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Principles Uncategorized

Let the Kids Play

“Let the Kids Play” (#LETTHEKIDSPLAY) was a marketing campaign released by Major League Baseball to put a spotlight on its young superstars. It encouraged a fun but competitive, trash-talking, bragging atmosphere normally seen in sports such as basketball and football. Given that Major League Baseball is paused due this pandemic, it’s time to borrow the campaign and hashtag and use it for a significantly more important reason: we need to let OUR kids play.

Before this post reads as a lecture from an expert on kid play, activities and nutrition, please read the following disclaimer:

Disclaimer: I am not the perfect parent. My kids have had more screen time than ever before. I have gone from despising my son’s online game play on Xbox to appreciating the social interaction he gets with his friends. Given that my sweet and chatty 7-year-old daughter is away from her friends she has a lot to say and even more questions, prompting a one-day, five pushup rule for every question. She did a lot of pushups that day. We have sat and watched a lot of movies and consumed a good amount of popcorn and ice cream. Some of my “cook dinner” nights have contributed to the frozen pizza shortage. When helping my kids with math I frequently find myself saying, “Let me show you how I do it.”

That said…

In the past 2 months, kids have lost recess, physical education, sports, the playground and free play with friends. They have more sitting time for distance learning and screen time. Parents, many who still work, are now homeschool teachers and activity directors. My wife and I put my kids through 2-3 intense workouts a week, play basketball and baseball, go for hikes, and ride bikes. And yet it’s still not enough. I can see some “rust” in movements and endurance. 

Kids are missing free play. Structureless and joyful free play. There was a time you did this. You ran around the schoolyard, neighborhoods or playground. It was all without feeling exhausted because you were having fun. Due to closures and social distancing, it’s time you returned to this for the sake of your kids. Tag, hide and seek with a chase component, challenge workouts, dancing and racing are all examples. Kids love goofiness and spontaneity. Parents and guardians… it’s time to get goofy and spontaneous. Have some fun. Put yourself in your kids’ shoes. You and your kids will love it. It is okay to laugh and have fun right now for the sake of the generation that has no control over what is happening and yet will be left with the results.

Sure, there will be some sprained ankles and strained hamstrings. Hips will tighten and low backs will bark. We can help with those (#shamlessplug). Kids need to play. To a greater extent, and not to start a health and political discussion, kids need to return to their normal. #LETTHEKIDSPLAY should take on a new, exceedingly more important meaning and representation. Spread the word: #LETTHEKIDSPLAY.

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Principles Uncategorized

Sharing isn’t always caring.

In our practice, we have the incredible opportunity to work with individuals that have been to multiple other providers without success.  We love challenges, and this allows us to have a positive impact on someone that, often times, has lost hope.

During the initial consultation, Clients tell us about the previously failed treatments they have undergone.  These stories often have a common theme… a complete lack of consistency and continuity of care.  They report bouncing around between different specialities, clinicians and assistants feeling like each visit was like starting over from scratch.

Previous care for most of our Clients has not been cohesive.

There are so many dimensions to you – your body, habits, aversions, preferences, movement patterns and history.  How can any clinician know enough to successfully treat you, when you’ve been scheduled with 1o different providers since your last session with them?  It’s simply not possible.

At MOVE, even with only 3 Therapists (no assistants), we simply can’t communicate everything that would be needed to successfully share Clients within our small team – so we don’t.  Every Client has ONE, primary Physio.  We don’t share, unless it is in the Client’s best interest to switch Physios, because of schedule, specialty, etc.  This way, every session progresses exactly where the last one left off.

Our Clients appreciate being able to ask questions and chat with their own Physio during and between sessions.  You aren’t a toy and shouldn’t be passed around.

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Principles Uncategorized

30-minute VS 60-minute Sessions

The more I learn and practice integrating all the systems of human body I realize 30 minutes sometimes may not be enough to work on dysfunctions to help : 1.Increase the range. 2. Retrain the patient’s brain to stabilize to keep that new range. 3. Incorporate motor control for efficient movement patterns

What is stabilization? Why is stabilization so important to keep the gains? Stabilization is awakening the deep core muscles in our body. These muscles often kick in only after all the superficial muscles get fatigued. In an efficient system, stability in the trunk always occurs first before movement in the extremities. Relearning a task that your brain has forgotten for years may take much longer than you expect. It may take over 5 minutes to just fire (initiate) one group of stabilizers. Repetition is another important factor to learn those tasks. In the course of treatment, we incorporate repetition after we initiate stabilization by adding movement in slow concentric and eccentric range. All the above factors help to build a strong foundation of an efficient system for optimal functioning.

Each pillar may have its own challenges of figuring out where exactly is the restriction coming from (musculoskeletal system, visceral system or nervous system). We resolve the restriction to gain new range and then work on stability and motor control within that new range. This systematic approach to treatment sometimes takes longer than our standard 30 minute sessions allow.

The great news is that we also offer 60-minutes sessions, where we can resolve at least 3 major restrictions and re integrate them.  Plus, the gains have a longer lasting effect, so treatment frequency is often much less. This also helps to finish the course of therapy much faster and will get you back in to functional activities and recreational/sports activities you love to be involved in.  60-minute sessions are not always necessary or the best approach, so talk to your Physio!

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Principles Uncategorized

Why Telehealth Stinks

Practically overnight, Telehealth has become the go-to method for delivering many healthcare services.  The transition is certainly a necessary evil during this pandemic, and while it can be made to work for the time being, the truth is: Telehealth Stinks.

Why?

Telehealth has quickly transformed the Healthcare system to one that is (by design) void of human experience or interaction – for everyone’s safety. However, I am a Manual Therapist and for me to offer the best care to a Client, I need to interact with them and use every sense when I assess them.  With Telehealth, we are relying on extremely limited information.  Without three-dimensional access to a Client’s body and a hands-on assessment, how can I gather the information I need to determine whether the ribcage, liver or nerve-bundle are responsible for a persons shoulder limitation?

So you don’t offer Telehealth?

Yes, we do offer Telehealth, but mainly for “Virtual” Consultations, which are typically 99% history-taking and education.  This can be easily performed virtually without missing too much or reducing the quality of service we can offer.

What about “Virtual” Treatments?

At Move Physio, we are integrated, Manual therapists. Each treatment session is based on the manual assessment of ALL the systems – that day.  Our treatments are never based on a random, general stretching program or exercise protocol. Since we can’t thoroughly assess through a camera, we are currently treating most Clients through in-person, hands-on sessions (with extensive precautions).  Following these sessions, there’s always homework to help reinforce and enhance the progress we make…

What are Virtual Treatments good for then?

“Movement is Medicine”, but we also know that strengthening a system, without fixing the underlying dysfunctions will definitely make those dysfunctions stronger and harder to overcome.  Fundamentally, this is why people aren’t successful (long-term) with traditional PT exercise programs. In many scenarios, we can use a “Virtual” Treatment to:

  • Assess & modify a Client’s home or work space
  • Progress or modify home exercises
  • Discuss and implement specific lifestyle changes
  • Instruct self-care strategies or techniques

I don’t feel safe coming in but I need help…what can I do?

We want everyone to be safe and stay home when you can.  My recommendation is to get your journey started with a Virtual Consultation.  Most people report learning a lot from us on this first visit and we can often teach principles that can help calm things down and start the healing process.

Another great option is to download the E-book I wrote.  You can access it toward the bottom of this page.  It’s full of information that may contradict what you’ve previously been told and has strategies that you can implement to help yourself today.

We are here to serve…in whatever capacity and method we can.  We will work within whatever constraints make the most sense for your situation.  Please reach out to us with any questions.

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Principles Uncategorized

Back sleeper? Things to look out for….

Waking up every morning with tightness in your neck or back is not okay. It may be because of the sleeping positions you are in. Unsupported sleeping for 6-7 hours at night may continue to cause strain in the body where your back muscles have to work hard to get your body back to neutral. The tightness generally is from those specific muscles which are overworking in a position to find the neutral for your body against gravity.

The goal while sleeping on the back is to keep the spine in neutral so there is no added strain on the body. Gravity still works on your system while you are asleep so we need to minimize the effects of gravity by adding extra pillows so all the muscles and joints in the body can relax while you lay in a particular position. Generally, laying on the back with the legs stretched out will increase the normal curvature in the small of your back. That happens because the psoas muscle that is attached to the front of the spine and the discs in the lower thoracic and lumbar segments to the hip is stretched which increases the curvature in the back. You don’t need to buy any fancy props to counteract that.  Instead, use at least two pillows to support your legs as follows:

The first pillow supports the leg from the bottom of the buttocks to the knees horizontally. The second pillow goes under the first pillow from under the knees to the ankles so the knees are slightly higher than the hips. This will help relax the small of your back in to the mattress for support. The third pillow goes under your head and neck supporting up to the top of the shoulders so there is enough support for the curvature of your neck.

Pillow supports can not only prevent symptoms but also protect your spine in the long term. If the position you are sleeping in comfortable, it will reduce the number of tossing and turning in the night and provide better sleep.

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Principles Uncategorized

The Definition of Insanity

Have you spent weeks, months, or even years performing the same exercises prescribed by your previous provider?

Hamstring stretching for low back pain?

Piriformis stretching for sciatica?

Banded rotator cuff exercises for shoulder pain?

How about pills?

You may find temporary relief from these activities, however your pain continues in the long-term.  Pills seem to only “take the edge off”  and you continue the vicious cycle of pain and no answer to the real reason behind your issues.  These stretches and exercises are typical among standard physical therapy and yet are rarely effective.  Your hamstrings are not short, your sciatic is not “caught” in your piriformis, and your rotator cuff is already strong.  A proper approach with thorough assessment can identify all the reasons you are in pain.

 

“The definition of insanity is doing the same thing over and over again, but expecting different results.”   -Albert Einstein

 

Please ask yourself why you are still doing the same things over and over and expecting long-term improvement.  It’s time for a different approach.

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Principles Uncategorized

What’s a Treatment Session Like?

Each treatment session may be a little different, but there is typically a pattern. 

After arriving and signing in, the first few minutes involves discussing the following with your therapist: response to your previous treatment, changes you are experiencing, your progress toward your goals and the plan for that session.  Your therapist will then assess for any measurable changes (strength and range of motion, for example). These measurements may be repeated throughout the session in order to detect immediate changes due to manual therapy and exercises. Manual therapy, or hands-on treatment such as soft tissue and joint mobilization, is heavily utilized at Move Physio. 

Depending on the type of treatment session, your condition and the plan, you may receive anywhere from 10 to almost 30 minutes of hands-on time in a 30-minute session (significantly more for 60-minute sessions).

Once complete, it is important to train your muscles and joints in the new ranges you gained during manual therapy. These exercises are specific to you and may be necessary to perform for a home exercise program.  During and/or at the end of the session a review of the session, a brief discussion of the plan for the next, instructions for self care at home, and any questions are addressed. 

The focus should be on you each and every session.  Take advantage of this time in order to reach your goals.

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Methodology & Techniques Principles Uncategorized

Mobilization Over Stretching

Stretching is the most common and touted way to increase flexibility and it may be the least effective.  Immediate gains made during stretching are a result of stimulating nerves that are also on stretch.  Your nervous system will reach a point of over-stimulation and begin to relax.  Once relaxed, your muscles are calmed down and therefore more flexible.  This process does not change the properties of the muscle.  For muscles to become longer, it is argued, takes days, weeks, and maybe even months of devoted stretching.

Soft tissue mobilization (STM) leads to immediate gains in flexibility.  The focus of STM is to promote stagnant and temporarily stuck layers of tissue (skin, fascia, muscle, bone) to glide more easily over one another.  These structures move together yet are independent.  The more freedom between them the more flexible you are.  Will these immediate gains stick around for the long-term?  Sure!  As long as you keep them moving and occasionally get into those once-challenging positions.

A good manual therapist can determine if soft tissues are limiting your flexibility and treat accordingly.

 

PRO-TIP:

Still feel the need to stretch?  Do a warm up to get your blood flowing and stretch in a relaxed manner.  Studies show that gentle stretching with mild discomfort is as effective (if not more) than aggressive stretching.

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Condition-Specific Principles Uncategorized

Post-Surgical Rehab Should Not Be a Cookie-Cutter Approach

Sometimes surgery for orthopaedic conditions is unavoidable.  Have you recently undergone surgery?

…Or did you undergo surgery a long time ago and still don’t feel fully restored?

 

Your surgeon likely gave you a general rehab protocol designed for all and then you underwent standard, one-size-fits-all, “cookie-cutter” physical therapy.

If the surgery was unique and individualized to you, shouldn’t the rehab be as well?

 

…More importantly:

Your rehab should address why you had to undergo surgery in the first place!

 

Yes, there are some very basic instructions and exercises to follow after surgery.  Beyond this, however, rehab should address the following:

  1. Features that may have contributed to why you needed surgery including range of motion limitations, weakness, and movement dysfunctions.
  2.  Proper progression after meeting your short-term milestone criteria and goals.
  3. Specialization.  In other words, training towards the specific demands for your daily life, work, athletics, and fun activities…(yes, fun activities!)
  4. A focus on long-term goals.
  5. You, the individual, and your physical and emotional response to the surgery and subsequent treatments.

Surgery is one step in the process.  Rehabilitation, in order to achieve the best results, should be at least slightly different for every individual regardless of the surgery.

 

Pro Tip:

If you do not feel like your needs are being met and/or your rehab looks the same as what everyone else in the room is doing, then you need to discuss this with your provider…or find a new one.

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Principles Uncategorized

Why Your Doctor May Not Recommend Physical Therapy

There are many instances with common orthopaedic conditions in which a physician (MD) may not suggest physical therapy.  They may even say you shouldn’t go… and I can’t blame them. Many patients have returned to their physician in worse condition after weeks of physical therapy.

Why is this? 

Standard physical therapy, at times, may consist of aggressive stretching, inappropriate strengthening, and performing the same exact activities 2-3 times per week for 6 weeks.  There is little to no consideration for addressing why patients are in pain to begin with.

After weeks of wasted time, no improvement, a physician will think twice before sending another patient with that same condition to physical therapy.  If a physician wants the best for the client, then why send them somewhere that is perceived ineffective or even detrimental?  

Good therapy addresses the root cause of the problem, adjusts and modifies treatment and exercises based on response and progress, and keeps open communication between the patient, referring physician and therapist.