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We are joined by physical therapists Saurabh Mehta and Christos Karagiannopoulos, who – along with a team of therapists and surgeons – developed a clinical practice guideline for rehabilitation following distal radius fractures. They share with us how a CPG is developed, how the evidence is synthesized and how they came to their conclusions based on the evidence to provide recommendations for evaluation, interventions and prognosis. Guest Bios: Dr. Karagiannopoulos is a full-time associate professor at DeSales University DPT program with a current line of research on the assessment and management of wrist sensorimotor control impairment. He has earned a Bachelor of Science, a Master of Education, and a Doctor of Philosophy in Kinesiology from Temple University. His master's in physical therapy was earned from MCP-Hahnemann University (Drexel University) in 1999. Christos has dedicated his 20+ years clinical practice in orthopedic physical therapy and the rehabilitation of the upper extremity as a Certified Hand Therapist. He has dedicated his clinical research line on the wrist sensorimotor control impairment, developing the active wrist joint position sense test and its psychometric properties. Dr. Karagiannopoulos has published his most recent research work in the Journal of Hand Therapy, and he co-authored the most recent 2024 APTA Clinical Practice Guidelines on distal radius fracture rehabilitation in the JOSPT. He has also co-authored the 2020 AAOS Clinical Practice Guidelines for distal radius fracture management. Dr. Karagiannopoulos has lectured at various local, national, and international symposiums. He currently serves on the APTA Academy of Hand & Upper Extremity as a program co-chair and a member of the research committee. He is also a member of the Journal of Hand Therapy editorial board.Dr. Mehta is a board-certified specialist in geriatric physical therapy and the Director of Research for the College of Health Sciences at East Tennessee State University. He has collaborated and published multiple data-based articles and systematic reviews in upper extremity rehabilitation, healthy aging, and improving physical functions in the elderly. Dr. Mehta recently led the efforts to develop ICF-based clinical practice guidelines for the rehabilitation of distal radius fractures. He is the chair of the Aging Research and Geriatric Rehabilitation Networking Group of the American College of Rehabilitation Medicine
For this month's Clinical Corner Article, Matt and Allie discuss a research report from the JOSPT that compared muscle strengthening in kids who have had recent knee injuries and those who have not. Would either condition be an ideal state to gain baseline strength? Strength/ strength deficits, different sport injuries, and opposite sexes were compared in this research. The results showed that strength improved but no gains were made thereafter.Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
Dr. Clare Ardern, assistant professor at the University of British Columbia and editor-in-chief of JOSPT, joins the Rehab and Performance Lab Podcast with host Phil Plisky to discuss confidence to return to sport after injury. Clare shares insights from her extensive research in ACL rehabilitation, addressing common mental barriers athletes face when returning to sport. Together, they explore practical strategies, including goal setting, confidence assessment, and techniques to create a safe therapeutic space for athletes. Don't miss this episode packed with actionable advice for supporting athletes to successfully and confidently return to sport.Interpret the evidence around supporting athletes and active people to feel confident about returning to sport after musculoskeletal injuryApply evidence-based, practical strategies to support athletes and active people's psychological readiness to return to sport after musculoskeletal injurySolve patient case scenarios involving low confidence to return to sport or high fear of reinjuryIntroduction to guestWhy this clinical question?What's the evidence and application?Three main takeawaysis brought to you by Medbridge. If you'd like to earn continuing education credit for listening to this episode and access bonus takeaway handouts, log in to your Medbridge account and navigate to the course where you'll find accreditation details. If applicable, complete the post-course assessment and survey to be eligible for credit. The takeaway handout on Medbridge gives you the key points mentioned in this episode, along with additional resources you can implement into your practice right away.To hear more episodes of Rehab and Performance Lab, visit https://www.medbridge.com/rehab-and-performance-labIf you'd like to subscribe to Medbridge, visit https://www.medbridge.com/pricing/
For this month's clinical corner article, Matt and Allie discuss a case report from the JOSPT that covers a scenario where a patient was able to avoid surgery on her shoulder with Blood Flow Restriction treatment in physical therapy. You'll learn how Blood Flow Restriction works, how it's applied in PT and who is a candidate for this treatment. Blood Flow Restriction is a treatment available at ALL Oxford PT locations, and you can learn more on our website.Read the article here: https://www.jospt.org/doi/10.2519/josptcases.2024.0031Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
Matt and Allie are back with the first clinical corner of the new year! For this month, Matt introduces a case report from JOSPT on the differential diagnosis of Parsonage- Turner syndrome and rotator cuff tear. Going back to basics, Matt helps Allie understand all the key components at play as he discusses the article's findings and outcome. You'll hear about the injury, treatment and recovery for the patient that was used for this report that emphasizes the importance of differential diagnosis.Read the article here: https://www.jospt.org/doi/10.2519/josptcases.2024.0038Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
To round out the clinical corner articles for 2024, Matt and Allie discuss a research report from the JOSPT that compares exercises to treat patellofemoral pain. You'll hear about the two subgroups of patients that went through hip focused exercises and quadricep exercises to see which had a better outcome. Learn about "pain catastrophizing", the scale they used to grade each patient's progress/recovery and how the patient's BMI plays a factor in treatment. Read the article here: https://www.jospt.org/doi/10.2519/jospt.2024.12503Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
Dr. Damian Keter is interviewed by Dr. Tony Varela. The focus of their discussion is Dr. Keter's research, “Priorities in updating training paradigms in orthopedic manual therapy: an international Delphi study,” investigating expert consensus on modifications and adaptions to training paradigms required for orthopaedic manual therapy education (OMT) to align with current evidence. This conversation further explores how neurophysiological, psychological, and biomechanical principles inspires person-centered approaches and patient factor effects that contribute to successful OMT intervention.REFERENCES:Keter D, Griswold D, Learman K, Cook C. Priorities in updating training paradigms in orthopedic manual therapy: An international Delphi study. J Educ Eval Health Prof. 2023 Jan 27;20:4. doi: 10.3352/jeehp.2023.20.4.Keter D, Hutting N, Vogsland R, Cook CE. Integrating Person-Centered Concepts and Modern Manual Therapy. JOSPT Open. 2023;2(1):60-70. doi:10.2519/josptopen.2023.0812Silvernail JL, Deyle GD, Jensen GM, Chaconas E, Cleland J, Cook C, Courtney CA, Fritz J, Mintken P, Lonnemann E. Orthopaedic Manual Physical Therapy: A Modern Definition and Description. Phys Ther. 2024 Jun 4;104(6):pzae036. doi: 10.1093/ptj/pzae036. PMID: 38457654.John M Mayer, Michael Jason Highsmith, Jason Maikos, Charity G Patterson, Joseph Kakyomya, Bridget Smith, Nigel Shenoy, Christopher L Dearth, Shawn Farrokhi. The influence of active, passive, and manual therapy interventions on escalation of health care events after physical therapist care in Veterans with low back pain. Phys Ther. 2024 Oct;104(10):pzae101, https://doi.org/10.1093/ptj/pzae101Peter Westlund Sørensen, P., Nim, C., Poulsen, E., Juhl, C. Spinal manipulative therapy for nonspecific low back pain: Does targeting a specific vertebral level make a difference?: A systematic review with meta-analysis. JOSPT. 2023 Sep;53(9):529-39. doi:10.2519/jospt.2023.11962Nim, C.G., Downie, A., O'Neill, S. et al. The importance of selecting the correct site to apply spinal manipulation when treating spinal pain: Myth or reality? A systematic review. Scientific Reports. 2021 Dec 3;11(1):23415. https://doi.org/10.1038/s41598-021-02882-zJorge E. Esteves, Rafael Zegarra-Parodi, Patrick van Dun, Francesco Cerritelli, Paul Vaucher, Models and theoretical frameworks for osteopathic care – A critical view and call for updates and research. International J of Osteopathic Med. 2020 Mar 1;35:1-4. Doi 10.1016/j.ijosm.2020.01.003.McDevitt AW, O'Halloran B, Cook CE. Cracking the code: Unveiling the specific and shared mechanisms behind musculoskeletal interventions. Arch Physiother. 2023 Jul 6;13(1):14. doi: 10.1186/s40945-023-00168-3.
