[Exclusive Interview] Why Study Strength Training & Coaching As A Physical Therapist With Dr. Al Lin, PT

There has been an undeniable shift in the clinical physical rehabilitation field, and it’s been steadily changing since about 2015. Physical therapists and chiropractors no longer focus solely on pain management, short-term relief, isolation techniques, manual therapy, and modalities. Instead, they aim to influence the whole person in front of them and achieve global long-term tissue change with a patient’s unique goals in mind.

This evolution has been extremely revolutionary. It has led to much more successful outcomes and happier patients. Clinicians who utilize this progressive approach can influence patients on a level we were never taught in school. Patients are reaping the benefits of progressive overload while adequately stressing tissues to make lasting changes.

Strength is the foundation for everything. The squat, bench press, deadlift, and overhead press are the most functional because they apply to every movement we do in our daily life. Unfortunately, doctoral programs lack the education in exercise prescription, progressive overload, or anything strength training related.

In this very special episode, Dr. Rori Alter, PT, PRSCC, SSC, and Dr. Alyssa Haveson, PT, PRSCC, CSCS, interview Dr. Al Lin, PT, who has been putting in the work to stay up to date with the massive shift, despite being in practice for 15 years. He is passionate about learning how to provide the best care for his patients. One of the most influential things for his clinical practice has been understanding the principles of strength training. He started powerlifting and noticed the importance of structured programming and the power of getting stronger.

He wanted the same for his patients. Therefore, he sought Progressive Rehab & Strength courses to understand how to program, prescribe, and teach each patient how to use strength training principles- no matter the clinical scenario.

By taking PRS Programming Fundamentals and Barbell Coaching & Movement Optimization, Dr. Al Lin feels fully equipped to achieve successful, lasting patient outcomes. This episode is chock-full of insight and lessons from 15 years in practice, where Al demonstrates that you are never too experienced to continue learning and advancing your practice.

Dr. Rori Alter, PT, PRSCC, SSC: [00:00:37] We're excited to chat with you because you are a prime example of the change. Or shift in the physical therapy or clinical rehabilitation world. At least I started to notice this shift in 2015. So I felt this massive shift was happening in the clinical rehabilitation realm. And I became exposed to barbells while I was in school. So I kind of feel like my graduating class, like that year, 2012, that everybody graduated in 2012 and like our generation was the first generation to start implementing more of a forward approach to physical therapy, integrating more exercise, progressive resistance, progressive overload. So I shouldn't say progressive resistance because we think of it like PREs, but it's not the same as progressive overload. So we wanted to chat with you today because you've taken one of our courses, one of our barbell coaching courses, and at the time that you took our first course in 2019, I think you had probably been practicing physical therapy for like 15 years at that point.

Dr. Al Lin, DPT: [00:02:07] Yeah, about 15. I graduated in 2004. So yeah, 15 years.

Dr. Rori Alter, PT, PRSCC, SSC: [00:02:12] Yeah, 15 years. And you were in that group of physical therapists who have seen a big shift in your clinical practice since you entered the field of physical therapy. We wanted to talk to you about how your clinical practice has changed over the years. Where you've seen the shift in physical therapy going, and how learning about resistance training, barbell training, and powerlifting has influenced your practice in physical therapy because we didn't learn this in school? It isn't taught to us in school; for most of us, it's not taught in our clinics or clinical rotations. So we're expected to learn it in our clinical rotations and exercise prescription as a whole; it could have parts one, two, and three in school, but there is none. And we learn a little bit about it, I guess, in our ortho courses. I can't even remember.

Dr. Al Lin, DPT: [00:03:16] Like, I think for us, it was more in our TherEx class, but very elementary level.

Dr. Rori Alter, PT, PRSCC, SSC: [00:03:21] Yes, and even the term applies that it's not the same as training or exercise. So when we think of therapeutic exercise, it's separate or different from general exercise, general strength, and conditioning. So that, you know, but it's not. And I think we want to talk to you a little bit about how you have learned about exercise and strength training and how you've implemented it in the clinic. Because our courses are geared towards, not just people who want to be coaches. Our courses are geared towards physical therapists and chiropractors or clinical rehabilitation specialists who want to bring true exercise prescriptions and true strength training into the clinical setting. Why don't you tell us a little about yourself and your barbell training and physical therapy background?

