Open letter from an “experienced therapist” to new grads (and anyone else who will listen :)).

I am approaching my 32nd year of practice as a physical therapist. Over the years, many things have changed, but some things will never change. So far, these have been my top lessons

  1. There is no end to learning. I tell my students all the time one you think you know it all you have stopped learning. If you see a patient with a certain diagnosis this year and then see them again a year later and you are doing exactly the same thing you havent grown. I earned by doctorate in my 30th year of treating and plan on continuing to learn and grow.
  2. Pick one system (Maitland, McKenzie etc) and learn the basics of the system well. It will give you a great base from which to work and allow you to grow and learn new techniques. But….once you have a base system don’t be afraid to add to your tool box. All patients do not fit into all systems, they didn’t all read the book and may require a different approach. . Be open to other ways of thinking. Residency training is a great way to accelerate the learning curve. I waited 10 years to joint a residency program and wished I did it as soon as i graduated.
  3. Make sure you find a mentor you can trust. I have made a concerted effort to find mentors over the years. Seek guidance and assistance from others if you need it (and we all need it).I reach out to my peers all the time for guidance.
  4. Teach and start early. It took me too long to teach because I felt I didn’t know enough or that what I had to offer wasn’t special. I have come to realize that the more I teach the more I learn. If you can explain it you understand. Some of the best teachers I have met take a complicated subject and make it seem easy, that is a sign of a great teacher.
  5. Treat your patients as if they are family (family that you like::) Go above and beyond your patients expectations. This can range from a quick text to see how they are doing to becoming a patient advocate. Despite the fact that you will not be able to cure every patient, you can make a difference in their lives and find them the additional assistance they need.
  6. Embrace change. Change is inevitable, the key is how we reposed to change. I continue to change as I gain more experience and that has allowed me to stay relevant and helped me continue to grow as a therapist.

2021

Happy New Year year, 2021 has to be a better year! I look back at 2020 and say, ‘what the f*** was that? I have done some sole searching this best week and read the book “Best Self’ by Mike Bayer. The book has helped me look at the different aspects of my life and helped me focus my personal promises for this year. I made a few promises for 2021. I don’t like to call them goals because goals sounds like more hope than a true plan. The word promise is more definitive and reflects a true desire and plan to get things done. My number one professional promise for this year is to write a book. The book will assist me in putting my system and thoughts on paper with the hope that it will help clinicians. I have always loved mentoring and have been working for years to find ways to help others make a difference in their patients’ lives. I am looking forward to this journey.

In the mind of…

 

I started doing interviews with some of the people who have made a difference in my career. I have always been fascinated by how people think and what makes some people tick. These interviews are about 20 minutes in length allowing just enough time to get some insight and short enough not to lose the listeners interest. Please follow this link to Professional Seminars (www.professionalseminars.com) and listen. I have ten more planned in the next few weeks, I hope you enjoy listening as much as I enjoyed speaking with my guests.

 

It’s been a while

Hello everyone, it has been a long while since I have posted and a lot has happened.  I am now the director of education for Professional PT and have been spending my time developing a curiculum, teaching and in my spare time getting my doctorate.  I am really enjoying the academia world and do see patients here and there.  Although I miss patients seeing patients on a daily basis  I have been keeping my skills sharp by teaching and mentoring.

Keep an eye out for clinical gems and my thoughts to be coming your way in the next few weeks.

Don’t forget about the art of manual therapy

For the past 23 years I have spent hours upon hours trying to learn and grow as a manual therapist. Early in my physical therapy education I remember watching one of my professors perform soft tissue and joint mobilization techniques on one of my classmates and I thought “wow, how do I make my hands do that.” I went to my professor asked that very question and I remember her response to this day and share it with my students (or anyone else who will listen). She said when you first begin to perform any hands on technique your hands are like cement and as you make a conscious effort to improve the cement chips away and you develop knowing hands. I never forgotten that advice.

