3×10 No More!

This post is part 2 of my summary of the lecture Dan Lorenz gave at the Midwest Student Conclave. Part 1 can be found here.

Dan talked at length about the importance of choosing not only the exercise being performed but also the sets, reps and load in a systematic and logical way. Here are the recommendations he gave for the following goals. Of course, these change from patient to patient.

Tip: Always start with large muscle groups first. This is not determined by muscle mass but individual needs for movement…things that need work most. (Simåo et al. Sports Medicine 2012)

force velocity

Strength:

arny strength

Sets: 3-4 per exercise  (8-10 exercises per muscle group Peterson, JSCR 2004)

Reps: 1-8

Load: up to 100% 1 RM

Rest: 1-3 minutes

Endurance:

endurance

Reps: 25-150

Rest: 10-30 seconds

Load: 30% 1 RM

Strength-Endurance:

rich

Reps: 60-120 per minute (high tempo)

Load: 25-50% 1 RM

Rest: short

Speed-Strength:

Adrian Peterson, Connor Barwin

Reps: 3-6

Rest: 1-3 minutes

Load: 20% of 1 RM coupled with resistance up to 40% 1 RM

Power:

NFL: Preseason-Kansas City Chiefs at Green Bay Packers

Sets: 4-8

Reps: 3-6

Load: 30% of 1 RM

Rest: Full recovery

Pictures courtesy of:

http://articles.elitefts.com/training-articles/sports-training/the-force-velocity-curve/

http://thedailybanter.com/tag/arnold-schwarzenegger/

http://kbhr933.com/current-news/olympian-ryan-hall-runs-podium-finish-yesterdays-nyc-halfmarathon/

http://www.bodybuilding.com/fun/rich-froning-crossfit-workout-train-like-a-crossfit-champ.html

http://images.publicradio.org/content/2012/12/24/20121224_peterson1_53.jpg

http://cdn2.sbnation.com/uploads/chorus_image/image/10090075/20120905_ter_sh5_189.0_standard_352.0.jpg

7 Commandments of Exercise Progression

Hey team,

I’m still trying to figure out why we keep calling PT student gatherings conclaves..maybe conference or meeting. Anyway, the Midwest Student PT Conclave was last weekend and I know a bunch of people didn’t get (want) to go so I figured I would right up a little summary of the notes I took because I’m just that kind of guy. Thanks to KPTA, KU Med. and all the people who helped organize the event, it was really great.

Speaker: Dan Lorenz, DPT, CSCS (@kcrehabexpert)

Quick Bio: Dan is literally the man…He owns a Orthopedic and Sports focused outpatient clinic in Overland Park, KS where he fixes everyone from professional athletes to the average Joe with back pain. Dan has been published numerous times, he was Sports PT fellowship trained at Duke and teaches as an adjunct faculty at Rockhurst University.

**Note: this summary will not be perfect, I will do my best to keep it organized and accurate**

Exercise Progression:

Why does this matter? OUTCOMES! To get insurance to pay you need logical, defendable exercise progressions.

Principles of Exercise Progression:

Principle #1- be an expert at the basics:

Dan talked about the importance of knowing the basics of the body…what we are learning in school know really really well, it makes a huge difference as you reason your way through things.

-Anatomy- origins and insertions of muscles, primary and secondary actions

-Palpation

-keep up with the literature

Principle #2- Just because you can doesn’t mean you should

He talked about how new PTs will get really excited about the opportunity to get patients on a BOSU and having them do crazy things…just because you can, doesn’t mean you should.

Principle #3- Keep it simple!! 

Change one variable at a time.

Principle #4- Systematic Progression

-gravity eliminated before gravity minimized.

-2 legs before 1

-slow before fast

-stable surfaces before unstable

-single plane before multi plane exercises

-single joint before multi-joint

-simple before complex

-simple movement before task related

Principle #5- Don’t forget the joints above and below the area of injury

A pathology or injury can primarily come from a different location. (Wainner, JOSPT 2007)

Principle #6- You must get 3×10 or 2×20 out of your head!

More on this here

Principle #7- You must have mobility before you can have length and strength

New Student Loans 101

Hey Classmates,

There has been a lot of buzz about student loans lately due to the recent passage of the new student loan bill. I wanted to take a blog post to break this thing down in layman’s terms..because that is hard to find on the internet and I feel like its important.  So here we go.

The New Bill

The new bill states essentially that the rates on our student loans are now tied to the rate of the Governments Treasury bond, which is how the government loans money from us..hope that makes sense, if not click on the link. So no longer are loans arbitrarily decided AND no longer are they FIXED.

WHAT DOES THAT MEAN!!??

