Modern Manual Therapy

https://webstories.edgemobilitysystem.com/shoulderimpin/amp Shoulder impingement or issues with overhead mobility? Try these simple resets.

https://www.themanualtherapist.com//top-5-fridays-5-villai Top 5 Fridays! The 5+ Villains of Evidenced Based Practice - have you run into any of them?

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MUSCLE PAIN (AND DISCOMFORT) NON-NEGOTIABLE FOR BFR TRAINING via @thehpm Blood flow restriction involves use of a cuff to restrict blood flow to the exercising muscle and is commonly performed with very low loads (20-50% 1RM). Due to the trapping of venous outflow from the exercising muscle and the restriction of blood flow, oxygen tension lowers, challenging local oxygen metabolism (ie Krebs Cycle) to produce ATP for energy. In order to maintain force output (ie not fail at ...the exercise), type 2 fibers are recruited earlier than they normally would compared to its free-flow alternative. However, the earlier recruitment of the type 2 fibers comes at a cost - muscle pain and increased discomfort. This is due to the metabolites produced through anaerobic metabolism (without oxygen) to produce energy stimulating the local muscle afferents - this isn't comfortable. WE MUST PUSH THROUGH THIS when exercising as this is the best indicator that good things are happening (ie muscle building stimulus)! Without experiencing these feelings, good luck growing muscles with light weights.

Hot off the press! The Eclectic Approach Weekly is out! http://modernphysionews.com/

Your Modern Manual Therapy Weekly Update -

https://www.themanualtherapist.com//untold-physio-stories- In the latest podcast, we go over a case in a healthy young woman without red flags, but things just don't add up

Pain is not simple. The human body is not simple. We cannot simply reduce all symptoms down to one specific cause. . Over the past years, clinicians have been using simple narratives of pain and creating the most complex exercises to help solve or fix someone’s abnormality. . We don’t need complex algorithms or unsubstantiated classifications to fit someone in a specific category that will help fix their one cause.... . Instead, we need to embrace the complexity behind the nature of pain, and think of simple ways someone might be able to improve their experience. . Whether that be pain modulation via certain manual techniques, promotion of meaningful physical activity/exercise, or pure education on natural history, stress management, etc. . This reframes the narrative away from a fix it solution into a manage it solution empowering the individual to have better control of their condition. Via @camfallerdpt See more

https://webstories.edgemobilitysystem.com/neck-tension-/amp Check out these easy steps if you have neck pain or tension headaches.

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https://www.themanualtherapist.com//best-weight-loss-tips- Best Weight Loss Tips for PTs

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https://www.themanualtherapist.com//back-squat-v-front-squ Squat Series Part 2: Back v Front v Transformer - Biomechanical Differences

Misconceptions of chronic pain. Fantastic infographic by the World Confederation for Physical Therapy (WCPT). Thanks for sharing @infophysiotherapy

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*10 Minute Shoulder Mobility Circuit* via @shift_movementscience - - I’ve tinkered with a lot of different overhead shoulder mobility drills, exercises, and circuits the last 10 years. -... - This one using some light soft tissue work, specific stretching, eccentrics, active range of motion drills, and skill specific drills seems to be the best combo I’ve found. - - I have people test and retest every day, and do this daily for 2 weeks. Usually when it’s based off a sound assessment, it’s super effective. - - It’s also important to modify strength programs to not feed the fire and reduce the volume of pull ups, leg lifts, and rope climbs (lat and teres major dominant) and find alternatives temporarily like feet elevated rows, L holds, or renegade rows / face pulls. - - Hope this helps! #gymnastics #shouldermobility See more

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https://www.themanualtherapist.com//a-brief-overview-of-ce Want to now more about cervicogenic dizziness? Here is a brief overview!

For many people spinal flexion is something that needs to be avoided due to the belief that it will cause or prevent low back pain. . However in reality, spinal flexion is just a normal movement that we need to be able to perform during the activities of our daily living. . There is nothing wrong in picking up something up from the ground.... . When lifting something really heavy from the ground (Deadlift), it might be useful and more safe to adapt a more neutral spinal positions. Keep in mind though that even when we try to maintain a neutral or even lordotic spine we still have large degrees of spinal flexion. . There are even cases that a totally braced round spine during heavy lifting might be beneficial both from a safety but also from a performance standpoint (Think of atlas stone lifting). . Let's not forget that our body has the ability to adapt to the various stressors that we impose on it. Via @thestrengthpts See more