Today there is a big push for evidence based practice, although I do understand the importance, I hope we, as manual therapists, don’t forget about the importance of practicing our art and listen to what our hands tell us. Experts say it takes 10,000 hours of meaningful practice to become an expert in any discipline. Next time you palpate a structure or perform a technique make sure you are doing it with purpose and thought,your hands can give you amazing information with you listen to them..

What the heck is a posterior sacrum ?

Great case study this weekend at the Hesch Method seminar in Las Vegas where I had the opportunity to assist Jerry teach. I’m just hoping what gets taught in Vegas does not stay in Vegas. :). One of the students presented with what Jerry Hesch calls a “posterior sacrum”. A posterior sacrum is defined as a dysfunction in which the entire sacrum is stuck in a posterior glide between the ilia and bilateral sacral sulci are shallow. When trying to spring the sacrum and ilium all motions are blocked and both sacrospinous and sacrotuberous ligaments are taut to palpation. This dysfunction can cause havoc up the kinetic chain up to the occiput. The mostly likely cause of this non-physiological dysfunction is some sort of trauma such as landing on the buttocks. A common complaint by the patient is increased fatigue, headaches and increased urinary frequency. This weekend one of the students had this seemingly rare dysfunction with these same complaints. She was used as a case study using the Hesch Method which consisted of gentle mobilizations which were performed both manually and with the use of props to enhance soft tissue mobility based on the the principle of viscoelastic creep. The treatment took a total of about 15 minutes and consisted of 5 different mobilizations to correct the dysfunction and associated mobility restrictions and the student got off the table and stated how loose and mobile she felt. She was given a home exercise program to follow and will report back to us on her progress.

The main purpose of this short article is to share with you another tool that can help you with those hard to figure out and often frustrating cases. For more information go http://www.heschinstitute.com or check out Jerry’s many videos on YouTube (search JerryHesch)

The Hesch Method Revisited

I had always found the sacroiliac joint (SIJ) to be confusing and frustrating to treat. For a long time I just ignored it because I didn’t want to deal with all the crazy tests and rules. In 2006 this all changed for me.

Continue reading “The Hesch Method Revisited”

Importance of Primal Reflexes in Rehab

I thought you might appreciate this paraphrased statement by Sally Goddard in “Reflexes Learning and Behavior” and whyI think PRRT (Primal Reflex Release Technique) is such an important part of the entire picture and complements the NKT (Neurokinetic Therapy)   and SFMA (Selective Functional Movement Assessment ) approaches,… Continue reading “Importance of Primal Reflexes in Rehab”

Great Home Exercise to Increase Ankle Dorsiflexion

Loss of ankle dorsiflexion (DF) is seen in the clinic on a daily basis. Lack of proper ankle DF can lead to compensations all the way up the kinetic chain. A good article to read on the importance of normal ankle mobility can be found on Eric Cressey’s web site. The primary motion of DF comes for the talocrural joint (TCJ) (the joint between the talus and the tibia). DF can become limited by decreased muscle length of the plantar flexors of the ankle and/or due to the lack mobility of the ankle joint itself (also called joint play). In order to regain normal range of motion, both of these must be addressed. The joint play that is most needed for full ankle DF at the TCJ is posterior glide of the talus on the tibia. After being mobilized in the clinic the patients need to be able to follow up at home to maintain the gains made. The following exercise addresses the muscle stretching and joint play components necessary to regain full ankle DF. It will help the patient mobilize their talus posteriorly as they are dorsiflexing, simulating the mobilization performed in the clinic.

Step1 : Tie a piece of theraband around a non-movebale object

step 2: Face away from the object and place the band around the front surface of the talus.

step 3: step away from the object until there is a moderate amount of tension pulling on the talus

step 4: with a majority of your weight on the leg to be mobilized, perform a forward movement of your knee while keeping your entire involved foot on the ground.

Step 5: Hold for 3 seconds and repeat this 30 times.

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