This means that our loan rates can and will change from year-to-year, based on the treasury bond–which is basically based on the strength of the economy. Meaning that as the economy strengthens, our rates go up, until they hit a ceiling (Direct- 9.5%, PLUS- 10.5%).

The numbers:

Direct Stafford Loan (unsubsidized)

Old Rate: 6.8% —–> New 2013-2014 Rate 5.41%

GradPLUS Loan (unsubsidized)

Old Rate 7.9% —–> New 2013-2014 Rate 6.41%

loan infographic

Don’t forget about the fees!

The one thing that NOBODY talks about with these loans is the fees. I wanted to briefly bring to light the numbers here as well. These fees didn’t change with the reform, but should still be known. Just incase you don’t know what these fees are, they are the amount of the loan that is removed before you even get the money, but you are still required to pay back the full amount, soo…they suck.

Direct Stafford Loan:  1.051%

GradPLUS loan: 4.204%!!!!!!!!!!

This means that when you pull out your GradPLUS loan you already are in the whole 4.204%…

All this basically means is for now our rates are lower, hopefully they will stay low, but they go up as the economy goes up.

Hope this is helpful, avoid these like the plague.

-Zack

infographic courtesy of: The Daily Californian

PT Advocacy Interview with Christina Wisdom

brandad

Here is the summary from my [first ever] interview with Rockhurst Professor Christina Wisdom, DPT, OCS.  Our topic was physical therapy advocacy and the role of the student.

What is PT Advocacy?

Making our voice heard on issues that affect our profession and our patients.  It’s not just impacting us on a legislation level, but also on a community, group (like the MS Society) and local level by making things better for our patients.

Who is involved in PT Advocacy?

Generally when you see PT Advocacy people are referring to APTA and the larger scale legislative level aspect of advocacy. But PT and PTA students, APTA members, and non-APTA members are all involved and affected. Also patients are a big part of this, they are advocates for the profession and for themselves. Insurance companies and other professionals are also involved and affected by PT advocacy. When we advocate for something, other professions are going to be trying to advocate for their own turf as well.

Who are the biggest “competitors” with PT when it comes to advocacy?

It depends on what issues you are talking about. If you are talking about direct access, then orthopedic surgeons are a big opponent to PTs getting direct access, while internal medicine physicians have come more on board with that. When you are talking about mobilization and manipulation, chiropractors are the biggest opponents to PT [in some states] they have tried to own the right to do manipulation.

What is the overall goal of PT Advocacy/ what do we want?

To create positive change for our patient and our profession. In advocating for the profession we are directly advocating for the patient as well.

Why is this so necessary?

There is a lot of history to this…we have evolved quite a bit from our beginnings. We used to not market ourselves whatsoever because we were very oriented to the medical model. Our role now has expanded so much that it is now important for us to fight for what we are able to do as PTs.

What can we do, as students to get involved?

Lots of things! Going up the chain, going to school-wide or community events and promoting PT–you never know who is going to be there. You could run in to a senator, orthopedic surgeon, etc. Being involved in community organizations and having an “elevator pitch” about PT to be able to explain what we do in a short amount of time. Students can also get involved at the state level in the state chapters of APTA. There is also a lobby day every year in each state where PT and PTA students can go to the capitol and go talk to the legislators. You can also go sit in on a board meeting on the state level. The APTA website is a great tool for students too. There is a section called the “Legislative Action Section,” where you can see who your states legislators are and get information on issues that are being discussed currently. You can also take action on those issues. Students should also attend the National Student Conclave!! The registration is open now and it is a great time to network, meet other students and learn about the profession. Social media especially Twitter chats are a great way to meet other PTs and current issues.

What’s your PT “elevator pitch”?

I’m a physical therapist and I help people improve their movement and function-then I would expand from there.

What are some issues that we are fighting for now?

Many states are still fighting for direct access, or more thorough direct access. Some states are fighting for equal co-pays. Medicare coverage is another issue–some clinics will soon not be able to treat Medicare patients because the reimbursement is too low to cover overhead. Term protection is another issue; basically it is saying that physical therapists are the only people who can perform physical therapy. Most states don’t have term protection; so many chiropractors can say they offer physical therapy.

Students are more organized and focused nationally now then ever and it is very encouraging.

 

Photo: shoutlet.com

What is #dptstudent and why care?

Hey Classmates,

I wanted to take a quick second to shed some light on an opportunity for all of you to connect with other DPT students and pros. As many of you know, I heart twitter.  I heart twitter because it has allowed me to make TONS of connections with awesome physical therapist and students who are constantly pushing the profession forward.  One of the ways that this has happened is through something called a tweet chat.

