Untold Physio Stories - Do You Train Recovery?
Oct 05, 2023
Erson shares a recent case - young female distance runner, at the top of her age group with severe knee pain. After 50% improvement with traditional strengthening, ankle and hip mobility training, modifying strike, getting new footwear, the patient discovered something else that made her able to run pain free.
Untold Physio Stories is part of the PT Podcast Network, find more amazing podcasts and new favorites here! Untold Physio Stories is sponsored byComprehend PT- Leave Comprehend PT running in the background or record audio when you have time. The AI based SOAP note generator does the rest! No need for accuracy or exact wording! It's a game changer and will give you more time with your patients! Use code MMT50 to save 50% off your first month. Free trial available at sign up!The Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.com Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Hollywood From a PT’s Perspective
Sep 06, 2023
We're joined again by Dr. Adrian Miranda of the web series Gross Anatomy on youtube. He was supposed to tell a story of working for a high volume clinic coming off of an esteemed residency program. But our geek mode took over and we ended up recoding an episode all about our love of movies, Tom Cruise, his crazy running gait, and how PTs should think when they view a great action scene. Have you ever thought of these things as a clinician when you watch your favorite movies or shows?
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
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This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - The Mysterious Case of Bilateral Shoulder Weakness
Aug 29, 2023
Andrew discusses a recent case with a curious finding. Bilateral Infraspinatus atrophy one side greater than the other. No myotomal or dermatomal overlap, no pain, no trauma or recent infection. What do you make of it? Any similar cases in your experience?
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
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This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - The PT Entertainer
Aug 22, 2023
We're joined by Dr. Adrian Miranda of Gross Anatomy Web Series on youtube. He tells his origin story of expectation of high school graduate, to earning his doctorate, teaching residency, and eventually forming a PT based entertainment company! Be sure to check out Gross Anatomy on youtube!
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Have You Ever Heard of Collagen Supplementation?
Aug 08, 2023
Erson chats with Dr. Sean Wells, author, nutrition specialist, speaker, and Modern Rehab Mastery mentor. Recently, Sean gave a talk on wholistic treatment for orthopaedic conditions in the older population. After being asked about collagen supplementation repeatedly, his biases were challenged.Dr Well's site can be found here - Nutritional Physical Therapy
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Breathing is a Habit
Aug 02, 2023
In this episode, Erson goes over a telehealth series of visits with another PT. What started out as a traditional lumbar radicular or neuropathy complaint rapidly turned to trying a LOT of different and non traditional treatments. Are you aware that over breathing/hyperventilation can affect many different systems in the body? Listen to this podcast to find out more.
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Unveiling the Mystery of Discogenic Low Back Pain
Jul 31, 2023
Back pain is a common ailment that many of us have experienced at some point in our lives. One specific type of back pain, known as discogenic low back pain (LBP), is characterized by pain originating from the intervertebral discs (IVDs) in the spine. Despite extensive research, the exact causes of discogenic LBP have remained elusive. However, a recent study conducted by Seiji Ohtori and his colleagues sheds new light on the underlying mechanisms of this condition.Animal Models and Discogenic LBP:Through the use of animal models, researchers have made significant discoveries regarding discogenic LBP. They have found that sensory nerves grow into the inner layer of the lumbar IVDs, and this nerve ingrowth is induced by certain inflammatory substances called cytokines. These cytokines, such as tumor necrosis factor-α and interleukins, stimulate the ingrowth of sensory nerves into the discs. Moreover, nerve growth factor has been identified as a key player in inducing this nerve ingrowth. Animal models have also revealed that disc degeneration triggers the production of collagenases, enzymes that break down collagen, leading to hypermobility and pain. Sinuvertebral NervesUnveiling Human Discogenic LBPFurther insights into the mechanisms of discogenic LBP have been gleaned from the examination of degenerated human IVD specimens. These specimens have revealed sensory innervation and nerve ingrowth, similar to what has been observed in animal models. The presence of cytokines in human discs suggests a shared mechanism with animal models. This indicates that the findings from animal studies can be applied to human patients as well. In addition to sensory innervation and cytokine involvement, sensitization of sensory nerve fibers innervating the IVDs is a crucial factor in discogenic LBP. When these nerve fibers become sensitized, they become more responsive to pain stimuli, leading to heightened pain perception.Psychosocial factors also play a role in the perception and experience of pain associated with discogenic LBP. Factors such as stress, anxiety, depression, and social support can influence an individual’s pain experience. Understanding the interplay between these psychosocial factors and the physiological aspects of discogenic LBP is important in developing comprehensive treatment approaches.Tackling Discogenic LBP: Treatment ApproachesUnderstanding the underlying pathomechanisms of discogenic LBP opens up avenues for potential treatment strategies. To effectively manage this condition, it is crucial to prevent sensitization of