therapists gain during their schooling in anatomy, physiology, neurology, and kinesiology.
A Doctor of Physical Therapy degree requires 6 years of school and passing a rigorous licensure exam. To specialize in a certain area, a physical therapist then has to take extra courses and training and pass another specialization exam. PTs are also required to have 30 hours of continuing education credits every 2 years to renew their license and ensure they are up to date on current practice guidelines and the latest treatment approaches.
This advanced schooling and knowledge that a physical therapist receives allows them to be able to take all the information they gain from a person’s history to evaluate a person’s movement and function and determine what tissue limitations or system impairments are occurring to limit function or cause pain. From that assessment and a person’s movement history, an appropriate physical therapy diagnosis can be made and treatment interventions are then chosen based on those findings.
On the other hand, certified personal trainers have to be at least 18 years old with a high school degree or equivalent to become a trainer. One certified personal trainer program I came across even boasts that their program only takes 4 weeks and requires no prior knowledge. In my opinion, that is not enough training to be able to fully understand the interworkings of the body to design a safe exercise program for someone with abdominal separation.
Personal trainers are well trained on proper form for performing an exercise and can provide cues to help correct poor form. But they aren’t licensed or trained to evaluate if a weakness or limitation in another part of the body is causing a client to have poor form during an exercise - a physical therapist can!
Physical Therapists can utilize different treatment approaches rather than just exercise alone.
A personal trainer can only design an appropriate exercise program to help someone reach their goals.
As physical therapists, we have a wide variety of treatment techniques that we can use in addition to therapeutic exercise to help you heal and correct movement dysfunctions including:
Manual Therapy
Cupping
Dry Needling
Ultrasounds
E-stim
We also provide endless education while we are treating you to help you better understand what is going on with your body and why we designed a specific treatment plan.
So, who should you work with?
A personal trainer is a great place to start if you are “healthy” and want guidance on setting up an exercise program to help meet your fitness needs.
A licensed physical therapist is the place to start if you have chronic or acute pain or an injury that needs help healing - like diastasis recti. We can assess your movement and help determine if a dysfunction elsewhere in the body is contributing to the pain or symptoms you are experiencing.
For abdominal separation, we can help you build the foundational strength and connection to the breath you need to be able to progress to advanced exercises. Doing the wrong exercise too soon can cause further abdominal separation; something you definitely don’t want.
Once you have the foundations built up with physical therapy, your physical therapist can work with your trainer to help transition your exercise program to them for progression as you get stronger.
If you’re suffering from abdominal separation and don’t know where to start, I have just the program for you. My CORE+ Healing DRA Masterclass will help you safely heal your core so that you feel stronger, more confident, and less leaky without worrying that you are going to do more harm. Interested? Click here to learn more!