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Articles Of The Week February 6, 2022

When we look at many of the things recommended as a major component of physical fitness flexibility is one of the topics that inevitably comes up. When we compare this to things like cardiovascular endurance, strength, or muscle endurance, is it really as important?

The Case Against Stretching – Alex Hutchinson

I sometimes wonder why others are able to accomplish more than me and honestly I get a little jealous about it. I’ve always thought maybe I just don’t have enough grit to get certain things done. However, it turns out this line of thinking can actually be detrimental.

How I Learned About the Perils of Grit – Todd B. Kashdan

We have always been big fans of movement as a tool to help patients who come in for help. Sometimes it can be a bit confusing on just how much movement to recommend (and this obviously depends on what the person is dealing with). So how much movement in general is beneficial for people? Well, here’s some guidelines!

24 Hour Movement Guidelines – Canadian Society For Exercise Physiology

At this time of year we may have people coming in with new years resolutions about health and fitness along with maybe a new gym membership. As it is with pain there may be a biopsychosocial influence behind why a person wants to do this, and it’s important we take it into account.

I Didn’t Start Weight Lifting Because I Wanted to Be Strong – Casey Johnston

It is often said that word of mouth is the best advertising. What if we took it a step further and took word of mouth online? As this article points out getting patient reviews can not only do great things for people who are booking in but also for the culture in your clinic.

Harnessing the power of patient reviews – Katie McBeth

Three Therapeutic Exercise Progressions For Lateral Movement Of The Hip

Last week we posted some hip exercises called the “Monster Walks” which were some great exercises you can do

right in your treatment room with a simple exercise band to help with balance and general exercises for the hips.

 

This week we’re going to add to those movements with some extra focus on lateral movements to help with

abduction and adduction.

 

Let’s start with just some simple lateral movements that will work the hip really well for abduction/adduction.

 

Once those more static movements get easier for your patients we can ramp up the intensity a little

by providing some more variability to the movement.

Now we’re going to increase that variability by adding some forward and backward walking movements.

 

Takeaways

  • Make sure your patient is part of the decision-making process for when to progress the exercises.
  • Use the least amount of resistance to start and then add more when the person you’re helping is ready.
  • If you’re giving this as homecare make sure they can give you a good explanation of what they’re supposed to do.
  • Find ways to make this fun and incorporate it into things they already enjoy doing.

Articles Of The Week January 30, 2022

 

We talk to our patients about taking care of themselves to prevent disability, but what about when it happens to us? We are in an interesting position as most of us are contractors so unless we pay into it ourselves, likely don’t have any kind of disability insurance. Many of us may push through injury, but how does this really affect us?

When Massage Quits You: The Tangible – Corey Rivera

Remember back in school when we used the pain scale of 1-10 as an assessment for pain? Well, times are changing. Instead, the focus is becoming more around the person’s ability to function. “The assessment of functionality is less subjective than the traditional numeric scale. But that’s not its only advantage. It’s also patient-centred.”

Tired of Rating Your Pain by Numbers or Smiley Faces? There’s A New Way to Communicate Coming – Avery Hurt

Sometimes when a person comes to see us they may have a condition we may know a lot, a little, or nothing about. In a case like Ehlers Danlos Syndrome, all of the above may apply. I did not know there are thirteen different types, nor did I know how it is diagnosed or many of the other things this informative post teaches us.

What Are The Ehlers-Danlos Syndromes? – Ehlers-Danlos Society

We talk a lot about the biopsychosocial aspects of pain. Usually, when we talk about this we’re looking at how these things influence pain. What about when an injury is influencing psychological factors and influencing things like anxiety? Concussions are one of those injuries that can cause anxiety so it’s important for us to understand the symptoms and how to influence better outcomes.

Concussion and Anxiety – Complete Concussion Management

I usually don’t include things I’m involved in with our articles of the week but I think this one is really important. RMT burnout is an important discussion (especially from the last two years) because while we work so hard to take care of the people who come to see us, it’s just as important to take care of ourselves and each other.

RMT Burnout – Jamie Johnston, Eric Purves, Stephania Johnson, Taylor Laviolette, Jocelyn Delorme

Three Therapeutic Exercise Progressions For The Hip

I joined a great gym last year and quite often when we are doing lower body exercises, they take us through a great warm up.

I have to give them credit because I can’t help but think these would be a great therapeutic exercise progression for the hips that we can easily use in our clinical setting.

It doesn’t take much room and all you need is an exercise band (and maybe something to hold for balance) and you can easily take your patients through this.