#dptstudent is an example of a tweetchat.  So basically all it is is a set time and place with a set topic for a set group of people to discuss things on twitter.  In the case of #dptstudent those things in the past have pretty much all been about PT, student loans, and other relevant topics for students.

All you need to do to join us (if you have a twitter account) is enter #dptstudent into your search and follow the search. This is much easier if you have a twitter application that saves searches for you, like HootSuite.  I reviewed HootSuite here, if you care. I hope you can join us.  If you don’t have a twitter account, get one!

Hope this is helpful

-Zack

July 17th Google Plus Hangout: New Vision Statement

As many of you know the APTA House of Delegates had their annual meeting in which they presented APTA’s new vision statement: Transforming society by optimizing movement to improve the human experience.  This new vision statement created quite a bit of discussion at the HOD and it continues to do so in PT circles everywhere.

We want to discuss pros and cons, likes and dislikes all in relation to branding PT.  How is this new vision statement good for our branding as PTs, how is it bad?  What can we do to communicate with our patients and communities that will help them understand out vision?  All questions we want to discuss.  If you want a little more info on the new vision statement, the HOD put out much of the discussion about the vision.

 

“Transcript” for discussion: https://plus.google.com/u/0/events/ca1q8m24af716oahbkksj5m1aks?authkey=CLHBlrqK1rKjPQ

 

What makes you tick

Image

Hey classmates,

We have been learning a lot about different ways to think, and different things that govern the way we do operate as PTs.  For example, we learned about the Code of Ethics, which governs (or should) how we interact with our patients, clients, co-workers, public..everyone pretty much.  The Code of Ethics was made with the Core Values in mind, another “governing force” in the way we think and act as professionals.  We also learned about the Nagi model, the ICF model, the EBP model, the patient management model…so many models and diagrams and things governing how we work as PTs.

These things are all good, necessary really, especially for our tiny 1st year brains.  These governing models act as a foundation to learn everything else.

I wanted to propose to you yet ANOTHER governing force to always be cognizant of and to always refer back to.  And that is the answer to this question What makes you tick? What I mean by that is, why are you doing this?  What caused you to want to be a PT.  What do you like about it.  Why are YOU doing what you are doing.

Why this matters:

The reason I am proposing this as a “governing force” in what we do as PTs is because amongst all the other great things we will learn that is simply the thing that will keep YOU on the track you want to be on.  The answer to this question will guide your studying, your time management; it will also give you solidity moving forward as a professional.  If you start your PT pursuit because you wanted to start a practice or you wanted to be in administration or you love working with peds, then never forget that. If we can constantly remind ourselves of our ticker, it will help guide us to (or back to) what we really enjoy about our work.  Let your ticker influence your treatment of your patients, and we will all benefit.

The Challenge:

I wanted to extend a challenge to any student or current physical therapist to really sit down and right out what makes you tick.  Why are you doing what you are doing, and let that guide you in your current situation.

 

Hope that is helpful

Active Learning

Hey classmates,

This will be a short blog post but I feel like it’s on a very important topic active learning.  As some of you know, I start PT school 3 weeks ago and we hit the ground running.  There has been a decent amount of totally new information (for me at least) thus far and I have found it fairly manageable and enjoyable.  I just wanted to touch on a few thoughts and give you guys some resources.

The first and biggest thought is Active Learning.  I think that now-a-days we have huge technological advances that can be leveraged to help us learn better but we also have the same age-old problems facing our education system, even in a doctoral level graduate program.  That is the tendency to learn passively, or just hear and receive information, usually in the form of power point presentations.  I’m not bashing slide show presentations for a mechanism to teach but I do think that it pushes most of us into this passive, “write things down because I’m hearing them” learning mode and that is really dangerous.  I said this was going to be short so I’ll hold to that promise.

While we can’t change the way we are taught at, we can change the way we learn.

I wanted to push/encourage all of you (myself included) to actively seek out knowledge in class and after class.  I have been using a resource for the last couple of years now that has been priceless (and free :P) called Khanacademy.org.  This website is a great tool for active learning–which to me, basically means learning information by challenging what you are hearing and being able to apply that information.  Khan academy allows you to stop, pause, think, rewind, fast forward through content at your own pace, which I think its huge.

Khan Academy is an online teaching system that has thousands of free videos that are taught by really smart people in a really simple and clean way.  The content ranges from general chemistry to art history and everything in between.  I have found it helpful to refresh myself on basic Biology principles and Chemistry already in PT school, as we learn Pharmacology and some intro Pathology.

 

I just wanted to push that resource across the table to you all.  I hope you check it out, it has been helpful for me and I hope its helpful for you.