Physical therapists know slow and steady. It's a rhythm that governs their work as they encourage stroke patients to flex a forearm and pull themselves upright, or coach accident victims through the sequence of muscle movements that will allow them to walk again.

For physical therapist Rita Arriaga, the sense that steady effort can pay big benefits governs not only her work with patients, but also her efforts to raise the profile of her profession and to increase the ethnic diversity of those who choose it as a career path.

Arriaga is a small, energetic woman, whose upright carriage makes the most of every inch granted her. As director of rehabilitative services for the UCSF Stanford Health Care hospitals in San Francisco, it is her job to ensure that the physical therapy, occupational therapy, speech therapy and exercise physiology services at UCSF and UCSF/Mount Zion are top notch. And as a faculty member of the graduate program in physical therapy, she works to educate the next generation of a profession that she believes has much to offer patients.

The 27-month physical therapy training program enrolls 32 students each year, says Arriaga, who herself received her physical therapy training at UCSF in the early 1970s, when the program offered a baccalaureate certificate rather than full-fledged graduate training. The current academically rigorous curriculum includes the most in-depth study of neuromuscular and skeletal anatomy required in any of the health sciences, including cadaver dissection and laboratory studies. Students immerse themselves in neuroscience, pathology and physiology, and take specific courses with specialists in orthopedics and other disciplines that bear directly on the work of the physical therapist.

When their training is completed, physical therapists disperse into the community, working in private practice or hospital-based programs that treat patients ranging in age from newborns to the elderly. They design strengthening exercises for patients with orthopaedic disorders, help patients recover muscle use after a stroke or neurosurgical procedure, and improve the flexibility and mobility of those who suffer from arthritis or systemic inflammatory diseases. Physical therapists also work with infants and children with developmental problems, and with patients undergoing reconditioning after organ transplantation.

Arriaga, who was raised in the East Bay, grew up perceiving doctors and nurses as the only role models in the world of health care. At UC Berkeley in the late 1960s, she pursued a pre-med curriculum. It wasn't until she awoke one morning with a violent neck spasm and ended up being treated by a physical therapist at the campus health center that Arriaga found out about the profession and what it offers. The experience inspired her to change her career path and enroll at UCSF, where she received her baccalaureate degree and physical therapy certificate in 1974.

Upon completing her training, Arriaga worked for 10 years directing physical therapy and occupational therapy clinical services at UCSF, then left in 1984 to work in a private practice in San Francisco. While completing a masters degree in health science at San Francisco State University, she accepted a UCSF faculty position in 1991 and became head of rehabilitative services in 1997.

Arriaga's own experience as being one of a very few minority professionals in her field -- she is Filipina -- and her perception that the applicant pool into physical therapy programs was predominantly white and female, encouraged her to begin work decades ago toward broadening the pool of applicants attracted to physical therapy.

"Diversity has been a concern of mine all through my professional career," says Arriaga, who serves as a member of the chancellor's committee on diversity and chair of the admissions committee for the graduate program in physical therapy. Her particular class at UCSF was unusually diverse, remembers Arriaga, with several black, Latino and Asian students. "We realized we were a demographic 'blip' in the program and we wanted to make that blip become the norm," says Arriaga.

On her graduation in 1974, she approached the physical therapy program director and asked to be involved in the interview process for new applicants. The next year she and several other program graduates formed an ad hoc group to conduct minority student interviews. It wasn't long before she was serving on the American Physical Therapy Association's advisory council on minority affairs, a group that Arriaga eventually chaired. She continues to advocate for professional diversity in the health sciences with her current work, chairing the student subcommittee of the chancellor's committee on diversity, which is working to improve student outreach, recruitment, support and retention.

"My goal is to have the applicant pool for physical therapy and all the health sciences mirror the general population," says Arriaga. There is still much work to be done. Recent figures from the American Physical Therapy Association indicate that less than 10% of physical therapists are ethnic minorities, says Arriaga.

Over the years Arriaga and others have worked to provide needed counseling to college students at "feeder" schools such as San Francisco State University, which runs the graduate program in physical therapy in conjunction with UCSF, to make sure that students who might be interested in physical therapy as a career understand what academic preparation is required as an undergraduate.

Part of her effort is directed to raising the profile of physical therapy with youngsters who might eventually consider it as a career option. Arriaga works at the Mission High School health clinic twice a month, typically evaluating youngsters for sports-related injuries such as a pulled shoulder or knee, and recommending treatment by a physician, if warranted, or strengthening exercises.

Arriaga and other faculty and students also visit local grammar and middle schools to screen youngsters for curvature of the spine and to make presentations on musculoskeletal health and posture to fourth through seventh grade students.

"Often we start with the basics of computer ergonomics -- how to work at a computer terminal without straining your eyes, wrists and back -- as a way to introduce them to the concepts of physical therapy," says Arriaga. They also review the principles behind treatment of musculoskeletal injuries, which include limb elevation, ice, compression and rest.

Arriaga often asks at the beginning of each class for a show of hands of those who know what physical therapists do. There are always a few youngsters who know about physical therapy, but Arriaga wants to see all the hands go up.

by Leslie Lingaas

Links:

• Graduate program in physical therapy website

1st appeared 4/13/98

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