6 Things I've Changed Since Becoming a Physical Therapist

I've been a physical therapist for over seven years now. A lot has changed... including my hair color lol

But one of the best parts about staying in this profession is realizing how much there still is to learn. The research evolves. My experiences with patients grow. And if I'm doing my job well, my practice should continue evolving too.

Here are six things I've changed my mind about since graduating PT school.

1. I'm not afraid to tell someone "no."

Early in my career, I wanted every patient to leave feeling happy.

Sometimes that meant trying to find a way to make their goals fit, even if I knew they weren't the best decision.

Now, I'm much more comfortable having difficult conversations.

If I think returning to racing too soon will set you back, I'll tell you.

If I think another week of patience will give you a better long-term outcome, I'll say so.

Patients don't need false reassurance. They need honesty.

At the end of the day, most people come to me because they want to get better—not because they want to hear what they were hoping I'd say.

2. Running form doesn't matter as much as I thought

This one usually surprises people coming from a running PT.

When I was a new graduate, I spent a lot of time looking for the "perfect" running form. "Lean forward." "Land more midfoot." "Shorten your stride."

Today, I still evaluate running mechanics, but I've learned there are often much bigger factors influencing injury risk.

Things like:

• Recovery

• Strength training

• Training errors (doing too much volume or intensity before your body has adapted)

• Sleep

• Nutrition

Can changing running mechanics help in some situations? Absolutely.

But I no longer believe form is the first place we should look for every running injury.

3. Load the tissue with the issue

I used to be much more cautious about loading painful tissues.

Now I know that avoiding movement often leads to lower capacity.

If we never ask an irritated tendon, muscle, or joint to tolerate load, it never has a reason to adapt. That doesn't mean pushing through severe pain or ignoring symptoms. It means finding the right amount of stress to stimulate healing. Stretching, massage, and manual therapy can absolutely have a place. But on their own, they don't create long-term tissue capacity.

Exercise does.

4. No exercise is inherently "off limits"

There was a time when I believed certain exercises were simply bad.

Shoulder shrugs? Avoid them.

Jefferson curls? Dangerous.

Lateral raises? Don't even think about it.

I've changed my mind.

Our bodies are incredibly adaptable.

Rather than labeling exercises as "good" or "bad," I think it's more helpful to ask whether someone has the strength, capacity, and experience to perform them today.

The goal isn't avoiding movement. The goal is building enough capacity to tolerate it safely.

5. Don't obsess over posture

PT school taught me to pay close attention to posture.

And while ergonomics still matter, I've become much less concerned with finding the "perfect" sitting or standing position.

Here's why: There probably isn't one.Our bodies thrive on movement.

Changing positions throughout the day is often more valuable than trying to maintain one perfect posture for hours.

If you work at a desk, my advice is simple:

Move every 15–30 minutes.

Your body will thank you.

6. The best home exercise program is the one you'll actually do

This is one of the biggest changes in how I practice.

I used to send patients home with pages of exercises and long stretching routines.

Now I try to simplify. Most people don't need ten exercises. They need the three or four that will make the biggest difference—and that realistically fit into their day.

Patient preferences matter.

If someone enjoys an exercise, they're more likely to stick with it. And consistency almost always beats perfection. A good home exercise program isn't the most comprehensive one.

It's the one that actually gets done.

Keep learning. Keep improving.

One of my favorite parts about healthcare is that no one ever has it completely figured out.

The best clinicians continue learning, questioning old beliefs, and adapting when better evidence comes along.

I hope that seven years from now, I'll have another list of things I've changed my mind about.

Because that's how we get better.

And ultimately, that's how we help our patients get better too.