Nutritionists and dietitians are highly trained members of the medical and lifestyle team whose skills in designing food plans aren’t matched by anyone in medicine. That said, did you know that prior to seeking their Doctoral degrees, the vast majority of physical therapists earned Bachelor’s level training in a health-related field where they, too, have gained valuable skills in nutrition?
Many don’t realize this is the same EXACT training that most nutritionists and dietitians have. Some practicing physical therapists have advanced training in nutrition. The biggest difference is that instead of seeking licensure in nutrition, we chose a physical medicine practice. So, how does this info help you, the client?
Nutrition plays a significant role in how people deal with pain and how they are going to heal. To be a complete NEW BREED PHYSICAL THERAPIST, you must address your clients’ nutrition concerns and barriers to ensure you are impacting all the dimensions of getting well.
As I practice physical therapy and strength and conditioning, clients often ask questions about how their nutrition could impact their outcomes. Clients usually don’t need to be explicitly walked through a diet plan. Having this kind of structure when clients ask for it is helpful. We send them to some of the country’s best nutrition pros when this happens. However, most people are making such HUGE mistakes with their personal nutrition that very basic biochemistry and physiology recommendations can be made that have a long and lasting effect.
Nutrition Tips From Your Physical Therapist
There are a couple of insights we offer to almost every client. These are the ways in which most people get their nutrition back on track for healing and performance:
The importance of this cannot be overstated, especially for people who are struggling with being overweight. Food's ‘thermic effect’ can account for up to 15% of your total caloric expense throughout the day.
Let’s say you are eating 2000 calories per day. If you eat those calories over three meals, you may lose the extra energy expended to “turn on” your digestive system. If you ate SIX smaller meals throughout the day, you could effectively increase your overall caloric expenditure to 2300 calories per day (2000 + 15%).
Get Adequate Lean Protein
This is an area that is ambiguous for many and can be frustrating. Protein is an essential building block for repairing tissues. Your body metabolizes proteins for many bodily functions, and missing out on enough can seriously slow your overall recuperative ability.
A rule of thumb for “How much protein should I eat?” is to take in 0.8 – 1.5 grams of protein per kilogram of body weight. This is a BIG range, but it makes sense.
If you exercise regularly and at a high intensity, you will rapidly break down your body, requiring more building blocks to repair. This client should be on the higher end of this range.
If you don’t exercise regularly, you still need protein, but you will need less.
I know the metric system is lost on many, me included, so here is the conversion:
1 pound = 0.453592 kilograms
For example, if you weigh 160lbs, you are 72.57kg
Get Energy From High Complex Carbohydrates and Fiber
CARBOHYDRATES ARE ENERGY! They aren’t fat. They don’t make you fat. They are essential for fueling your body to produce the effort to do real work that makes people better… AT EVERYTHING! You’ve got complex carbohydrates and simple carbohydrates.
- Complex carbs = fiber, wheat, bran, oats; foods that are overall less easy to digest and, therefore, are broken down in such a way as to give you energy over a longer period.
- Simple carbs are found in highly processed products, anything with added table sugar, and in many ‘junk’ foods. Like many kinds of berries, natural foods are also high in sugars. That said, there are times and situations when simple carbs are OK or advisable. At most other times, complex, high-fiber carbohydrate foods are the way to go.
When choosing the types of carbs to eat, the rule of thumb should be to ask yourself, “Am I going to use this energy NOW?” If the answer is no, you have absolutely NO reason to eat food or drink a drink loaded with sugar. This type of food is FUEL! Fuel up with the high-octane stuff and watch your performance improve almost IMMEDIATELY!
Most of us don’t drink enough water! It’s among the most plentiful resources; by most accounts, it’s still almost free. Yet, we elect to drink so many fluids that contain sugar, carbonation, caffeine, and nothing good for you. The gold standard for the amount we should be drinking varies depending upon who you ask or where you read, but you’ll never go wrong getting eight to ten 8oz glasses of water per day. You should drink more if you are performing a good bit of high-intensity exercise. It's not rocket science here. You are made up of mostly water. You should do your best to ensure all your tissues are correctly hydrated to maximize your body’s ability to heal and perform.
How Nutrition Fits Into Our All-the-Way Well Philosophy
We don’t specifically offer nutritional guidance as a stand-alone item. That being said, we include these basic nutritional insights to our clients as all-the-way well care. All physical therapists have the biochemistry and physiology training to play a larger role in our patients’ nutrition and health. A major barrier to this is that most physical therapists cannot spend adequate time or effort needed to address nutrition. Most don’t even have the hands-on time to do their best work!
Fad diets and repackaging standard diet and nutrition information come and go! There is some good to fad dieting – structure! Almost all PTs can give you excellent nutrition advice without overstepping their scope of knowledge. Some simple tricks will always apply – fewer “bad” calories, less sugar, lean proteins, high fiber, etc. Once you get that foundation down, you'll determine the specifics based on your body and needs.