GP recently interviewed Ben Gallagher DPT, FMSC. If you happened to figure out that Dr. Ben is related to us, you are correct. Ben is a physical therapist at Somerset (PA) Hospital Rehabilitation and Wellness Center. As brothers, we share some very similar concepts in the treatment of patients. But, we also share contrasting viewpoints, which makes it fun to learn from each other and gain a better understanding of the professional roles we serve in providing improved quality of patient care.
Now, let's get to the questions.
GP: Please introduce yourself and give our readers some information on your professional, educational, and athletic background (as well as what you have had to overcome since birth in order to participate in athletics). BG: My name is Ben Gallagher, brother to Sean and Ryan. I live in Somerset, PA with my wife and daughter. I am a physical therapist and have been working at Somerset Hospital Rehabilitation and Wellness Center for over two years. I graduated from Indiana University of Pennsylvania (IUP) with a degree in Exercise Science in 2008. Then went on to Saint Francis (PA) University to get my Doctorate in Physical Therapy, graduating in 2012. Since graduating I have become FMS (Functional Movement Screen) certified, focusing my continuing education on movement analysis and manual therapies thus far.
Athletically, I grew up playing most sports, mainly focusing on basketball until the 8th grade when I got into ice-hockey as a goaltender, then that became my passion. I played through high school and into college at IUP. As for what I had to "overcome," that would be referencing my heart condition. I was born with Tetrology of Fallot, a congenital disorder that required surgery as a young child and again in 2008, and another in about 15-20 years. The condition restricted me from some sports and it is not advised I lift max weights, placing a limitation of how I could physically train for sport. However, prior to my 2008 surgery, in which my heart was over 3x normal size, I had no issues or symptoms. The doctors attributed my training to why I could function so well with such a crappy heart. Training was a mainstay, and still is.
GP: The thought process in your evaluation and management of patients is not widely instructed in physical therapy programs. What were the biggest influences in your professional development in not only the care that you provide, but also why you sought out additional resources beyond what you learned in school? BG: The purpose of physical therapy school is to: 1) make sure you pass the licensure exam, and 2) make sure you don't seriously hurt anyone. As for producing quality clinicians? No. School just teaches you the basics, and most practicing therapists provide you just that, the basics, which is what you could find on a Google search. So, as for what helped my professional development, honestly the biggest thing was I just thought differently. I saw things differently and I attribute that to my athletic background and training history. For example, as a PT student I would tell my class-mates, "I'm gonna have my grandmas deadlifting." My classmates would gasp, as if that was the most absurd thing they ever heard. But my thinking was, "If someone needs to build strength, why am I gonna have them lie down and lift their leg? When I want to build strength, I train the squat and deadlift, so how couldn't the same application benefit my patients?" Now let me clarify, not all movements are appropriate for all people, at all times. That's why programs need to be individualized, not cookie-cutter.
So for me, I thought, why do I want to further inundate myself with PT knowledge that is elementary and narrow-minded. I sought out other means to fill that thirst for a fuller, better understanding of how the body functions. FMS, which is for any health or fitness professional, is just one of many means to that end that I am pursuing.
Plus, I have to add this: In reference to the grandmas deadlifting story, there was a research article published shortly after in regards to the most effective exercises to strengthen the hips. The study basically ridiculed all traditional PT exercises and found the most effective was a single-leg deadlift. How 'bout them apples?
GP: You are extremely involved with your patient’s care, preferring to perform a lot of manual therapy and oversee the exercise process. This is not common of the majority of physical therapists. Can you speak to why you find this so valuable in the outcomes your patients are able to achieve? BG: I don't even know where to begin with this issue. I get fired up about the lack of quality care there is in this field. Most therapists treat with a shot-gun approach, meaning they're not sure what is really going on or how to treat so they will throw a ton of stuff at you hoping something sticks and works. But the best in rehab are like snipers. They isolate what the exact issue is and address it appropriately. And how can you do that if you are not present and in the mix with your patient's rehab process?
GP: As a physical therapist, you see tremendous value in what chiropractic care has to offer. Could you please give your thoughts on what makes chiropractic and physical therapy so complementary? BG: Following off the above question, when you are involved with your patient's care, you may find that some issue(s) may be out of your scope and there may be better, more skilled hands that are able to provide effective care. How can one means of healthcare be the most effective? What is most effective is what the patient needs. How can chiropractic care be so bad, which is the view of many therapists, when chiropractors help so many? And how can therapists think we are the kings of rehab and exercise when many therapists stick you on a machine and walk away? I have referred patients to chiropractors and massage therapists. But, I do so instructing them on what they need to share with those professionals, because just going blindly to another professional does not always mean you will get quality care. Chiropractor, massage therapist, physical therapist, strength coach….I don't care what your title is; if you're good, you're good.
GP: Posture, stability, and mobility are intensely debated topics at conferences and continuing education seminars. Could you expand on your philosophy when it comes to the dynamic role between posture, stability, and mobility, what athletes and coaches should understand about these topics, and what should be left to physical medicine providers such as physical therapists and chiropractors? BG: The first thing that athletes and coaches should understand about posture, stability and mobility is that you likely don't fully understand these concepts. Most lay people honestly don't understand how posture impacts how their body feels and the role it has in movement. Someone with good posture likely can't explain why they have good posture or how they achieved it. But, that is why we, as professionals, are here.
The stability-mobility debate is like a left-wing versus right-wing debate. My philosophy is it's a spectrum. No one physical issue is 100% in either direction, but I do believe stability is the issue the majority of the time. And if mobility is an issue, and is addressed, such as stretching or mobilizing, it should complimented by stabilization training to ensure you have control of the new motion you have just obtained.
GP: You have developed a reputation in your area as a “go-to-therapist” for athletes being referred from orthopedic surgeons because of your eye for assessing movement and your ability to successfully return athletes to competition. Besides the FMS, what other assessments do you find valuable in dealing with athletes and their competition needs? BG: For those who don't know, the FMS is a tool used to assess a person's quality of movement using seven standardized movements. If you move poorly, you are then going to compensate, compensation leads to altered or poor biomechanics, which leads to injury. So the whole purpose of the FMS is to make sure you move well. The job of the clinician is to not only identify poor movement, but to also figure out why you are not moving well. Therefore, what other assessments do I find valuable for athletes? I want to see them go through their athletic movements: swing a golf club or hockey stick, throw a ball, jump, land, cut, sprint, run, etc.
To be able to do this effectively you must first be able to analyze the movement correctly. Is the movement efficient? If it is not, then you must be able to figure out why it is not and be able to address the problem effectively. All this said, what is really needed is knowledge of athletic movement, a good clinical eye, and the knowledge of how to fix whatever issues are present.
That’s a Wrap Ben, thank you for taking the time to answer our questions. Your knowledge and insight is truly appreciated. We hope this was informative for our readers as well. For those in the Somerset, PA area, be sure to check out Ben at the Somerset Hospital Rehabilitation and Wellness Center for tremendous results when it comes to returning from injury or understanding how to move better for your exercise or sport-related goals.
Guest - Josh Gregory
on Thursday, October 09, 2014 09:03
Great read. Thanks Dr. Ben for challenging all practitioners to go the extra mile in educating ourselves on how to best treat our patients. Great insight!