AN ALTERNATIVE METHOD TO STANDARDIZE APPLIED PRESSURE DURING BLOOD FLOW RESTRICTION TRAINING via @thehpm Best practice for setting blood flow restriction (BFR) application pressure involves use of a computer system or an external doppler ultrasound (DU) to determine the minimum pressure needed to completely restrict arterial flow and occlude venous return and is known as limb or arterial occlusion pressure (LOP). Exercise is performed at a percentage of these values to inc...rease safety. However, these approaches are cost prohibitive or require a skilled practitioner for implementation, adding a barrier to safe BFR practice. Other ways to increase safety may allow for more widespread use of BFR training. Prior to this paper, one paper has suggested the use of pulse oximetry (PO) (Zeng, 2019) for the upper extremity as an easy-to-use way to standardize applied pressure. PO is worn on the finger and the device shuts off once LOP is met. This study by Lima-Soares (2020) provides additional support for the use of PO to provide a valid measure of LOP and extends it to multiple positions using a 5 cm cuff- supine, seated and standing. METHODS: 70 participants (33 M, 37 W, ~23.2 yo) had their LOP determined by a DU (10 MHz) and PO (Oxy Control) simultaenously in the aforementioned positions with two blinded investigators (audio was blocked for both using headphones). PO was placed on the index finger and DU was placed on the radial artery. The process was repeated for each position with 5 min of rest in-between. RESULTS: Similar LOP values for all positions between DU and PU, with 60/70 (86%) showing same AOP values for both methods in sitting, 51/60 (73%) in standing and 57/70 (73%) in supine. In cases where differences were observed, DU was about 10 mm Hg higher than PO. Correlations between LOP values in both conditions were very strong at r= 0.955, 0.980, and 0.955 in supine, seated and standing, respectively. The maximal differences between methods was +/- 10 mm Hg. CONCLUSIONS: PO can be a valid way to assess LOP in healthy adults. SOURCE: Lima-Soares et al. (2020). Determining the arterial occlusion

https://webstories.edgemobilitysystem.com/sciaticneurodynam Improve your hamstring and toe touch with these neurodynamic movements!

https://www.themanualtherapist.com//top-5-fridays-5-ways-t Top 5 Fridays! 5 Ways to Manage Stress

Get moving! #Arthritis likes movement! It doesn't have to be painful. Here's a really basic progression from @theinspirationaldpt to get you started moving those joints and feeling better. Via @feldmanpt

https://www.themanualtherapist.com//untold-physio-stories- In the latest podcast, we're joined by Dave Kittle who goes over what to do if you're accused of IP and patient theft.

Building a therapeutic alliance with your patients has been a key determinant in their recovery. . By engaging in shared decision making and creating a positive environment, patients are more likely to instill trust and show improvements. . By the same token, dispositional optimism has the ability to potentiate a placebo response given its characteristics of imprinting a generalized positive outcome expectancy.... . The truth of the matter is we are walking placebos and have the ability to dictate recovery with the words we use, how we dress, and the environment we are creating. . Whether you want to blame it on building a therapeutic alliance or creating dispositional optimism, there is nothing wrong with building up people’s values and motivation to show them their capabilities. Via @camfallerdpt See more

https://www.themanualtherapist.com//physical-therapy-and-a Physical Therapy and Alcohol, a Good Mix?

7 Types of Concussion Via @mollyparkerpt Type yes if cheat sheets like these are helpful. On Tuesday in PT I was finally feeling solid with my rehab and what it would look like in 2021.... In the past, as I made my goals for the new year, I’d feel completely frustrated with my rehab. I was willing to put in the work, but just couldn’t find the help. I didn’t fully understand what to do, and couldn’t find people who did. I just knew I still felt like sh*t. So I popped a survey in my stories to check in on how y’all were feeling about YOUR 2021 rehab. Only 20% of this community is feeling on track. Yikes! Many of you said you didn’t know what to do next or who treated your symptoms. So this post is for you SAVE it Persistent concussion symptoms are treatable. You can fully recover from a concussion. But here’s a key point you need to know to recover faster~ There are different types of concussions. Understanding which types you’re experiencing allows you to identify what treatment is going to be effective for YOU. Start by: 1. Identify which categories you are experiencing symptoms (multiple or all is common) 2. Pick which 1 or 2 most affect your life 3. Research the healthcare provider specializing in concussions who treats your top 2 areas. See if anyone around you has referrals or hop on Google. Type in Concussion, the profession and where you live. Click search. 4. When you’re able to locate the ones in your area give them a call first and say, Hi I am__. I had a concussion X long ago and I’m experiencing X symptoms. Is this something you have experience treating successfully? That way you can identify if the clinic is a fit BEFORE spending the time and money to go in. I know sometimes finding a good practitioner is easier said than done and this year is especially weird. So if you don’t have help available in your area or there are pieces missing @concussioncompass was created for you (and right now it’s 2 months for the price of 1) Don’t drag out your recovery unnecessarily- save time, money and your sanity. Click the link in bio to learn what it can do for you or send me a DM You can feel like you again! You g