sensory nerve fibers within the IVDs. This can be achieved through targeted interventions that aim to suppress the pathogenic increases of cytokines. By reducing the levels of pro-inflammatory cytokines, such as tumor necrosis factor-α and interleukins, the ingrowth of sensory nerves into the discs can be controlled, thereby reducing pain.In addition to cytokine regulation, addressing disc hypermobility is an essential aspect of treating discogenic LBP. Hypermobile discs can magnify pain and further damage the disc structure. Treatment options such as physical therapy and specific exercises can help stabilize the spine, reduce hypermobility, and alleviate pain. Other interventions, such as spinal manipulative therapy and epidural steroid injections, may also be considered in certain cases to manage pain and promote healing.Conclusion:Discogenic low back pain is a complex condition with multiple underlying mechanisms. The research conducted by Seiji Ohtori and his colleagues has provided valuable insights into the pathomechanisms of this condition, highlighting the role of sensory nerve ingrowth, cytokines, and disc hypermobility. By understanding these mechanisms, health professionals can develop more targeted treatment approaches to help patients suffering from discogenic LBP.One innovative product that aids in the understanding and communication of discogenic LBP is the Professional LxH Dynamic Disc Model by Dynamic Disc Designs. This model accurately represents the structure and function of the intervertebral discs, allowing health professionals to visually demonstrate the impact of disc degeneration, nerve ingrowth, and hypermobility to their patients. By using this model during patient consultations, health professionals can help individuals better comprehend the nature of their condition and the rationale behind the recommended treatment approaches.Check out MMT's Exclusive Blue Nucleus model!Via Dr. Jerome Fryer - Dynamic Disc Designs
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This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - The ED Misses a PE
Jul 26, 2023
Andrew is back talking about a colleague's recent case. This is a new grad, only practicing for 5 weeks or so, but kudos to his differential diagnosis skills and applying the Wells Criteria for Pulmonary Embolism. If you're not familiar with it, its something you should keep in the back of your mind, especially with post op patients, those who have been recently immobilized, or with history of Cancer or PE.
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
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This article was originally posted on Modern Manual Therapy Blog
[RESEARCH] Collagen Supplementation for Joint Pain and Arthritis: Does it Really Work?
Jul 24, 2023
Collagen Supplementation for Joint Pain and Arthritis: Does it Really Work?By Dr. Sean M.Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DNRecently I was presenting at the annual conference of Athletic Trainers' Association of Florida (ATAF) and I was overwhelmed by one consistent question: why didn't you talk about collagen supplementation? My talk was specifically on orthopedics for older adults and naturally I focused on osteoarthritis (OA) and how important exercise and diet are for that condition. I did touch on some supplementation, but I left off collagen because my last examination of this supplement, using one of my favorite websites Examine.com, yielded mediocre results. However the participants at the sports medicine conference piqued my interest and convinced me that perhaps I had missed something -- almost every single one of these participants had some form of joint pain or stiffness and felt significantly better after taking collagen daily. So, back to the literature, and asking some of my clients, I went!What is Collagen?Collagen is a protein found in the body that provides structure and support to various tissues, including joints, bones, tendons, and ligaments. It may play a role in maintaining joint health and may have potential benefits for individuals with joint pain. A few small-scale studies have shown positive results in reducing joint pain and improving joint function when individuals with osteoarthritis took collagen supplements. These studies often used specific collagen formulations, such as collagen peptides or hydrolyzed collagen, which are broken down into smaller peptides for better absorption by the body. However, it's important to note that the findings of these studies are not yet conclusive, and more robust research is necessary.The ResearchIt's worth mentioning that joint pain can have various causes, and collagen supplementation may not be effective for everyone. Factors like age, underlying health conditions, overall diet, and lifestyle habits can also influence joint health. For instance, a meta-analysis on collagen supplementation for OA showed improvements in the WOMAC, a functional score for knee arthritis, but it didn't yield significant results for knee pain. Meanwhile, another review article looking at collagen supplementation for joint pain, muscle protein synthesis, and body composition found that collagen did significantly reduce joint pain (it had effect on the other metrics). Here's a nice table listed in the article:The joint pain included in the review included knee pain and Achilles tendinopathy, all predominately in an athletic population. Another glaring observation is several of these studies included physical therapy and exercise prescriptions with the supplementation (Yay! Nutrition and Physical Therapy), which can also alter the results and effects of collagen as well. It's important to see the doses varied in the studies from 5, 10, to 40 grams per day; moreover, the collagen can come in varying form from peptides, hydrolyzed proteins, to denatured collagen. Having such variability in the type of collagen also likely explains the variability in responses and data.DosingSo, roughly how much and what type of collagen should a client take? Well, many studies have used