Diet
and nutrition are vital parts of the body healing and a key component to many
conditions that physical therapists manage daily. As a physical therapist we must be
knowledgeable and comfortable addressing this with our patients. But with so many new diets, fads and
supplements, where do we start?
The
APTA position is that it is “the role of the physical therapist to screen for
and provide information on diet and nutritional issues to patient, clients and
community within the scope of practice.” Because each state has a different
scope of PT practice it is important to make sure that you understand varying
stances, particularly the position of the state in which you practice. For example, some states are
silent on nutrition and therefore can turn to state laws governing nutrition
advice. Some states may only allow a
registered dietician to give nutritional advice while others allow health care
practitioners to give advice but only allow registered dietitians to bill.
Starting them young! The Byerly boys (two of Jessie's three kids) hard at work helping prep a meal :)
Avoiding discussion on nutrition is leaving a void in practice and healing. Here are just a few examples:
· Obesity leads to changes in body
composition. An increase in fat tissue,
adipose, changes your body’s metabolism, ability to regulate insulin which in
turn has a correlation and influence on inflammation and pain. Medicare has
instituted Body Mass Index assessments.
But, how many in practice set goals, such as patient education, around
those assessments?
· In a dehydrated state muscles
will not receive the proper oxygen they need to heal. What is happening? Our bodies pull water from
skin and muscles to protect our vital organs. So, in order for our patients to
heal, hydration should be a key component to their plan.
· Smoking, nicotine specifically,
decreases the efficiency of heart and lungs thus the delivery of oxygen to the
body. Without oxygen, as discussed,
muscles are dehydrated and weak. Lack of oxygen also results in slower healing
and general fatigue. There is also a study that links smoking to
chronic pain.
· There is a growing body of
evidence suggesting that nutrition may play a key role in concussion
management. Research supports the use of key nutrients and sufficient caloric
intake to reduce the inflammatory responses that occur in post-concussion and
in post-concussive disorders.
Poor
nutrition, dehydration and other poor lifestyle habits can have a direct effect
on our patients’ outcomes. It is
important to not only recognize when this is occurring but take steps in
optimizing the healing environment.
As the Director for
Clinical Education for CORA Physical Therapy, Jessie Byerly has spent much of her
career devoted to enhancing post- professional education for clinicians.
She is a Movement Links certified practitioner and instructor. She uses
her specialty in movement science, and passion to teach youth about sports
wellness and injury prevention.
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References:
1. Rea BL,
Marshak HH, Neish C, Davis N. (2004) The role of health promotion in physical
therapy in California, New York, and Tennessee. Physical Therapy 84:
510–523
2. Morris
DM1, Kitchin EM, Clark DE. (2009) Strategies for optimizing nutrition and
weight reduction in physical therapy practice: The evidence. Physiotherapy
Theory and Practice, 25(5–6):408–423
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