Mastery in Physical Therapy Part III

ICYMI: Check out Mastery Part I: Finding your Life Task and Mastery Part II: Skills and Apprenticeship.


It’s been years since your physical therapy school orientation week. Years since your graduation, even (hah….I wish…). You’ve spent these years in intense study of your field, taking continuing education courses, reflecting on your episodes of patient care, studying your mentors and masters in your field, absorbing their knowledge and internalizing it. At least, from my perspective as a patient right now, I really HOPE you’ve been doing this! You’ve “Mastered” what already exists in the world around you.

True Mastery is more than this. Once you have reached this stage, it’s time to become active and to synthesize all the things you’ve learned, put them together in new ways or take them apart, add your own uniqueness to it. This creative activity, if it produces something both novel and needed in the physical therapy world, is what we call Mastery.


Don Reagan, in his lecture at Duke R2P, and Robert Greene alike are both quick to point out that you cannot be TRULY creative (and therefore, Masterful), without first internalizing the information that already exists. “You have to learn the rules before you can break them”, right? You have to put in the time and effort to learn your field in depth before you can play with it and make truly meaningful changes, additions, or subtractions. To this point, Don remarked that there are a LOT of people out there putting “content” out on the internet – instagram, snapchat, blogs, look at this new exercise, this new way of using therabands or barbells, this different way to think about a concept. Maybe this blog is part of that group (though I see it, for me, as more of a learning process or a way to solidify concepts and ideas in my head. I am in no way trying to pretend that I thought of this shit first.). And I think as a whole, this isn’t necessarily a bad thing – but MOST of the content out there is not Mastery.

If you’ve already gotten to the point where your head is full of other people’s information….how do you engender creativity? It’s probably a very difficult mindset shift, right? Going from simply eating up everyone else’s ideas to using them to formulate your own ideas? How does one even go about that? I can’t pretend like I’m an expert on this – remember, I’m still at the very beginning of my apprenticeship phase – but Greene gives plenty of ideas for how to foster creativity, a few of which I’ll highlight below:

Negative Capability, aka “letting go of judgement”

Often when we hear a new idea that doesn’t quite mesh with what we’ve been taught, or what we think we know is true, we meet it with skepticism and scorn. We dismiss it as an impossibility, an aberration. But, as Greene says, “skeptical, cynical attitudes can actually cut us off from so many interesting questions and from reality itself”. Open your mind to the uncertainties, and to the possibilities. When you hear or observe something new, force yourself to withhold judgement. Simply consider things as they are – they may end up being impossibilities or aberrations, but they may also end up being the missing piece to your project. Consider everything.


Broaden your Horizons

‘”The future does not lie in increased specialization, but rather in the combining and cross-fertilization of knowledge in various fields”

Once you have mastered the nuts and bolts of your own field, and internalized your mentor’s way of thinking and practicing, it can be hard to extract yourself from those walls and create something new, or start thinking in a different way. That’s why it’s best to go both deep AND wide with your education – look into other fields, and you might just find your inspiration there. This can be especially salient in physical therapy for diversifying your practice. I know personally, my background in evolutionary biology and exercise physiology gives me a more nuanced understanding of the human body and human movement; my experiences as an athlete and as a patient will color my approach to communication and the direction I want my future practice to go in. Think about all the things you ‘ve studied or participated in – if you haven’t already made connections between them and your physical therapy practice, now is a good time to start!

This is also where continuing education can help. Taking courses on many different aspects of physical therapy is part of this, of course, but why not go further? Get a strength and conditioning certification, or a USATF coaching certification, take communication, marketing, business courses, shadow the surgeons whose post-op patients’ you’re probably already treating, take a course taught by a chiropractor (*gasp* omg did she say that? She actually said that!). We physical therapists talk so much about interprofessional education, but are any of us actually DOING it? At the very least, grab a cup of coffee with someone who’s not a physical therapist, heck, with someone who’s not even in the medical field – you never know where it might lead.


Treat Yo Self

Of course, another way to broaden your horizons is to simply give your brain a break. Greene remarks that when we’re deep in thought, concentrating hard, our mind narrows and can become stale and tired with the intensity of focus. He gives anecdotes of numerous masters, Albert Einstein included, who got so frustrated with the block on their progress that they “gave up”, went to bed, and woke up with the solution right there in front of them – a “eureka” moment, if you will. If you’re stuck, and you’ve been trying to push through but the wall just seems to be getting thicker, take a break!

I personally like to use this as an excuse for a second run, bike ride, or lifting session, or even just a long walk –. Most of my ideas for blog posts come to me during workouts (then again, I’m not sure that we’d call this true creativity since I really barely begun to scratch the surface of my chosen field). Other times, I come home with Disney songs stuck in my head, so I can’t say this strategy works EVERY time…but regardless, it might find that taking a shower or a swim helps, or even just moving to another task. Or, hey, if worst comes to worst, just put on the new season of Orange Is the New Black and call it a night.


Bottom line: Ideas can come from anywhere. And “the future belongs to those who learn new skills and combine them in creative ways”. To achieve mastery in physical therapy, you must first have PASSION for it. You must love it enough to make all the late nights, years without money, and failed attempts worth it. You must have this passion because you’re going to need to put in years of learning and absorbing information.

Only when you’ve mastered this, can you branch out, entertain ideas from other fields, and begin to create.

“You must become increasingly bold. You must expand your knowledge to related fields, giving your mind fuel to make new associations between different ideas” THAT, people, is how we move physical therapy forward.


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