dosages ranging from 8 to 12 grams of collagen peptides or hydrolyzed collagen per day for joint-related benefits. Research suggests that type II collagen supplementation may help reduce joint pain and improve joint function in individuals with arthritis, particularly osteoarthritis. It is believed to work by helping to restore and support cartilage health, potentially reducing inflammation and promoting joint mobility. It's important to note that collagen supplements are available in various forms, such as powders, capsules, and liquids, and their concentration of collagen can vary. Therefore, it's crucial to follow the manufacturer's instructions and consult with a healthcare professional to determine the appropriate dosage for your specific needs.It's also worth mentioning that collagen supplements are often combined with other ingredients, such as vitamins, minerals, or herbal extracts, which may influence their effectiveness. If you decide to try collagen supplementation for joint pain, it's a good idea to choose a reputable brand and look for products that have been tested for quality and safety. I suggest using Labdoor.com to help you or your client find a high-quality collagen supplement, if and when appropriate.SummaryIn the end, perhaps the participants at the ATAF conference were right -- there is something to say about collagen and joint pain. Not every study is exact and more research needs to be done on what dose, what age, what condition, and what exercises should be done with the collagen -- but that's why we practice physical therapy! Love to hear your thoughts and maybe some of your clients' responses to collagen. If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60! Earn CEUs in most states for PTs!
Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!
Learn more online - new online discussion group included!
Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school.
NEW - Online Discussion Group
Live cases
webinars
lecture
Live Q&A
over 600 videos - hundreds of techniques and more!
Check out MMT Insiders
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Constant Pain Needs Sustained Techniques
Jul 17, 2023
In this episode, Erson goes over a tough case of constant and flared up cervical pain with radiating complaints. What do you think of his solution? Have you ever had a similar case that responded to sustained holds better than repeated loading or traditional techniques?
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Don't Assess Yourself
Jul 06, 2023
Erson tells a story of getting back to rock climbing after a 20 year break. After a finger injury that wasn't healing, he got some totally unexpected great advice from another climber. What do you think of the solution and has anything similar ever happened to you?
Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
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This article was originally posted on Modern Manual Therapy Blog
The Cervical Spine in Tension Type Headache
Jul 05, 2023
Tension-type headache (TTH) is a prevalent and burdensome condition that affects many individuals. Recent research suggests that the cervical spine, specifically the trigemino-cervical nucleus caudalis, may play a role in the development of TTH. This nucleus facilitates the exchange of pain signals between the upper cervical spine and the trigeminal nerve, which is involved in headache generation. Links between the upper cervical spine and TTHStudies have shown that individuals with TTH often exhibit musculoskeletal impairments. Common findings include forward head posture and restricted cervical range of motion. These physical dysfunctions may contribute to the headache symptoms experienced by TTH patients. Neck pain and sensitivity in the cervical spine are frequently reported alongside TTH and may worsen the clinical presentation of the headache. These symptoms could be epiphenomena resulting from the sensitization of the trigemino-cervical nucleus caudalis.While forward head posture is a common observation in TTH, its direct relevance to the headache remains a topic of debate. Similarly, the relationship between restricted cervical range of motion and TTH is not well understood. It is uncertain whether these musculoskeletal impairments are causative factors or consequences of the headache.Clinicians often use the cervical flexion-rotation test to assess upper cervical spine mobility, which has proven useful in diagnosing cervicogenic headache. However, its application and significance in TTH are not extensively studied. Further research is needed to elucidate the role of this test in TTH diagnosis and management.Another intriguing observation is the reproduction of headache pain through manual stimulation of the upper cervical spine in both cervicogenic headache and TTH. This suggests that referred pain from the cervical spine may be involved in the pathophysiology of primary headaches. Understanding this mechanism could lead to novel therapeutic approaches for TTH.Additionally, trigger points in the neck-shoulder muscles may contribute to TTH symptoms by generating muscle referred pain. These trigger points can refer pain to other areas, including the head, and may exacerbate the headache experienced by individuals with TTH. Managing TTH in practiceA multidisciplinary approach involving physical therapy interventions targeting musculoskeletal impairments, exercise, and psychological aspects is essential for the management of TTH. The effectiveness of cervical treatment approaches varies, and personalized strategies should be tailored to individual patients. Understanding the role of the cervical spine in TTH and differentiating between cervical components and sources can aid in the recognition and treatment of diverse headache presentations. Our cervical spine models help professionals manage the connections between TTH and the role of the cervical spine. Check out my exclusive blue nucleus anti-nocebo version!via Dr. Jerome Fryer - Dynamic Disc Designs
Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!
