Articles Of The Week March 25, 2018

As a follow up to the article he published last week, Curtis shows us how important pain science explanations are vs. biomechanical explanations when communicating with our patients.

“Biomechanics Vs. Pain Science Part 2” – Curtis Tait

How do you explain tension headaches and their treatment to your patients? This post is full of information you could use to explain why Massage Therapy can help treat their headaches.

“Massage Therapy For Tension-Type Headaches” – Richard Lebert

We all know how important exercise is. As a result, some schools are getting more involved in exercise education for professionals using exercise as treatments for various pain and mental health issues. In fact, it is predicted that exercise recommendations are going to increase from world health organizations because of our sedentary lifestyles (which is part of the reason these schools are ramping up programs).

“How Exercise Prescriptions Could Change The NHS” – The Guardian

There are many facets to pain, and many variables on how to manage it. So, do pain management programs actually get people ‘doing’ in real life? Well, it could depend on the relationship between doing/performing and coping/adapting.

“Do Pain Management Programmes Really Influence ‘Doing’ In Daily Life” Bronnie Thompson

This is a pretty scary warning, but certainly one worth looking at. It turns out there can be catastrophic injuries from epidural steroid injections for back pain. Could be some useful information if one of your patients is considering one of these type of injections for their pain.

“FDA Warns About Dangers Of Epidural Steroid Injections For Back Pain” – USA Health Times

Articles Of The Week March 18, 2018

Do you focus on a biomechanical style of treatment, or do you prefer to focus on pain science? Not sure what the difference is, or confused how to integrate both? Well, this post should help out with that. It’s only the first one in a series, but it’s a good way to get started if you’re not sure about those topics.

“Biomechanics Vs Pain Science: Bridging The Clinical Divide” – Curtis Tait

They say exercise is medicine. In clinical studies, it has been shown that regular aerobic exercise is as effective as anti-depressants for reducing symptoms of mild to moderate depression. Unfortunately in our society inactivity is the norm, so exercise isn’t used as much.

“Running From The Pain”  – Scott Douglas

More about exercise! Intense exercise can cause dramatic improvements in heart health, even at older ages.

“Hearts Get ‘Younger’, Even At Middle Age With Exercise” – Patti Neighmond

There are four critical questions we ask ourselves which make us feel like we are connected to our communities. It turns out taking one extra second to be connected with others can actually improve the quality of that presence. 

“How To Change Your Life In One Second Flat” – Katherine Schafler

There is a subheading in this article that is truly amazing. “The best workout isn’t always the most extreme one. The best on is the one you enjoy.” I’d say the same would apply to exercises you recommend to patients for homecare.

“Whatever Happened To Moderate Fitness?” – Colleen Stinchcombe

It’s Time To Start Building Your Tribe

“If you think leadership is only for other people, you’re wrong. We need YOU to lead us” – Seth Godin

We live in a time where information and innovation are at our fingertips.

Yet, within our profession, we still sit steeped in outdated information and a lack of updated education for our students coming out of college.

But there is a reason for that. It’s easier!

It’s easier to teach people to be sheep that follow along, rather than challenge the status quo. It’s easier to go decades without updating curriculum, while still teaching old information with confidence, and failing students for questioning otherwise.

What’s also easier is to just follow rather than question. And there’s nothing wrong with that, it’s human nature. Why would we question what educational institutions and regulatory bodies say?

Well, we have to in order to grow. 

This is where you come in. Your community needs you, and our profession needs you. We need you to embrace the tension between what you were taught and what new information says (it’s literally at your fingertips). 

If you don’t think you can do something like this, you’re wrong. There is a leader in all of us, sometimes we just need to learn how to bring it out.

So with that, here are some examples of therapists doing great things in their communities both locally and professionally to bring about change and make a difference.

Four Therapists Building Their Tribe

Rajam Roose

She was not a professional event organizer and had never taken on the task of organizing a conference while running her massage therapy practice. But, in January of 2014, after organizing a combination CEU course with Barrett Dorko, and Diane Jacobs, a light bulb went off. Rajam would go on to create the “San Diego Pain Summit,” which would officially start in 2015.

Rajam reached out to presenters and would organize them coming to one place to present on pain science, which would, in turn, start to influence our industry (this is where she started building her tribe). Many don’t know that she does everything for the conference herself, from managing the website, organizing speakers, hiring video, negotiating venues, and organizing volunteers (just to name a few of the necessary tasks), which has led her down a road into being more of an educator than strictly a Massage Therapist. Not only has this opportunity led into more business developments, it has also developed quality relationships with therapists from around the world, and gives her a feeling like she is serving our Massage Therapy community by helping therapists change how their patients pain is managed.