The complex world of clinical practice in musculoskeletal rehabilitation brings many challenges. Some you might feel prepared for, while others...not so much. Musculoskeletal physiotherapist and shoulder specialist, Jared Powell, is here to reassure us that no-one expects you to have all the answers, encourage us all to think carefully and critically when evaluating information, and to embrace a work-related niche that resonates with your passions and strengths. Jared shares ideas on how to succeed as a compassionate and effective musculoskeletal rehabilitation specialist. ------------------------------ RESOURCES "Dear newly graduated physical therapst" article: https://www.jospt.org/doi/10.2519/jospt.2024.12676 ------------------------------ The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2
Send us a textIn this episode with Robin Kerr, we explore a recent paper looking at the addition of manual therapy to an exercise program for subacromial shoulder pain. We discuss: Discrepancies in current shoulder researchImportance of individual patient treatment selectionExercises used within this paper for shoulder rehabilitation Manual therapy within treatmentImportance of subgrouping in research
Today brings a refresher on best practice in managing non-traumatic shoulder pain. Professor Karen McCreesh (University of Limerick) guides the listener to the best available clinical practice guidelines and runs the ruler over different approaches to exercise therapy. ------------------------------ RESOURCES Diagnosing, managing and supporting return to work for people with rotator cuff disorders (practice guideline): https://www.jospt.org/doi/10.2519/jospt.2022.11306 Efficacy of exercise therapy - systematic review: https://www.jospt.org/doi/10.2519/jospt.2024.12453 GRASP trial: https://pubmed.ncbi.nlm.nih.gov/34382931/ JOSPT Insights episode 173 (shared decision making): https://podcasts.apple.com/ca/podcast/ep-173-shared-decision-making-what-it-is-and-what-it/id1522929437?i=1000651049481 or https://open.spotify.com/episode/6CCh5FRTGAsz54bdpWbYGB?si=c40b2c227eb94a12 ------------------------------ The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2
Today's episode takes the spirit of our popular SPORTS CORNER series, and flips it to learning about playing a leading role in the world of sports medicine and rehabilitation. Dr Ciara Burgi has worked across collegiate, professional men's, and professional women's sport, and has a ton of wisdom to share. From building rapport with athletes and patients, to valuing your work in the present without looking too far ahead to what might (or might not) come next, and doing what you can with the resources at your disposal, are among the topics Dr Burgi covers. ------------------------------ RESOURCES The American Academy of Sports Physical Therapy and JOSPT are co-hosting the second Virtual Sports PT Conference on Saturday 2 November. You'll hear from world-leading clinician-scientists including Drs Terri Chmielewski, Lori Michener, Karin Silbernagel, Liz Wellsandt and Rich Willy. Register now to take advantage of the extended early-bird price and the opportunity for up to 13 continuing education contact hours. Registration and information: https://tinyurl.com/3xkcrtu2
The YAHiR (Young Athletes Hip Research) Collaborative takes over the JOSPT Insights podcast today. Tune in to learn about best practice in diagnosing and managing inguinal-related groin pain. Willem Heijboer, sports physiotherapist and clinical epidemiologist from the Amsterdam University Medical Centre, joins Dr Josh Heerey to share the latest research to inform your practice. ------------------------------ RESOURCES Learn more about how the YAHiR collaborative is partnering to promote and protect athletes' hip health through high-quality research: https://www.ndorms.ox.ac.uk/research/yahir The next Young Athlete's Hip Symposium is on 25-27 September, 2024, at Worcester College, Oxford University The YAHiR Collaborative, La Trobe University and JOSPT are co-hosting a webinar mini series in May and June 2024. In these webinars, you'll hear more from experienced clinician-researchers Drs Josh Heerey, Jo Kemp, Kate Jochimsen and Mike Reiman. Dr Lindsey Plass and Luke Kearney, who both have lived experience of hip pain limiting their sporting careers, bring the athlete's perspective. For more information, and to register: https://semrc.blogs.latrobe.edu.au/events/yahir/ More on the terminology of inguinal-related groin pain: https://pubmed.ncbi.nlm.nih.gov/36111127/ Reliability and accuracy of clinical tests for diagnosing inguinal-related groin pain: https://pubmed.ncbi.nlm.nih.gov/36643406/ Rehabilitation and return to sport after surgery for inguinal-related groin pain: https://www.sciencedirect.com/science/article/abs/pii/S1060187217300382
For this month's clinical corner article, Matt and Allie discuss an article from the JOSPT that discusses the current diagnostic imaging curriculum in PT schools, comparing it to different PT programs in the country and how it has evolved in the past several years. Currently, not all states permit physical therapists to order or read MRI/X-ray/CT Scans etc. With the increase of Direct Access patients - in order to promote more efficient care, physical therapists could have the ability to refer patients for diagnostic imaging in the near future.Read the article here: https://www.jospt.org/doi/10.2519/josptopen.2024.1026#_i11Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
Dr. Zac Morgan // #ClinicalTuesday // www.ptonice.com In today's episode of the PT on ICE Daily Show, Spine Division Leader Zac Morgan discusses the gap between social media and actual clinical practice, seeking real mentorship from real clinicians treating in the clinic instead of social media influencers, and the importance of having a healthy sense of humility regarding manual therapy treatments. Take a listen or check out our full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about our Lumbar Spine Management course, our Cervical Spine Management course, or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION INTRODUCTIONHey everyone, Alan here, Chief Operating Officer here at ICE. Before we get into today's episode, I'd like to introduce our sponsor, Jane, a clinic management software and EMR with a human touch. Whether you're switching your software or going paperless for the first time ever, the Jane team knows that the onboarding process can feel a little overwhelming. That's why with Jane, you don't just get software, you get a whole team. Including in every Jane subscription is their new award-winning customer support available by phone, email, or chat whenever you need it, even on Saturdays. You can also book a free account setup consultation to review your account and ensure that you feel confident about going live with your switch. And if you'd like some extra advice along the way, you can tap into a lovely community of practitioners, clinic owners, and front desk staff through Jane's community Facebook group. If you're interested in making the switch to Jane, head on over to jane.app.switch to book a one-on-one demo with a member of Jane's support team. Don't forget to mention code IcePT1MO at the time of sign up for a one month free grace period on your new Jane account. ZAC MORGANGood morning, PT on Ice Daily Show. I'm Dr. Zac Morgan, lead faculty here with the cervical and lumbar spine management, teaching both of those courses on the weekends. And if you have not had those courses, both of them involve a decent amount of manual therapy. So we enjoy kind of teaching manual therapy, doing manual therapy on one another those weekends and kind of reframing how you might frame that manual therapy intervention with your clients. in the hopes of maybe creating a little less dependence on manual therapy and instead a lot of independence in our patients and kind of pushing them towards a more fitness-forward lifestyle. For those of you that have been to the courses, you know that's a big deal to us here at ICE and we love doing that. And this morning's podcast is titled Manual Therapy Misconceptions because I think this is definitely an area in the manual therapy world, physical therapy specifically, where I see a lot of disconnect between what happens in the clinic and then what happens on social media. So I want to start out by talking about over the last several years of spending a lot of time on the weekend, you know, teaching manual therapy techniques, fielding questions in those settings, as well as spending a lot of time in the clinic treating a lot of clients with acute back pain, with acute neck pain, with persistent back pain, with persistent neck pain. I see a lot of misconceptions and at our clinic we spend a lot of time training younger clinicians and bringing through students and then also on the weekends working with a lot of seasoned clinicians And I just see that social media has had an influence on our profession's willingness to use manual therapy and our understanding of everything. And so I think that's what today's podcast is about, is sort of how that has been influenced and maybe just reframing some of our thoughts around it. THE GAP BETWEEN SOCIAL MEDIA & REAL CLINICAL PRACTICE There's one thing that's for sure. If you spend a lot of time on social media and specifically follow a lot of the conversation that happens in our profession, you'll see a huge gap between what a lot of people say out there on social media and what actually clients want and what drives people to seek out physical therapy. So there's a huge gap there. And that's where I want to kind of start is with the social media conundrum. Obviously, social media platforms have become such a popular way for us to get new clients, for us to educate the public, and for us to educate one another within the profession. But there is a conundrum here. And the conundrum is that all of the platforms, really regardless of which one you spend time on, they are built specifically for the reason to drive engagement. The goal of those apps is to keep you on them for longer. That's why they exist. So within that, the content that typically keeps people's eyes on it for longer is generally framed more contrarian or more negative, that tends to drive engagement more frequently. So if you post something negative or if you point out something negative, often you will see a lot more engagement, a lot more comments, a lot more likes, a lot more just overall view of that content. And I think that this can cause a lot of issues in clinicians and has caused a lot of issues and I've seen it firsthand and that's a huge issue in our profession. So I kind of want to talk a little bit about those issues specifically and then what we might do to sort of reconcile them. SOCIAL MEDIA DRIVES CLINICAL CONFUSION So the biggest issues that I see and this is really regardless of whether it's a younger clinician or somebody who's a little bit more of a seasoned veteran What we see is when people spend a lot of time kind of intaking some of that negative information from social media, it drives a lot of clinical confusion. People are confused about what they should do with their patients. It drives ethical challenges. Some of these posts call into question how ethical manual therapy is, and it makes people feel like maybe it's a little unethical for us to be doing hands-on care. And they definitely often drive further away from expert opinion. So when I say expert opinion, I mean things like our clinical practice guidelines. So you think about what that is, like how those are formed, and it's really the foremost experts in our profession getting together, synthesizing