Learn more online - new online discussion group included!
Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school.
NEW - Online Discussion Group
Live cases
webinars
lecture
Live Q&A
over 600 videos - hundreds of techniques and more!
Check out MMT Insiders
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Poking and Hoping
Jun 26, 2023
Erson goes over an interesting TMJ case of posterior disc subluxation and severe pain with opening and eating. It turns out after significant improvement the patient was still checking for tenderness a bit too much.
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Preventing Muscle Mass Loss
Jun 19, 2023
By Dr. Sean Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DNAs physical therapists (PTs) we do our best to optimize our older clients' strength, balance, and functioning. Obviously, our mainstay interventions focus on exercises, balance training, and adaptive equipment. In our courses, we highlight the importance of Vitamin D status and protein consumption for older adults, to improve balance, strength, and prevent sarcopenia. A recent study in Nature Aging highlights yet another potential dietary component that impacts muscle function: ceramides.Ceramides, a sphingolipid, which is a type of fat, has been shown to reduce muscle mass and functional capacity in rodents. Moreover, it has been shown that offering ceramide-inhibiting medication effectively reverses sarcopenia, which is very promising for human studies. In the current study the authors examined older adults with a genetic variant to inhibit ceramides. The results showed these adults with the variant had significantly better grip strength, walking distance, and sit to stand function: all metrics that Doctors of Physical Therapy (DPT) routinely measure. The next big step for these researchers is understanding how to yield these results via medication and/or dietary changes.Fortunately, other authors have highlighted how PTs and other clinicians can advise their patients on how to naturally reduce ceramides in their diet. In the FRUVEDomic pilot study, authors demonstrated that a diet low in fruits and vegetables, and high in saturated fat, facilitated an increase in hepatic ceramide production. The researchers concluded that even transitioning patients from a standard Western diet to even the US Dietary Guidelines would yield positive responses for aging. Imagine the impact on aging and physical functioning if we took the diet to a bit more extreme, such as the true Mediterranean or predominant plant-based diet? More research is needed, but PTs need to be aware that fruit and vegetable consumption is important for many health outcomes, and screening tools are available and easy to use. We discuss this and more in our courses!If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60!Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!
Learn more online - new online discussion group included!
Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school.
NEW - Online Discussion Group
Live cases
webinars
lecture
Live Q&A
over 600 videos - hundreds of techniques and more!
Check out MMT Insiders
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Grandma Has Functional Overlay
Jun 16, 2023
Andrew finds out the hard way what the term Functional Overlay means in regard to a slow or non responding patient. Have you ever heard of this term or has anything similar ever happened to you? Comment on our socials or on the podcast on Spotify!
