Common Pitfalls for Therapists When Starting Out: Tips to Avoid Them

Starting out as a therapist can be exciting and overwhelming. The positive impact of your job lies in the ability to help people enhance their mental and physical well-being. However, therapists may encounter common pitfalls in the early stages of their careers. In this article, we will explore these pitfalls and provide tips on how to avoid them.

1. Lack of precision in Motor Skills and Examination:

Accurately diagnosing a patient’s condition is a crucial skill for physical therapists. It can, however, be challenging, especially for those new to the field. It is possible for inaccurate diagnoses to lead to ineffective treatment and to obstruct the process of recovery. To avoid this pitfall, it is essential to seek feedback from experienced colleagues, attend workshops, and engage in continuing education courses. You will constantly improve your examination skills if you participate in these activities.

2. Inadequate movement analysis and correction:

The ability to analyze and correct movement is at the core of physical therapy practice. Many therapists struggle with identifying movement impairments and developing effective treatment plans. Overcoming this challenge requires practicing observational skills, reflecting on your own behavior, and seeking feedback from others. By honing these skills, you can enhance your ability to analyze and address movement issues effectively.

3. Insufficient interviewing skills:

Interviewing skills are vital for obtaining a patient’s history, identifying their symptoms, and developing an appropriate treatment plan. It is not enough to ask the right questions; therapists should also empathize with the patient and create a safe environment for open communication. To enhance your interviewing skills, consider participating in communication workshops and experiential learning opportunities. These resources will help you improve your ability to connect with patients and gather essential information.

4. Limited mastery of motor skills in treatment 

Despite mastering the anatomical and physiological aspects of their profession, physical therapists may take time to become proficient in delivering interventions. While practice is essential for improvement, it is equally worthwhile to engage in hours of repetition, examination, and collaboration with other experts. This dedicated effort will help you refine your motor skills and deliver treatments effectively.

5. Inadequate mastery of patient  education and counseling:

To promote recovery, it is crucial to educate and counsel patients effectively. Therapists often struggle with explaining complex concepts or meeting patients’ requests for additional information, even though they excel in providing treatment.To address this pitfall, consider attending workshops or seminars focused on cognitive-behavioral techniques. These resources will equip you with effective strategies for patient education and counseling.

To build a successful therapy practice, prioritize patient-centered care and strive to help your clients overcome physical and mental challenges. By being aware of these common pitfalls and implementing the suggested tips, you can enhance your skills as a therapist. This will enable you to provide better care for your patients.

Keep it Simple

The more I mature, in years that is not necessarily in other ways, the more I realize the more simple the better. The best teachers I’ve ever had simplified a subject that seemed complex. I admire that in a teacher and a clinician. It doesn’t have to be that complicated. . I remember having the opportunity to watch one of my mentors treat a patient in the clinic, I was so excited to see all the cool techniques he we was gong to use. To my dismay his treatment was so
simple, but it was so effective at the same time. He didn’t add tons of acrobatic exercises or crazy complicated manipulation techniques, he simply used the right tool for the job nothing more and nothing less. In addition to feeling great, the patient was overjoyed. Thank you Rob Panariello. Lesson learned; simple, direct with the right tool for the job wins every time. Still a work in progress for me, i tend to be an over thinker 🙂

Open letter from an “experienced therapist” to new grads (and anyone else who will listen :)).

I am approaching my 32nd year of practice as a physical therapist. Over the years, many things have changed, but some things will never change. So far, these have been my top lessons

  1. There is no end to learning. I tell my students all the time one you think you know it all you have stopped learning. If you see a patient with a certain diagnosis this year and then see them again a year later and you are doing exactly the same thing you havent grown. I earned by doctorate in my 30th year of treating and plan on continuing to learn and grow.
  2. Pick one system (Maitland, McKenzie etc) and learn the basics of the system well. It will give you a great base from which to work and allow you to grow and learn new techniques. But….once you have a base system don’t be afraid to add to your tool box. All patients do not fit into all systems, they didn’t all read the book and may require a different approach. . Be open to other ways of thinking. Residency training is a great way to accelerate the learning curve. I waited 10 years to joint a residency program and wished I did it as soon as i graduated.
  3. Make sure you find a mentor you can trust. I have made a concerted effort to find mentors over the years. Seek guidance and assistance from others if you need it (and we all need it).I reach out to my peers all the time for guidance.
  4. Teach and start early. It took me too long to teach because I felt I didn’t know enough or that what I had to offer wasn’t special. I have come to realize that the more I teach the more I learn. If you can explain it you understand. Some of the best teachers I have met take a complicated subject and make it seem easy, that is a sign of a great teacher.
  5. Treat your patients as if they are family (family that you like::) Go above and beyond your patients expectations. This can range from a quick text to see how they are doing to becoming a patient advocate. Despite the fact that you will not be able to cure every patient, you can make a difference in their lives and find them the additional assistance they need.
  6. Embrace change. Change is inevitable, the key is how we reposed to change. I continue to change as I gain more experience and that has allowed me to stay relevant and helped me continue to grow as a therapist.


