Tag: physical therapy

Refer In: When Trainers Can Work with People in Pain

It is a common recommendation to immediately refer clients in pain to a medical practitioner. However, immediate referral is oftentimes not warranted, and in certain cases is discouraged. But as a trainer, how do you know when a client’s pain is a medical problem, and when is it not? With today’s podcast, I hope to answer that question for you, as well as give you tips on working with people in pain, and collaborating in a manner that is in your client’s best interest. Enjoy, and check out the modified transcript below                  Modified Transcript If you are a trainer, and your client has pain, what should you do? Well I’m glad you asked. Many people on the interwebz will make the claim that if your client has pain, you should refer. The reason why this claim is made is 1) because you do not want to make your client problem worse; 2) you also want to cover your ass. If you do something and your client’s problem gets worse, you could potentially get sued. That’s why people say “when in pain, refer out.” I think that this claim is bullshit, and here’s why. Reasons why immediate referral can be problematic There are three negative consequences when you pull the referral trigger too early. Pain does not equal tissue damage This claim assumes that pain and tissue damage are synonymous. If you listen to my talk, Practical Pain Education, you would find that

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Social Media Resources

I was asked recently about how I utilize social media.  Namely, who I follow, why I follow them, so on and so forth. Up front, I do the best I can to limit my time on these platforms exposure. As we all know, it is very easy to get sucked into a rabbit hole of walls, posts, cats of Instagram hashtags, etc. Before you know it, it’s been four hours and you missed the most recent episode of “Days of Our Lives.” Secondary to the inevitable timewarp that you can be pulled into on social media, I utilize each platform with various goals in mind. This helps me stratify my consumption, and provide me the most relevant information.

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Thoracic Outlet Syndrome, New Grad Advice, and Interview Questions – Movement Debrief Episode 21

Movement Debrief Episode 21 is in the books. Here is a copy of the video and audio for your listening pleasure. Here were all the topics: The step-by-step process of treating someone with Thoracic Outlet Syndrome How to leverage your strengths as a new grad searching for a job Why new grads need mentors My favorite questions to ask interviewers and to find out about a company If you want to watch these live, add me on Facebook, Instagram, or Youtube. They air every Wednesday at 8:30pm CST. Enjoy.                  Here were the links I mentioned tonight How to Design a Comprehensive Rehab Program All About Jobs – Movement Debrief Episode 20 “The Briefcase Technique” by Ramit Sethi Join my mentorship program, get a movement consultation, or let me design an online fitness program for you. Here’s a signup for my newsletter to get a free acute:chronic workload calculator, basketball conditioning program, podcasts, and weekend learning goodies: [yikes-mailchimp form=”1″ submit=”Get learning goodies and more”]   Thoracic Outlet Syndrome New Grad Advice Interview Questions

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All Gain, No Pain Foreword

All Gain, No Pain  releases today. If you haven’t grabbed your copy of it yet, what the heck are you waiting for? ALL GAIN, NO PAIN   I had the honor and pleasure to write the foreword for this excellent book, which Bill has so graciously let me reprint. You can read it below, and if it doesn’t inspire you to grab Bill’s new book, what will? Foreword “Good morning!” He had that shit-eating grin on his face. The type of smile you see when your parents found out something you didn’t want them to know. That smile you saw right before your untimely demise. I knew damn well what that smile meant. Back then I was Bill’s student. A quiet, shy, and uncertain kid. After doing a deal with the Mafia to find his email, offering up my future first born to learn from him, and signing a blood oath, I somehow convinced Bill to accept me as his physical therapy intern. This was like meeting a rock star! Bill was all over Men’s Health magazine, T-Nation—the type of stuff young bucks like me were reading to get ahead of the curve. The last thing I wanted to do was let the guy down. Then I overslept. Stressed, frantic, and brushing only my front teeth, I made it to the clinic 30 minutes late. Only to be absolutely destroyed by that smile—a look that will forever be burned into my brain. I apologized, he mildly scolded me, and we

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All Gain, No Pain Book Review

For those of you who don’t know, my colleague, mentor, friend, and Daddy-O Pops Bill Hartman is about to release his upcoming book All Gain, No Pain. Though the book is targeted to those over 40 who are getting back into fitness either post-rehab or in pain, it includes an incredible amount of valuable content for just about anyone. If you want a lesson in physiology, breathing, variability, and stress, this book has it. If you want an excellent plan to get jacked, a plan that got me (not over 40 and not in pain) under 10% body fat for the first time in my life, this book has it. If you want tips, strategies, and rituals that’ll help you live a better life, this book has it. In spades in fact. Though I’m biased (I wrote the foreword and edited the book), it is one of the most comprehensive self-betterment books I’ve ever had the pleasure of reading. I want to extend that pleasure to you. The book releases this Monday, 9/25/17, on Amazon.com. But what if I told you if you act now you could snag a free copy? Yes, I said free!!! F….R….E…E #free It might be the best free thing you ever get. If you want a free copy of this absolutely outstanding book, click the link below to be directed to Bill’s website. Sign up, and you’ll get your free copy when this great read releases.   ALL GAIN, NO PAIN   If my stamp

