Machine training is a real issue in PT. Are you a good PT when using machines or not? That question can only be answered by looking at the target and level of the customer.
First of all the level is important. When a customer comes to you the start must be the operational movement “machine” of the individual. You teach them how to move well, perform the exercises in the right way and adapt to new challenges. Next is motivation and coordination. At the end of your series of lessons you teach how the customer can set up its own program and measure performance. This is the normal situation of PT work when working toward a final goal and let the customer go. If you and the customer agree to have a permanent relationship, the building blocks are different.
In most cases of top PT the customer comes with a target in mind. A real target, not such vague one as “oh sir, I want to lose weight”. Performance PT is target directed. You start at A and end at Z. When the target is reached both move on their way.
In the first part we use machines to support motion control. Each machine has a fixed movement pattern and it is often hard to adjust it to an individual level. Our bodies are not made to get accustomed to fixed movements as we all have an individual adjustment system and unequal left and right movement. Hardly anybody has a synchronized or symmetrical movement between left and right side. Machines offer no choice than a symmetrical movement. This can increase injuries in many cases.
Free weights or alternative resistant offers a wider range of motion and enables individual adaption. A PT should use this more than machines. But there are reasons to use them. Fun reasons such as a circuit training, revalidation of specific area’s with low or max resistance under safe circumstances, control of the range of motion and in some cases used as test instruments.