How to Fix Neck Pain After Lifting – A Live Treatment

While in the Hamptons, my main man Cody Benz started developing some neck trouble.

We thought it might be helpful for y’all to see what I would do to help a cat like him.

Here you will see me go through an entire treatment session with Cody, while I do my best to explain every decision I make. A major kudos to Daddy-o Pops Bill Hartman for asking some great questions throughout the treatment.

Instead of the typical transcript I provide for these longer videos, I decided to write this up similarly to my neck pain with sitting case study format. I reflected on this case while editing the video, so you’ll see some added thoughts I had while you read through. I would recommend watching the video and reading the case study to get the most out of the material.

Enjoy watching the session.

Continue reading “How to Fix Neck Pain After Lifting – A Live Treatment”

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.

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”

Master Sagittal Plane, Coaching Progressions, Detaching, & TFL Inhibition – Movement Debrief Episode 5

Did you miss Movement Debrief live yesterday? Though much more fun live, I have a video of what we discussed below.

This debrief was quite fun, as we had an impromptu viewer q&a. Thank you Alan Luzietti for the awesome questions! If you follow along live on Facebook or Youtube, I will do my best to answer any questions you ask.

Yesterday we discussed the following topics:

  1. Why you should emphasize sagittal plane activities longer than you think
  2. How to coach exercises to maximize client learning and compliance
  3. Why detaching from your client encounters makes you a better clinician
  4. Viewer Q&A – “centering from the chaos” & TFL Inhibition

Lastly, if you want the acute:chronic workload calculator I spoke about, click here.

Without further ado:

The Ultimate Guide to Treating Ankle Sprains

A Humdinger No Doubt

 

Ankle sprains. Such a bugger to deal with.

Worse than childbirth, as David Butler might say.

 

Ankle sprains are one of the most common injuries seen in basketball. The cutting, jumping, contact, fatigue, and poor footwear certainly don’t help matters.

Damn near almost every game someone tweaks an ankle.

Treating ankle sprains in-game provides quite a different perspective. Rarely in the clinic do we work with someone immediately post-injury. Instead, we deal with the cumulative effects of delayed treatment: acquired impairments, altered movement strategies, and reduced fitness.

The pressure is lower and the pace is slower.

You shed that mindset with the game on the line. You must do all in your power to get that player back on the court tonight, expediting the return process to the nth degree.

I had a problem.

Figuring out the most efficient way to treat an ankle sprain was needed to help our team succeed. I searched the literature, therapeutic outskirts, and tinkered in order to devise an effective protocol.

The result? We had 12 ankle sprains this past season. After performing the protocol, eight were able to return and finish out the game. Out of the remaining four, three returned to full play in two days. The last guy? He was released two days after his last game.

It’s a tough business.

The best part was we had no re-sprains. An impressive feat considering the 80% recurrence rate¹.    Caveats aside, treating acute injuries with an aggressive mindset can be immensely effective.

Here’s how. Continue reading “The Ultimate Guide to Treating Ankle Sprains”

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”

Course Notes: Explaining Pain Lorimer Moseley-Style

Why Weren’t you Here??!?!?!?!?!

A late addition to the yearly course list, but a decision I will never regret.

Regret? You serious?
Regret? You serious?

 

Lorimer Moseley is one of my heroes in the pain science realm and I’ve always wanted to hear him speak. His teaching style—slow paced, humorous, filled with story, and unforgettable—really resonated with me and made his material so easy to understand.

My admiration for him tremendously grew because he was readily admitting if he didn’t know something, critical of his own body of work, and very open to what we we do clinically. I got the impression that he was okay with us practicing how we wish, as long as our treatments are science-informed and coupled with an accurate biological understanding.

I left the talk validated, reinvigorated, and better adept at educating patients. He put on one of the best courses I have been to. If you haven’t seen Moseley live or had the chance to interact with him, please do so.

Let’s go over the big moments. Continue reading “Course Notes: Explaining Pain Lorimer Moseley-Style”

Smooth Talker: Nonthreatening PRI Patient Education

I recently had the pleasure and honor of speaking at the annual PRC conference at this past weekend’s Interdisciplinary Integration. I happened to have my younger older brother Connor Ryan record the event.

Didn't even have to photoshop this
Didn’t even have to photoshop this

We unfortunately had some technical difficulties, so a few bits are missing. But you’ll get the gist from the videos below.

Enjoy!

 

Smooth Talker handout