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

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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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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

The Meaning of Cost in Value

We associate many things with money. One example: If it costs more, it’s better.

Money is not just a physical item representative of some good or service.  It has meaning past trade. Having more money does not just mean that you can accumulate more things. Socially, it states that maybe you have accomplished more, are a better decision maker, make better behavior choices, etc. It possesses status and other cultural attributions. Not a surprise. You know this.

The $15 beer will taste superior to the $1.50 beer. It just does, because we know it’s better. It’s contextual priming. That’s why blinded taste trials are often so interesting, because the context is removed and you are left with a singular sensory organ (taste organs of the tongue and mouth, yes and olfaction). Continue reading

Bio-chemico-physio-behavioro-environmento being

heart tree PTBrainTrustimage credit

“Why didn’t the brain go to the party? Because he had no body to go with!” – My 6.8 yr old.

There is only one thing. There is no disconnect. It is all connected, as in, related. Interacting, melding, smushing, giving and taking and trading.

There only reason you think that Chemistry is separate from Biology is because we, as humans, divided up the information in to chunks. There is no actual divide. You cannot have biology without chemistry. You cannot have either without physics, and physics is nothing without matter (chemical, particle or biological). Thusly, there is no divide, it simply depends on where you point your lens. What do you choose to “pull out” as important? Continue reading

Top PTBT Posts of 2015

Wishing a Wonderful year’s end to you all!! As we walk 2015 down the aisle to get married to the past, we pause and reflect on the year, as I hope you all do as well. In the spirit of the season, I have compiled the most viewed posts from the #PTBT in 2015. (As is typical, Dr. Stephen Henry’s posts round out the top views. That guy’s writing has a full passport!) If you read us often, then you will likely have read/seen these top posts. So at the end of this post I’ve also included our least read (for one reason or another) posts for the year. Enjoy!

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The advice we give

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Do this drill: Ask yourself “Do you think that everything you believe or think about the world is the truth?”  (Most thinking people will say ‘no.’) Follow-up with this question: “What are you wrong about?” … hmm…

We often think our way of thinking and understanding the world is correct. Well, we always think we are correct and act on it, but we know deep down that, since we are human, we cannot always be right. This is besides the point a bit, but this post deals with our advice, our own beliefs in what we and others should do. Sometimes there is a disconnect. Continue reading

I just want you to KNOW…

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I was getting sick. Ugh. I was able to hold off long enough to finish my caseload, but once I was home, I let my resistance to the bug go. My clinical crew knew I wasn’t feeling well, but I thought I’d be back by the next day.

Next morning: nope. I needed to stay home. I tell my wife I’ll be staying home as she leaves for work, “s’all good, honey.”

So I call in to the clinic to let them know.  When they answer the phone my voice changes a bit ( I notice retrospectively). I explain I’m worse *cough*, and thank them for arranging the schedule to cover me *cough*. Then hang up.

What was that about? I ask myself. I was not sure that I sounded sick, or did I?  Did I just throw in an extra throat-clear for emphasis? I realized that I felt a strong urge to sound sick, to “sell” that I wasn’t feeling well. My sickness was the truth. Yet, I was pulled very strongly to embellish it in my short 30 second interaction… hmmm.


The purpose of communication is often to get a point across to some audience outside of yourself. You express yourself so others will know what you mean, how you feel, why you think, etc. Continue reading