Professional- licensure, reimbursement, other

I really appreciate the responses I have received.

Thank you everyone!!

Thank you!

The PTs and ATCs I worked with didn’t have time to cover everything the client needed. Also, they would usually only see the client once per week at best because their schedule was so packed. I covered what they couldn’t. So no, they didn’t have any concern with me doing this. It was nice to be an integral part of the care team.

We are not doing rehab - we are working with patients who are no longer in an acute phase of an orthopedic issue and have graduated from PT and our job is providing an exercise prescription that addresses any chronic orthopedic issues while improving their overall functional capacity.

I agree, Pat! It seems there is fairly wide variation in Ex Phys programs regarding education in strength & conditioning and exercise prescription for common orthopedic issues and I feel we are doing our clients a disservice if we are not well versed in this area. Those with medical issues very often also have chronic orthopedic issues such as OA, spinal stenosis, scoliosis, rotator cuff injuries, etc. and it is incumbent on us to develop an exercise prescription that takes these issues into account just as we consider cardiac and pulmonary conditions.

Our team had several referrals from physicians whose patients developed an exacerbation of a chronic orthopedic problem in a cardiac or pulmonary rehab program. A robust understanding of these conditions is essential for a safe and effective exercise prescription for anyone of any age or ability.

The PT's and ATC's were always so appreciative of having a team of seasoned CEP's to work with their patients on discharge or even during PT to maintain overall strength and fitness during the rehab process.

I don’t know your training and experience. Exercise Physiology academia does not always include hands-on practical coaching. Are PTs resistant? No, because once the client-athlete is released from PT, they need to transition to playing their sport. In college and high school, this is most often done by the Strength & Conditioning Coach. Way beyond FITT & Rx, S&C takes a functional (total kinetic chain) approach towards return-to-play. If this is a void in your experience, fill it!

Thank you!

Just wondering.

In your opinion, do physical therapists and athletic trainers feel that CEP's should not be doing orthopedic rehab since that is their area.

Thank you!!

To Polly's point, bring something to the table. The strength of the CEP is in exercise physiology, not necessarily in the MSK-orthopedic / performance arena.

Unless you have experience in an orthopedic clinic, in a college-university athletic program, or in a Strength & Conditioning setting, you may need to shadow some PTs or ATCs.

If you hold the NSCA S&C certification, or the CFSC I & II [Certified Functional Strength Coach], by far the best 'hands-on' cert course, you will be better equipped.

Know your local demographics, especially when it comes to leisure-time sports, adventure, travel and physical hobbies.

Some PT facilities do hire a CEP-Trainer to run VO2max tests, etc.

Good luck!

Pat

I was the first CEP hired at an orthopedic hospital and was able to build a Performance Services department that now has 10 full time CEP's. The key was to demonstrate the various services that would ad value and generate revenue. Our services are entirely cash-based. Our services fall under 2 main areas: Testing & Training

Testing includes: Basic Fitness Assessments, Metabolic Testing, Sports Specific Assessments for Running & Golf, Return to Play testing.

Training options include: 30 and 60 minute individual training sessions available as single sessions or packages, individual zoom sessions, 4-6 week group zoom sessions for specific populations - building bone, healthy back, postpartum, etc.

Since insurance tends to run out before athletes are really ready to return to play, we provided a valuable bridge from PT to Performance as well as providing safe training for orthopedically fragile individuals (OA, osteoporosis, chronic spine patients, rheumatological issues, etc) or individuals with other medical co-morbidities. Our referrals typically come from the PT's who are happy to transition their patients to a safe training option. We also get referrals from physicians who feel comfortable referring their most orthopedically or medically challenged patients to our team. In general, patients are able to find a service with a price point within their budget.

I think there is huge potential for CEP's to establish a presence in the orthopedic setting! Once you can demonstrate your value and the potential for a new revenue stream, you're on your way!

Thank you very much!

I was able to do this. Entered in the Sports Performance training offering that was under the Orthopedic / Sports Medicine department. Ended up working with athletes willing to pay cash for my services which were rehabilitative in nature but also included some sports performance work. These athletes often were under care of a physical therapist using insurance to pay for those services. The physical therapist and I would coordinate accordingly. Some of the athletes I see came to me in search of an alternative to using a physical therapist.

I know other CEPs who have followed this path too. These opportunities are rare though. Hope this helps.

Hello,

I am a CEP who is really interested in working with injured athletes in the sports rehab setting. I have never seen any positions available for a CEP to do this type of work.

Just wondering if anyone has any experience with this as I know this is not an area where CEP's tend to work.

Also, any suggestions on how to break into this area would be greatly appreciated.

Thanks very much!!