Seeing the Whole Picture While Honoring the Details: How I Work With Patients

by Erin Collins, PT, MSPT, Astym Cert. in / Physical Therapy / Pilates / Wellness Posted on 

02/09/2025 12:11

Why the Way We Look at Health Matters

Have you ever felt like your symptoms were treated in isolation?

Maybe you went to a provider for back pain and left with a list of stretches, but no one ever asked about your sleep, stress, or how many hours you spend at a desk. Or maybe you were given broad lifestyle advice—“get more exercise” or “work on your posture”—but no one ever showed you how to move in a way that feels good and safe for your body.

Most of healthcare still operates in these silos. Providers either try to focus on a single body part or symptom, or they zoom out so far that the advice feels disconnected from your lived experience. And traditional PT? Too often it does neither.

Why Most Traditional PT Misses the Mark

Here’s the tricky truth: traditional physical therapy often doesn’t do a great job of individualizing care.

Patients are usually funneled into a protocol—three sets of ten exercises, a couple of generic stretches, maybe some ultrasound or e-stim—and then sent home with a handout. It’s not that these tools are “wrong,” but without context or precision, they rarely lead to lasting change.

• No true zooming in:The details of how your body actually moves are often overlooked. The subtle shifts in ribcage expansion when you breathe, the way your nervous system reacts under stress, or the tiny compensations your body makes when you lift a leg—these layers of nuance usually don’t make it into a cookie-cutter plan.

• No true zooming out:At the same time, the broader systems and circumstances that shape your health—sunlight, stress, sleep, hormones, nutrition, daily routines, even your limiting beliefs—are rarely considered. The body is treated as if it’s isolated from the person living in it.

The result? People feel unseen, stuck, and often bounce from one provider to another without real progress.

This is why my approach looks different. Being able to simultaneously “zoom in” and “zoom out” is my superpower. They are essential and inseparable to the way I practice. Precision at the micro level only matters if it connects to meaning at the macro level—and big-picture insights only help if they’re grounded in the way your body actually moves today.

The Art of Zooming In

When I zoom in with a patient, I’m looking at the smallest details of how their body moves and functions. This might mean:

• Looking at angle of your lower ribs when you lift a leg in Pilates

• Watching how your ribs expand (or don’t) when you breathe 

• Noting if you use breath to cheat when you want activate your deep abdominal muscle
  

Pilates is my favorite tool for this kind of detailed work. Because the method is built on precision, alignment, and control, it allows me to retrain neuromotor patterns—essentially teaching your brain and muscles to communicate more effectively.

This is where those “aha!” moments often happen: when a patient realizes that a small adjustment can completely change the way an exercise feels in their body.

But here’s the thing: zooming in only makes sense if it connects to and makes sense in the context of the bigger picture.

The Power of Zooming Out

When I zoom out, I’m considering all of the systems and circumstances that shape your health. This comes from my background in public health and behavior change theory, functional medicine, and lifestyle medicine.

Zooming out means asking questions like:

• How do your daily routines impact the way your body feels?

• What role are hormones, nutrition, or stress playing in your symptoms?

• How does your environment—work setup, caregiving responsibilities, even your community—support or strain your physiology?

• What patterns have developed over time that might keep you stuck?
  

The big picture lens gives personalized value to the details I see when I zoom in. It’s what transforms a single posture correction into a meaningful step toward your specific goals.

How the Two Work Together

The magic happens in the constant interplay between these two perspectives.

For example:

• A patient comes in with persistent shoulder pain. Dialing in, I notice limited mobility in the ribcage,  diaphragm tension, poor oxygenation, and impaired ability to activate her scapular stabilizers. Dialing out, I learn she spends 10 hours a day at a computer, under chronic stress at work and at home, gets very little sunlight, often skips meals, and also has had low-level back pain that she's ignored, believing she just has "one leg longer than the other." Addressing both the micro- and macro-factors allows her not only to move better but also to feel better in her daily life.

• Another patient struggles with recurring low back pain. Zooming in, I use manual therapy and Pilates to re-educate her deep core and pelvic floor system. Zooming out, I help her explore stress resilience strategies and protection patterns that make those core exercises actually stick.
  

It’s never either/or. It’s always both.

Why This Sets My Practice Apart

Traditional physical therapy often focuses narrowly on the “site of pain” and hands you a standard list of exercises. Lifestyle medicine providers may give you supportive recommendations but without hands-on guidance. Pilates instructors may teach beautiful, precise movement but without the integration of manual therapy and lifestyle support.

I blend these worlds. My work isn’t about treating you like a diagnosis. It’s about honoring you as a whole person—with history, habits, stresses, and goals—while also making sure the details of your movement are refined and supported.

This dual perspective allows me to:

• Create faster and more lasting results.

• Tailor every session to what your body and mind need that day.

• Help you reconnect with your body in ways that feel empowering, not overwhelming.

Why My Patients Value This Approach

The women I work with are often:

• High-achieving and used to pushing through discomfort.

• Frustrated by feeling dismissed or oversimplified in mainstream healthcare.

• Ready for a deeper, more integrative approach.

What they tell me after working together is that they feel seen, understood, and guided in a way they haven’t before. The zoomed-in precision makes their body feel better. The zoomed-out perspective makes their progress meaningful and sustainable.

Bringing It Back to You

Maybe you’ve been struggling with pain that doesn’t go away.

Maybe you’ve tried “doing all the right things” but nothing seems to stick.

Or maybe you’re just tired of being treated like a body part instead of a whole person.

If any of that resonates, know this: your body is interconnected, and your health story deserves both detailed attention and big-picture perspective.

This is why I do what I do. And it’s why I’ll keep zooming in and zooming out—because the combination is what creates real change.

A Gentle Next Step

If you’re curious about what this approach could look like for you, I’d love to talk. You can book a session here. Whether we’re working on your low back issues or getting rid of the migraines, my goal is always the same: to help you move, feel, and live better.

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