via @rehabscience Compartment syndrome describes a dangerous accumulation of fluid within a muscular compartment of a limb that can lead to impaired blood flow, decreased oxygen delivery and cell death, in severe cases. This condition is classified as either acute or chronic, with acute often being a medical emergency that requires surgical intervention. - In this video, my friend @evan_ask shows how his leg appears now after suffering an acute c...ompartment syndrome of the quadriceps compartment several years ago. He experienced this injury after receiving a hard check during a hockey game and immediately noticed swelling and sensory and motor changes in his leg. He was rushed to the emergency department of the local hospital where they splayed his thigh open, cutting some of the fascia, which allowed the pressure to drop and prevent any permanent damage to the femoral nerve. This procedure is known as a fasciotomy. His leg was left open for several days to allow intracompartmental pressure to decrease. During this time, blood clots were removed daily by hand and the wound was closely monitored for signs of infection. - Following surgery, rehab focused mainly on regaining knee flexion range of motion. He reports that strength came back without problem, but still has numbness around the incision. - These days, he has no pain or issues with function and competes professionally in motorcycle racing. Pretty cool case! . #RehabScience See more

https://www.themanualtherapist.com//top-5-fridays-5-hangin Top 5 Fridays! 5+ Hanging Exercises for Strong Core and Grip

https://webstories.edgemobilitysystem.com/lattibglide Limited ankle mobility? Try this simple reset and re-test. If improved get loading!

Stiff #shoulders or trouble reaching overhead? Try this #eccentric exercise from @jnunezdpt to improve #mobility Find out more about eccentric exercises: link in bio

https://www.themanualtherapist.com//untold-physio-stories- A perfect Untold Physio Stories episode for the holiday season! Let us know what you think in the comments!

With over 80% of the population experiencing back pain at least once in their life and the US spending approximately $240 billion dollars annually in direct and indirect costs, better approaches need to be made in helping individuals manage this condition. . According to an excellent retrospective study published in the BMC Journal, the authors found that early referral to Physical Therapy (<90 days) resulted in significantly reduced costs and decreased the odds of receiving ...several ancillary services. . Better yet, this study found that participants who were referred early yet failed to adhere to their recommendations still had lower costs and services compared to the group that had a delayed referral and adhered to all the best recommendations. . Yes, research has shown that a lot of back pain will resolve on its own regardless of the treatment, but when it comes to producing great outcomes while avoiding downstream costs, early PT appears to be the route to go. . . Via @camfallerdpt Know someone who might find this helpful? Tag them below or share! . . If you enjoy this content, please be sure to like or save; that best helps me understand what to keep producing! See more

From my lecture in the @modernpaincare Complete Clinician Course section on Pain Science via @drjarodhalldpt

via @rehabscience The ankle dorsiflexors act as the antagonist to the calf muscles (plantarflexors) and play an important role in the walking (gait) cycle. These are the two primary actions during gait: - The dorsiflexors are activated when contact is first made with the ground. As the heel hits, this group must contract eccentrically in order to allow the foot to be set down smoothly. Weakness of the dorsiflexors during this task creates the ‘foot ...slap’ phenomenon as the foot falls quickly and slaps the ground. - The dorsiflexors are activated a second time as the foot is picked up and swung forward in preparation for a new step. These muscles must dorsiflex the ankle, so that the toes do not catch on the ground. In situations of dorsiflexor compromise, the toes may catch, which is termed ‘foot drag’, and may cause the individual to trip and become injured. - Besides gait issues, the dorsiflexors are often implicated in more common orthopedic issues such as shin splints, tendon disorders and more severe low back cases (L4 level) that can be associated with dorsiflexor weakness and foot drop. - If you have pain in this region or some other condition that has weakened your dorsiflexors, give these exercises a try and let me know if you have any questions. - 1Isometric March: In this heel march, the dorsiflexors must hold the ankle in neutral as gravity tries to pull the ankle into plantarflexion. - 2Dorsiflexor Taps: Lift the foot up and down and try to squeeze the muscles on the front of the shin. - 3Dorsiflexor Curl: With a band secured around both feet, move the ankle through concentric and eccentric dorsiflexor contractions. . #RehabScience See more

https://www.themanualtherapist.com//squat-series-back-squa Part 1 of the Squat Series: Back Squat vs Front Squat vs Transformer Bar Squat: Biomechanical Differences

https://webstories.edgemobilitysystem.com/tmj/amp Have TMJ or facial pain? Try these simple movement and isometric based resets.

