Documenting Knee Extension Range of Motion

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I’ve talked a lot about the importance of regaining knee extension range of motion (ROM) after a knee injury or surgery. In this post, I want to talk about how exactly I believe we should be documenting knee extension range of motion.

I think it’s important because I hear many other medical professionals and students document differently. Hope this post clears the air and gets everyone on the same page.

Knee Extension after ACL

I’ve written about getting knee extension back after an ACL and how to figure out if it was a cyclops lesion or not. You can read this recent post if you like..it should help you gather more information on diagnosis and treatment of a cyclops lesion.

Therefore, I can’t stress the importance of obtaining not just knee extension, but symmetrical hyperextension after a knee injury or surgery.

With that, I feel as if many practitioners are all over the place with their documentation. This makes it difficult to communicate with each other and with the patients.

Documenting Knee Extension Range of Motion

In this video, I discuss the rationale for how I document knee hyperextension. I think it;’s important that we’re all on the same page to avoid confusion.

 

Does this make sense to you? Is this how you document knee hyperextension?

Let’s discuss in the comments section or on social media. You can find me on Twitter or Instagram @lenmacPT.

If you want to learn more about how I treat ACL’s or the knee in general, then you can check out our all online knee seminar at www.onlinekneeseminar.com and let me know what you think.

We cover the anatomy, rehab prescription, ACL, meniscal injuries knee replacements and patellofemoral issues. Furthermore, the course covers both the non-operative and post-operative treatment.t

This is an awesome course if you’re interested in learning more about rehabilitating the knee joint. And if you’re a PT, there’s a good chance you can get CEU’s as well.

The Week in Research Review, etc 8-26-18

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Predictors of Pain and Functional Outcomes After the Nonoperative Treatment of Rotator Cuff Tears Jain et al OJSM 2018

Who should have RTC surgery and who may not need RTC surgery? That’s a big question but this study tries to give us a better understanding.

70 patients with rotator cuff tears were diagnosed based on the clinical impression of a sports/shoulder fellowship–trained attending physician and evidence of structural deficits on MRI (when available). In cases where an MRI scan was available, both of these conditions had to be met for a patient to be diagnosed with a rotator cuff tear. If an MRI scan was unavailable (because it was not clinically indicated; n = 14), the diagnosis was based on the clinician’s impression.

The Shoulder Pain and Disability Index (SPADI) was used to determine the level of disability at 3, 6, 12, and 18 months.

✅Being married as compared with being single/divorced/widowed

✅Shorter duration of symptoms

✅Daily shoulder use at work that included light or no manual labor versus moderate or heavy manual labor

✅alcohol use of 1 to 2 times per week or more as compared with 2 to 3 times per month or less

✅Absence of fatty infiltration

✅ College level of education or higher

✅ Partial-thickness tear versus full-thickness tear

Interesting results, especially the alcohol use and being married (kinda surprising but intriguing). Does this help you to guide your future patients if they ask about RTC repair surgery? Tag a friend or colleague who may benefit from this information…thanks!

 

 

Playing video games for more than 3 hours a day is associated with shoulder and elbow pain in elite young male baseball players. Sekiguchi et al JSES 2018

[HOT OFF THE PRESS] in Sept 2018 issue showing the potential effects of playing video games on injury rates in youth baseball players.
200 Japanese ‘elite level’ male baseball players ages 9-12 years old were included in the analysis.

Playing video games for ≥3 hours/day was significantly associated with an elbow or shoulder pain vs. spending <1 hour/day playing video games.

The amount of time spent watching television was not significantly associated with the prevalence of elbow or shoulder pain.

Originally saw this study on Twitter by Dan Lorenz and thought it was interesting, considering @redsox pitcher @davidprice14had a recent injury and attributed it to playing video games.

Not sure how valid the results are but I just wanted to share with my friends and get your opinions. Tag a friend or colleague that may be interested in these results…thanks!⠀

 

 

 

Shoulder Stabilization Drills

More closed chain rhythmic stabilization drills that we like to utilize at @championptp for our upper extremity patients.

A recent study in 2014 Kang et al showed “The EMG activity of the infraspinatus and the ratio of the infraspinatus to the posterior deltoid activities were significantly increased, whereas the posterior deltoid activity was significantly decreased under the CKC condition compared to the OKC condition.”

I prefer to position the patient with an open palm to make it a less stable surface on the ball. Cue them by telling them ‘don’t let me move you’ as I give manual perturbations along the forearm.

To advanced the drill, we can have them perform it with their eyes closed or in a single-legged stance position with their push-off leg on the ground (if they are a pitcher).

You can also advance them in a time-based manner by extending the duration of the exercise to focus on more of the endurance aspect of the rotator cuff.

This is a great drill for those patients with hyperlaxity that need a relatively stable position to perform their exercises in a relatively pain-free fashion.

Do you utilize these drills or know someone that may benefit from them? tag them below so we can discuss them further…thanks!

Credit to @shift_movementscience for the ER wall stabilization drill that he showed us recently. We always performed them IR Wall Stab drill but a quick 180-degree shift and we got a great posterior RTC exercise!⠀

 

 

Lachmans Test for an ACL Tear

Video showing an obviously positive Lachman’s test in a recent @NFLpreseason game.

Check out the anterior translation of the tibia on the femur while the knee is flexed to about 25 degrees.

This is the best way to diagnose an ACL injury and should be the 1st ACL test that you do in your clinical exam.

Remember to rule out the PCL or you may get a false positive if you see excessive anterior translation because the tibia is sitting too far posteriorly.

According to Benjaminse et al 2006, The Lachman test is the most valid test to determine ACL tears, showing a pooled sensitivity of 85% and a specificity of 94%. There are numerous other studies that conclude this as well.

They even discuss the pivot shift as a test to consider but I think the Lachman’s test will be the most valid overall.

Do you agree? What do you think? Tag a friend or colleague who may benefit from this post…thanks!

 

 

Shoulder Drills

[REPOST] from @tony.comellatalking bodyweight drills that you can use as a warm up or even as part of a shoulder rehab program. Take a look below and applaud these movements by Tony! 👏🏼⠀
⠀
BODYWEIGHT SHOULDER DRILLS⠀
—⠀
🙋🏻‍♂️The shoulder can get overly complex, but the goal of this post is to keep it simple. There are a ton of exercises we can perform, utilizing a variety of equipment (bands, weights, barbells, cable, etc), but here are a few drills I like to perform using only bodyweight:

1️⃣ Prone swimmers. This drill can be deceivingly challenging, as we fight against gravity to keep our arms above the ground. Try and keep your arms as high above the ground as you can and elbows straight (think about reaching fingertips away from you). If you have trouble on the ground you can do this on a bench, or if this is too easy, hold some light weights <5lbs. No need to go too heavy here, as your ability to move a lot of weight won’t impress anybody.

2️⃣ Downdog toe tap. We get the shoulder into full flexion overhead (working on serratus) and some thoracic spine movement too. AdAn additionalonus is showing some love to the posterior chain (hamstrings, calves).

3️⃣ Bear roll. You can’t work on overall shoulder health and not include thoracic spine drills. This beautiful dance move targets the thoracic spine and closed chain shoulder stability at the same time.

😎These are 3 great bodyweight exercises to mix into your warm-up or exercise routine for overall shoulder health. Which one is your favorite?

 

The Week in Research Review, etc 8-19-18

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We posted a lot of information this week to review so hopefully you were able to keep up with it all. If not, here’s a bunch of it from the week. Check it out and comment as you want. Lots of good information on:

  1. Advanced Rhythmic Stabilization Drills
  2. Our ACL rehab paper from 2012
  3. PT usage for Frozen Shoulder
  4. Comparison of posterior shoulder stretching techniques
  5. Increased Sweating after an ACL surgery? Seems pretty common in the comments section
  6. @theprehabguys show how to do a posterior shoulder stretch

 

Advanced stabilization drills

These advanced stabilization drills are a great way to progress the patient once they’ve shown improved neuromuscular control with the basic drills from the other day.

I use these for most of my clients that need improved dynamic stability, especially those hypermobile athletes that play baseball, swim, or do gymnastics.

You can modify the speed and amount of force that I give during the drill based on how they are responding that day and how they have progressed overall. You can also increase the time of the drill to bring in an endurance component, as well.

The goal is to use these to prep the shoulder for higher level activities such as plyometrics, throwing, etc.

I want the shoulder joint to be as strong as possible. And most importantly, I want the client to perceive that their shoulder is stronger so that they are more confident!

Do you use these rhythmic stabilization drills with your patients?

Tag a friend who may benefit from these drills and try them on your patients the next time they’re ready to progress their dynamic stability drills!

Recent advances in the rehabilitation of anterior cruciate ligament injuries. @wilk_kevin et al JOSPT 2012 @drlylecain @dugasmd1

We wrote this paper in JOSPT to help clinicians better understand the rehab involved after their patient undergoes an ACL reconstruction.

The paper discussed the principles of ACL rehab, including:
✅obtaining full symmetrical extension
✅restoring patella mobility
✅ROM goals
✅Decrease inflammation/swelling
✅voluntary quadriceps control
✅restore neuromuscular control
✅Gradually apply loads

We also discuss special rehab implications for:
✅The Female Athlete
✅Concomitant injuries (MCL, meniscus, LCL, cartilage lesions)
✅Implications of Graft type

Our Accelerated ACL-PTG protocol is included to help guide the rehab process and give the rehab specialist some goals to achieve.

Again, a protocol is just a guide and by no means meant to place aggressive limitations on a patient.

Hope this paper helps you to better understand ACL rehab. Tag a friend or colleague who may benefit from this post.

 

Outcomes From Conservative Treatment of Shoulder Idiopathic Adhesive Capsulitis and Factors Associated With Developing Contralateral Disease Lamplot et al 2018 OJSM 2018

A minimum 2-year follow-up of patients diagnosed with idiopathic adhesive capsulitis.

They were treated with a single intra-articular glenohumeral injection of local anesthetic and corticosteroid as well as 4 weeks of supervised PT.

Physical therapy reduced the use of a second injection as part of treatment. Contralateral disease was more likely in patients with diabetes and those younger than 50 years.

PT is an important component of a conservative treatment protocol, as PT decreased the likelihood of receiving a second injection from 100% to 27.3%.

In my opinion, a cortisone injection + PT is the best treatment ‘cocktail’ for someone with frozen shoulder, particularly in the freezing phase.

Do you guys agree? Let’s discuss this very debilitating pathology. Tag a friend who may want to discuss this further.

A Randomized Controlled Comparison of Stretching Procedures for Posterior Shoulder Tightness McClure et al JOSPT 2007

This study looked to compare changes in shoulder internal rotation range of motion (ROM), for 2 stretching exercises, the “cross-body stretch” and the “sleeper stretch,” in individuals with posterior shoulder tightness.

From their results, “The improvements in IR ROM for the subjects in the ✅cross-body stretch group (mean ± SD, 20.0° ± 12.9°) were significantly greater than for the subjects in the control group (5.9° ± 9.4°, P = .009). The gains in the ❌sleeper stretch group (12.4° ± 10.4°) were not significant compared to those of the control group (P = .586) and those of the cross-body stretch group (P = .148).”

Just be aware of the large standard deviations and low number of subjects…plus the subjects were all asymptomatic.
With that, I still believe clinically that the cross-body stretch is one of the better stretches for the shoulder. I have gotten away from the sleeper stretch because I don’t believe the risk/reward presents favorably.

✅✅I personally prefer the supine horizontal adduction stretch with the scapula stabilized. I feel like this best isolates the posterior soft tissue (mainly muscle, in my opinion) and that’s my target tissue.

Do you use the sleeper stretch with your patients or do you prefer the cross-body stretch?

Comment below and let’s talk about it. Also, tag a friend who may benefit from this post…thanks!

Sweating Leg after an #ACL

Had this in my story and posted to Twitter and got some pretty good discussion going. Is this some altered autonomic nervous system response after #ACLsurgery? I’ve seen it a bunch, where the area inferior to the incision sweats significantly more than the contralateral leg. Anyone else see this phenomenon and have an opinion? Have had people say that maybe it was compartment syndrome or CRPS but it happens with many many ACL patients so it seems very normal. What do you think? #ACL #ACLrehab

Horizontal Adduction Stretching

Perfect timing by @theprehabguys with their horizontal adduction post from the other day. Blends perfectly with the McClure 2007 et al study I posted the other day that showed horizontal adduction is the best way to obtain internal rotation mobility at the shoulder. I often tell people to wedge their lateral scapula against a wall to help stabilize but this way may also benefit them. Check out their post below!⠀
👇🏻⠀
Are You Performing The Arm Across Body Stretch Correctly⁉️⠀
[How to Stretch Your Posterior Cuff]

A tight posterior cuff is associated with a handful of shoulder dysfunctions like subacrominal impingement syndrome, posterior impingement, anterior instability, etc. And thus, ⬇️ tone/increasing extensibility of the posterior cuff is part of the treatment protocol for many with shoulder pain. The cross-body stretch is a fantastic way to target the posterior cuff but far too often it is done INCORRECTLY.

‼️In order to effectively stretch the posterior cuff, you need to keep your SCAPULA STABILIZED ie your scapula CANNOT MOVE!‼️

❌If you pull your arm across your body and your scapula comes with it into horizontal abduction, the only stretch your getting is of your mid-scapular muscles like your rhomboids or traps. Furthermore, in this position there’s more of a distraction force on the glenohumeral joint than a true stretch of the posterior cuff – aka not as specific as it can be.

✅First pull your shoulder blades back. This will keep your scapula in a retracted position. Only WHILE MAINTAINING THE POSITION OF YOUR SHOULDER BLADES BACK can you effectively target the posterior cuff. Pay attention to WHERE you feel the stretch, as you should feel a “deep stretch” in the back of your shoulder in the highlighted area on the video. If you feel a stretch or anything else not in the back of the shoulder, you’re either doing the stretch incorrectly or abutting other structures in your shoulder due to pathology (ie don’t do the stretch anymore and seek out a physio if you’re in pain).

Try it out and let us know how it feels! Tag a friend who NEEDS this stretch! #shoulderstretch #posteriorcuff#posteriorcapsule

 

The Week in Research Review, etc 8-12-18

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This week’s articles discuss a wide variety of research topics. We discussed:

  1. Risk Factors for ACL tears
  2. Injury after a concussion
  3. EMG of the hip to minimize TFL activity
  4. We made of our posture and applied it to daily tasks
  5. Rhythmic Stabilization drills for the shoulder

Hope you enjoy and make sure to share with your friends and colleagues!

Factors Associated with Non-Contact Anterior Cruciate Ligament Injury: A Systematic Review. Pfeiffer et al IJSPT Aug 2018

This study looks to examine the existing literature for risk factors associated with non-contact anterior cruciate ligament (ACL) injury in both sexes.

A total of 79 full-text articles were reviewed, 55 of which met criteria for inclusion.
✔️Degrading weather conditions⠀
✔️Narrow inter-condylar notch index or width⠀
✔️Increased lateral or posterior tibial plateau slope⠀
✔️Decreased core and hip strength⠀
✔️Potential genetic influence

Individuals with previous ACL injury are at a higher likelihood for injury in the same knee (9.1x risk).

Take a look at this study because they do a good job of breaking down the literature and pointing out some of the common risk factors, both extrinsic and intrinsic.
✅Anatomic factors⠀
✅Neuromuscular Factors⠀
✅Physiologic Factors⠀
✅Biomechanical Factors⠀
✅Genetic Factors

Check out this paper and tag a friend or colleague that may benefit from reading this paper.

 

 

Musculoskeletal Injury Risk After Sport-Related Concussion: A Systematic Review and Meta-analysis – McPherson et al AJSM 2018

This systematic review & meta-analysis looked to determine the odds that athletes will sustain a musculoskeletal injury after a concussion. It was hypothesized that a concussion would increase the risk for MSK injury.

Eight studies met inclusion criteria for meta-analysis reporting 860 male and 163 female athletes with concussion compared with 3719 male and 507 female control athletes without a concussion.

✅Athletes with concussion had 2.11 times greater odds of sustaining a MSK injury compared with control groups and 1.67 times more likely to experience a lower extremity injury.

✅Female athletes with concussion had 2 times greater odds to sustain injury compared with non-concussed female control athletes.

✅Male athletes with concussion similarly demonstrated an increased odds of 2.1x risk for injury compared with non-concussed male control athletes.

Of course, they say further studies are needed to determine the physiological reasoning behind the increased risk for injury after a concussion.

Kinda makes sense, right? Anecdotally I feel like we see this a lot but good to be able to see it in the literature and educate our clients prior to a return to their sport.

 

 

Electromyographic Analysis of Gluteus Maximus, Gluteus Medius, and Tensor Fascia Latae During Therapeutic Exercises With and Without Elastic Resistance. Bishop et al IJSPT 2018

This study looked to determine the gluteal-to-tensor fascia latae muscle activation (GTA index) and to compare electromyographic muscle activation of the GMax, GMed, and TFL while performing 13 commonly prescribed exercises designed to target the GMax and GMed.

Clams with and without resistance, running man gluteus maximus exercise on the stability trainer, and bridge with resistance, generated the highest GTA index respectively.

It seems as if these 3 exercises may give you the biggest bang for your buck when trying to maximize gluteal activity and minimize TFL activity.

Knowing previous research, it seems as if most single-leg-stance exercises are going to give the patient the best gluteal activity per EMG.

Do you guys use any of these exercises? Maybe you need to use them more for your patients looking to improve their hip strength.

Tag a friend who may need bigger 🍑 and may benefit from this research by the esteemed Barton Bishop and his research team! TThanks, carlokoo for modeling!⠀

 

Loss of knee extension after a surgery can greatly impact a patient’s function in the long term.

Although opinions vary greatly in the orthopaedic world, I am a firm believer that regaining symmetrical knee extension is critical for a surgery to be successful.

Shelbourne et al showed that the number one factor in determining long-term satisfaction after a knee surgery was symmetrical knee hyperextension.

Per Benner et al 2016, obtaining full hyperextension that is anatomically normal for most patients does not affect objective stability, ACL graft tear/failure rates, or subjective scores after ACL reconstruction with patellar tendon autograft.

So why do some docs and PT’s still think you only need 0 degrees of knee extension? 🤔⠀

I’m not sure but I’ll tell you it is safe to get hyperextension and here are 3 tools that I use to help regain that last bit of motion.

1. Low load long duration in supine: in my opinion a better position to regain extension and more comfortable than hanging a patient’s leg off of a table. You try doing that and see how you like it!

2. Retro treadmill walking: walking at ~ 1.0 mph on the treadmill has been a great way to get that last bit of motion back and is something they can do at their gym when they’re not with you in PT.

3. Retro cone walking: Again, the goal is to accentuate the end range into hyperextension and it will also challenge their dynamic balance.

So, do you use these techniques with your patients? If not, tag a friend or colleague that may benefit from seeing this post!

 

I love when we can make fun of ourselves & this post nails it! Give @beardthebestyoucanbe a follow!

There is no such thing as good or bad form or posture. There is no right or wrong “exercise”. What does “functional exercise” even mean, & what is this “core” thing everyone keeps talking about whilst planking or crunching?! My newsfeed is blowing up with these so-called “fitness coaches” and “rehab experts” putting all type of crap out there. For 1 of 2 reasons, maybe both⠀
1. Pure ignorance⠀
2. Trying to grow their following by giving people what they think they want⠀
_⠀
The only bad posture is the posture we spend too much time in (shout-out Andreo Spina). Life is not perfect posture & neither is sports⠀
As human beings, our movement capacity should be vast. If we only stay in a small handful of postures we aren’t fulfilling our movement potential and we’re creating more dysfunctions and weaknesses because of it. Your body will devolve rapidly⠀
If you always hammer down the same posture, even if it’s “good posture”, you’re only creating strength and neurological control in that specific posture. So when your body slips out of that particular shape, weakness and injury is the outcome – and that’s not a good sign⠀

There is no such thing as a functional exercise, just functional (or non-functional) joints that can fulfill movement potential. If your joints can’t successfully control a range of motion that is necessary for your daily life, you should probably make that a priority for your training practice⠀

So in conclusion, is it that you need to practice good form (and never lose it, ever)…or practice multiple forms⠀

How do we practice in those ways? Well, it’s going to take a philosophical change first and foremost. Understanding our biology and neurology is important⠀

If you do not know how to train in such ways, find those who do.

 

I use Rhythmic Stabilization drills daily in my practice for most of my upper body patients.

I think they are critical to use to help the patient regain neuromuscular control, a sense of their joint and it’s a great way for the PT to get a sense of how the patient is doing overall.

The hands-on strength training (trying not to trigger dependency by the patient, so relax!) is a great way to gauge a patient’s progress.

Various tools can be used to progress and regress these exercises. I hope these few basic RS drills can give you a basic understanding of what we do @championptp

I hope to get more of these videos out in the future.

Share with your friends and colleagues so they can see these valuable drills for the shoulder joint!

 

 

 

The Week in Research Review, etc 8-5-18

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The Week in Research Review, etc 8-5-18 we discuss a wide variety of topics including:

  • Long-term disability if weak during adolescence
  • Using heat during rehabilitation
  • OKC vs CKC exercises after an ACL
  • Live look at an Achilles rupture (with sound too!)
  • A fun look at the different types of PT’s
  • Congrats to all of the newly licensed PT’s!

Muscular weakness in adolescence is associated with disability 30 years later: a population-based cohort study of 1.2 million Swedish men. Henriksson et al BJSM June 2018.

Conclusion: There was a strong association between muscular weakness and disability. A combination of muscular weakness and low aerobic fitness was an especially important risk factor for disability. This adds weight to call for muscular strength and fitness-enhancing exercise for adolescents in all BMI categories.

This study out of Sweden looked at the associations of muscular strength in adolescence with later disability pension.

A total of 1 212 503 adolescent males aged 16–19 years, recruited from the Swedish military conscription register between 1969 and 1994.

Moral of the story: exercise as an adolescent may help to reduce issues later in life, including the potential for disability.

Taking it 1 step further… why is physical education being cut out of school requirements when studies like this show the potential negative effects of inactivity?!

Turning Up the Heat: An Evaluation of the Evidence for Heating to Promote Exercise Recovery, Muscle Rehabilitation, and Adaptation McGorm et al Sports Medicine June 2018.

Key Points: Animal and human trials have shown that various forms of heating can be used in conjunction with exercise or stress to enhance recovery, adaptation and limit muscle atrophy.

Heating muscle activates protective mechanisms, reduces oxidative stress and inflammation, and stimulates genes and proteins involved in muscle hypertrophy.

Further studies highlighting the differences between various heating modalities will help inform athletes and coaches on the best heating practices for specific situations.

This article has a ton of great information that I highly recommend any PT, strength coach, athletic trainer or massage therapist.

It is a review of the literature and there are still many questions to be answered so, as always, take with a grain of salt.

I am a fan of heating before treatment…I do it daily with 99% of the clients that I see and they love it…so that says something.

What do you think? Do you like to heat your clients up before treatment or before a workout? Tag a friend that may benefit from this post! Thanks, guys!

The Effect of Open- Versus Closed-Kinetic-Chain Exercises on Anterior Tibial Laxity, Strength, and Function Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis Perriman et al JOSPT July 2018 Level 1a

FINDINGS: There was no significant difference in anterior tibial laxity, strength, patient-reported function, or physical function with the early or late introduction of open-kinetic-chain exercises in those who have had anterior cruciate ligament reconstruction, when compared to closed-kinetic-chain exercises, at all follow-up time points.

They wanted to determine whether OKC quadriceps exercises result in differences in anterior laxity, when compared to CKC exercises, at any time point following ACLr.

Also, they wanted to determine whether there are differences in strength, function, quality of life, and adverse events with OKC quadriceps exercises when compared to CKC exercises at any time point.

Overall, calculated effect sizes showed a slight increased laxity in the OKC groups, particularly for the hamstrings graft. The⠀
pooled difference was not statistically significant (P>.05)

When considering all graft types, there was low- to moderate-quality evidence from 3 studies suggesting that there were no between-group differences in laxity at any time point when OKC exercises were introduced earlier than 6 weeks post ACLR, compared to CKC exercises.

There seemed to be a trend that showed early OKC knee extension was safer after a PTG than a hamstring autograft but protocols varied so data was inconsistent.

Of interest to me, they said “The early introduction of OKC quadriceps exercises did not appear to offer additional significant benefits in function and strength for the average patient post ACLR; therefore, this early introduction is questionable, especially in patients with a hamstring graft.

From Twitter’s @IrineuLoturco showing the moment this athlete ruptured their achilles tendon. Pretty impressive and you can see the eccentric loading of the tendon that caused the rupture. See his original post below…

A very impressive recording of the exact moment when an elite sprinter had an acute and complete rupture of the Achilles tendon. Pay attention to the “boom”.

[REPOST] If there was an ESPY for a post by a PT then @theperformancedoc would definitely get it for these videos! Great job and keep pumping out great content. Give him a follow if you haven’t already!

👇🏻
💥Different Types of Physical Therapists In the Real World💥 SWIPE 👉🏽 (Turn on 🔊) Sometimes we have trouble “turning it off” when we are outside of the clinic. Which one are you?! Tag, Comment, & Share with a Physical Therapist‼️
–
▪️
#ThePerformanceDoc #RehabWithTheDoc
#TeamMovement

Congrats to all of the newly licensed PT’s out there…Welcome to the profession!

My advice to you:

Stay humble and put the patient first, always

Keep learning and try to avoid complacency

The road will seem rough but it does get a little easier. Get experience…as much as you can. Each interaction with a patient is a snapshot to help guide your future interactions.

Put yourself in their shoes… give them the best experience as you would expect to receive if you were sitting on the plinth being asked questions.

Follow people on social media that help you to learn and keep an open mind. Don’t get pulled into 1 system. Take a little from each and package it nicely.

The research is often biased. Opinions come and go. Stay somewhere in the middle…remember the bell curve, always!

Each “system” has huge overlap despite their ‘trademarked’ proprietary information…they all involve motion and strengthening. That’s the key to PT- keep people moving and keep them stronger…or at least keep them positive and hopeful.

I recently wrote a blog post discussing the evolution of a PT. Take a look…the link is in my bio on Instagram.

These words are the basis of my practice. Take what you think is important and apply it to your practice. Good luck, now work on your dives!

A great week of content that I hope you found valuable and willing to share with your friends and colleagues! Thanks for reading!