Announcement

Collapse
No announcement yet.

Pot-Pourri

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Originally posted by Johnny_Nada View Post
    There's so many things in that article to pick out where would you start.

    I will say one thing though is that live heard a lot of things about stretching, but I think it's the first time I've ever heard of them being "the next big fitness fad".
    Ben

    Comment


    • Patient enters clinic.

      "I want a massage"
      Reply: go see a massage therapist

      "I want my back popped"
      Reply: go see a chiropractor

      "I want some stretches"
      Reply: go to a stretch studio

      "I want some exercises"
      Reply: go to personal trainer

      "I want to get stronger"
      Reply: go to a S&C coach

      "I want some ultrasound and e-stim"
      Reply: go see an athletic trainer
      I may not be as smart as most people, but I'm sure as hell not as dumb....
      "The views expressed here are my own and do not reflect the views of my employer."

      Comment


      • Can't argue much with your post Johnny Nada. Just for my learning, when a patient enters a clinic, when is your reply: you are in the right place?

        Comment


        • JoshL,

          Believe it or not I say that frequently.

          If I can rule out red flags/non-MSK issues or concerns, relevant yellow flags (significant depressions/psychosocial factors) that's a start.

          From here I go with:

          Patient unsure of what to do, options, who to see, where to go
          Mechanical pain condition
          The loss of some physical capability paired with their motivation to regain/restore it
          Evidence suggesting surgery or invasive procedure is not necessary

          Put those together I'll tell them they are in the right place. If they have a mechanical or persistent pain issue but are looking for fix/cure/miracle/passive/fix me up type. I won't say it.
          I may not be as smart as most people, but I'm sure as hell not as dumb....
          "The views expressed here are my own and do not reflect the views of my employer."

          Comment


          • Originally posted by Josh L View Post
            Can't argue much with your post Johnny Nada. Just for my learning, when a patient enters a clinic, when is your reply: you are in the right place?

            All patients with pain should see a well informed Physiotherapists first point of contact. It is literally here where a good Physiotherapists has the biggest and most important impact.


            Physicians are ill-equipped to do it.


            Use the STarT back tool and stratify patients. By and large most patients can be managed by re-assuring them and telling them what to do (one session).


            Those who are down the rabbit hole should be streamed to a Physiotherapists who does ZERO passive modalities and provides good TNE and sends them on their merry way (1-3 sessions).


            Never going to happen.


            But that's how it should work.

            Comment


            • Proud,

              I don't disagree with you, but will ask a few questions to promote discussion.

              How important and how much stock do you place in the "start back" (I get tired of remembering what letter to capitalize)?

              Do we really need a survey to identify who may be more difficult to treat? Wouldn't a subjective suffice?

              That said, even if the individual is medium or high risk, are we the right person to see simply because we are low cost with low harm (assuming an informed up to date, non-passive physio)?
              I may not be as smart as most people, but I'm sure as hell not as dumb....
              "The views expressed here are my own and do not reflect the views of my employer."

              Comment


              • Originally posted by Johnny_Nada View Post
                Proud,

                I don't disagree with you, but will ask a few questions to promote discussion.

                How important and how much stock do you place in the "start back" (I get tired of remembering what letter to capitalize)?

                Do we really need a survey to identify who may be more difficult to treat? Wouldn't a subjective suffice?

                That said, even if the individual is medium or high risk, are we the right person to see simply because we are low cost with low harm (assuming an informed up to date, non-passive physio)?

                Agreed. I can probably determine what I am dealing with in under 5 minutes on most instances.


                But for objectivity sake...The STarT back adds some validity to the process.


                I've said it all along. We (Physiotherapists) went off course when we opted to compete in the bouquet industry rather than position ourselves as NMSK experts.


                This is how bullshit like dry needling has come to exist. All dry needling really is....is a means to up the ante and claim to own the most invasive, spectacular appearing thing on the market.


