Proprioceptive Neuromuscular Facilitation (PNF)

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.  Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog

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

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

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.  Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog

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