Explaining Context

When people ask “why does it hurt?” I’ll get around to stating that “… also, context of [your pain] is a factor in how it feels.”

Now this may make sense to you, the PTBT audience, but this is often not an idea that people have thought of. Most people only remember a politician saying his/her words were “taken out of context” so it may be important to explain context.

Here are two quick context stories I tell. Please use them, please make them your own…

spooky-forrest

1.) Context example… “So now let’s say you are walking in a spooky forest, it’s dark out, you’re by yourself, a bit creeped out and you feel this on your shoulder (lightly tickle the skin), what would your reaction be?” Often a patient will exaggerate looking back quickly or state “I would jump, think it was a spider or something”, etc. Continue reading

If a Tree Falls in the Forest

tree-falling

If a tree falls in the forest, and no one is around to hear it, does it make a sound?

Ah yes, a classic riddle indeed and one I will answer. No. It does not make a sound. Let’s explore this, and how it relates to understanding pain and sensation.

First we will define a sound. The English Oxford dictionary defines it as “Vibrations that travel through the air or another medium and can be heard when they reach a person’s or animal’s ear.”  You need both waves and an ear to complete the “hear.” So in our above riddle, there is no hear of the sound due to there being no person’s ear in the riddle, as it is in the definition. 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

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

Experience and the Experiment

Image Credit

“Dad, let’s do an experience” my 6.5 year old said to me this morning. “Let’s see how far away these walkie-talkies can go and we can still hear each other.”

“Do you mean experiment?” I ask. “Yes, ex-per-i-ment” she says. We go over its pronunciation a few times. It’s a mix between my daughter having no front teeth and that she just gets her word choices mixed up now and then. Experience. Experiment. It’s an easy one to slip up on, plus they could be viewed in the same category in her head. “I will have an experience and learn something.” “I will do an experiment and learn something.” Same thing, basically, to a 1st grader.

So, you can see this question coming: Do you get Experience and Experiment mixed up? Continue reading

Commute = Classroom

Commute time can either suck your life force, or it can become a valuable part of your development. So, yes, there are tons of great Podcasts on the subject of Physical Therapy / Physiotherapy from many angles, and I encourage you to listen and learn. But what I’m going to share today are 3 Non-PT Podcasts… for PTs.

1)     The You Are Not So Smart podcast, hosted by David McRaney.  There are tons of great episodes here, primarily on psychology, cognitive biases, social patterns, scientific thought and all things thinking. I cannot state enough how important these types of topics are for the practicing PT, primarily because, no matter what the injury or body part, we all treat people.  They’re all great, but… Some highlight episodes: Continue reading

The Punnett System

Oh Lord, I have heard the claims!

I have listened to the persuaders, the charmers, the charismatics.  Most of their ideas make sense and can follow logical patterns. (see How To Fool a Smart Person by Erik Meira)  I have a thirst for knowledge, and for universal truths… so I’m listening!

But I have one helpful tool that I use to quick-check these fantastic claims: The Punnett Square. The marriage of factors combined to make truth babies.  Hypothetical genotypes producing theoretical phenotypes. (I don’t know what all that means…)

The punnet Square is commonly used in biology (I’ll let Khan Academy teach you about that here,) but we can use it in our own evidence based practice.  Here’s how: Let’s take the claim that poor posture = pain and make a Punnet Square. Continue reading

It’s Your World

Nociception is subject to all the truths and flaws of any other input system.

Patients never have this view, since their pain has been described to them in terms of body parts and structures.  However, the tissue is as important in pain as the eyeball is in what we see.

This past week’s viral internet subject is a great example of all that (Black ‘n’ Blue dress).  Vision is simply our brain’s decision based on the information available to it, including, but not limited to, the light waves of objects.  The eye itself is simply an Continue reading

Tell me a story: A metaphor for understanding analogies

Start here, with this TEDtalk-

I like to use a story or analogy to explain things to patients.  It helps me come into their world and attempt to contact them on their own turf.

It’s not that patient’s are dumb, and can’t understand concepts or facts and figures. Stories are just a great way of conveying information. Adriaan Louw points out that when we are little children we have stories read to us (Aesop’s Fables and the like) that illustrate points, morals and teach concepts. You listened to the story and you got the point to that story, so it starts very young.

When you are on a cruise or on a bus or meeting people for the first time at a restaurant, why do you tell stories? Continue reading

Therapy vs. Therapeutic

If you are grappling with concepts of treatment effects and how a technique works or if something is effective and what role it plays in your patient’s recovery… then this post is for you!

A few classmates and I recently attended a lecture on Music Therapy from Tracy Bowdish, MM, NMT Fellow, MT-BC.  We discussed some fascinating music therapy concepts in treating movement disorders, but  while discussing research paradigms she posed the question about Therapy vs. Therapeutic and I have been thinking about it since. Many answers lie in answering the question: Is this therapy, or is this therapeutic? Continue reading