[orev]

By “Fitness Instructor” I think you mean “Physical Therapist” (and definitely not a Chiropractor). In the US, a fitness instructor can be literally anyone who runs an aerobics class, while a physical therapist actually has medical training.

[legitster]

No, I mean a fitness instructor. Or perhaps a "personal trainer". There are certain certifications that exist (And some people are both trainers and physical therapists).

In my (limited) experience, physical therapists tend to have much broader recommendations. Like a PT might tell you to walk an hour a day, but a trainer might recommend a specific kind of crunch that targets the actual muscles in question.

And to OP's point, PTs are very much ingrained in the US medical system and consuming their services can be a pain in itself.

But the guys who get professional athletes back on the field every week are for the most part just personal trainers with a master's level education in sports science. THOSE are the guys you want to help your back recover.

[Moto7451]

Boosting this comment, you want to talk to someone with a Masters or Doctorate in Kinesiology. Some Physical Therapists will have this or equivalent training. Some other specialists will fit the bill as well but not all.

My wife had back pain due to a disfigured vertebrae. That’s something they do not want to operate in until every other option is exhausted. Much of her pain and numbness is caused by imbalanced muscle development from a lifetime of incorrect posture and movements that compensated for the defective vertebrae. She’s worked with both a Physical Therapist and a Trainer to improve her strength and how she moves to the point that she is pain free 90% of the time. Both were referred to her by her doctors. They’re not part of a PT chain or gym.

[ianai]

50/50. The problem with going to fitness/sports people is they may get "distracted" with other concerns of theirs and ignore your central complaint. So if that fitness instructor is incredibly informed and clearly taking your priorities straight then, sure, go there. But if they seem to have a chronic case of "jock brain" and seem to be only concerned with your physical appearance then go elsewhere.

[Moto7451]

These aren’t fitness instructors. The trainer in this medical setting is someone that has you perform exercises to restore mobility rather than for general fitness. There’s certainly a link between the two but that’s not why you go to a hospital to work out.

Kinesiology is the study of how the body moves. While the largest target audience for that is going to be people looking for a standard gym fitness trainer, the higher degrees are wasted on that sort of thing and are better used to restore the range of motion of an elbow after a car accident.

[mtalantikite]

It really depends. I know plenty of people that are "fitness instructors" (mainly yoga and Pilates teachers) and I'd recommend them over regular PT in most situations. They know a ton about anatomy, how to read body imbalances, and can work with you to train your body back from injury.

Personally, I had a debilitating shoulder injury, couldn't put any weight on my right arm at all, and one of my yoga teachers put me on the path of fixing it up. Same with a low back injury, I couldn't even sit at one point and she helped fix me.

I'd 100% recommend someone with back pain visit a highly trained yoga or Pilates teacher. Some Pilates studios even take health insurance, since some are considered PT.

[sizzle]

I would be careful with shoulder injuries, your body simply can’t repair certain things like rotator cup injuries if I recall correctly.

[mtalantikite]

Absolutely, some things we actually need surgery for. But most of the time it's not necessary and really the only solution is to fix poor movement patterns and to strengthen the body. A lot of back pain comes down to strength and flexibility issues.

For my shoulder the main thing that worked was getting into the habit of doing pull-ups and stretching out my pec minor. Anytime I neglect pull-ups for a while the discomfort will creep back in. I probably should also buy a split keyboard.

[pokeymcsnatch]

So, you're definitely right- go to someone with actual medical training first. But a physical therapist's job is to get people back to basic functioning. From there, a good fitness instructor can help a person with stretching, light exercise and strength training, and stuff like posture/positioning and meal planning to maintain and improve on the initial work put in with the PT. A fitness instructor/coach is a fraction of the cost of a PT, and if you maintain a good relationship, you can just kind if drop in for guidance as needed vs going to weekly dedicated sessions.

But yeah, they can be literally anyone. A good one understands simple (bio)machines and pays close attention to how a body moves AND is a good teacher.

Edit: "A PT will get you to functional, a fitness instructor will get you to capable"