Category: General PT Talk

Foam rollers, we all hate them, but they are so goooood. It’s a love/hate relationship. It’s one piece of equipment that is synonymous with our profession. While the jury is still out on the working mechanism of foam rolling, there have been a couple of good reviews, one here by Dr. Greg Lehman. I know from experience that foam rollers have worked great for me.

BUT which foam roller should you get? Which one works the best?

I did somewhat of a survey as well as a quick internet search and 2 foam rollers rose to the top. The Trigger Point Grid Roller and the Perform Better Foam Roller. So I got them both and I wrote up a quick review. Here are my thoughts.

TP Grid Roller

The Grid, as I like to call it is a 5″ PVC pipe covered in a fancy hard form covering. There is a method to Trigger Point’s madness with the design of the roller. The 3 distinctive portions of the roller are meant to simulate a forearm or palm, fingertips, or like fingers and a thumb. 

I don’t know if I really feel the difference in the separate areas BUT I do like that fact the the Grid has ridges. I have used it a number of times on my quads and IT band, and it feels really terrible in a good way.

Pros:

1. Durability. The Grid has a PVC pipe core and the foam on the outside is very tough. The thing is going to last until kingdom come.
2. Ridges. As I said before the mechanism for why foam rolling works is still debated, but these ridges seem to add a little intensity to my experience. I love them.
3. Portability. The Grid is 13″ long and 5″ wide, making it very portable. Great to throw in your trunk, if you’re a traveling therapist or just going to the gym.
4. Warranty. The grid has a 1 year warranty…can’t beat that.

Cons:

1. Price. The 13″ Grid costs $39. That’s a tad high for some people. The full sized Grid 2.0 is 26″ long and costs $64.

Perform Better Foam Roller 

The Perform Better foam roller is a classic foam roller. The reason it is so great is that the molded foam has no cells in it, making it more firm and much more durable than a traditional white foam roller. There is really nothing fancy about this foam roller, it is a straight shooter. From my experience, it is the best of its kind.

Pros:

1. Durability. The foam is hard, it doesn’t deform easily and it is going to last you A WHILE, longer than the Grid.
2. Price. The 3″ long 6″ wide foam roller costs $20 normally, right now they are on sale for $15.95.

Cons:

1. No features. The PF foam roller has no frills.
2. No warranty. 

Conclusion:

Both of the rollers are fantastic, the “better” foam roller depends on what you are going to use it for. For me, a student physical therapists and a fitness nerd, I love the TP Grid. The portability, durability and the color options (why not) make it the perfect foam roller for me. If you are a business owner who needs to buy 6 foam rollers that need to last for a while then I would definitely choose the PF foam roller. It’s simple, durable and cheap making it perfect for a clinic. It all comes down to what you really need.

Wait a second physical therapy has residencies AND fellowships? Some of you probably are familiar with post-PT school education, but those of you who don’t, this post is for you.

Foundation:

In order to understand residencies and fellowships more fully, we need to set a little foundation. All DPT programs have one goal in mind, to train excellent general practitioners.  We are prepared to work in any setting and perform well. However we are not specialized at all coming out of school, thats where residencies and fellowships come in.

Residencies:

Similar to medical residencies, physical therapy residencies are post-graduate programs that you apply for [here], that are designed to make you a specialist in an area of physical therapy. Residencies come in many shapes and setups that vary depending on the setting that you prefer. Some are research based, at universities, others are entirely clinical, where you hone your skills under the supervision and guidance of an expert.

After completing your residency you are able to sit for a board certification test in that field. For example, if you completed a residency in orthopedics you are able to sit for the Certified Orthopedic Specialist exam, which otherwise would have taken 2000 hours of orthopedic patient contact.

Its the fast road to specialization. Residencies take 12-18 months whereas 2000 hours of treating orthopedic patients can take up to 8 years.

