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, ( @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


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.

Continue reading

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

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

Early Access and #GetPT1st


We often see them way too late. We start out trying to “play catch-up” to a limitation. This is the nature of rehab to one degree or another.

In my clinic I am often months late… sometimes years late to being allowed to address an issue. 6 years of pain and medication and just now making it to the clinic, for example, or 4 months after a shoulder-strain injury at work. You name it, and I’ll basically state the same thing to myself: “Sure would have liked to address this earlier on in the process.”

We all value early access to help people, across all settings in physiotherapy. Similar to a stain on the rug, dirt on your car, or a chair left out in the rain… addressing problems early lessens the impact of an issue. 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