Differences Between Muscle & Bone Healthcare Practitioners

Did you get injured working out but don’t know which health care provider to see? You’re not alone. With a wide variety of health care practitioners that are certified to treat muscular & skeletal  (musculoskeletal) disorders, it can be quite confusing. Here, I hope to clarify the major differences in musculoskeletal clinicians, and the general progression of care/ referral process if you are injured.
Physical Therapist
Evaluates, diagnoses, and provides treatment  to develop, maintain, and restore maximum movement and function throughout your life. Components of movement and function that are evaluated by a physical therapist include: strength, range of motion, flexibility, balance, posture, body mechanics, joint play, coordination, endurance and general mobility. Physical Therapists emphasize a treatment program that eventually transitions from manual treatment techniques & one-on-one strength training programs to an  independent treatment program designed to prevent re-injury through exercise prescription and mobility training. You can see a Physical Therapist without a referral from your Doctor.
Common treatment techniques: manual joint mobilizations and/or manipulations, stretching, strengthening (creation of exercise program prescription), soft tissue mobilization, motor control retraining (brain to muscle connection).
Education: Doctor of Physical Therapy

• 4 yr. Undergraduate Degree
  
• 3 yr. Post-Graduate program

Chiropractor:
Evaluates, diagnoses, and provides treatment  to develop, maintain, and restore maximum movement and function throughout your life. Components of movement and function that are evaluated by a chiropractor include: range of motion, flexibility, posture, stability, joint play, and muscle tone. Chiropractors emphasize maintaining proper spinal alignment through regular routine skeletal adjustments. You can see a Chiropractor without a referral from your Doctor.
Common treatment technique: manual adjustment and/or manipulation, stretching, soft tissue mobilization
Education: Doctor of Chiropractic

• 2 - 4yr.  Undergraduate Degree
  
• 3-4 yr. Post- Graduate program
  

Personal Trainer
Develops and implement fitness programs for clients who have no apparent physical limitations or who have received medical clearance to exercise. Personal trainers are not licensed to evaluate or diagnose a client with a musculoskeletal disorder.
Common treatment techniques: Developing exercise program for weight loss and/or to improve overall fitness
Education: The profession of personal training does not have an educational standard and is self-regulated. Trainers’ experiences may range from a master's degree in biomechanics with five years of experience working at an athletic setting or a weekend certification with no experience, however, ACE (American Council of Exercise) created a universal standard for personal trainer certifications.
Orthopedist (Orthopedic Physician, Orthopedic Surgeon)
A Medical Doctor that specializes in evaluating and diagnosing diseases and injuries pertaining to the musculoskeletal system. They handle everything from minor issues such as a sprained ankle to complex procedures and surgeries such as a hip replacement. Orthopedists refer to Physical Therapy (PT) first. If conservative treatment (PT) doesn't work, they look into surgical interventions. If surgery is performed, Orthopedists will refer a patient back to PT.
Most common treatment techniques: Medication prescription, referral to Physical Therapy, surgery (if conservative measures are ineffective)
Education: MD (Medical Doctor) or DO (Doctor of Osteopathic Medicine)

• 4 yr. Undergraduate Degree
  
• Medical School
  
• 4-5 Year Residency
  

Physiatrist (Physical Medicine & Rehabilitation Doctor)
Physical Medicine and Rehabilitation (PM&R), also called Physiatry, is the branch of medicine emphasizing the prevention, diagnosis and treatment of musculoskeletal disorders that may produce temporary or permanent disability. They handle everything from minor issues such as an injured knee to Spinal Cord Injuries and Strokes.
Most common treatment approaches: Specialize in non- surgical treatment, medication prescription,  use of “whole body approach” that goes beyond the resolution of symptoms to include prevention of recurrence including referrals to Physical Therapy or Chiropractors.
Education: MD (Medical Doctor) or DO (Doctor of Osteopathic Medicine)

• 4 yr. Undergraduate Degree
  
• Medical School
  
• 4-5 Year Residency

References: 
1.  http://www.spinesport.org/physical-therapist-chiropractor-physician-whats-difference/ 
2.  https://www.acefitness.org/blog/2179/what-s-the-difference-between-a-personal-trainer
3.  http://www.physiciansandsurgeons.net/physiatrist.htm

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