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Growth of the Lower Back Pain Endemic Worldwide
Jun 12, 2023
In a recent article in The Lancet Rheumatology, researchers show how lower back pain is a rapidly escalating global issue, affecting an estimated 619 million people in 2020 – nearly 10% of the world’s population. Experts predict that this number will reach 843 million by 2050.Compounding problems in the lower back epidemicAsia and Africa are expected to experience the most significant rise in lower back pain cases. These regions often already face challenges due to limited and overburdened social support systems and healthcare resources.The COVID-19 pandemic has further exacerbated the problem. Increased inactivity due to lockdowns and poor ergonomics from remote work setups have contributed to the intensity and prevalence of lower back pain. Additionally, limited access to healthcare services during the pandemic has added to the suffering of individuals already affected by this condition.It’s important to consider that the provided figures may underestimate the true burden, as they do not fully account for the impact of the pandemic.The Societal Burden of Lower Back PainLower back pain imposes a substantial burden on society and the economy. In the United Kingdom, the National Health Service spends nearly £5 billion annually on general practitioner appointments alone for this condition.Similarly, the cost of lower back and neck pain in the United States reached a staggering $134 billion in 2016. Of course, the consequences extend beyond the financial costs.Lower back pain leads to increased absenteeism, reduced productivity, and early retirement, particularly among the working-age population. There is also a strong association between lower back pain and higher rates of depression, leading to prolonged disability and hindering recovery.The researchers warn it is crucial to address the societal impact of lower back pain and develop comprehensive strategies to mitigate its effects.Addressing the Issue of Back Pain GloballyAddressing the global issue of lower back pain will require immediate attention and collaborative efforts. Solutions should prioritize strategies aimed at alleviating lower back pain in the workplace, where many people spend a significant part of their time.Implementing ergonomic practices and promoting physical activity can help prevent and reduce the problem of lower back pain. Moreover, improving access to rehabilitation services is essential for effective management and recovery.Specialized training for healthcare practitioners in the treatment of lower back pain can lead to better outcomes and patient care. Additionally, reducing reliance on ineffective and potentially harmful treatments, such as opioids, is crucial.Finally, the researchers stress that governments, healthcare systems, and policymakers must work together to prioritize lower back pain and allocate resources effectively. By taking proactive measures, we can alleviate the burden of lower back pain and improve the quality of life for millions of individuals worldwide.Are you a professional helping in the fight against lower back pain? Take your practice to the next level with our lumbar area anatomy models.Via Dr. Jerome Fryer - Dynamic Disc DesignsCheck out our EXCLUSIVE Anti-Nocebo BLUE Nucleus Disc Model! This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories Podcast - Severe Scapula Pain in a CrossFit Athlete
Jun 08, 2023
Andrew Rothschild is back with an interesting case of severe pain and hyperalgesia around the scapula area in a CrossFit Athlete. This is the second time in 1 year after good resolution the year prior. Both times there was no clear cut mechanism of injury. Then randomly on social media, Andrew saw two posts regarding a differential diagnosis of severe pain in this area in overhead athletes. Treatment ended up being the same, but it makes for interesting discussion on how and why these things may happen. Ever seen a case of nerve entrapment like this?
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Just Screen the Spine Already
May 30, 2023
For this episode, Erson talks about a recent case of marathon runner diagnosed with a grade 1 hamstring strain. It was an insidious onset after wearing orthotics for forefoot overpronation. Ever see anything similar in your practice? Do you screen the spine on every extremity patient?
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - One Case Changes a Career
May 23, 2023
Sometimes a point in your career is reached where you just want something different. Other times, a particular case can ignite that spark or drive to make the change. Today, we're joined by Dr. Ryan Martin, who is making waves currently in the MSK Ultrasound world. You can follow him on LinkedIn here. Ryan gives his origin story and how he got where is today, a leader in the field of MSK Ultrasound and advocate for PTs.
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - Cervical Retraction for Bilateral Complaints
May 16, 2023
In this episode, Erson is joined by Dr. Malik Parker. He happened to stumble upon some quick fixes for bilateral thumb issues. Have you ever seen something like this in your practice?
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - High Anxiety for Provider and Patient Over Open Lock TMJ
May 08, 2023
In this episode, Erson is joined by Dr. Hannah Cox who recently attended one of his live TMJ Seminars. Upon leaving, she felt prepared to take on the TMJ world! Until that is two days later, she had a patient with high fear avoidance and complaints of open lock TMJ, headaches and neck issues. Luckily, Erson was able to instill her confidence over an online mentoring session and all worked out great over 3 sessions only!
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
Keeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
Untold Physio Stories - A Tough Lumbar Lateral Shift Case Part 2
May 04, 2023
Erson follows up with the difficult lumbar lateral shift patient from this episode a few weeks back. As in the past, he's doing much better and this time Erson takes care not to flare him up! Interestingly enough using the Activforce 2 handheld dynamometer reveals some significant hip and trunk rotation strength percentage differences that could be key to better prevention.
Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded IndividualCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practicesKeeping it Eclectic...