                It's absolute bullshit 100%


                We should be direct access, front line workers were patients get triaged directly to us to rule out red flags, things that are ripped torn or broken (where we re-direct to the appropriate provider).


                After that our role is not as "fixers" but more as those that guide.


                Not lucrative but then again I don't think healthcare was ever meant to buy people yachts.


                Physiotherapists were (still could be) extremely important players if we just stopped the BS.
                Last edited by proud; 16-07-2017, 08:44 PM.

                Comment


                • proud,

                  But a patient was dry needled and felt lot better!

                  You're asking to get punched.
                  Barrett L. Dorko

                  Comment


                  • Sadly Barrett,

                    thats all many in the profession want or need to hear....

                    Those speaking at conferences or CEU courses may discuss babies and bathwater.
                    I may not be as smart as most people, but I'm sure as hell not as dumb....
                    "The views expressed here are my own and do not reflect the views of my employer."

                    Comment


                    • The scientific method and discussion have been downgraded. I use the word "destroyed" to reflect what has actually happened.

                      Many therapists go along with this.

                      They don't visit here.
                      Barrett L. Dorko

                      Comment


                      • Thank you gentlemen!
                        (I mis the "thank you" button)
                        We don't see things as they are, we see things as WE are - Anais Nin

                        I suppose it's easier to believe something than it is to understand it.
                        Cmdr. Chris Hadfield on rise of poor / pseudo science

                        Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

                        We don't need a body to feel a body. Ronald Melzack

                        Comment


                        • Bas,

                          I miss the "thank you" button too!
                          Barrett L. Dorko

                          Comment


                          • Proud,

                            Originally posted by proud View Post


                            Those who are down the rabbit hole should be streamed to a Physiotherapists who does ZERO passive modalities and provides good TNE and sends them on their merry way (1-3 sessions).


                            Never going to happen.


                            But that's how it should work.

                            Thanks for the response. For one, I cannot disagree. Some patients, 1-3 sessions in plenty. I agree that is how it should be.

                            However, as you know, we continue to live in a biomedical world. To take patients from an external locus of control, in large part to the medical system, to internal in 1-3 visits would be/is tough. I view this as quite the change and too much for some individuals. If people perceive the change too much, then they are less likely to change. Therefore, I do not push the pain education right away and gradually introduce over visits. Part of this is because I have 1 year of experience, lack confidence and some patients tell me I look like a teenager.

                            According the the book "Switch" by Dan and Chip Heath (has nothing to do physical therapy directly), the key to behavioral change in self-efficacy. To build self-efficacy takes time. Hence, why i am okay with seeing patients for more than 3 sessions

                            Comment


                            • http://pride.physio/rise-failure-top-bottom/

                              proud, you out there???
                              I may not be as smart as most people, but I'm sure as hell not as dumb....
                              "The views expressed here are my own and do not reflect the views of my employer."

                              Comment


                              • So your back hurts? Well here are some options if you want someone to DO SOMETHING TO YOU.

                                Here's a secret; these are all as effective as one another....Enjoy!

                                First:
                                https://www.youtube.com/watch?v=wiiUymY-L5g

                                Second:
                                https://www.youtube.com/watch?v=jNfG9rL2gi8

                                Third:
                                https://www.youtube.com/watch?v=CKhnnrBrRZw

                                Fourth:
                                https://www.youtube.com/watch?v=wPdim-BQk74&t=19s

                                Fifth:
                                https://www.youtube.com/watch?v=zqxUJPGkMaA

                                Sixth:
                                https://www.youtube.com/watch?v=CMgeOzK49TA

                                Seventh:
                                https://www.youtube.com/watch?v=P0oXx61L8EU
                                I may not be as smart as most people, but I'm sure as hell not as dumb....
                                "The views expressed here are my own and do not reflect the views of my employer."

                                Comment

                                Previously entered content was automatically saved. Restore or Discard.
                                Auto-Saved
                                x
                                Insert: Thumbnail Small Medium Large Fullsize Remove  
                                x
                                x
                                Working...
                                X