Performance Patterns: OT Got There First
Occupational Therapy is the Hidden Treasure of Performance Training
Performance Patterns: OT Got There First
When people hear performance training, they often think of physical therapy or strength and conditioning. I get it because on the surface, they seem to own the conversation. But here’s the reality: occupational therapy (OT) defined the very skills and patterns that underlie human performance decades ago.
The irony? Modern training is just catching up, but it’s doing so without using the language or frameworks that OT has already built and validated. Exercise Science is a new field, and the dogma in the field sets itself back.
Why I’m Writing This
People often mistake me for a physical therapist. I’m not. My lens is OT-informed performance. I use the same frameworks that once helped stroke survivors relearn how to live and recover. Now I apply them to athletes, professionals, and everyday movers who want to feel and function better.
Performance isn’t just about muscles or joints. It’s about the integration of skills and patterns. That’s where OT has been leading for decades. It’s an essential framework for any program, and many miss the mark as they are not introduced to the origin itself. From a scope of child development, one can see that the Run, Hit, and Throw, is a singularity of efficiency that is deeply ingrained in the human neuromuscular system. Daily routines are no doubt important, but ice baths and meditation are only a small piece of the pie. One must see the full scope to understand the simple is more effective than the complex.
Performance Skills and Performance Patterns
In OT, performance skills are the observable, goal-directed actions that make up performance. They’re divided into:
Motor skills – how you stabilize, align, move, manipulate, and transport.
Process/Praxis skills – how you initiate, sequence, organize, adapt.
Social interaction skills – how you connect, express, and engage.
When woven together, these create performance patterns—the habits, routines, roles, and rituals that shape everyday life.
Skills become patterns, patterns become routines, and routines become habits. This is the foundation of OT, and should be the foundation of any skill oriented learning.
This isn’t fringe language. It’s the backbone of how occupational therapists assess, treat, and measure success in people across all abilities. Frustrating to me, is when you see high level performers working on high level patterns, but negating the smaller skills that make up the larger outcome.
Why This Matters for Training Today
Look at today’s performance world. Coaches and trainers are talking about:
Habits and routines.
Skill transfer and adaptability.
Load management and recovery.
Movement efficiency and flow.
Sound familiar? These are essentially rebranded OT concepts—except they rarely cite OT research or frameworks. Instead, they present them as “new discoveries.” Entire methods require a system to succeed. OT provides that “system” of operation.
OT vs. PT: Where the Mark Is Missed
Physical therapy does great work in acute rehab and pathology. But when it comes to performance, there is much desired in developing resilient, adaptable humans who thrive in real-world demands… PT often narrows its scope to fixing impairments. You will find them “researching” on paper what can’t be described efficiently without observation. Most PT’s will fail to understand the foot and ankle, yet they will “rehab” a knee with ancient protocols that have a high re-injury rate.
There are a growing number of “doctors” in that field who have been taught in a classroom, but lack the practical skills or practical knowledge to truly shine. Sure, PT has a role, but they are far from the most qualified when it comes to caring for the future of our youth.
There are a plethora of personal trainers in our world, many have graduated from programs, others are self taught in the age of the internet. They all learn from one another, but ask them about OT and you will find they can’t define the profession. It shows too, as they will tirelessly work on “Strength” and “Conditioning” but fail at seeing the proper developmental sequences of human behavior and locomotion.
Occupational therapy, by contrast, has always asked the bigger question: Can this person perform in the context of their life, roles, and environment? That perspective is performance training in its purest form.
Closing Thought
If modern training wants to move beyond chasing the next gimmick, it should look back at the discipline that already mapped out human performance in full detail: occupational therapy. I have worked as a consultant for several performance programs and they have too adopted language unknowingly just from hearing it over and over again. That’s why routines (in this case instructional) become habits.
OT defined the language. OT did the research. OT built the scaffolding.
Now, I have two parents who preceded me in the field of Occupational Therapy. I was technically a “patient” from birth. The developmental milestones were laminated on the wall in the bathroom. I had checklists and visual aids throughout my childhood. I still use them today. I do know the OT leadership has largely dropped the ball in our profession. They have deeply integrated themselves into lobbyists for insurance reimbursement and seemingly spend more time fighting over pay source than advancing the profession. Today, OT continues to be redefined and stripped of its true origin. This is what ultimately led to me entering private practice.
Performance trainers like me are here to bridge that gap and it’s time the conversation started giving credit where it’s due. But, that credit should go to the systems and not the credential. I know the systems work, and it’s difficult getting into organizations who are most in need. So, if you are looking for an Trainer, a Safety Guy, or someone to just give you feedback on how your organization works as a whole… Hire an OT.
Stay InTune.
- Cody