How many patients do you have that have tried the physical therapy somewhere else first? via @aaronlebauer . . . #IworkForPatients #IamCashPT #CashPT #cashbasedphysicaltherapy #cashbasedpt #physicaltherapystudent #physicaltherapyschool #dptstudent #dptstudents #dpt #dptschool #ptstudent #ptstudents #healthcarememes #healthcarememe #ptmeme #ptmemes #physiomeme #physiomemes #physicaltherapymemes #businessmemes #entrepreneurmemes #entrepreneurmeme

https://www.themanualtherapist.com//top-5-fridays-5-steps- Top 5 Fridays! 5 Steps to Prove Your Therapy is Effective, Even When It Isn't

New Products just in time for the holidays! - https://mailchi.mp/modernmanualtherapy.c/topproducts-988398

https://www.themanualtherapist.com//untold-physio-stories- In this episode of Untold Physio Stories, I go over a differential diagnosis for cervi

https://webstories.edgemobilitysystem.com/lumbar-extension- Lumbar extension blocked or painful? Try this simple isometric reset and re-test!

https://www.themanualtherapist.com//can-botox-help-cervico Can Botox Help Cervicogenic Vertigo?

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The Rehab Spectrum from @adamsperformancept While we typically want to get all of our patients to higher levels of exercise, we have to meet them where they are at - both physically and mentally At a simple level, sometimes it comes down to one question when choosing how to appropriately dose treatment:... Should I protect this person or should I expose this person To quote one of our favorites @greglehman - we either need to calm s&$# down or build s&$# back up. If someone is in more of an acute phase, we likely lean towards protecting them early on. If tissue healing has occurred or pain has lasted longer than expected, exposure might be the way to go Either way the end goal is always progressing back towards building resiliency and there are many avenues to get there! #physicaltherapy #getpt1st #modernpatienteducation

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[ SALE WEEK] Thanksgiving Sale on EDGE Mobility, Online Seminars, and MMT Insiders!! - https://mailchi.mp/modernmanualtherapy.com/thanksgiving2020

https://webstories.edgemobilitysystem.com/hipimpingement Hip pinching during squats? Try this simple progression of resets and movements.

https://webstories.edgemobilitysystem.com/shoulderimpin/amp Problems with overhead mobility or pain with shoulder elevation? Try these simple movement based resets

https://www.themanualtherapist.com//top-5-fridays-5-reason Top 5 Fridays! 5 Reasons Why Direct Access to PT is Beneficial

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https://www.themanualtherapist.com//untold-physio-stories- Listen to this latest podcast, where I go over a not so clear case of the importance off alignment.

Sleep and athletic performance via @partners4rehab . What sport factors may affect ? high training loads unfamiliar sleeping environment... night conpetition night before competition long haul travel . What non-sport factors may affect ? family commitments lifestyle choices attitudes and beliefs work/studying social demands . Sooo....avoid situations that present ongoing risks to sleep; promote positive habitual sleep behavior . When incorporating strategies to enhance sleep or performance in the field setting, take account of other factors that may impact results (eg, ongoing illness) . Walsh NP, et al. Br J Sports Med. 2020 . #sleephygiene #sleepmatters #athlete #athleticperformance #physicaltherapy #physicaltherapist #partners4rehab #dptstudent #2020 #getpt1st #alwayslearning #partners4rehabexcellence See more

https://www.themanualtherapist.com//could-meat-lower-heart Can meat lower heart disease risk and how does this relate to PT and your patients?

https://www.themanualtherapist.com//top-5-fridays-5-spider Top 5 Fridays! 5 Spiderman Mobility Drill Progressions

3 HURDLES TO BFR SUCCESS via @thehpm In order to have a successful BFR training experience, there are 3 common hurdles that every BFR practitioner must be overcome. Without overcoming these hurdles, the confidence in appropriately integrating this tool into your practice becomes less and less, reducing the chance of long-term success both in terms of client/patient outcomes but also business revenue! Hurdle 1 - The Science of Hypertrophy - Without understanding how muscle is ...built and the ingredients necessary to do so, how can one possibly articulate the benefits of BFR training and where it fits in relative to normal training? Hurdle 2 - The Traffic Lights (Safety Screening) - Understanding that BFR training is not for everyone, as some people may display larger than normal responses to this form of training. Screening is a crucial process! Likewise, understanding ways to alter BFR training to reduce the magnitudes of these responses can also be useful. Hurdle 3 - Effective Communication - Without the knowledge and confidence gained in overcoming the prior 2 hurdles, it is near impossible to communicate in laymens terms the benefits of BFR to a client/patient or the in-depth science to a potential referral source. These hurdles form the crux and direction of @thebfrpros online 4.5 hour BFR training course. By the end of the course, you can be confident in your ability to overcome these hurdles and achieve optimal success in your practice (and your muscle gains!). Lucky for you- if you’re looking to get trained, we’re running a SCARY PROMOTION of $120 off the retail price of $299.99! Check the link in bio to sign up and use code SCARY120 at checkout! Post below some of the common hurdles you've had to overcome in your practice to successfully implement BFR training!