Tag: therapist

Online Consult with The Manual Therapist

The Rundown My good friend Erson Religioso of The Manual Therapist fame recently contacted me to do a consult for some back/leg trouble he has been having. It was a very interesting eval for many reasons. Online consults are a completely different animal, as you cannot do any hands-on testing. Moreover, when you have a therapist who is initiated into pain neuroscience, you don’t have to go so much the Explain Pain route 🙂 So with this eval, we looked at things a lot through a PRI lens, and were able to get him strategies to modulate his pain experience. The eval runs a smidge over 1 hour, so here are some vids with a quick rundown. Subjective – Getting paresthesia down the R LE that began 2 weeks ago after a car ride…has peripheralized since initial event. – Symptoms are aggravated with static sitting or standing…onset ranging from seconds to minutes. – Has tried loading/unloading MDT strategies, neurodynamics, Mulligan techniques, IASTM, compression wrapping, etc…all to no avail. Objective (major findings) – Limited B Apley’s scratch (1 per FMS scoring) – Negative slump and ASLR – Painful lumbar motions of extension, right rotation and sidebend. R sidebend was limited. – Negative thomas test on left, positive on right – Slight limitations in active seated hip IR B, R>L. – Adduction lift scores 1/5 B. My Impression If I were to classify Erson, it seems his symptoms would seems to be more dominant as peripheral nociceptive ischemic and central sensitivity (he stated he has

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Lessons from a Student: The Interaction

The Inspiration Over the past few weeks I have felt called to write about an often uncovered yet extremely important component of the therapeutic process: Patient interaction. We had an instance in which I came back into the clinic from my lunch break and my intern was supposed to have a patient evaluation. Instead, she opted to have me take this particular patient. This patient was a lovely 17 year old lady who was being seen for bilateral foot pain. This was her second bout of therapy, and her and her mother was very dissatisfied with their last physical therapy experience just a few months (and 17 visits) prior. She was not a happy camper and wanted a second opinion. After hearing stories from my coworkers, I expected the worst. We progress through the evaluation, and my student observes nothing but smiles throughout from the patient and her mom. Jokes were cracked, movement was looked at, and edumacation happened. At this point, after a little explain pain and kinetic chain discussion, these women were sold. We leave the treatment room and I said “that wasn’t so bad yes?” My student replies “that’s because they are in love with you.” But really, that essentially is what you have to do with the patient interaction. You can have the greatest hands, the greatest exercise plan, and evidence up the wazoo; but if your patient hates your guts you will fail. I heard this from Patrick Ward that 80% of your success with

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