Dr. Al Lin, DPT: [00:04:20] Yeah. So I graduated from Maryland PT school in 2004, and I was in the last master's class, and then the year after, they started the DPT program. So I was in this weird transition period, and then I returned to school part-time to get my DPT. But when I graduated, physical therapy was very heavily modality based because that's when insurance companies were paying for ultrasound, e-stim, hot packs, cold packs, those types of things. And then, the first clinic I worked at was all we were expected to do. Every patient had to do those types of things. We had to reach a certain number of units, and manual therapy was just starting to become popular with therapists. So we're learning how to do different types of joint manipulations. But even in school, they wouldn't have us do it. They just told us, "Hey, you're able to when you get more experience, you can learn these things, great manipulations, but leave that to the chiropractors." And so that became popular when I first started practicing. So then, most of my early years were spent learning different techniques and Maitland and all those different. So I started going more heavily manual-based, got manual therapy certification, and thought, "Oh, like, I could just manipulate the whole spine, several different lumbar spines that will fix everybody's issues." And, you know, it's like the chiropractors. You'll see they'll get instant relief. They'll walk off the clinic. But then they returned two or three days later and said, "Hey, you know, my shoulder still bothers me. I feel the same. Nothing's changed."

Dr. Rori Alter, PT, PRSCC, SSC: [00:06:05] Right?

Dr. Al Lin, DPT: [00:06:05] I had always been interested in exercise and working out, but I never knew anything about the structure training program. But it's true. As you said, 2015 was when I started to notice that. I didn't notice it in my clinic because my coworkers at that time, I was one of the younger ones. Some of my coworkers were maybe 20-30 years practicing, and some just had master's degree bachelor's degrees in physical therapy. So they're very old school in the way that they were thinking. But I think that's when CrossFit also started to become very popular. And then, more of the population was getting into it. So you start to see more patients that said, "Hey, I do CrossFit," and then from there, you start to see, Oh, there's also powerlifting. There are other strength sports besides CrossFit. And so at that time, one of my good friends who's also a PT. But he's much younger than me. He's six years younger than me. So he got into powerlifting, and we used to do all the other sports together. We used to play basketball. We used to play golf. And I never thought he would be into powerlifting, but he's much shorter than me, and he has a good build for it. So he got into it. He said, "Hey, come, come watch a meet." Maryland State meet. So I went to go just to see what it was like. Well, he built his gym in his clinic. And he's like, I just train during my lunch. And then he's like, But I let my patients use it too, like all of my patients have to do deadlifts.

Dr. Rori Alter, PT, PRSCC, SSC: [00:07:38] I know who you're, I know who you're talking about. Does he own his practice?

Dr. Al Lin, DPT: [00:07:43] No, he works for a large mid-Atlantic corporation. But they have a lot of flexibility. And now he's been a clinic manager for at least since 2015.

Dr. Rori Alter, PT, PRSCC, SSC: [00:07:57] And he was able to bring the barbell?

Dr. Al Lin, DPT: [00:07:59] yes, they were very open-minded. Whatever you want to build out in the gym. You put a rack. You want to bring your barbells. So that's how he had so much space. And he said, "well, I'm going to start training at work, but I'm also going to start implementing it with my patients." And then he was like, "Yeah, I start to see a lot more carryover and long-term benefit improvements in the function. And he would just slowly be teaching me, like, "Hey, you should start trying some of these things in your clinic." And I mean, my clinic, they weren't open to buying a barbell and not a squat rack. However, some of the same principles you're talking about, like progressive overload, really push out our patients a little bit more. Because before it was most clinics, I've been to maybe 10lb dumbbell at the most and then blue or black TheraBands, and that's the most resistance you'll get.

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