Happy New Year year, 2021 has to be a better year! I look back at 2020 and say, ‘what the f*** was that? I have done some sole searching this best week and read the book “Best Self’ by Mike Bayer. The book has helped me look at the different aspects of my life and helped me focus my personal promises for this year. I made a few promises for 2021. I don’t like to call them goals because goals sounds like more hope than a true plan. The word promise is more definitive and reflects a true desire and plan to get things done. My number one professional promise for this year is to write a book. The book will assist me in putting my system and thoughts on paper with the hope that it will help clinicians. I have always loved mentoring and have been working for years to find ways to help others make a difference in their patients’ lives. I am looking forward to this journey.

In the mind of…


I started doing interviews with some of the people who have made a difference in my career. I have always been fascinated by how people think and what makes some people tick. These interviews are about 20 minutes in length allowing just enough time to get some insight and short enough not to lose the listeners interest. Please follow this link to Professional Seminars ( and listen. I have ten more planned in the next few weeks, I hope you enjoy listening as much as I enjoyed speaking with my guests.


It’s been a while

Hello everyone, it has been a long while since I have posted and a lot has happened.  I am now the director of education for Professional PT and have been spending my time developing a curiculum, teaching and in my spare time getting my doctorate.  I am really enjoying the academia world and do see patients here and there.  Although I miss patients seeing patients on a daily basis  I have been keeping my skills sharp by teaching and mentoring.

Keep an eye out for clinical gems and my thoughts to be coming your way in the next few weeks.

Don’t forget about the art of manual therapy

For the past 23 years I have spent hours upon hours trying to learn and grow as a manual therapist. Early in my physical therapy education I remember watching one of my professors perform soft tissue and joint mobilization techniques on one of my classmates and I thought “wow, how do I make my hands do that.” I went to my professor asked that very question and I remember her response to this day and share it with my students (or anyone else who will listen). She said when you first begin to perform any hands on technique your hands are like cement and as you make a conscious effort to improve the cement chips away and you develop knowing hands. I never forgotten that advice.

Today there is a big push for evidence based practice, although I do understand the importance, I hope we, as manual therapists, don’t forget about the importance of practicing our art and listen to what our hands tell us. Experts say it takes 10,000 hours of meaningful practice to become an expert in any discipline. Next time you palpate a structure or perform a technique make sure you are doing it with purpose and thought,your hands can give you amazing information with you listen to them..

What the heck is a posterior sacrum ?

Great case study this weekend at the Hesch Method seminar in Las Vegas where I had the opportunity to assist Jerry teach. I’m just hoping what gets taught in Vegas does not stay in Vegas. :). One of the students presented with what Jerry Hesch calls a “posterior sacrum”. A posterior sacrum is defined as a dysfunction in which the entire sacrum is stuck in a posterior glide between the ilia and bilateral sacral sulci are shallow. When trying to spring the sacrum and ilium all motions are blocked and both sacrospinous and sacrotuberous ligaments are taut to palpation. This dysfunction can cause havoc up the kinetic chain up to the occiput. The mostly likely cause of this non-physiological dysfunction is some sort of trauma such as landing on the buttocks. A common complaint by the patient is increased fatigue, headaches and increased urinary frequency. This weekend one of the students had this seemingly rare dysfunction with these same complaints. She was used as a case study using the Hesch Method which consisted of gentle mobilizations which were performed both manually and with the use of props to enhance soft tissue mobility based on the the principle of viscoelastic creep. The treatment took a total of about 15 minutes and consisted of 5 different mobilizations to correct the dysfunction and associated mobility restrictions and the student got off the table and stated how loose and mobile she felt. She was given a home exercise program to follow and will report back to us on her progress.

The main purpose of this short article is to share with you another tool that can help you with those hard to figure out and often frustrating cases. For more information go or check out Jerry’s many videos on YouTube (search JerryHesch)

The Hesch Method Revisited

I had always found the sacroiliac joint (SIJ) to be confusing and frustrating to treat. For a long time I just ignored it because I didn’t want to deal with all the crazy tests and rules. In 2006 this all changed for me.

Continue reading “The Hesch Method Revisited”