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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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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: Why you should emphasize sagittal plane activities longer than you think How to coach exercises to maximize client learning and compliance Why detaching from your client encounters makes you a better clinician 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: Master Sagittal Plane Coaching Progressions Detaching Refocusing TFL Inhibition

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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:  Visit 2 & 3 of our patient with the lumbar fusion Using familiar concepts from old exercises in new exercises Strategies to enhance learning. Prioritizing Problems in the Profession. Embracing Failure and The Dunning-Kruger Effect In Episode 3,  we discuss the following concepts: My Failure The Dunning Kruger Effect – and how to hack it Embracing Failure Learning from Failure Anchoring Old Movements to New Movements Expanding PT Embracing Failure

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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 End of Pain

I’m Done Treating Pain. Yes. You read that correctly. I’m over it. Several different thoughts have crept into to my mind sparked by what I have read and conversations I have had. I would like to share these insights with you. I remember when I was visiting Bill Hartman Dad a few months ago and we were talking about a specific treatment that is quite controversial in therapy today. He said something that really resonated with me: “Maybe they measured the wrong thing.” This sentiment was echoed in “Topical Issues in Pain 1” by Louis Gifford. Check out this fantastic excerpt: “Thus, pain can be viewed as a single perceptual component of the stress response whose prime adaptive purpose is to powerfully motivate the organism to alter behavior in order to aid recovery and survive.” Notice what I bolded there. Pain is a single component of the stress response. Not the stress response. Not a necessary component of the stress response. Just one possibility. Why do we place so much importance on pain? Many proponents of modern pain science (myself included) often use this statement against individuals who are over-biomedically inclined: “Nociception is neither necessary nor sufficient for a pain experience.” Agreed, pain is not always the occurring output when nociception is present. That said, pain is only one of several outputs that may occur when a tissue is injured. Just because pain is absent does not mean other outputs are also absent. Many different outputs can occur when an individual is

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Course Notes: PRI Integration for the Home

The Pilgramage One of the many reasons I was drawn to make the trek to Lincoln was to experience my man James Anderson’s original affiliate course. I always enjoy hearing James’ perspective on PRI, and he did not disappoint here. The course felt like an Impingement and Instability with a bias towards the geriatric/chronic pain populations. Some might argue that James is the king at implementing PRI here. I really admired James saying throughout the course that the Geriatric population houses his favorite athletes, and they really are.  High performance at any task, be it sprinting 100 meters or walking to pick up the mail, require similar alternating and reciprocal components. We still go after the same pieces to achieve different goals along a continuum. So let’s dive into this high performance course for some high performing individuals. PRI 101…or at Least the Pieces You Didn’t Get from My Other Reads  The affiliate courses have a huge introduction that gives an overview of PRI principles, namely the Left AIC and Right BC patterns. I’m not going to go through all the nitty gritty as this course did, but instead I’ll review concepts that James cleaned up for me. Think of this post as an in-depth FAQ. If you want to learn more about the left AIC, you might want to read the course notes on Myokinematic Restoration and Pelvis Restoration. If you want to learn more about the Right BC, then read my Postural Respiration notes. The Overviewing Overview The big keys

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My 50th Post: Motivation to Learn

A Little Personal It is hard to believe that I have already written my 50th post after starting this blog in February as a way to enhance both my learning and the learning of others. This blog has allowed me to interact with a variety of different individuals that I otherwise would not have. And when people who I deeply respect say they admire what I have to say (or at least my version of what other people say), I am deeply humbled. But I have had several cases in which people wondered if I do anything other than physical therapy and personal training (I do). One of my former mentors came up to me saying that she was worried about me because of how much I am into this. These interactions have made me reflect on why I am reading, working, writing, and learning as much as I can. Thus, I have come to some conclusions as to what drives me to help others. And this drive, while not the norm that some of my peers are accustomed to, is far from wrong. Others are Depending on You When you work as a health professional, some people neglect the fact that your patients and clients trust their bodies with you.  They put their confidence in your knowledge and skills to show them the path to bettering themselves. When someone puts this amount of trust into me, the last thing I want to do is let them down. So I

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