all the data that exists, synthesizing clinical experience as well, and then making evidence-based recommendations. To get a clinical practice guideline published, it requires a lot of work, a lot of experts to communicate with one another and develop expert opinion. And here's what we think. This is a grade of A, this is a grade of B, and so on. To get a social media post out requires nothing other than an internet connection and a device that can do it. sometimes we're reading these opinions from non-experts and those non-experts could wind up being very loud and have a large platform and that doesn't always equate to someone that actually spends a lot of time in the clinic. So I think this is where some of that confusion can come into our practice, whether again, whether you're a younger clinician or someone that's more seasoned, it's kind of who we're choosing to listen to because of who's the loudest on social media and that being where we get most of our information. "MANUAL THERAPY DOESN'T WORK" So the narrative specifically, the misconception specifically that I'm addressing in today's episode is this manual therapy doesn't work narrative. So a lot of people have that feeling that manual therapy doesn't work and there are certainly studies that have challenged the efficacy of manual therapy and you see those studies get talked about a lot on social media again because they're negative and they drive engagement. But that narrative is one that I have heard often be challenged either on the weekend or in the clinic where people are just confused about whether or not manual therapy works. And that's a huge disconnect between clinicians that you talk to that do treat a lot of these issues. Those clinicians typically feel strongly that it does work and again our experts If you look in the clinical practice guidelines for back pain, for instance, you're going to see that really regardless of the presentation, there's some expert opinion that we should use manual therapy, that it should be used almost regardless of acuity or stage. Manual therapy might be something that should be included in back pain. And that's not just profession-specific. A lot of clinical practice guidelines make those suggestions, but ours certainly do. The updated ones from 2021 from Stephen George and colleagues make a lot of recommendations surrounding manual therapy. So I think that disconnect is driving a lot of clinical confusion for us. The reason this podcast kind of came up in my head, the topic, really came to me when I was looking through the recent JOSPT and there was a systematic review from, forgive me if I butcher the name here, but I think it's Ruzick et al, and this was just a couple of weeks ago that this one was published. You might have seen it in Hump Day Hustling, our newsletter. But essentially, it was a systematic review. It was done over at Bellin College. So the DSC program and the fellowship there at Bellin went in and they did a systematic review, kind of analyzing the literature, looking at manual therapy for low back pain. The question they were trying to answer was, are the methods in these manual therapy studies, the way they're described, are they repeatable? So in other words, if you read these studies, and you're an independent researcher outside of the group that just did that study, could you read through that and then actually replicate the findings? And the way they were looking at that is, are the methods described well enough for us to replicate the interventions? The answer was no. There was poor reporting in manual therapy intervention studies, and that limits the reproducibility of those findings. This is a big issue because one of the major tenets of science is that it needs to be replicable. You need to be able to check your work. If you're not able to do that, I would call into question whether or not it actually is science. At the end of the day, science has to be described well enough that an independent researcher could then come in and replicate the interventions to see if they can replicate the findings. If you then get a lot of data pointing in one direction, we start to say, you know what, I think there's some merit here. But if the methods aren't described well enough that we could even replicate them, you have to call into question whether or not that's actually science. And I guess my point here is a lot of these conclusions that are drawn on social media posts are of an independent study where maybe the methods aren't even described well enough to where you could apply them to the clinical cases you're seeing. And so we're drawing a huge conclusion that manual therapy doesn't work Meanwhile, the studies aren't even replicable. I think this is a massive issue. There's a huge disconnect there. And so I don't just want to point out the issue, I also want to talk to you briefly about what we might could do going forward, given that the studies don't guide us that well, given that they're not super replicable, and given that we can't draw those big conclusions off of non-replicable studies. And so let's address those problems. CLEAR UP CLINICAL CONFUSION WITH ACTUAL MENTORSHIP I think that the confusion here can be sured up by seeking mentorship. expert opinion and just time around expert practitioners. So what you will find often when you're actually seeing those people treat in the clinic, when you're working alongside of those people, is they're not confused about whether or not manual therapy works. They often have some type of a framework that they're bringing forward to the patient and they feel confident that they can often help patients because of their skill set. So I think we, as a profession, need to lean more on the empirical side of the scenario, given that our data is a bit confounded by lack of replicability. So what I mean by empirical is things you can witness, things you can see. The test-retest model, actually spending time around clinicians that utilize that and frame it positively for patients. That's what I think we should be seeking out as our evidence-based practice right now, because I think a lot of our actual evidence is challenging. That is the short-term solution. In the short-term, I would suggest if you're a younger clinician or a seasoned clinician who has some disconnects surrounding manual therapy, seek out mentors that have an understanding of manual therapy, who see a lot of back pain, who have busy schedules, busy caseloads full of patients with back pain looking to get better and see how they handle those scenarios. I think that is a much better route than seeing social media posts and drawing a huge conclusion from those posts. Meanwhile, the evidence that they're analyzing isn't that great. RESEARCH METHODS MUST IMPROVE The second thing would be a more long-term solution, and this is more speaking to the research going forward. We have to improve the methodology. That's what that systematic review from JOSPT That's what they suggested, and I couldn't agree more. In the future, our methodology has to improve. We have to get better at describing our techniques so that we can, over time, whittle down what is the most effective. But the problem is, that doesn't help you today. When you go see that patient that comes to see you with five days of low back pain, and they're really looking to feel better quickly, and they're starting to lose a lot of functional capacity because they're not doing much, because their back hurts so much, and you're confused about whether or not you should use manual therapy, long-term improvement of methods won't help you. You need to fix the short-term problem and get some understanding by spending time around clinicians that are used to seeing that and that can help you move that patient forward. And again, our practice guidelines are pretty clear here. they make a lot of suggestions surrounding utilizing manual therapy. And most of my colleagues that also treat a lot of back pain, that's basically my whole caseload is back pain and neck pain, occasionally shoulders, hips, knees, but a ton of back pain and neck pain. and I utilize a lot of manual therapy. And I don't feel bad about that. I feel like framed in the right way, it's so helpful to help that person reduce their concern and improve their activity. I agree that there are some ways you could frame it that might challenge someone's belief system in their body, but just don't do that. Just frame it correctly. And so that's my call to action. Seek credible mentors, contribute by pushing our profession forward with the use of these techniques that patients are going to seek out and they're going to get regardless of whether they see you or someone else. So let's be good at it so that they do seek us and then reframe the methods in future studies so that that way we can actually get good scientific data moving forward and understand what works and what doesn't. SUMMARY Team, in summary, I think a lot of clinical confusion comes down to a mismatch of understanding the quality of the information you're receiving. Social media has made it very easy to get your opinion out there, and often there will be opinions coming from folks who may or may not even be experts, who may or may not even be treating in that region, and challenging your belief system on whether or not an intervention works. And I see that confusion manifest as confused young clinicians who have a challenging time deciding whether or not they should utilize manual therapy. Spoken from someone who treats a lot of those problems and who has spent a lot of time around experts who also treat those problems, I've been very lucky to get a lot of time on board with experts. there's not that much confusion on the other side of the coin. So I think that mismatch of where you're getting the information from is huge. So my call to action is let's improve our manual therapy skill set. If that's what you're looking to do and this message is resonating with you at all, I'm going to tell you about a handful of upcoming courses because this is huge for us at ICE. This is why we don't hire people who aren't clinicians. It's really important to us that at ICE, when we bring forward a message to you, you're getting that message from people who actually are in the treatment room. They're behind the walls. actually trying to eradicate these problems over time. UPCOMING COURSES If you're looking for that in the cervical spine, May 18th and 19th, Casper, Wyoming, that one's filling up fast. So if you're in that area and you need a spot there, Casper, Wyoming only has a few seats left, make sure you jump into that. At the end of June, the 29th and 30th, will be in Kent, Washington. And then in July, the 13th and 14th, Charlotte, North Carolina. So a handful of options there for neck. If you're looking for low back, this weekend we've got two course offerings. If you want a last minute ticket, you can certainly jump into one of those. Carson City, Nevada, and then right here where I'm at in Hendersonville, Tennessee. Still seats left in both of those. And then next weekend, April 13th and 14th, near Boston in Braintree, oh I'm sorry, yeah, in Minnesota. I think I've got that down wrong. I think it's Braintree, Massachusetts and that's actually over in the Boston area. So if you're looking for either one of those and you're liking these narratives for reframing manual therapy, jump in with us. We're excited to bring forward some different ways of framing manual therapy. Thanks, that's all I've got for you team. We'd love to hear some interaction here in the comments throughout the day. Keep an eye on the thread. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.
