What I Learned in Physical Therapy
A few weeks, I saw a physical therapist. Nothing was especially wrong. I wanted advice on how to deal with some nagging tightness in my right hip before I started ramping up my weekly running mileage. When I arrived for my appointment, my physical therapist asked if his intern, Natalie, could participate in my appointment. I agreed—two experts for the price of one!
Over the course of our one-hour session, I learned a lot about my right hip, but I also got to observe my PT teaching, guiding, and mentoring Natalie. Here are a few things that stood out:
Gradual Release of Responsibility: When my PT was confident that Natalie could lead an exercise or test, he let her lead. When he was partially confident, they talked about the exercise in advance, and he observed her closely. When he didn’t think she could lead, he led and talked to her each step.
Quick Correction: At one point, my PT asked me to do some squats. Natalie started modeling the squat move. Immediately, my PT asked her to stop demonstrating, explaining that I was imitating her form (true) and that they wanted to observe my natural form.
Theory and Practice: When my PT rotated my hip, he explained to Natalie how he was rotating it and what he was hoping to learn. He did the same thing when he measured my hamstring flexibility (poor) and had me walk barefoot and so on. He wanted Natalie to understand the what and the why of what he was doing.
Visible thinking: Throughout the session, my PT explained his evolving assessment of me to Natalie—even when I wasn’t doing specific exercises and tests. He shared what he gleaned from my walk, my sitting posture, my standing posture.
Debrief everything: At the one-hour mark, my PT asked me if I could stick around for a few extra minutes to try a new exercise. I said yes, and the PT paused and explained to Natalie that he often did this and has built time into his schedule for this sort of thing. Not even scheduling was left un-debriefed.
Natalie is in her third and final year of her Doctor of Physical Therapy degree. She spent the first two years of her program learning the science and theory of physical therapy. Now, she is applying that knowledge in a clinical setting. She has already spent 12 weeks interning at a rehabilitation center for elderly patients. She will be spending another 12 weeks interning with my PT at Rehab 2 Perform.
So what’s my point? I have many, but I’ll share just three.
Preparing Teaching: Teacher education should look more like Natalie’s physical therapy education. It’s that simple. That’s the insight. Teachers should receive more education about learning science, cognitive psychology, and the content of their subject area. Then, they should apply that knowledge in an apprentice setting, where they can observe an expert teacher, gradually assume more responsibility, receive frequent and immediate feedback, and debrief their work. This may happen in some teacher development programs. It doesn’t happen in many. It needs to happen in all.
Teaching Students: Natalie is also a student, and my PT treated her like one. He was attentive to what she could do, could do with some scaffolding, and still needed to learn. He used a mix of explicit instruction and hands-on, project-based learning to grow and solidify her knowledge. Again, this is not a profound insight, but that’s what teachers need to do with their students. Students need clear, direct instruction followed by relevant opportunities to apply that knowledge.
Leaving Nothing to Chance: My PT didn’t assume that Natalie would just figure out to stop modeling proper squat form for me on her own. He didn’t assume that she would understand what my posture revealed about my hip strength. When I was a school administrator, one part of my job was to support struggling teachers. One of the biggest debates I had with department chairs and instructional coaches was when to intervene and when to let a teacher work through the challenge independently. Our default was usually to let the struggling teacher “figure it out.” He was often “just not quite ready to make the change” or we assumed that “he’d figure it out on his own when he was ready.” Now, sometimes that approach worked, and the teacher asked for help or made progress on his own. But more often than not, we’d find ourselves intervening weeks later, when the situation was worse, when the teacher was more stressed, when the students were less trusting. This approach was wrong. It wasn’t fair to the teacher. It certainly wasn’t fair to the students. We needed to stop making assumptions that our teachers would magically guess or figure out how to improve. We shouldn’t have left it to chance. My PT left nothing to chance.
I left the appointment equipped with some new stretches and strengthening exercises. I also left the appointment believing that Natalie’s physical therapy program is more useful and more thorough than any teacher preparation program or degree in the United States. This should enrage teachers, students, and parents, alike.
We need to demand more for our teachers and for ourselves. We need to demand more from our state legislators. We need to demand more from our education schools. Every deserves better.
One last note about Natalie: I returned to physical therapy last week for a follow-up appointment. Natalie was still there, but this time she wasn’t shadowing my PT. Instead, she was working independently with another client, guiding him through some knee-related exercises. When my PT had to take a call, he asked Natalie to make sure I was doing my new exercises correctly. She offered a few adjustments to my lunge form, and then went back to the other client.
