There’s gotta be a reason. You can’t have an event pass by you without knowing why, right? Right.
“Well, you know, the weather made it hurt. It’s all that rain…”
“My back is hurting today, I was at a family BBQ and I stood for an hour yesterday, so…”
“The knee feels much better, I think it was the tape you put on there.”
Post Hoc Ergo Proctor Hoc. After that, therefor because of that.
Making a reason for things is not conscious, often. We always see cause and effect as a truth. If we’re wrong, it’s confabulation, not a lie. It’s “only human.” See a quote below from some of the Split Brain research: Continue reading
One of the most real, shared experiences that we have as humans is non-existent in the true sense of cause-and-effect reality. The sense of wetness.
There is no “wet receptor” or nerve fiber type devoted to the sensation of wetness. No indeed. Insects have “humidity receptors” but we lack the ability to feel the water that so defines our planet. The human sensation of wetness is the complex, near magical (if you don’t mind me saying so) confluence of pressure change, light touch change, motion direction, speed and pattern, temperature change, and visual input. Continue reading
Allow me to make the case to discuss modern* pain science views with all who will listen, importantly, people who are NOT in pain.
There seems to be support for pre-operative pain education as an effective intervention. Studies have shown improved surgical experience and reduced health care utilization (1), improved short term pain reporting, quicker return to activities and utilization of nonpharmalogical pain management strategies (2). Long term pain outcomes are not significantly effected (that I could find), but it certainly helps the patient in meaningful way (3). Continue reading
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There is no such thing as Time Management. There is only Self Management, time goes on as it will, no matter your intentions for it.
So what can happen over time? Time is one of these factors that is hard to account for, but does a lot of the treating of a patient for you. (see: It’s not ALL about you). The biology of tissue healing occurs over a timeline and it occurs at a pace that is affected, but not determined, by us or your patient. Continue reading
Repetition is a wonderful way to work at an issue. Consistent, vigilant, methodical practice.This does not speak to magnitude. Small efforts, in time or intensity, aimed at a goal are a real meaningful attack.
This is a perspective shift for many. For clinicians and patients. People, humans, want a “fix,” an immediate “undo” if you will. I find myself explaining that rehab is a process, not an event. So I will often try to tell a story about it.
What’s going on here? 1
Communication is complex, rich, diverse and ever important when attempting to portray your ideas, or persuade those around you. As it turns out, certain phrasing can lend an air of credibility to your words.
In the fantastically named paper Birds of a feather flock conjointly(?): Rhyme as Reason in Aphorisms, McGlone and Tofighbakhsh (2000) illustrate the power of structure in extracting meaning and truth from phrasing. Continue reading
Dost thou follow me on Twitter?
Marketing is not mysterious. Let me simplify.
Be Yourself. In Public. Continue reading
Seeing is believing. It can be also expressed as “only physical or concrete evidence is convincing” which you surely have heard as a popular argument on many fronts.
Well, your patients are human, and thus, adding physical evidence to your statements or positions can aid in understanding and spur conversation.
Dr. Spencer Muro ( @SpencerMuro ) suggested that, when educating pt’s on pain science or imaging results, we use the above concept to corroborate our “claims.” Use visible evidence, not just repeat it verbally. Enter: The Patient Education Binder.
We used to show patient’s pictures of these images on our phones, but a print-our hard copy in large font is more useful and meaningful (personal anecdote). So we did not make these images, and I will give credit to the maker’s / authors of them. I asked The Sports Physio ( @AdamMeakins ) to tweet some of them, PainCloud.com ( @PainCloud1 ) produces great stuff, the rest are found on Twitter or a search engine. Disclaimer disclaimer etc. (Most credit is available on the image itself). They are great representations of current understanding.
If they help us understand, why not share with your patient? Continue reading
Pain is like the wind.
It can only be viewed by its interface with the environment.
We see the trees move, the leaves rustle, the flower petals quiver. We see the thick dust in the air, the yard furniture toppling in a pile by the fence, the branches dropping to the street.
Our skin turns alive with an unseen pressure. We are urged to move to the left by an unseen force from the right. It blew my hat off.
“I cannot take a picture of the wind. I can show you a picture of a windy day… but not the wind.” Continue reading
We have seen large changes over the past year from personal perspectives here at the PTBT. The posts have continued… a host of topics following our varied and changing interests.
The transition from student-blogger to practicing-clinician-blogger is an interesting one. You must walk the walk. Cerebral idealism, philosophical concepts and metacognition are affronted by the real world N=1 scenarios, workplace pressures, time constraints, technique and exercise challenges and more comorbidities than you can shake a stick at.
“You wrote about how you should interact with this type of person/case, now they are in front of you.” Writing and reflecting on how to treat has kept the ship pointed in the right direction. Through the process of trying to form a thought, and even a thought that another person might understand (we hope!) you develop a skill for reduction. Reduction to the fine points. Continue reading