Fellowships:

If residencies take you from general practitioners to a specialist in an area of physical therapy, then fellowships are what takes you from a specialist to a sub-specialist. Being a fellow means that you are the expert in that particular field. If you completed your orthopedic residency but what to become an expert in the sub-specialty of manual therapy then you could apply for a fellowship in orthopedic manual therapy. Fellowships take 12-18 months.

To put it simply:

We finish school as general practitioners-> residencies make you a specialist->fellowships make you a sub-specialist

//Graphic courtesy of the lovely and talented Ashli Duhamel//

Hey teammates,

The 2013 National Student Conclave was great, I have finally had some time to get the audio from the break sessions I went to loaded. Figured I would share for anyone who cares.

Talks:

1. Orthopaedic Breakout Session: Audio File

Elaine Lonnemann PT, DPT, OCS, FAAOMPT and Paul Lonnemann PT, OCS, FAAOMPT discuss Thrust Manipulation. Great talk, they are both Fellows of the American Academy of Orthopaedic Manual Physical Therapists…so they know what they are talking about.

2. Private Practice Breakout Session: Audio File

Jason J. Gauvin, PT, MS, LAT, ATC, SCS, CSCS; James Buenaventura, PT, DPT,
CGFI; and Robert Snow, PT, DPT, OCS talk about private practice.

3. Residencies and Fellowships Breakout Session: Audio File

Matthew Briggs, PT, DPT, SCS, ATC; John DeWitt, PT, DPT, SCS, ATC; Kendra
Harrington, PT, DPT, MS, WCS and other experts explain and than field questions on residencies and fellowships in a panel format.

Hope the audio sounds good and that its helpful.

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)

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:

Reps: 25-150

Rest: 10-30 seconds

Load: 30% 1 RM

Strength-Endurance:

Reps: 60-120 per minute (high tempo)

Load: 25-50% 1 RM

Rest: short

Speed-Strength:

Reps: 3-6

Rest: 1-3 minutes

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

Power:

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

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

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

Let’s be honest we all want to be great and change the world, thats why we go to PT school (maybe thats not 100% true for everyone) but what really makes us GREAT Physical Therapists?

I have recently been on a quest, to find What makes a Great PT.  My brain is very categorical and I like to be systematic so I have been observing and eliminating factors that I DON’T think make a PT great.  I’m pulling an Edison on this question probably, by finding a 1000 things that don’t make a PT great to find that one (or few) things that really separate the Great from the good.

List of things that DON’T make you great:

1. getting the best grades in school
2. always going “by the book”
3. being comfortable in your knowledge
4. treating your work as just a job (no passion)
5. being disconnected from other professionals
6. doing it for the money

Possible IT factors:

1. curiosity– Pursing new info, ways to treat, certifications, etc.
2. passion– loving what you do!  I don’t think enough weight can be put on this
3. critical thought (challenging current thought)- challenging what you are actually doing
4. creativity– Undervalued in PT I think.  New ways to approach old issues.
5. Willingness to teach- huge huge huge (Thanks Jimmy)

I have a few PTs in my immediate circle that are GREAT PTs and I am still trying to distinguish what it is that separates them from the rest.  But the end result is a PT that gets good outcomes, is professional, is confident, is a leader, and is looked up to.

I want to be a Great PT and I want my classmates (you guys) to also.  Maybe that is the it factor itself.

Hope this is helpful 🙂

(picture curtesy of pastormark.tv)

Hi classmates,

If you didn’t already know I currently work at a PT clinic in Kansas City that is in many ways a “regular” 3rd party based PT clinic.  It is a fantastic place to work and to be treated but I am trying to broaden their services by including some cash based services to increase their positive cash flow.  Here are some of my ideas that I have passed along to the owner.  Let me know what you think.

Those are just a few I thought of, I don’t think these are anything new I just hope that they get your mind stirring.  I think that cash based services are an important part of any clinic’s financial health.  I’m not all about making money, thats not why I’m doing PT, there are better ways to make money out there, but I think the more stable and financially healthy your clinic is the better able you are to treat people and change lives.  You can’t treat patients if you have to close.

Hope that is helpful