This article was originally posted on Modern Manual Therapy Blog
[RESEARCH REVIEW] The High Cost of Standing: Uncovering Risk Factors for Low Back Pain
Apr 27, 2023
Introduction SummaryLow back pain (LBP) is a prevalent and costly health problem that affects a significant portion of the global population. Pain developers (PDs) are individuals who are considered a pre-clinical LBP population at risk of developing clinical LBP, which can exact great social and economic costs. Prolonged standing has been identified as a risk factor for LBP, and it is necessary to investigate the risk factors of standing-induced LBP in PDs comprehensively. By identifying these risk factors, appropriate preventive measures can be planned, which may reduce the incidence of standing-induced LBP and its associated costs.This study1 used a systematic review and meta-analysis approach to investigate the distinctive characteristics and risk factors of standing-induced LBP in PDs. The study aimed to identify statistically significant differences between PDs and non-pain developers (NPDs) in demographics, biomechanical, and psychological outcomes and to determine the pooled effect sizes of these differences. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Characteristics of Pain Developers and Non-Pain DevelopersThe systematic review and meta-analysis identified 52 papers and theses involving 1070 participants (528 PDs and 542 NPDs) that were eligible for inclusion. The studies used a prolonged standing duration greater than 42 minutes to classify adult PDs and NPDs without a history of LBP.Significant differences were found between PDs and NPDs in terms of movement patterns, muscular, postural, psychological, structural, and anthropometric variables. PDs exhibited altered motor control in the anterior hip abduction (AHAbd) test and displayed higher lumbar lordosis in individuals over 25 years old. These factors were found to have a statistically significant association with standing-induced LBP.Muscular differences were also identified between PDs and NPDs. PDs had a higher level of co-activation between gluteus medius and the erector spinae muscles, which can lead to increased lumbar loading and potentially contribute to the development of LBP.In terms of postural characteristics, PDs had less trunk control and increased trunk sway during standing compared to NPDs, which may suggest a lack of postural stability.Psychological characteristics were also found to differ between PDs and NPDs. PDs had higher levels of pain catastrophizing, which is the tendency to magnify the threat value of pain and to feel helpless in the face of it, and is associated with increased pain intensity and disability.Finally, anthropometric and structural differences were found between PDs and NPDs. PDs tended to have higher body mass index (BMI) and shorter stature compared to NPDs, which may result in altered spinal loading during standing.These findings suggest that PDs have distinct biomechanical and psychological characteristics that may predispose them to standing-induced LBP. Altered motor control displayed in AHAbd test and higher lumbar lordosis in individuals over 25 years seem to be probable risk factors for standing-induced LBP. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Risk Factors for Standing-Induced Low Back PainThe systematic review and meta-analysis identified several factors that were found to have a statistically significant association with standing-induced LBP:Lumbar fidgets – Participants with PDs displayed more lumbar fidgets, defined as small voluntary or involuntary movements of the lumbar spine, which are indicative of discomfort or pain. This factor was found to have a significant negative effect size (Hedge’s g − 0.72).Lumbar lordosis in participants over 25 years – Participants with PDs had higher lumbar lordosis, defined as the natural curvature of the lumbar spine, in individuals over 25 years old. This factor was found to have a significant positive effect size (Hedge’s g 2.75).AHAbd test – Participants with PDs displayed altered motor control in the AHAbd test, which measures the ability to control the hip and pelvis while lifting one leg. This factor was found to have a significant positive effect size (WMD 0.7).Gluteus medius co-activation – Participants with PDs had higher levels of co-activation between the gluteus medius and erector spinae muscles. This factor was found to have a significant positive effect size (Hedge’s g 4.24).Pain catastrophizing – Participants with PDs had higher levels of pain catastrophizing, which is associated with increased pain intensity and disability. This factor was found to have a significant positive effect size (WMD 2.85).These risk factors suggest that altered motor control, higher lumbar lordosis, increased gluteus medius co-activation, and pain catastrophizing may predispose individuals to standing-induced LBP. The findings may help identify individuals at risk of developing standing-induced LBP and plan appropriate preventive measures.Future research should investigate the association of the reported distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. Such interventions may include physical therapy, posture correction, and mindfulness-based stress reduction, among others. Identifying modifiable risk factors may lead to the development of effective interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP.Implications for Future ResearchThe systematic review and meta-analysis identified several distinct characteristics and risk factors for standing-induced LBP in PDs compared to NPDs. However, the study authors note that the identified risk factors do not necessarily prove causality or provide a complete understanding of the mechanisms underlying standing-induced LBP. As such, future research should investigate these factors in greater detail, and identify modifiable risk factors that can be targeted for preventive interventions.The study authors recommend that