Happy New Year! Kicking off the clinical corner series for 2024 with a Meta-analysis article from the JOSPT. Hear how assessment of over 850 studies proved the accuracy of certain clinical diagnostic tests for Greater Trochanteric Pain Syndrome (GTPS). Students! Matt and Allie are back with your clinical corner quiz question! Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
The end of the year is here! Matt and Allie go over a Clinical Practice Guideline from JOSPT that revises treatments for Plantar Fasciitis. Hear the list of interventions listed in the recommendations that have been revised and given a letter grade based on effectiveness. Hope everyone has a safe and wonderful Holiday, and a happy New Year!Read the JOSPT article here: https://www.jospt.org/doi/10.2519/jospt.2023.0303Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
Hip pain is common in athletes, especially in sports like ice hockey.Nonarthritic hip pain encompasses a variety of intra-articular diagnoses that are often seen in these athletes that are not related directly to osteoarthritis. These include dysplasia, bony changes, femoroacetabular impingement, labral tears, and more.A recent clinical practice guideline on this topic was published in JOSPT to help guide us. In this episode, I talk to the lead author, Keelan Enseki, about the findings of the CPG.Full show notes: https://mikereinold.com/nonarthritic-hip-pain-with-keelan-enseki Click Here to View My Online Courses Want to learn more from me? I have a variety of online courses on my website!Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show_____Want to learn more? Check out my blog, podcasts, and online courses Follow me: Instagram | Twitter | Facebook | Youtube
Dr Jeremy Graber joins us to help answer the question: how often should patients with total knee arthroplasty come to rehabilitation? To answer this and more, we dive into the 2023 JOSPT article, “Expert Consensus for the Use of Outpatient Rehabilitation Visits After Total Knee Arthroplasty: A Delphi Study.” ------------------------------ RESOURCES Dr Graber and his colleagues led a expert consensus process to establish recommendations for how often and for how long you might consider scheduing rehabilitation visits. The group also discussed discharge planning, how to implement telerehabilitation, and monitoring the patient's progress to guide clinical decisions Check out the JOSPT article: https://www.jospt.org/doi/10.2519/jospt.2023.11840 For more on predicting outcomes after total knee replacement: https://www.medrxiv.org/content/10.1101/2023.10.23.23297404v1 (preprint)
What you can do to help prevent neck pain? What are the best exercise approaches? PhD candidate, Florian Teichert, and Professor Daniel Belavy, from The University of Applied Sciences in Bochum, Germany, discuss which exercises and why they might work. We use their recent systematic review published in JOSPT as a launching point for the discussion. ------------------------------ RESOURCES To read the full systematic review: https://www.jospt.org/doi/10.2519/jospt.2023.12063 Blog and infographic: https://www.jospt.org/do/10.2519/jospt.blog.20231011/full/
Do you work with young people with ACL injury? Well, you're in the right place! Today, Drs Chris Kuenze and Adam Weaver walk through the story behind creating a comprehensive normative dataset for knee function and strength outcomes. You'll learn how the project got started, and how you can use the information to help make even more informed clinical decisions. ------------------------------ RESOURCES Find the paper "Age-, Sex-, and Graft-specific Reference Values From 783 Adolescent Patients At 5-7 months After ACL Reconstruction: IKDC, PEDI-IKDC, KOOS, ACL-RSI, Single-leg Hop, and Thigh Strength" on the JOSPT website: https://www.jospt.org/doi/abs/10.2519/jospt.2023.11389 To access the normative database: https://dataverse.lib.virginia.edu/dataset.xhtml?persistentId=doi:10.18130/V3/JNPHUB For more on the Virtual Sports PT Conference (3-4 November, 2023), including the full program and to purchase tickets, head to https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427.
Have you ever found yourself feeling uncertain or confused when choosing a patient-reported outcome measure (PROM)? Today we're talking about the hallmarks of a PROM for people with patellofemoral pain. Physical therapist, educator and researcher, Professor Lisa Hoglund, fills in the gaps to help us find the promise in PROMs. ------------------------- RESOURCES Construct validity, reliability, responsiveness and interpretability of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2023.11730 Content validity and feasibility of PROMs for patellofemoral pain: https://www.jospt.org/doi/10.2519/jospt.2022.11317 Find out more about the KOOS (including the Excel scoring sheet): http://www.koos.nu/index.html ------------------------- The American Academy of Sports Physical Therapy and JOSPT are joining forces to bring you the Virtual Sports PT Conference on Friday the 3rd and Saturday the 4th of November, 2023. Visit the link below to see the full conference programme and to secure your ticket. If you purchase your ticket before the end of August, you can take advantage of a $50 discount. https://www.eventbrite.com/e/aaspt-and-jospt-virtual-sports-pt-conference-tickets-694110913427
Dr Lionel Chia joins Chelsea and Dan to bring his 2022 article in JOSPT, Beginning With The End In Mind: Implementing backward design to improve sports injury rehabilitation practices, to life. Lionel outlines 4 categories to consider when planning return to sport and performance: (1) deconstructing goals, (2) determining key performance indicators, (3) assessing the challenge point, and (4) using the control-chaos continuum to guide interventions. We work through examples of why and where to use the concept of backward design during rehabilitation. ------------------------- RESOURCES Find Lionel's paper here: https://www.jospt.org/doi/10.2519/jospt.2022.11440 More on designing effect exercise progressions during rehabilitation (Blanchard & Glasgow): https://pubmed.ncbi.nlm.nih.gov/28756390/ More on motor learning and the challenge point—where effective practice occurs: https://pubmed.ncbi.nlm.nih.gov/15130871/ The control-chaos continuum and progressing rehabilitation (Taberner and colleagues): https://pubmed.ncbi.nlm.nih.gov/30737202/
What would you do with $1500 savings? Your choice of where you receive your PT can make the difference! Listen to Matt explain this month's Research Report from the JOSPT that covers data from past physical therapy patients and compares cost, duration of visits, and the overall savings on cost for those who chose to start their PT earlier or through Direct Access!Read the Article here: https://www.jospt.org/doi/10.2519/jospt.2018.7423Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
重啟慢性疼痛的篇章 這次先跟大家討論什麼是認知功能療法(CFT) 之後會講到如何應用的部份 請大家盡請期待囉！ Timecode: 00:28 長輩群組椎間盤突出治療討論 14:00疼痛科學、神經科學的相關知識為什麼對物理治療師很重要？下背痛的醫療支出已經超越癌症及糖尿病的醫療支出！推薦JOSPT pain science in practice 系列文章！ 23:10 簡介發表在The Lancet的CFT隨機對照試驗，CFT不只有效還比較省錢 26:30 沒有相關背景知識的物理治療師可以學得會嗎？ 30:15 CFT三面向：理解疼痛(making sense of pain)、控制下暴露(exposure with control)、生活模式改變(lifestyle change) 33:00 加入動作感應器生理回饋在CFT的效果？ 37:00 Multimodal treatment 多樣介入模式花費太高 40:00 2pro PT 為何想再講一次慢性疼痛 歡迎到Facebook, Instagram追蹤或來信來訊跟我們提出疑問～ Email: 2propt@gmail.com Reference: Kent P, Haines T, O'Sullivan P, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial [published correction appears in Lancet. 2023 Jun 17;401(10393):2040]. Lancet. 2023;401(10391):1866-1877.
