Time

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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

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.

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What’s going on here? 1

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Rhyme as Reason

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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

Patient Education Binder

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

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

A Year In Review: II

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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

Self Residency

BrainTrust Study Group*image credit

The decision to go to residency is so easy. Yes, of course I want to go. Learn more? Become better skilled in the path you wish to take? Have confidence in my Knowledge, Skills and Abilities? No problem.

Well, the time and monetary cost (with no direct compensation link) are a common deterrent to pursuing residency after school… or in the middle of a career. Yes, the third year of DPT school should be a residency in your anticipated specialty field, getting paid and paying for a residency… but that’s another discussion. For those of you that do not or cannot seek out the residency may I suggest a Self-Residency. Continue reading

THE role for Physical Therapists

HomeRun GwynnImage Credit

There is a clash between knowing that biomechanics and structure are not 100% responsible (ie. a 1-to-1 relationship) for pain, and the fact that (from an Example I got from Mike Eisenhart) some one with a poorly moving C5-C6, (as best we can tell the difference and as valid as our hands may be) has a risk factor for future neck pains and problems.

No. Not causative, but a risk factor.

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Best treatment to stop knee pain.

 

Warning- an anecdotal post to 1) stimulate reflection on musculoskeletal pain and treatment. 2) Encourage experiment with ones own pain 3) Self reflection on resolution of my own knee pain with 1 exercise.

Oh that pesky knee pain. As I attempt to train for a year filled with fitness goals and by far the most long distance races in one year the all too familiar running partner relentlessly tags along, knee pain. Knee pain and I seem to ALWAYS meet up at the 3 mile mark for the past 3 months. Knee pain who skips the warm up and starts on strong on the right knee then soon after left knee, medial and lateral burning/stinging with a feeling of superficial fullness. What I would call a bursitis pain with a feeling of simply too much friction.

Being the therapist I am, and with a curiosity of pain, body, and exercise, I ask this. Continue reading