Treating in the low socioeconomic climate

My clinic serves a low socioeconomic area. Now, I am sure that there are any number of stranger work conditions, treating in a gang-controlled area, for example, but the conditions and problems of low socioeconomic status (SES) are a niche unto themselves.

Almost everything “straight ortho PT” gets thrown out. Low SES throws a wrench in the gears.

From our clinic perspective, it means lots of un-managed chronic conditions, high cancellation rate and difficulty with adherence to HEPs. Transportation to the clinic is a large issue because it has a cost (either money or time) to the patient that is often a deterrent to coming to appointments. People prefer not to wait for the bus in the cold. Continue reading

G O A L !

What you perceive today as a struggle is not truly due to the task at hand. It has to do with what the goals of the activity are.

The goal determines how the steps will play out. A worthy goal can bring you through any tough time. If the outcome is not of interest to you, no simple/light task is easy. It’s all a struggle if the goal is not meaningful. Continue reading

The Thousand Word Image

There is no more credible a thing than an image. Seeing is believing. I’ll have to see it to believe it. A picture is worth a thousand words. Vision trumps other senses (McGurk Effect).

How are the words you choose to use, in the healing context of your presence, going to combat the fact that it has been visually shown that things are “messed up in there” ?

It is not our fault, us humans. Wilhelm Conrad Roentgen developed this lovely technology. About a month later, humans were using it clinically.  It is amazing. And I mean X-ray, CT-scans, MRI, fMRI, UltraSound… it’s all incredible. It was developed so we used it. We used it on people in pain, people with broken limbs, people with ailments of this nature or another, and that is the vantage point from which our opinions were based. We saw people with pain have strange looking images. We therefore conclude, that the changes we saw were the cause of the pain, and here we are today.

Post Hoc, Ergo Proctor Hoc. After this, therefore because of this. It is all in the development of the tool. We pointed our delicate and precise imaging tools at the sick, and we found sickness. Continue reading

V O M I T

VOMIT-Poster-2014-SAMPLE

After a few weeks back in the out patient physical therapy setting I am re-confronted with the pathoanatomical-ness of diagnosis.

The battle for language and context of explanation rages on: full strength, full power, full speed.  Whew, just trying to hang on. Daily I must combat the destructive thoughts of a fragile body, or a decaying joint, a shredded tendon, or a tear from here to there.

Sometimes it is very true. Others not. But trying to de-fixate an individual’s thoughts off of the negativity of their structures is unaided by visual proof that they are internally “disfigured.” Continue reading

Think about it…

How do I help my patient get better? It may depend on many things, the disease, injury, co-morbidities, etc. And in many cases it can be hard to ignore big factors that “stand in the way” of recovery. Some patient’s are just tough. Complex. Hopeless.

Of course, we make sure to keep a mask on. We attempt to prevent our patients from seeing Continue reading

You Should Be Using Music with Your Patients with Brain Injury

Music has the ability to go deep and move us.  We have all been on the dance floor when “our jam” comes on and you just have to pick up the pace and move with the music.  You had no choice.  Contemplate that for a moment, why is that?  Why does it feel so good to match your movements to the beat?  Let’s dive in…

We will use the research study: Interactions between auditory and dorsal premotor cortex during
synchronization to musical rhythms, by Joyce L. Chen, Robert J. Zatorre, Virginia B. Penhune, 2006 in NeuroImage to explain the premise.  (open source!)

To start off- some background information on Continue reading