– Lumbar Extension – Selling – Pain&Expection – Evolved Shoulder – Posterior Hip Pain – Posterior Chain – Gray Cook – EBP? –
1) Our profession and our society has become so afraid of lumbar flexion that it’s almost a phobia. This obsession of avoiding lumbar flexion has allowed another problem to slip by – excessive lumbar extension. I’ve been noticing more lumbar extension dysfunction in the clinic. Read about it in this months post here.
2) The more I practice the more I start to think the most important aspect of PT is the patient’s mindset. I look for 2 things in the eval to see where their mindset is: 1) Pt wants to know why they hurt 2) Pt wants to take an active role in getting better. The ones that come in with these 2 questions get better much faster. If not, try Eric Cressey’s 6 Tips on the “Buy-In”.
3) This is an incredible library of resources from North American Sports Medicine Institute & Advances in Clinical Education. And here is their great journal club to follow to keep up on the latest research.
4) JOSPT added some more research to the pain/expectations paradigm shift. Expectations have a great influence on outcomes. They mentioned one study that injected saline solution into 2 groups: the first group was told that it was a great analgesic, the second group was told that it intensifies their pain. The exact same intervention was given, yet the two groups had a significant difference in pain (correlated with expectations – 1st group decreased, 2nd group increased).
5) Apparently our ability to throw fastballs “evolved roughly two million years ago as a way of improving our hunting prowess”. Interesting article on the evolution of the human shoulder.
6) Of course Wolverine deadlifts!
7) I’ve recently had a lot of hip patients whose main complain is posterior hip pain with prolonged sitting. This study showed that the most common referred pain from the hip joint is in the posterior hip. When patients are sitting for prolonged periods of time they are just jamming their femur into the superior of their acetabulum. This can aggravate a labrum or a bony impingement, thus causing referred pain into the posterior hip. Of course it’s important not to chase pain, but it’s also important to try to understand where it might be coming from.
8) We’re 3 months away from the NYC Marathon. Posterior chain extensibility is extremely important in runners. I have most of them doing this exercise. I learned this one from Chris Johnson – he has many more great exercises for runners here.
9) Gray Cook is one of the most influential physical therapist our time. On his website he has a section called “Gray Cook Radio“. It has short 10-15 minute discussions about some great concepts. I usually load them on to my iPhone and listen to them while I take my crazy dog for a walk.
10) Erson’s Friday Five’s – here’s 5 good things you should add to your practice. I’ve just started using the compression wraps myself. They can make a significant difference in edema and ROM.
11) This is a long read, but it makes a great point about our current Evidence Based Medicine (EBM) obsession. It discusses how we aren’t robots treating a chemical reaction or defective anatomical structures. We are clinicians treating people. Empirical-based humoral pathology has been around for 2,000+ years, why throw it away for protocols and algorithms?
