Is it Pain or Discomfort?

Perhaps one of the biggest struggles we can run into in working with people in pain is getting our clients feeling safe when returning to movement. The reality of the matter is that the chances of a person in pain experiencing some symptoms as he or she returns to activity is real and part of the process. How can we get our people to trust the process? To be comfortable being uncomfortable? I think Aline Thompson, a physical therapist I trust out of Denver, has the answer. In today’s post, she outlines how changing the belief frame someone approaches pain with can have profound impacts on returning to life. Without further adieu, here is what she has to say: Is there a Difference Between Pain and Discomfort? There’s a difference and it matters. More often than not the question goes more like this: “Tell me about your pain…” After which you get a pause, with a look of contemplation. When this happens I wonder; what are they thinking? Should that silence be filled with a follow up question? “…. Or is it discomfort?” When I ask folks whether there is a difference between pain and discomfort everyone says yes. When I ask how they differ these are the answers: “Pain is discouraging, Discomfort is just frustrating” – “Discomfort is annoying but you can ignore it. Pain interferes with your brain and thought processes. You can’t do a complex math problem easily when you’re in pain” – “Pain can hinder progress

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Sitting Posture, Hypermobility, and Fear-Avoidance – Movement Debrief Episode 72

Movement Debrief Episode 72 is in the books. Below is a copy of the video for your viewing pleasure, and audio if you can’t stand looking at me. Here is the set list: Does sitting slouch = extended? Why do people appear flexed when they sit? What is going on when someone sits slouched? How should I work with someone who has a hypermobility syndrome? What is Ehlers Danlos? Are isometrics a worthy starting place? What about unstable surface training? What is fear-avoidance? How do I go about using education to reduce fear avoidance? What other tactics do I use to mitigate fear avoidance?

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How to Communicate with People in Pain

Communicating with people in pain is a tricky situation. If you say the wrong thing, or act afraid amidst pain, negative consequences will ensue with your client. So what is a clinician or coach to do when talking with a client? Are there better word choices to make when communicating with someone in pain? If you have these questions, then check out this week’s podcast and post. I provide some suggestions to help communicate with your people in pain, which will help them reach their goals.

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Top 10 Posts of 2017

At the end of each year, I like to see what you beautiful…sexy…outstanding people liked the most from the jazz I be putting out. I want to understand you. Let me in!!!! While most of the top 10 were in the exercise-specific realm, I didn’t really see a common trend. It seems as though my fam have eclectic tastes. It’s probably why we get along so well! I want to thank you, the fam, for making 2017 an outstanding year. It has been all the comments, questions, stories, and praise that keeps me outputting content for you. I got some big things planned for 2018, and we may mix up the format a bit, but I think you will like the changes. But enough rambling. Let’s check out the top 10. First off… 10. Resilient Movement Foundations Course Review One of my favorite classes of the year,  put on by my fam from Resilient. Here we learned all the fundamental keys to effective movement, how to perform the big lifts savagely well, and how to use specific movements to improve joint position in these lifts. Follow these guys, they are some of the biggest stewards of the profession. 9. Practical Pain Education My thoughts on pain education have morphed a substantial degree over the past year. While I think my understanding of pain’s complexities have enhanced, I’ve worked on simplifying my education paradigms. I’ve often found that going down the neurophysiological rabbit hole is completely unnecessary, and providing simple examples

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Practical Pain Education

I gave a talk on how I approach pain education in the land of China, and yes I finally got around to re-recording it. Here were some of the topics I discussed in this talk: The history of pain education The difference between the three pain mechanisms What the current research suggests regarding pain and threat The 14 most common maladaptive pain beliefs, and how to squash those thoughts via education If you want immediate access to the remainder of the 1 hour and 49 minute talk, and a FREE 21 page PDF file of my talk notes, fill out the form below. Without further adieu, here is the first 20+ minutes of the talk.

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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. 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

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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: The necessary organizational fix to worker’s compensation Ways physical therapists can have patients simulate work Targeting educational-specific impairments The need to expand scope or collaborate to help clients thrive How to deal with patients who are always late and don’t do their exercises 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. Workers’ Compensation Explaining Pain Simply Expanding Your Scope Dealing with Late Patients Fall Prevention  

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Movement Debrief Episode 1: Meet the Patient at Their Story

A Live Movement Video Series Hey party people. I recently started doing some live feeds on the interwebz. You can check me out on Facebook and Youtube if you want to see me live. Otherwise, I thought I’d share with the very first episode of “Movement Debrief.” Here we dive into the following topics: The importance of reflection Using similar language to the patient. De-threatening that language Restoring sagittal plane control A case for manual therapy Enjoy!

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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.   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.

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Come Hang With Me: Courses At My Clinic

Dear Readership  We are hosting several courses at my clinic this year, and we would love to have you, the readers, attend. The three courses that East Valley Spine and Sports will be hosting are all excellent courses. I have taken two of these classes prior, and the third I have taken a prior rendition of. And let me tell you, these courses are boss. Aside from us bringing some excellent content, you will also have the opportunity to hang out with a good group of people, and imbibe in some good beverages with me. Here is what we are bringing. PRI Pelvis Restoration: March 28th-29th  I took this course a little over a year ago (read the review here) and I am very excited to be learning from Lori again. She presents this very complex material in a systematic and understandable fashion. Most importantly, she’s funny! Signup for the course here. ISPI Therapeutic Neuroscience Education: Educating Patients about Pain: June 6th-7th Adriaan Louw is one of the best speakers I have heard, and the material is priceless (read my review here). This course gives several practical insights as well as easy-to-learn neuroscience education that will help you become adept and educating patients on pain. Signup for the course here. ISPI Neurodynamics: The Bodies Living Alarm: October 17th-18th  I took a version of this class when Adriaan spoke for the NOI group, and I am excited to see what tweaks have been made since. This time we are bring Louie

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The Post Wonderful Time of the Year: 2014 Edition

And That’s a Wrap It’s that time of the year that we get to look back and reflect and what posts killed it (and which bombed). It seems as though my fine fans be on a pain science kick this year, and rightfully so. It’s some of the best stuff on the PT market right now. It’s definitely a topic I hope to write about more in the coming year, and one I will be speaking on at this year’s PRC conference. But without further ado, here are the top 10 posts of 2014. 10. Treatment at the Hruska Clinic: PRI Dentistry and Vision Going through the treatment process as a patient has really upped my game in terms of knowing when to integrate with my patients. It has also been a life-changing experience for my health and well-being. Learn how they did it for me. 9. Course Notes: THE Jen Poulin’s Myokinematic Restoration So much fine tuning occured the second time around. I love how Jen acknowledged the primitive reflex origin of the patterns, as well as fine tuning both lift tests. She’s an excellent instructor (and fun to party with)! 8. Treatment at the Hruska Clinic: Initial Evaluation The start of my alternating and reciprocal saga. Made for one of the most fascinating evaluations I have ever experienced. Ron Hruska is otherworldly. 7. Course Notes: PRI Postural Respiration I love a good foundational course taught by the Ronimal. You always get a few easter eggs that allude to

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