future research should investigate the following areas:Association with standing-induced LBP – Further research should investigate the association of the identified distinctive characteristics and risk factors to standing-induced LBP. Studies should investigate whether these factors are predictive of standing-induced LBP and whether they are specific to standing-induced LBP or generalizable to other types of LBP.Mechanisms underlying standing-induced LBP – Future research should also investigate the underlying mechanisms of standing-induced LBP, such as the interplay between motor control, muscle activation, and posture. Understanding the mechanisms underlying standing-induced LBP can help identify modifiable risk factors and develop effective interventions.Intervention strategies – Future research should investigate the efficacy of various interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP. Such interventions may include physical therapy, posture correction, mindfulness-based stress reduction, and other strategies aimed at reducing risk factors identified in this study.Generalizability of findings – Finally, future research should investigate the generalizability of the study findings to other populations, such as individuals with clinical LBP or those with different occupational or lifestyle factors. This will help to determine the applicability of the findings to a broader population and inform the development of preventive measures for standing-induced LBP.ConclusionIn summary, this systematic review and meta-analysis found that pain developers (PDs) – individuals with a history of low back pain (LBP) – have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing. These characteristics include altered movement patterns, muscular, postural, psychological, structural, and anthropometric variables. The study also identified several risk factors associated with standing-induced LBP, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale.These findings have important implications for preventing and managing standing-induced LBP, particularly in individuals with a history of LBP. The study suggests that altered motor control displayed in the AHAbd test and higher lumbar lordosis in individuals over 25 years old are probable risk factors for standing-induced LBP. Therefore, future interventions may focus on improving motor control and reducing excessive lumbar lordosis. Additionally, the study highlights the importance of addressing psychological factors, such as pain catastrophizing, as a potential risk factor for standing-induced LBP.Overall, the study emphasizes the need for a comprehensive approach to preventing and managing standing-induced LBP, including a focus on biomechanical, psychological, and other factors. Future research should investigate the association of these distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. By identifying and addressing these risk factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.This study emphasizes the importance of developing appropriate preventive measures for standing-induced low back pain (LBP) in pain developers (PDs). PDs are individuals with a history of LBP and are considered a pre-clinical population at risk of developing clinical LBP, which can lead to significant social and economic costs. The study found that PDs have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing, which suggests that targeted interventions may be necessary to prevent standing-induced LBP in this population.The development of appropriate preventive measures requires a thorough understanding of the risk factors associated with standing-induced LBP in PDs. This study identified several risk factors, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale. These risk factors suggest that interventions targeting motor control, lumbar lordosis, and psychological factors may be effective in preventing standing-induced LBP in PDs.In addition to identifying risk factors, the study highlights the importance of comprehensive interventions that address biomechanical, psychological, and other factors associated with standing-induced LBP. These interventions may include postural education, physical therapy, and cognitive-behavioural therapy. By addressing these factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.Overall, the study underscores the importance of developing appropriate preventive measures for standing-induced LBP in PDs. Identifying risk factors and developing targeted interventions may help reduce the burden of LBP in this population and improve their overall health and well-being.Dynamic Disc DesignsDynamic Disc Designs offers dynamic anatomical models that musculoskeletal healthcare workers (chiropractors, medical doctors, physiotherapists, osteopaths) can use to help explain how the spine is impacted when one stands, for example. The models are designed to simulate the spinal movement dynamically, allowing various spinal specialists to better illustrate to patients the impact that standing can have on the spine.Using the dynamic disc model, a healthcare worker can demonstrate how the intervertebral discs are compressed when standing due to the force of gravity on the spine. They can show how the discs lose water content and height throughout the day, resulting in reduced shock absorption and increased pressure on the spinal nerves. This can lead to various symptoms, including low back pain, stiffness, and numbness or tingling in the legs. In this particular research highlighted in this post, a practitioner can explain dynamically what excessive lordosis means and how the facets are approximated in this case. Explore.Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!Learn more online - new online discussion group included!Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion GroupLive caseswebinarslectureLive Q&Aover 600 videos - hundreds of techniques and more! Check out MMT InsidersKeeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog