A Conversation on Learning with Lance Goyke and Jason Bryne

I recorded a really good conversation with two good buddies of mine, Lance Goyke and Jason Bryne.

Lance is a strength coach, photographer, student, and writer. He runs the show at IFAST University, coaches at IFAST, and runs his own excellent blog and Youtube channel. He is also a dear friend of mine, one of the first people I met when I interned with Bill Hartman at IFAST.

Jason is an Athletic Trainer at Brandeis University and with the Boston Cannons. He is an avid learner, tinkerer, and phenomenal human being. I truly admire his ability to connect with others, his humility, and comfort with learning from failures. Check him out on Twitter or email him at jbyrneatc@gmail.com

We went off the top of the dome on this one, as there was no agenda. I was just hoping to help better all of our learning processes.

We got that…and then some!

Here were some of the topics we covered:

  • Designing a learning process
  • Test-Retest
  • Failure
  • Being comfortable being uncomfortable
  • Connecting with others
  • How to learn
  • Study habits
  • and more

If video isn’t your thing, I have a transcript of our conversation below.

You can also download the audio version of this talk if you’d like by subscribing to my newsletter.

Without further adieu, here is the conversation

Continue reading “A Conversation on Learning with Lance Goyke and Jason Bryne”

Trial and Error, Triplanar Movement, Networking, and Mentors – Movement Debrief Episode 11

Did you miss yesterday’s Movement Debrief? We had a lot of fun. The first time I went on facebook, twitter, and Instagram simultaneously.

This debrief was a bit different, as it didn’t involve as much reflection on my patient care, but more on the wonderful continuing education weekend I had.

I got to spend time with all my friends learning about a lot of different things. And it led to some great reflections.

Here’s what I talked about:

  1. Why trial and error is important
  2. Being outcome-focused
  3. How triplanar movement impacts single plane movements
  4. Why having a good network is important
  5. Keys the networking
  6. The importance of mentors

If you want to watch these live, add me on Facebook, Instagram, or Twitter. They air every Wednesday at 8:30pm CST.

Enjoy.

How to Design a Comprehensive Rehab Program

Just when I thought I was out, the clinic pulls me back in.

Though I’m glad to be back. There’s just a different vibe, different pace, and ever-constant variety of challenges that being in the clinic simply provides. This has been especially true working in a rural area. You see a much wider variety, which challenges you to broaden your skillset.

I’m amazed at how much working in the NBA has changed the way I approach the clinic.

Previously, I was all about getting people in and out of the door as quickly as possible; and with very few visits. I would cut them down to once a week or every other week damn-near immediately, and try to hit that three to five visit sweet spot.

This strategy no doubt worked, and people got better, but I had noticed I’d get repeat customers. Maybe it wasn’t the area that was initially hurting them, but they still were having trouble creep up. Or maybe it was the same pain, just taking much more activity to elicit the sensation.

It became clear that I was skipping steps to try and get my visit number low, when in reality I was doing a disservice to my patients. This was the equivalent of fast food PT—give them the protein, carbohydrates, and fats, forget about the vitamins and minerals.

If fast food PT fits your macros tho right?!?!

Was getting someone out the door in 3 visits for me or for them? The younger, big ass ego me, wanted to known as the guy who got people better faster than everyone else. Yet the pursuit became detrimental to the patient’s best interest. There were so many other ways I could impact a patient’s overall health that I simply sacrificed in place of speed.

I only got them to survive without pushing them to thrive.

I see a lot of individuals proudly proclaim how many visits it takes for them to get someone out of pain, but pain relief is only part of the equation. There are so many more qualities we can address before we consider a rehab program a success.

This stark realization has reconceptualized how I structure a weekly rehab program. I now emphasize all qualities necessary to return to whatever task the patient desires, and attempt to inspire them beyond those initial goals.

You want to know what my visit average is right now?

I stopped counting, and started treating.

Let’s look designing the rehab week to take your clients to the next level.

Continue reading “How to Design a Comprehensive Rehab Program”

Lat Stretch Arm Position, Exercise Programming, and Staying Neutral? – Movement Debrief Episode 10

Episode 10 of the Movement Debrief, we went straight up q&a from readers.

It was a lot of fun and I got a lot of great question from people.

Here was what we discussed:

  1. Should the arm be in internal or external rotation when stretching the lats?
  2. If general exercise works, why should we incorporate specific exercises?
  3. Why coaching exercises well is of utmost importance
  4. Is staying neutral in a good joint position important?

If you want to watch these live, add me on Facebook or Instagram. They air every Wednesday at 8:30pm CST.

Enjoy.

Workers’ Compensation, Dealing with Late Patients, Fall Prevention, & More – Movement Debrief Episode 9

Episode 9 was a long one, and I’m so sad if you missed it live.

Here were some of the topics:

  1. The necessary organizational fix to worker’s compensation
  2. Ways physical therapists can have patients simulate work
  3. Targeting educational-specific impairments
  4. The need to expand scope or collaborate to help clients thrive
  5. How to deal with patients who are always late and don’t do their exercises
  6. Working on getting up off the ground after a fall

If you want to watch these live, add me on Facebook or Instagram. They air every Wednesday at 8:30pm CST.

Enjoy.

Return to Play after a 5th Metatarsal Fracture – Case Report

I was recently featured on my buddy Scott Gray’s podcast,  a great clinician in the Florida area who I have a lot of respect for.

Before we dive into the podcast, let me tell you a bit about why I like this guy so much.

It’s not just because he is a part of the IFAST family.

I’ve been going back to the basics as of late, reviewing concepts such as tissue pathology, anatomy, surgical procedures, and the like.

If there is anyone who has the fundamentals down savagely well, it is Scott Gray.

He put out an Ebook called “The Physical Examination Blueprint”, which you can download by subscribing to his newsletter. Here he details all the essentials on screening your patients.

To me, the most important aspect of patient care is knowing who you can and cannot treat. Stratifying your patients based on who needs to be referred out, and who you can help is essential to providing the best care.

Quite simply, there are few better resources out there that outline how to do this than Scott’s ebook.

In it, he delves into what relevant questions to ask, tests to perform, and establishing a relevant diagnosis. Often underlooked, yet exceptionally important components of the clinical examination.

Again, I cannot recommend Scott’s ebook and site enough. It’s a great resource for many things PT, including many of his eclectic and unique manual therapy techniques. Definitely check this guy out.

Rehabbing a 5th Metatarsal Fracture to High Level Basketball

In this podcast, I outline a case I worked on back when I was in the NBA D League. 

This kid suffered a distal 5th metatarsal fracture with only a couple minutes to spare in a game. It was a brutal injury after one of the worst games in my life that I experienced, namely because we had three guys go down in one game.

Talk about awful.

I outline my entire process and every detail of what I did to get this kid back to high level basketball. A process that started with a fracture and ended with him establishing a franchise rebounding record the last game of the season. Pretty spectacular to say the least.

I feel very fortunate to have worked with such a driven and hardworking guy, and ultimately that was what his success hinged upon. Though minor, it was an honor to be this guy’s guide back to high level performance.

In this podcast, we dive into the following topics:

  • Immediate post-injury rehabilitation
  • Post-surgical care
  • The non-weight bearing phase
  • The weight bearing phase
  • Return to play Criteria
  • Return to performance criteria
  • Acute:chronic workload monitoring

Again, thank you to Scott Gray for featuring me on the podcast. I had a blast doing it.

If you’d like to download this podcast and get my free acute:chronic workload calculator that I used with this patient, subscribe to my newsletter by clicking here or simply fill out the form below.

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How to Treat Pain with Sitting – A Case Study

Case studies are much more valuable than many give credit for.

It is this type of study that can often lead to sweeping changes in how further research is conducted, often create paradigm shifts in their own right.

After all, there was only one Patient H.M.

One thing that I wish I saw more in case studies was the clinician’s thought process. Why did they elect to do this treatment over that, what were they thinking when they saw this? How do they tick?

I was fortunate enough to have an online client of mine suggest to that I make her a case study, and it was a very rewarding experience on both fronts.

My hope is that you can see how a clinician thinks first-hand, and see the challenges a clinician faces…

When you can’t work with your hands.

Continue reading “How to Treat Pain with Sitting – A Case Study”

Teaching Movement, Expanding PT, Embracing Failure: Movement Debrief Episodes 2 & 3

Here are this week’s Movement Debriefs. I’m hoping to get on a regular schedule once I get settled into my new gig as a PT Mercenary, but hope you enjoy.

Anchoring Old Movements to New, Prioritizing PT’s Professional Needs

In Episode 2,  we discuss the following concepts:

  1.  Visit 2 & 3 of our patient with the lumbar fusion
  2. Using familiar concepts from old exercises in new exercises
  3. Strategies to enhance learning.
  4. Prioritizing Problems in the Profession.

Embracing Failure and The Dunning-Kruger Effect

In Episode 3,  we discuss the following concepts:

  1. My Failure
  2. The Dunning Kruger Effect – and how to hack it
  3. Embracing Failure
  4. Learning from Failure

Change The Context: 3 Tools to Treat Neck Pain

Basket Case Study

The other day I woke up with some right-sided neck pain. I had some discomfort and slight limitations rotating or sidebending right.

Now I’ve already completed many systemic-oriented treatments, and don’t really have a go-to non-manual for the occasional crick in the neck. I was unable to get any manual therapy, nor were self-mobilizations effective.

What’s a guy to do? Continue reading “Change The Context: 3 Tools to Treat Neck Pain”

Chapter 15: In Conclusion

This is a chapter 15 summary of the book “Movement” by Gray Cook.

The Goal

The goal of movement retraining is to create authentic unconscious movement at acceptable levels. We can develop many methods to achieve our goals, but working under sound principles is paramount. Some of the principles Gray advocates include:

  • Focusing on how we move.
  • Look to movement to validate or refute your intervention.
  • Movement is always honest.
Of course I did my corrective exercise, I swear.
Of course I did my corrective exercise, I swear.

When designing a movement program, we must operate under the following guidelines:

  • Separate pain from dysfunctional movement patterns.
  • Starting point for movement learning is a reproducible movement baseline.
  • Biomechanical and physiological evaluation do not provide a complete risk screening or diagnostic tool for comprehensive movement pattern understanding.
  • Our biomechanical and physiological knowledge surpass what we know about fundamental movement patterns.
  • Movement learning and relearning follows a hierarchy fundamental to the development of perception and behavior.
  • Corrective exercise should not be rehearsed outputs. Instead, it should be challenging opportunities to manage mistakes on a functional level near the edge of ability.
  • Perception drives movement behavior and movement behavior modulates perception.
  • We should not put fitness on movement dysfunction.
  • We must develop performance and skill considering each tier in the natural progression of movement development and specialization.
  • Corrective exercise dosage works close to baseline at the edge of ability with a clear goal.
  • The routine practice of self-limiting exercises can maintain the quality of our movement perceptions and behaviors and preserve our unique adaptability that modern conveniences erode.
  • Some things cannot be fixed, but change what you can.
  • The brain that learns function can learn dysfunction.
  • Be safe, be satisfied, and play.
I can always tell when movement is sassified.
And I can always tell when movement is sassified.