In part 2 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield and Dr Laura Cutler, with Dr Jake Bleacher continue discussing how they used graded motor imagery to help a patient with low back pain. Treatment sessions 3 and 4 include breakthroughs, progressions, graded movement exposure, and mindfulness training. We discuss who finds pain neuroscience most helpful, and Dr Chris Hughes explains why this case was a perfect match for JOSPT Cases. ------------------------------ RESOURCES Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875 Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/ Find the Why I Hurt Flashcards and heaps of helpful information about pain neuroscience education here: https://whyyouhurt.com/WYH-why.html Find out more about Headspace, and download the app for free: https://www.headspace.com/ Find "Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation" here: https://www.jospt.org/doi/10.2519/jospt.2018.0610 The NOI Group's website has plenty of courses and resources for clinicians on managing pain: https://www.noigroup.com/ Don't forget, JOSPT has a terrific series called Pain Science in Practice, which is all about helping you understand and link basic pain science to the clinic and quality musculoskeletal rehabilitation care. Find part 1 in the series (6 editorials, and more on the way!) here: https://www.jospt.org/doi/10.2519/jospt.2022.10995
In part 1 of this JOSPT Insights x JOSPT Cases collaboration, clinicians Dr Cody Mansfield, Dr Laura Cutler, and Dr Jake Bleacher review their approach to supporting a patient with chronic low back pain. First, they review the history, clinical assessment, and the interventions performed over the first 2 treatment sessions. Next, the clinical team reviews how they decided when to leave the biomechanical world and when to focus on graded motor imagery and laterality training. Dr Chris Hughes, Editor-in-Chief for JOSPT Cases, introduces the journal. He explains why case reports are important in musculoskeletal health and rehabilitation. ------------------------------ RESOURCES Check out the case report article that is the main subject of today's discussion plus its supplemental material: https://www.jospt.org/doi/full/10.2519/josptcases.2021.9875 Dr Lorimer Moseley on the role of the brain in chronic pain (snake story): https://www.youtube.com/watch?v=bj9CUGzw6fs&t=26s Dr Peter O'Sullivan and “Jack” sharing how Jack regained his life: https://www.youtube.com/watch?v=j4gmtpdwmrs&t=214s Understanding pain in less than 5 minutes, and what to do about it: https://www.youtube.com/watch?v=C_3phB93rvI Back pain: separating fact and fiction with Dr Peter O'Sullivan: https://www.youtube.com/watch?v=dlSQLUE4brQ The Recognise App from the NOI group: https://www.noigroup.com/product/recogniseapp/
Dr. Lindsey Hughey // #ClinicalTuesday // www.ptonice.com In today's episode of the PT on ICE Daily Show, Extremity Management division leader Lindsey Hughey highlights the four pillars of healthy living behaviors: mindfulness, exercise, diet, and sleep. These pillars are essential for improving overall health and wellness. Mindfulness involves helping patients become more aware of their beliefs and mindset towards their body, and providing them with strategies to think about their body in a healthier way. For patients with hip and knee issues, mindfulness should also involve reframing their mindset to view their bodies as having opportunities for improvement through strength and flexibility. Exercise is crucial for meeting physical activity guidelines, which recommend 150 to 300 minutes of physical activity per week. The WHO recommends aiming for 300 minutes as it is more beneficial. However, prescribing physical activity for patients in pain can be challenging. The episode suggests starting where the patient is at and finding ways to infuse physical activity, such as starting with five-minute bouts. Therapeutic exercise is also helpful but may only result in small to moderate size effects on pain and disability due to variability in patient response. Diet involves adding healthy foods to a patient's diet, rather than taking away harmful foods. This is especially important for those who have received negative messages about their body. Sleep is also crucial for tissue healing, and strategies such as sleeping in a cool, dark room and going to bed at the same time daily can help improve sleep quality. Overall, addressing these four pillars may be challenging, but they are essential for improving brain tissue and making the body more resilient. The goal of mindfulness is to help patients become more mindful of their bodies and to frame their mindset in a more positive and proactive way. Meeting physical activity guidelines is a must, and therapeutic exercise can be helpful but may only result in small to moderate size effects on pain and disability. Adding healthy foods to a patient's diet and improving sleep quality are also crucial for overall health and wellness. If you're looking to learn more about our Extremity Management courses, or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION 00:00 Dr. Lindsey Hughey, PT, DPT, OCS, FAAOMPTGood morning PT on Ice Daily Show, how are you? I am Dr. Lindsay Hughey, one of our lead faculty from our extreme management team coming to you live from Grass Valley, California. Kind of an atypical place to see you all, but I'm just finishing up teaching a course here with body logic. What a weekend and about to take off to Delaware a day of travel, but I'm so happy to be with you all this morning. Today I'm going to chat with you about hip and neo-a and really the unspoken battle we have with these folks when we're treating them. But before I dive into the topic at hand, I would love to review just briefly some courses that Mark and I and our extreme management team have coming up this summer. So our next offering is July 15th, 16th, we will be in Holmes Beach, Florida. And then July 22nd, 23rd, we will be in California again, but now we'll be in the southern part, almost the most northern part. So we'll be in Sydney Valley, California, and there are still spots in both of those courses. So we'd be delighted to have you with me. And then July 29th and 30th, we're going to be at Onward Madison. I think there's only one or two spots, maybe zero. Check it out though, because we are filling up because that's right before the CrossFit Games. And one of our faculty, Kelly Bempi, is competing in the CrossFit Games. So I'm going to teach that weekend and then stay the whole week and cheer her on. I couldn't be more pumped and a lot of ICE faculty would be there. So think about that as one of your weekends if you're wanting to go to the CrossFit Games as well and kind of make a week out of it. And then check us out on ptlnice.com in our extreme management division because we also have courses in August and then early September. But I'd love to unspoken battle. So in this episode, I want to briefly review what we know helps hip and knee away, which we in the last couple of years keep seeing studies that really just confirm exercise is the way. It's not injections. It's not surgery. It is exercise medicine. And just recently, a 2023 systematic review and meta-analysis on hip and knee away just came out out of the Lancet Rheumatology Journal reiterating this. The exercise is superior to no exercise. And kind of the challenge and this study in particular, its title was Moderators of the Effect of Therapeutic Exercise for Knee and Hip Osteoarthritis, a Systematic Review and Individual Participant Meta-Analysis. This involved 91 RCTs and they compared exercise versus non-exercise strategies and they included both knee or hip or included studies that actually looked at both or looked at each individually. And really the outcome measure is pain and disability, right? The number one things patients are coming to us for. And then the study just really reiterated the importance of therapeutic exercise. What we often just say exercise, but what this article defined therapeutic exercise to be was it involves participation in physical activity that is planned, that is structured, repetitive, and purposeful for the improvement or maintenance of a specific health condition such as osteoarthritis, right? So this has to be purposefully planned and it has is multimodal and in nature. This article not only reiterated that therapeutic exercise, in fact, that combination of multimodal treatment is helpful, but it also further demonstrated that we always see small to like moderate size effects or effect sizes as it relates to pain and disability. Meaning not really huge shifts and necessarily changing that patient's world and then implying it to the broad population because there's a lot of variability in patient response. We are just still missing the target here is what that's telling me, right? We're missing the target in this patient population because we're not even though we know exercise is the way, we're not reaching everyone. People are still going on to getting knee replacement. They're still going on to having pain and disability. And I believe it's because our focus is really misdirected and what the underlying battle here is. And it's not just about strength, range of motion, access. It is a much bigger underlying systemic issue because we're not even reaching the target. Because what is happening under the surface with hip and knee away is a really complex process. And while it's complex, I'm going to just unpack it for you in like a minute. But when we see folks that are inactive, not moving, and whether it's because they first started having pain and then they stopped moving or because of being sedentary, they started kind of developing osteoarthritis. What came first, the chicken here, but what we do know is there's this cyclic cycle where when you stop moving and you have underlying osteoarthritis, sarcopenia starts to happen, right? We start to see muscle wasting. With this inactivity in this sarcopenia in our tissues, we start seeing accumulation of visceral fat. And then macrophage infiltration throughout our body, hanging out, low grade. We see links to osteoarthritis and then this cycle where this leads to Alzheimer's disease. Our brain cells, our brain tissue starts to become unhealthy because of this low grade systemic inflammation. This starts to affect these immune cells are hanging out in our blood tissue. We have unhealthy blood. So we get atherosclerosis, right? We get buildup along our arterial walls. This starts to lead to insulin resistance and glucose just hanging out in our blood because it's not being uptaked as much as readily as it needs to because again, the blood is unhealthy and this leads to type two diabetes. We see cyclical links and then guess what? Then our blood no longer is oxygen rich. We see links to then anemia and osteoarthritis and this cycle of low grade chronic inflammation continues leading to other major diseases that affect our whole ecosystem. We know this, right? This is a like this cycle I'm describing came out in 2018 from school at L&T and JOSPT just talking about the importance of if we don't get our patients moving and physically active, this low grade inflammation, it's just going to hang out there. And if we pair that with what we know is happening in our society at large, I don't just mean the United States, but globally, when we look to the WHO, right? The World Health Organization and you look at the top 10 causes of death, right? Guess what just got added to that top 10 list recently? Diabetes, diabetes, diaphragm, diabetes, right? And we have our folks with hip and knee osteoarthritis, not in pain, so they're not moving. And then this low grade systemic inflammation cycle, which leads to diabetes and things like Alzheimer's, which is also on our list of top 10 issues are things leading to death. We are dealing with metabolic disease with hip and knee away. We have to address the hard conversations around metabolic disease if we really want to impact our humans, our patients lives with hip and knee away. Think about most of your folks that have it. Most of those folks have diabetes on their past medical chart, right? We have an opportunity to not just impact joint health, right? But we have an opportunity to impact their blood, how their blood takes up sugar, right? And uses it for their body. We have an opportunity to ward off risk against developing Alzheimer's. We have an opportunity to work against leading towards anemia and sarcopenia. Our job is pretty huge here. So we have to do better. And I'll tell you, these conversations are so hard, right? But our society, we are, yes, living longer from a longevity perspective and lifespan, yet we're getting sicker. And you can look to the Who for data about that. I'll tell you at ICE, any faculty member, it doesn't matter what specialty division. Mine is in particular extremity management. We have pelvic health, we have CMFA, we have modern marriage with older adults, spine health, right? If you really ask each one of our faculty what we're really fighting against, what is ICE really doing? We are fighting against metabolic disease. We are championing and fighting for healthy living behaviors because we see this sickness in our society that we are getting more unhealthy, even though we're living longer. And it's because of sedentary behaviors. And we have to have these hard conversations surrounding how do we change these unhealthy living behaviors? How do we get these patients moving? Because again, it's not just about symptom management of their hip and knee pain. And it's not just about via exercise. It's really about infusing fitness into their life, into their tissue health. And when you think about that cyclical cycle I just described and that School.L article in 2018 gives a great visual. But this includes, when we think about fitness forward, we think about healthy living behaviors that help improve brain tissue, that help improve your blood, making your blood healthier. And we do that via cardiovascular physical activity. We want the ecosystems of our humans to be more healthy and more resilient. And really the best and most efficient way to think about how do we do this in the clinic, right? Because I mentioned this is a hard, hard conversation when we think about how we change patient lifestyles, how they eat, how they sleep, and how they move. The best way to think about this is through meds. Thinking about the four pillars. And med stands for mindfulness, exercise, diet, and sleep. When we think mindfulness for these folks that come in with hip and knee, or think about any patient you've ever had, what is our greatest responsibility here in mindfulness? When we think about mindfulness, I think we typically think about breathing strategies, taking a walk in nature, maybe journaling, some physiologic sighing, meditation. And yes, when your patients are stressed, yes, we want to give them this and give them those tools. And for our folks with hip and knee, this is fair game. But I'll tell you with these folks, when I say mindfulness, I'm thinking about how you frame their mindset, how you help these folks be more aware about what they believe, right? The folks that say, I had bad knees, my mom had bad knees, my great grandmother had bad knees, my great great grandmother had bad knees. They're the people that sit back, open up that hip angle, and you know you're about to get a long story that first visit, right? About this history. And this is deep ingrained beliefs, right? About their knee health. And we have to also acknowledge that this is probably deep ingrained lifestyle behaviors, right? When it comes to our food choices, our sleep choices. So there's some really entrenched shifts that we have to make. But we have to let them know, no matter what, like really let them tell us those beliefs, and then allow a reframe, a mind shift that these are knees that aren't bad, right? Please stop saying your knees are bad, Betty. Your knees have an opportunity, your hips have an opportunity, your hips have an opportunity to blank, right? To be stronger, to be more flexible. Your body has an opportunity to move more. Yes, we can help them manage stress with some of those techniques that I mentioned earlier, but it's really more about helping them be more mindful of how to think about their body in a healthier way, and giving them strategies to do so, right? So they're no longer a victim, but a victor. Exercise is that next, so we did mindfulness, and then exercise is that next pillar we have to address with these folks. Meeting physical activity guidelines. 50, 150 to 300 minutes, right? Of physical activity is a must. And the WHO acknowledges that 150 is on the low end, right? That we want more towards 30, which means 300, excuse me, which means 30 minutes at minimum, but probably 30 to 60 minutes of physical activity five days a week. If they're doing higher intensity exercise, right, 75 minutes is fair game. But this is so tough, right? Because these patients are coming to us in tons of pain. So what do we do? How do we get them moving? And this is the hard part, right? If Betty can only walk three to five minutes, and it's painful for her to just make it into your clinic, and she needs a rest break, it's hard to prescribe, okay, 30 to 60 minutes of activity a day. And so we have to start where they're at and figure out ways to infuse physical activity. Maybe initially that's that five minute six bouts, right? And some of you are like, Lindsay, you're freaking crazy. My patient, Betty's never doing that, right? Maybe we start off small at 50%. Maybe the first goal is just five minutes, three times a day, right? We have that dose, and we see her response to movement. The real key part is we figure it out. It doesn't matter. It doesn't have to be walking. It could be dancing to music, right? It could be calling, Betty could be calling her grandson and going for a little walk so she's a little bit distracted. It could be marching in place. It could be an exercise video. It could be linking them to their community. It doesn't matter what it is. You have to figure it out. And it is hard, but you have to partner with that patient and figure out a way to get them moving. And then that's not enough. It's not just the physical activity piece. It's then adding in strength, flexibility, endurance, neuromuscularity, right? Kind of the things in our wheelhouse and figuring out what really helps their tissues feel better. That also respects irritability. In extremity management, we talk a lot about the rehab dose, which is an irritability respecting dose. And that part is really key in these folks because you need that initial buy-in, right? Our CEO, Jeff Moore, says we manage symptoms to maximize fitness. If you don't first get that modulating buy-in window of opportunity by dosing exercise well to show patients that actually exercise, right? You do about an exercise and then you retest some maybe knee flexion, knee extension, hip flexion, or maybe how fast they're walking and show them, right? Oh, wow, you're now moving faster. Oh, wow, you now have more motion, Betty. That's awesome. You have to give them that show me moment. So our test retest strategies have to illustrate that exercise is medicine. Exercise is the thing making tissues feel better, right? Not just our manual therapy. So that's a big thing that we can do to help with this exercise pillar. And then diet, right? This is probably the hardest one and these folks have been told they're obese and they need to lose weight and that's not the answer, right? Please don't say that to those folks, right? They've heard that time and time again. They've heard it from providers that haven't even looked up from their chart or from their computer to look them in the eye. What I want you to do is a weight neutral strategy where we add resistance training. We add things that increase basal metabolic rate and then start chatting about things they can add like half their body weight in ounces of water, right, for a diet and then maybe adding a little bit more protein, right, for tissue healing and to help as they continue to increase their exercise activity level, right? So it supports their activity level. Talking to them when they're open to it, eating more plants, right, more colorful, diverse diets. That's kind of where we go with our diet discussion. It's not right away take away the soda, take away the bowl of ice cream because you're going to lose buy in with those folks, right? And we know the harmful inflammatory effects of sugar but with these folks that have been told a harmful message about their body already, let's add to these folks with hip and knee away before taking away. Sleep is our final pillar so we've talked mindfulness, exercise, diet, sleep and I'm pushing my time limits a little bit here. Sleep, we need to help our folks work on sleeping better, right, in a cool dark room that's 60 to 65 degrees. Use blackout curtains, go to bed at the same time daily. Those are just a few of our strategies that we really love to help with quality of sleep, right? While seven to nine hours is ideal and I would love sleep quantity on board for tissue healing, work on sleep quality before quantity first with these folks. And again, yes, these pillars, addressing these pillars are hard and no, we can't address them all at once, right? We'll dose our education just like we dose exercise. But we have to have the hard conversations with these folks. Behavior and lifestyle change, I mentioned earlier, they are hard but they have to occur to make our society healthier. Diabetes was just added to the top ten killers of our world, not just the United States. That's a big deal and most of our folks with hip and knee away have diabetes so don't miss that link, right? Fitness forward is not just about lifting heavy shit with your friends. Although barbell medicine is a key part of it, right, because it brings on intensity for our tissues and that pumping effect for good healthy blood, right, and it tends to make a patient feel pretty bad ass when they start getting heavy. But we are here to wage war on metabolic disease with our hip and knee away. It is plaguing our system, it's plaguing our country and our world. Hip and knee away is associated with diseases like diabetes and Alzheimer's. It will not go away without engaging the hard, it will not go away without engaging the hard conversations and the hard behavior change. We have to wage war here and we as physical therapists that have that experience, as our patients, probably have the greatest opportunity to wage war on the underlying tissue inflammation that is there in these folks, the sedentary lifestyle that's associated with that pain and the poor mindset of I have bad knees. Take this opportunity with your folks this week to address one of the pillars, mindfulness, exercise, diet, sleep. I suggest starting with the M and getting some buy-in with the E. Thank you for your time this morning everyone. Joining me in Grass Valley in an atypical spot here. It's been a pleasure. Have a great, happy Tuesday. 19:32 OUTRO Hey, thanks for tuning in to the PT on Ice Daily Show. If you enjoyed this content, head on over to iTunes and leave us a review and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ICE content on a weekly basis while earning CU's from home, check out our virtual ICE online mentorship program at PTOnICE.com. While you're there, sign up for our hump day hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to PTOnICE.com and scroll to the bottom of the page to sign up.
The Journal of Orthopedic and Sports Physical Therapy, or JOSPT, is one of the most well-read and prestigious journals in our field. Clare Ardern, Editor-in-Chief of the journal, has done an amazing job.In this episode, she's going to share some exciting new things that JOSPT has been working on that I know you're going to love. Plus, we're going to take a peek behind the scenes of the editorial process of JOSPT, talk about her role as editor-in-chief, and she's even going to share some valuable advice for prospective authors on how to write the best manuscripts to increase your chances of publication.Full show notes: https://mikereinold.com/behind-the-scenes-of-jospt-with-clare-ardern----------Want to learn a complete system to help people restore, optimize, and enhance their performance?Enrollment in my Champion Performance Specialist program is opening soon. We only open the doors to new cohorts twice per year. Click here to learn how to join the pre-sale VIP list to save $300 and enroll a week early to secure your spot. Click Here to View My Online Courses Want to learn more from me? I have a variety of online courses on my website!Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show_____Want to learn more? Check out my blog, podcasts, and online courses Follow me: Instagram | Twitter | Facebook | Youtube
Chris and Sam sat down with Clare Ardern to discuss all things return to sport. Clare is the Editor-in-Chief of JOSPT, the Journal of Orthopedic and Sports Physical Therapy, Physiotherapist, and researcher currently based out of Vancouver, British Columbia. We focus the conversation around the paper titled, “2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern” in which Clare was the lead author. We discuss: The spectrum of return to participation all the way up to return to performance, defining success across multiple stakeholders, shared decision making, the StaRRT Framework, assessing readiness, ACL specific RTS considerations and timelines, and future priorities and directions. Primary Paper Discussed: 2016 Consensus statement on return to sport An additional read that Clare recommends: 2022 Bern Consensus Statement on Shoulder Injury Prevention More About Clare and JOSPT: Clare's Twitter JOSPT Twitter JOSPT Insights Podcast JOSPT.org JOSPT Instagram --- More about us: YouTube: https://www.youtube.com/e3rehab Website: https://e3rehab.com/ Instagram: https://www.instagram.com/e3rehab/ Twitter: https://twitter.com/E3Rehab --- Sponsors: Minimalist Footwear: https://www.vivobarefoot.com/ (Discount code: E3Rehab15 for 15% off) VALD: www.vald.com --- @dr.samspinelli @dr.surdykapt @tony.comella @chrishughen --- This episode was produced by Matt Hunter.
Do you work with young people with ACL injury? Well, you're in the right place! Today, Drs Chris Kuenze and Adam Weaver walk through the story behind creating a brilliant, new normative dataset for function and strength outcomes. You'll learn how the project got started, and how you can use the information to help make even more informed clinical decisions. ------------------------------ RESOURCES Find the paper "Age-, Sex-, and Graft-specific Reference Values From 783 Adolescent Patients At 5-7 months After ACL Reconstruction: IKDC, PEDI-IKDC, KOOS, ACL-RSI, Single-leg Hop, and Thigh Strength" on the JOSPT website: https://www.jospt.org/doi/abs/10.2519/jospt.2023.11389 To access the normative database: https://dataverse.lib.virginia.edu/dataset.xhtml?persistentId=doi:10.18130/V3/JNPHUB
How do you approach managing low back pain with children and adolescents? Do you have a different approach than when working with adults? Diving into the 2022 JOSPT clinical commentary, “What Works When Treating Children and Adolescents with Low Back Pain?”, Dan and Chelsea chat with author Dr Tiê Yamato. They review the physical, psychological, pharmacological, interdisciplinary and family-centered, and communication interventions that are most effective for treating and managing low back pain in this important population. Read Dr Yamato's article here: https://www.jospt.org/doi/10.2519/jospt.2022.10768
In the final episode of JOSPT Insights for 2022, we're wrapping and putting a bow on a big year of content. Drs Chelsea Cooman and Dan Chapman join Dr Clare Ardern to share their big take-aways from a year of listening to and learning from all the wonderful experts who have contributed their wisdom on JOSPT Insights in 2022. 02:15: Prof Nicola Philips on optimal loading (https://tinyurl.com/3j4j7vpy) 04:05: Dr Ebonie Rio on loading tendons (https://tinyurl.com/rtvh6sfj) 06:35: Dr Tasha Stanton on managing osteoarthritis symptoms (https://tinyurl.com/yc8djs75) 07:45: Drs Matt Klein and Nathan Brown on running injuries (https://tinyurl.com/9t7jprjh) 09:25: Dr Kevin Wernli on moving better with pain (https://tinyurl.com/44ukf339) 11:30: Dr Amy Arundale on authentic connections with athletes (https://tinyurl.com/4tc8dewr) 13:50: Dr Matt Whalen shares injury prevention resources (https://tinyurl.com/23j2cxuj) 15:00: Dr Mike Rosenthal shares the American College of Radiology Appropriateness Criteria (https://tinyurl.com/5dwac4mt) 16:40: Dr Marie Boo on injuries in women's football (soccer) (https://tinyurl.com/bdfchmss)
Today's episode is another JOSPT Cases cameo! Dr Mike Rosenthal, associate editor for JOSPT Cases, explains a clinical case of a patient after total hip arthroplasty with pain symptoms that don't quite add up. We discuss why it is important to continue red flag screening throughout care, how to frame an urgent referral, and how the imaging approach can influence health care. There are even some bonus tips for authors who are considering submitting case studies to JOSPT Cases (https://www.jospt.org/toc/jospt-cases/current). ------------------------------ RESOURCES American College of Radiology Appropriateness Criteria: https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria Radiology Across Borders' Diagnostic Imaging Pathways: https://radiologyacrossborders.org/diagnostic_imaging_pathways/ IFOMPT International Framework for Red Flags: https://www.jospt.org/doi/10.2519/jospt.2020.9971
A recent meta-analysis in JOSPT looked at what the best exercises for low back pain were.What were the best exercises for chronic low back pain?Do these exercises work for everyone?Is a more tailored or individualized approach necessary?Tune into this week's episode and find out!Links:https://www.jospt.org/doi/10.2519/jospt.2022.10671*********************************************************************
Dr Lynn McKinnis (Associate Editor for JOSPT Cases, the sister journal for JOSPT) takes Dan and Chelsea through a case that reminds us of a rare but important differential diagnosis. Without giving the diagnosis away, this case highlights the importance of performing the upper quarter screen, choosing the right neurological special tests, and timely referral for imaging. ------------------------------ RESOURCES Read more about the case here: https://doi.org/10.2519/josptcases.2021.10049 Seen an interesting clinical case lately and want to share it with the JOSPT Community? Why not submit the case to JOSPT Cases? We offer timely, fair and quality peer review. For more information, check out the instructions for authors: https://www.jospt.org/pb-assets/JOSPT%20Cases/JOSPT%20Cases%20Instructions%20for%20Authors%20with%20form_02112021-1613587003923.pdf Subscribe to JOSPT Cases: https://www.jospt.org/action/ecommerce
Chris talks with Seth for a second time to discuss his brand new paper in JOSPT, “The Blind Men, the Elephant, and the Continuing Education Course: Why Higher Standards Are Needed in Physical Therapist Professional Development." We dive into the paper and discuss: his motivation to write this piece, the problem of unwarranted variability in clinical practice, the blind leading the blind, drawbacks of the current continuing education / continuing competence system, 3 suggestions for developing higher standards in professional development, and advice for clinicians seeking out information, mentorship, and education. Seth is the owner of The Motive Physical Therapy Specialists in Oro Valley, AZ and he continues to maintain a faculty position at A.T. Still University. We hope you all enjoy! More of Seth's recent publications: From Idea Cults to Clinical Chameleons: https://pubmed.ncbi.nlm.nih.gov/35442753/Continuing Education Courses for Orthopedic and Sports Physical Therapists in the United States Often Lack Supporting Evidence: A Review of Available Intervention Courses: https://pubmed.ncbi.nlm.nih.gov/35358320/ (PT Inquest Episode on this paper: https://open.spotify.com/episode/1xNKyyGpI03XQARueToP4S?si=5a09505df0fa4769)Who writes this stuff? Musculoskeletal information quality and authorship of popular health websites: A systematic review: https://pubmed.ncbi.nlm.nih.gov/35453015/Seth's Twitter: @drsethptSeth's IG: @themovementbrainery@adaptabilia@the_atg_physio@mas.moore@chris_barbellmedicine
終於來到這個系列的最後一集 這集要討論的是針對慢性足踝扭傷的介入 這類病人還需要護踝或貼紮嗎？ 是不是所有方式的介入都要做效果才比較好？ 這集同時也討論了一些罕見個案 快來聽我們討論吧～ Timecode: 00:00閒聊: 近況更新變成英文小教室 11:27 “慢性”腳踝扭傷: External support 不建議使用 13:12 “慢性”腳踝扭傷: 建議加強平衡訓練以及臀部肌群的訓練 15:00 “慢性”腳踝扭傷: 關節鬆動術的短期療效 17:05 乾針 (Dry Needling) 的療效 19:17 “所有介入都做” vs. “只做運動” 28:53 特殊個案討論 #1-血管瘤 37:16 特殊個案討論 #2-Talus fracture 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80
急性扭傷什麼可以做？什麼不能做？ 真的別再做超音波了！有其他證據等級更高的儀器 但別忘了要做運動喔！ Timecode: 00:00 閒聊時間：VR與慢性疼痛控制 12:49 足踝扭傷復原的時程表 25:55 足踝扭傷的介入：做徒手治療還要記得搭配運動治療喔！ 33:14 足踝扭傷的介入：針灸 33:35 足踝扭傷的介入：冰敷慘遭CPG降級?!! 36:39 足踝扭傷要不要吃抗發炎的藥物呢？ 37:13 足踝扭傷可不可以做物理因子儀器治療呢？ 39:02 急性足踝扭傷的病人絕對不能做超音波!!!! 41:38 再次討論抗發炎藥物到底要不要吃？ 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80
號外！我們IG粉絲破千了！來聽聽我們的破千QA吧！ 這次CPG討論： 從來沒扭傷到底要不要穿護踝預防扭傷？ 治療腳踝扭傷的病人要提早承重才能提早恢復 證據等級最高的就是運動介入喔！ timecode: 00:00 近況更新 05:00 破千Q&A: 體能訓練師與物理治療師的相同之處 13:30 治療師一定要會專項運動才能走場邊嗎? 18:48 足踝扭傷的介入: 扭傷預防與急性期的介入 29:53 足踝扭傷的介入: 盡早承重、運動治療的好處與VR研究討論 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80
We're premiering a new series focused on JOSPT Cases—a teaching tool to help develop your clinical reasoning and highlight how to apply evidence in your practice. Today, Dr Kimiko Yamada explains an orthopedic case from JOSPT Cases. She outlines how JOSPT Cases works, how you can subscribe, and how you can submit your own cases to be highlighted in future editions. To visit JOSPT Cases you can follow the link here: https://www.jospt.org/loi/jospt-cases
本集討論足踝扭傷的臨床評估 告訴大家實用的臨床量表、理學檢查和功能性評估的項目 看看自己評估足踝扭傷的病人有沒有用到這些方法喔！ Timecode: 00:27 Frank對膝關節跌倒後鑑別診斷的經驗分享 09:40 常用的踝關節評估量表(outcome measures): FAAM, LEFS, PROMIS- 14:17 針對足踝扭傷的理學檢查 18:34 Stan覺得髖外展肌群真的很重要，Frank也有個案可以分享 25:50 針對足踝扭傷的功能性評估 32:41 針對足踝扭傷評估的新科技和技術 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80
端午節快樂連假來聽聽2PRO PT 繼續支持物理治療師修法 本集討論足踝扭傷的評估與鑑別診斷 腳踝扭傷之後要等4-5天後，才適合做鑑別診斷喔！ 臨床上要如何判斷病人是否有骨折呢？聽過Ottawa Ankle Rule嗎？ Timecode: 00:27 物理治療師修法了! 大家要堅持下去! 12:15 ” 急性” 外踝扭傷 20:00 Drawer tests 扭傷之後多久做才合適? 21:50 “慢性” 外踝扭傷 24:55 問卷IDFA跟CAIT哪個好呢? 28:50 “急性” 足踝扭傷的鑑別診斷-Ottwa Ankle Rule 34:03 鑑別診斷: 建議受傷後4-5天評估，提高準確度 35:48 “慢性” 足踝扭傷的鑑別診斷 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80
本集討論急性足踝扭傷和慢性足踝不穩的病程 慢性腳扭傷一直沒有好，病人會需要開刀嗎? 研究建議先進行物理治療3-6個月之後再評估是否有開刀的需求 Timecode: 00:27 閒聊時間：聽眾提問的QA時間 11:50 足踝扭傷的病程 18:30 慢性腳踝不穩(CAI)的病程和CAI徒手治療成功的預測因子 24:45 Frank補充預測腳踝不穩徒手治療預測因子研究的內容 30:25 本集總結 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80
足踝扭傷的危險因子很多， 本集討論了腳踝活動度、BMI、特定的平衡測試、場地及其他危險因子 再次強調：臀中肌真的很重要 timecode: 00:27 Stan分享在美西最大醫療機構的上工實況 16:00 急性足踝扭傷的危險因子 21:00 Ankle Dorsiflexion活動度不足是危險因子嗎? 24:40 髖部肌力不足原來也是足踝扭傷的危險因子! 26:22 如何用Star Excursion或Y-Balance Test預測足踝會不會扭傷 32:00 Single Leg Hop Test也可以用來決定病人受否是高危險群 34:00 "比賽vs訓練，人工草皮vs真正草皮，室內vs.室外" 哪裡比較容易受傷? 35:36 慢性足踝扭傷的危險因子跟急性有哪些不同? 43:42 要建議病人穿護踝嗎? 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s
Had a lovely chat with Shawn Hanlon who is a PhD candidate about his relatively new paper exploring patient features and clinical characteristics and how they may define certain subgroups of Achilles tendinopathy . Lots more to learn in this field and this is early work, but we discuss some of the juicy potential clinical implications. Hope you enjoy! And here is the link to the paper and also the 1/ Hanlon, S.L., Pohlig, R.T. and Silbernagel, K.G., 2021. Beyond the diagnosis: Using patient characteristics and domains of tendon health to identify latent subgroups of Achilles tendinopathy. journal of orthopaedic & sports physical therapy, 51(9), pp.440-448. 2/ And this is the bumper issue of JOSPT from 2015 that is all about tendinopathy: journal of orthopaedic & sports physical therapy, 45(11) See omnystudio.com/listener for privacy information.
足踝扭傷很常見，但很少人會去看醫生或物理治療師 人工草皮真的比較容易扭傷腳嗎 臀中肌無力竟然是腳踝扭傷的危險因子 Timecode: 00:27 閒聊時間：為什麼縮足運動不是PFPS的介入首選 12:05 足踝扭傷的好發率 17:05 足踝扭傷的復發率和慢性足踝扭傷 18:27 足踝扭傷可能會同時產生的傷害 25:10 CPG統整的足踝扭傷和慢性足踝不穩常見的五個問題 36:18 Frank好奇為什麼徒手治療對足踝扭傷這麼有效 歡迎到各平台追蹤或來信來訊跟我們提出疑問～ Facebook: https://www.facebook.com/2PROPT/ Instagram: https://www.instagram.com/2pro_pt/ Email: 2propt@gmail.com 也可以在此收聽： Apple podcast: https://tinyurl.com/y97q7tms Spotify: https://tinyurl.com/ydavzqxu Google podcast: https://tinyurl.com/yd86pbcl YouTube channel: https://tinyurl.com/y82ewo5b Music by Elizabeth's Groove by Amarià @amariamusique Creative Commons — Attribution 3.0 Unported — CC BY 3.0 Free Download / Stream: bit.ly/elizabeths-groove Music promoted by Audio Library youtu.be/-MO-mrBlo5s Reference: Martin RL, Davenport TE, Fraser JJ, et al. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision. JOSPT 2021 51:4, CPG1-CPG80
How prepared are you to support someone who is living with post-exertion symptom exacerbation? Dr Todd Davenport wants to start a conversation about re-imagining the way most of us have thought about fatigue, physical activity and exercise. Tune in to learn more about post-exertion symptom exacerbation, including what it feels like, and how to test and monitor it. For a deeper dive on post-exertion symptom exacerbation, check out the JOSPT blog: Lessons for long COVID from myalgic encephalomyelitis: https://www.jospt.org/do/10.2519/jospt.blog.20220202/full/ Abnormal physiologic response during acute exercise: https://www.jospt.org/do/10.2519/jospt.blog.20220209/full/
Dr. Kimberly Durant (e-mail) of Leadbetter Rehabilitation and Dr. Meghan Musick (e-mail, LinkedIn, Twitter, Instagram) of Jefferson Physical Therapy are interviewed by Antigone Vesci regarding a presentation they gave at the 2021 AAOMPT Conference titled, “Fourth Trimester and Beyond - Where is the Treatment? What is the Evidence?” This episode contains information that will be interesting for practitioners who want to learn more about pelvic health as it relates to orthopaedic clinical practice and the postpartum population. Additionally, to find the resources mentioned during this interview use the following links: Podschun et al 2013 (the hamstring/pelvic floor case study), McArthur et al 2016 (urinary incontinence does not go away), Moore et al 2021 (BJSM and JOSPT systematic review about factors contributing to return to running), Dakic et al 2021 (effect of pelvic floor symptoms on women's participation in exercise), Cozen Screening Tool (for pelvic floor dysfunction), AAOMPT Pelvic Health Special Interest Group's Decision Tree, Brown et al 2006 (3 question incontinence screening tool), Talasz et al 2011 (phase-locked parallel movement of diaphragm and pelvic floor during breathing and coughing), the American College of Obstetricians and Gynecologists (ACOG) recommendation for postpartum exercise, Donnelly et al 2020 (return to running), Cassidy et al 2017 (Canadian pelvic health survey), Julie Wiebe courses (including external only techniques), Antony Lo (Physio detective), Evidence in Motion's Pelvic Health I course, Kelli Wilson of Alcove Education, Tough to Treat Podcast by Susan Clinton and Erica Meloe, Herman & Wallace Pelvic Floor Level 1 (internal course), and APTA Pelvic Health Pelvic Health Physical Therapy (Level 1 or PH1 is an internal course). Listeners may also find the BJSM Return to Running Blog to be useful.Find out more about the American Academy of Orthopaedic Manual Physical Therapists at the following links:Academy website: www.aaompt.orgTwitter: @AAOMPTFacebook: https://www.facebook.com/aaompt/Instagram: https://www.instagram.com/officialaaompt/?hl=enPodcast e-mail: aaomptpodcast@gmail.comPodcast website: https://aaomptpodcast.simplecast.fm
In this episode we cover all things Tendon. We discuss the physiology of training to build tendon strength as well as practical program design strategies. If you are studying for the CSCS Exam, make sure to check out The Movement System Study Course at www.themovementsystem.com Research referenced in this video: https://sandcresearch.medium.com/do-we-need-to-think-about-connective-tissues-when-strength-training-f4307d0b2d1b https://journals.physiology.org/doi/full/10.1152/jappl.2001.91.1.26 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555899/ Keitaro Kubo has various published papers and is a great resource for this info.
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