This past week I had a few instances that made me feel quite inadequate as a therapist. The first was a patient with knee pain and the other was a patient with neck pain. In both visits I managed to use up everything I knew, every decision path and subsequent treatment solution. And I got… no within session change.
As it happens I was stuck with the uncertainty of their treatments, their prognosis, and the uncertainty of my ability to be effective. I knew what bothered them, I thought I knew Continue reading
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
There is quite the debate these days about how manual therapy works and particularly what types are best or get different/better results or is it all just placebo. Here is a case, n=1.
I’m evaluating a patient with upper back pain, medial to the scapular border and lateral to the spine, around T5-ish. We all know where this spot is, right? The complaints are approximately 8 months in duration, 5/10 pain secondary to increased breast tissue (20 lbs) during pregnancy and post-partum time periods, per the patient. Continue reading
Ah yes, time to go to the parallel bars and do some balance training. As we all know, because we are super nerds, Balance is made up of a few major sensory components. The visual system (just written about by Spencer, here) proprioception from the joints Continue reading
I just recently finished 8 weeks at an excellent neuro-rehab facility. During my time there I presented an inservice proposing visual dominance as an indication for mirror therapy, but as I suggested during my talk–I think this sensory preference could go much further than indicating the use of a mirror during stroke rehab if we take advantage of it. Continue reading
More of this Motor Control business. See the previous Background and Learning post to get caught up.
“Science is built up of facts, as a house is built of stone; but an accumulation of facts is no more a science than a heap of stones is a house.”-Jules Henri Poincare
Practice is built upon theories, as a house is built of stone… Let’s put these theories into practice. Time to build a house….. Continue reading
Stephen’s post on Central Sensitization got a lot of attention, and it is well deserved. Part of getting results in this population is explaining how the nervous system works. The following metaphor is a nice way to get the idea across. Continue reading
There is some talk of spinal manipulation improving motor control. We know that pain, fatigue, joint or neurological issues affect motor control. There seems to be evidence that manipulation can help any one of these factors. But how? Continue reading
The following insight was made by the guys at PT Podcast episode 35 and I wanted to get it down and share it with you. Continue reading