 

Here is the first progression you can use.

 

Here is the second progression, a little bit tougher.

 

And the third progression, a little bit tougher again.

 

 

Takeaways: 

  • Make sure you start with the easiest exercise first.
  • Let your patient be part of the decision-making about when to progress and make it harder.
  • Start with the least resistance first.
  • It doesn’t have to be complicated, just get them started.

Articles Of The Week January 23, 2022

 

How many times have you had a person looking to book because they need help with vertigo? I had it happen this week and didn’t know what I should do. Fortunately, this post has a three-step guide to understanding when this is a red flag, being able to identify different types of vertigo, and when to refer out.

Referral Strategies for Persons Experiencing Vertigo-Like Symptoms – Chris Burgard

Science is pretty amazing! Researchers are working on a way to help people with Osteoarthritis by developing a device that appears to regrow cartilage in a damaged knee with every step taken. While this is a long way from being implemented in humans, this looks pretty interesting.

Suffering from osteoarthritis? This breakthrough could be the key to relief – John Elder

We love analogies around here and this one is pretty awesome. Here are four reasons why massage is like ice cream (and honestly, who doesn’t love both!?).

Why Massage Is Like Ice Cream – Matt Scarsbrook

One of the biggest reasons people come to get a massage is to help with pain. While massage is pretty reliable at helping people with this, there are other factors at play contributing to a person’s pain experience where we can’t help but could refer out. Turns out our metabolic health can have a profound effect on joint pain and even contribute to Osteoarthritis.

Metabolic Health: How Our Diet Affects Joint Pain – Howard J. Luks MD

For the past month or so I’ve been going through treatment for insomnia with a Psychologist and learning more and more about sleep and how it works. While I don’t agree with everything in this post there is some valuable information on the importance of sleep and being in business, which is important for all of us as we are all our own business!

Regaining Control of Your Sleep Life…From a (Recovering) Insomniac Entrepreneur – Greg Smith

Flipping the Script: Shared Decision-Making

Hi new patient, I’m the expert. I am a physical therapist (no DPT, sorry) with 35 years of experience. Those years include a ton of continuing education and independent research. They include tens of thousands of patient-contact hours. I’ve been an educator in the continuing education field since 1995. With all that experience, I should know a thing or two. Right?

Wrong.

I do know a lot and have seen various models of intervention work quite nicely for a range of disorders, so much so that I feel I can reach for a certain tool (metaphor) when you come into my office with a certain complaint. But a wise person once told me that if you already know what you would do or what you would use with a certain patient and their problem before they come into your office, then you don’t know what you are doing. You are complex. I’m complex. Put the two together, and you have double complexity.

While I know a lot, there is one thing missing when you walk in my clinic door. I don’t know what you are feeling, fearing, expecting, and hoping for until I ask. If you don’t tell me, assuming I know what to do, we are missing a unique opportunity to help you in ways I alone cannot accomplish.

I could wow you with a bunch of research citations that speak to just why you need to speak up, but you are looking to feel better, not to be bored with what seems like my ego telling you about a cool study or two. I know that you expect me to determine what is wrong with you and to know what to do to help you. However, while I might have some ideas, I need your help. I need your help to determine if what we do, be it manual therapy or movement-based work, feels useful. Not from a theoretical perspective, but to your body and brain. For instance, does it feel like the stretch we are doing is replicating or calming your symptoms? Does it feel like I am doing something that might be helpful? If not, does it feel like what we are doing right now could be harmful? If so, I’m going to stop immediately. I’m not going to try to talk you into biting on a stick while I dig your pain out of your body with my manual therapy or tell you the No Pain, No Gain crappy story many like to believe.

What’s that? You say that you like deep pressures? You think it needs to hurt to help? OK, then let’s negotiate this whole pressure thing. I’m not going to hurt myself just to help you, nor am I going to do so much pressure or use so much resistance with movement/exercise to put you at risk, but maybe we can meet in the middle. How’s that? Do you feel like I’m having a conversation with your symptoms? Is the pressure enough? What, you’d like a little less? No problem, is this better?

So right now, with the exercise or stretch that we are doing, do you feel the connection to your problem? Yes? OK, does it feel like this exercise/stretch might be helpful for that? Great, then let’s spend some time with it.

This is what I meant about sharing decision-making. I told you that how I treat patients is different, as if you left it up to me, I may have never done something that you found perfectly useful and potentially helpful. What’s that? Why don’t other clinicians ask you to take part? Dunno, though I think that they should.