All too often many of us sit back because of “imposter syndrome” for fear that we can’t do something, or don’t know enough. So, I have to include this quote from Rajam:

I also have a bit of a rebellious personality. From prior life experiences, I’ve learned that we can do anything we set our minds to. I enjoy shaking up the status quo. For example, most people may be shocked to learn that I have very little formal education. I only have 2 years of high school and 1 year of a college education under my belt. I hope people will read this here, learn what I have and am doing, and be inspired to know they can do anything if they want.

Sarah Haag

Six years ago sitting on a train platform in Milan, Sarah was talking to her friend Sandy Hilton discussing how much better the world would be if healthcare was better, simpler, more efficient, and more scientific. They shared common goals and dreams when it came to patient care, so they started Entropy Physiotherapy.

Part of the goal was to host courses in their clinic where they and other therapists could learn from the best in the world, not just the best who happened to be closest to them when they needed a course. When picking speakers, they chose the ones that would challenge them, make them a little uncomfortable, and start discussions that would make practitioners better.

They wanted course offerings that left you energized from new ideas, collaborations, and developed new relationships. They reached out and started to find those exact kind of instructors, and also took a different approach in dealing with them. As a team, Sarah and Sandy would be very mindful of treating speakers well and not gouging them, or the course participants. While they didn’t have the intention of building a tribe, it has happened in the ensuing years. The people they’ve met at courses and conferences have become their tribe, which is something they’re only too happy to be a part of, not one they feel like they are leading (and they’re having a lot of fun doing it).

Brian Rutledge

“Necessity is the mother of invention” – Plato

After years of co-owning a successful group practice, Brian decided to go out on his own. 

He thought he had all the right skills and all the right plans, but he had no idea what was in store. While solo practice hasn’t exactly been great for his wallet, there have been other opportunities develop.

Having extra time, he has been able to learn about himself, while growing and refining his vision and purpose. This has given Brian the time to start teaching (even though advocating for up-to-date science can be an uphill battle and one that isn’t exactly rewarded), to engage with other professionals, and to pursue other interests. Some of those interests have led into building a community locally and online, as well as creating more educational content, to put on more courses locally for other practitioners.

Those interests have helped shape his practice and resulted in more enjoyment in what he does, a better relationship with patients, and the ability to refine crucial communication skills which have brought about a greater connection with people.

Two years of personal and professional development haven’t been easy, but building his tribe has been priceless.

Jenn Sharman

In October 2017 Jenn teamed up with an old classmate to open a new clinic.

They had a strong desire to create a clinic grounded in evidence-based approaches to treatment and patient care within the biopsychosocial lens while staying within their scope of practice as RMT’s. 

Knowing there was new research detailing advances in pain science for patient care, that wasn’t taught in school, they wanted to discuss these developments with other colleagues. They decided to create a monthly ‘pain science discussion group’ at their clinic. So far the response has been far more enthusiastic than expected (especially since it’s on Friday nights).

So far, three meetings in, the discussions have been on topics like “reconceptualizing pain, enhancing placebo-minimizing nocebo, and shifting from structural pathological to biopsychosocial.” 

Their group has a wide range of people from new grads to seasoned veterans who are all helping in their own way. While this represents an exciting time for manual therapy, it has brought about concerns. If students are not taught up to date information on pain it is doing a disservice to the public, which highlights how we need to come together as a profession to understand current best practices and let go of approaches or theories not supported by scientific evidence.

In creating this group, there is an attempt to share relevant research and get conversations started based on where to look for valid research and information.

This is another spot where I will include a quote:

it’s really exciting to see the level of interest amongst the community of RMTs. Once you get a group of passionate people talking in the same room, new connections and opportunities to create change will grow from there. I’m really excited to be a part of the conversations that need to happen to move our profession forward so that we can provide effective, compassionate and evidence-informed patient care.

Photo by: rawpixel

Now It’s Your Turn

I hope some of those examples will resonate with you as a therapist. 

It doesn’t take a fancy education, huge credentials, or a big financial backing to start making a difference. It just takes some motivation and the desire to create change. 

Part of what needs to be done is changing the effect some of the “modality guru’s” have within the manual therapy professions, they have made their own tribes. But those people are not where we are going to make change. Growth happens when we reach out to those who aren’t committed members of a tribe, but rather those who are at the fringes questioning modalities, old theories, or questioning those gurus. 

Looking at your local community right now, there are a few ways you can start to build your own tribe. Start by reaching out to other practitioners, whether they are Physio’s, Chiro’s, Athletic Therapists, or other Massage Therapists and be willing to start a conversation (just for the love of all that is good, please make sure it’s evidence-based). You will soon find out if they can be part of your tribe. 

Start pulling people in and discussing best practices, business, education, and whatever else will help each person in your tribe grow professionally and personally. 

Be a leader!

Once you have started locally, reach out online. Start fostering relationships with other practitioners, join in conversations, start conversations, watch debate and see what you can learn.  Join some facebook groups that will challenge your thinking, you will soon find out who you can learn from, and who is still stuck in old theories. Just make sure you join in the conversation.

As Jenn Sharman said, “it’s an exciting time to be a manual therapist,” and it’s a lot more exciting when more people are joining in. 

 

 

Articles Of The Week March 11, 2018

Is yoga effective for managing chronic pain? Maybe, but then again maybe we just need to look at safe, non-threatening movement as a way to cure or manage chronic pain.

“Yoga, Mice, Pain and Your Brain” – Sarah Haag

There are some great points in this article about doing aggressive psoas work on patients, but there’s some things I don’t like about the article. To say that only those trained in visceral work should be doing this kind of work (because there’s not much evidence to say visceral manipulation is effective), is a bit of a stretch. However, I like the overall gist, that only trained professionals should be doing the work, and to be careful, there’s no need to do “aggressive” work.

“Serious Warning – If You Do Any Releases To Your Psoas or Abs, You Must Read This” – Antony Lo

Load management in athletes is an important factor in making athletes available for, and being in the best shape possible for competition. This post reviews three factors related to load management to help your athletes.

“Load Management Is Not About Decreasing Minutes” – Tim Gabbett

I love sleep, so I hate this part of the year where I lose an hour of it putting the clocks forward (why are we still doing this!?). A lack of sleep can lead to a host of health conditions and can affect brain health. Fortunately, massage therapy helps with sleep, so this could be a good article to share with your patients as another reason to get a massage!

“Why Are We So Sleep Deprived And Why Does It Matter?” – The Conversation

I’ve been asked many times if I would ever open up a practice at home and while it’s not for me, I know plenty of therapists who do. This post lays out several things to consider if you are wanting to open a home-based practice.

“Opening A Home Based Massage Business” – Allissa Haines

Articles Of The Week March 4, 2018

This one is really interesting as it is several small interviews with different pain experts on different aspects of pain.

“Trust Me, I’m An Expert” – The Conversation

Next isn’t so much an article, it’s a video. But, it’s a great video you could use to help explain pain to patients (or anyone else for that matter). In less than five minutes you could give a simple explanation to patients about what’s going on with them.

“Understanding Pain In Less Than 5 Minutes” – Get PT 1st

Scientists have found “anxiety cells” in the hippocampus which regulate anxious behaviour. They have even found ways to silence them!

“Scientists Just Identified The Physical Source Of Anxiety In The Brain” – Peter Dockrill

It turns out the gut-brain connection is starting to show that certain foods influence the bacteria in our gut, which in turn can influence the mental health. The brain and serotonin are also directly influenced by the gut and dietary improvements may be a strategy for managing mental health.

“Is Your Diet Fighting Depression – Or Intensifying It?” – Natalie Shoemaker

Wow, it seems there’s lots on pain this week, but this is pretty cool! New fitness machines called Jymmin combine a mixture of working out and free musical improvisation, and they make us less sensitive to pain.

“Jymmin, How A Combination Of Exercise And Music Helps Us Feel Less Pain” – Neuroscience News

Articles Of The Week February 25, 2018

 

It can be a bit stressful when we think about treating patients with chronic pain as there is a lack of understanding and tools for treating this population. However, the biopsychosocial approach is a framework that can be effective, and this post shows why.

“A Plea To Providers: This Is Why Biopsychosocial Treatment Of Pain Works” – Devra Sheldon

I know there is some research being done at our local university on this exact topic, but can a blood test actually diagnose a concussion? Well, not yet, and this post shows four reasons why.

“Can A Blood Test Diagnose A Concussion?” – Complete Concussion Management

I hate paying taxes, but unfortunately, it’s that time of year again. Maybe next year I will have to use some of the advice from this post to make sure I’m ready at tax time.

“Tis The Season For Taxes (Again)” – Cath Cox

It seems as though the real learning in our industry happens after college and in continuing education courses. However, we need to be careful when choosing which courses to take because they can actually reduce our credibility.

“Fantasy Physiology And The Post Hoc Fallacy” – Whitney Lowe

Have you ever looked at the cost difference between getting a new client, or retaining the ones you have? Over the long term, you’re better off to build solid relationships with your current patients, and since they love your treatments and trust you, they’re more likely to refer their friends to you. While this post is directed at personal trainers, there’s some solid advice in there for therapists too.

“The Importance Of Client Retention” – Michael Anderson