Misuse and immoral desires have lead pharmaceuticals companies and the medical field to create a situation where 115 people in the US are dying everyday from opioid overdose.
There are many solutions to this problem. And many of them should be implemented. Including a greater focus on preventive care and conservative treatment (i.e. Physical Therapy). But I digress…
One easy solution is to limit the duration of use. This will significantly decrease the risk of becoming addicted.
In 1995 a paradigm shifting study on osteoarthritis was published.
They found:
“hypertension, hypercholesterolemia, and blood glucose are associated with both unilateral and bilateral knee OA independent of obesity, and support the concept that OA has an important systemic and metabolic component in its etiology”
This shows that osteoarthritis is not just a wear and tear pathology. Systemic and metabolic factors have a huge influence.
The take home clinically…lifestyle factors in OA patients need to be addressed for the best outcomes.
On March 3rd, 2018 we welcomed our first child into the world. Remi Hendrix Rogers Swanson was born at 11:06pm in Asheville, NC.
As many parents say, words can’t describe this experience. The amount of love and joy of having a baby are so overwhelming that the mere act of trying to put it into words diminishes its significance.
It’s been 1 week since he was born. It feels as if we’ve been time traveling. Looking back, there’s a few things we’ve learned in the first week.
7 Things We Learned in One Week
1) MY WIFE IS SUPER HUMAN
When it comes to birth, most people discuss the baby and parenting. One thing I wasn’t prepared for was the intensity and the thrill of the birthing process. While there are many digressions I could go into, I think the most amazing aspect was watching my wife, Gaelyn, act like a superhero.
I’ve always thought the most of Gaelyn. She’s an incredible person, extremely strong, and has never shied away from adversity. But after watching what she did during the weekend Remi was born, I have a new role model myself.
She never wavered, didn’t resist, embraced the intense struggle, and went above and beyond the insane requests her body and Remi were making. Hell, she even made a few jokes in-between the intense contractions. Her rockstar performance made me feel honored to be her husband. I’ve never been so proud in my life.
Watching birth also solidified the notion that women are the stronger gender. We’re lucky they keep us around.
In fact, controlling the mind to control the body is common practice.
There’s sports psychology for improved performance, meditation to relieve stress, and placebos to decrease pain.
Even in our everyday life it’s easy to see this mind-to-body perspective.
When we’re sad we frown or cry. When we’re angry or stressed our blood pressure goes up. When we see something funny we laugh.
But what if it’s reversed? What if our feelings are actually a result of our body states instead of our emotional states?
What if we’re sad because we’re physically tired? What if we’re angry and stressed because we have too much tension in our body? What if we laugh because we’re physically excited?
In other words, we should consider that we might be transferring our physiology to our psychology.
THE FLIP SIDE
It’s more difficult to understand the reverse process of this mind-body connection (the body-to-mind connection).
Maybe because it’s uncommon to discuss the process of how our body affects our mind (sometimes referred to as embodied cognition).
It might be weird if we conversed in terms of our physiology instead of our psychology.
A Valentine’s Day card declaring our current sympathetic arousal state wouldn’t exactly charm our partner.
And yelling “I didn’t sleep much last night and I have a lot of tension in my body since I’m running late for work!” at the car that just pulled out in front of us wouldn’t have the same catharsis.
So maybe we don’t need to go as far as explicitly bringing our physiology up in social situations.
Now of course we don’t want to hear this answer to certain simple questions.
We don’t want the local to tell us “I don’t know” when we’re lost and asking for directions. We don’t want our financial advisor to say “I don’t know” when we ask him if our investments are doing well. We don’t want our physical therapist to say “I don’t know” when you ask him why breathing is important.
There’s definitely a time and a place for the “I know” answer.
But maybe for some questions we should look for the “I don’t know” answer.
Ephemeral – lasting a very short time; short-lived; transitory;
1) “There are many forms of ephemeral art, from sculpture to performance, but the term is usually used to describe a work of art that only occurs once, like a happening, and cannot be embodied in any lasting object to be shown in a museum or gallery.”
2) “Because different people may value the passage of time differently, “the concept of ephemerality is a relative one”.[3]
3) One of the things I like most about hiking is the ephemerality of it. Depending on the time of day, the weather, the season, the animals, and the people, it’s different every time. It is constantly altered by time and perspective. And on a bigger scale, with the soaring trees, wrapping vines, flowing rivers, and tectonic shifts, the natural world could be considered the greatest ephemeral “art”.Continue reading “2017 Hits : Vol. 1 : Ephemerality”
“Complexity is the enemy of execution” –Tony Robbins
1. More bad news for our phone addicted society. Using your phone at night decreases your alertness the next day.
2. You should watch the documentary, Minimalism, on Netflix. You don’t have to start throwing away stuff, but you might want to utilize their concepts: true values, needs vs. what we can afford, seeing through capitalism’s traps/brainwashing, and spending time where it matters. It’s definitely worth the watch.
3. “As a maker, you tend to do too much, because you’re there with all the tools and you keep putting things in. As a listener, you’re happy with quite a lot less.” –Brian Eno
4. This 10 second video explains why our country is having so many problems.
5. Singularity, when artificial intelligence escalates to a point of runaway technological growth and change the word, is a very interesting concept. Maybe it’s what needs to happen to save our species and our planet?
6. Look into your dog’s eyes. It will release oxytocin and make you both feel better.
7. ”People have always gotten their values, social skills and aspirations from their family, local community and circle of acquaintances. Are we approaching a tipping point where people start to get those things from commercial advertising and entertainment, news, and social media?” In this case, we could be confirmation biasing our way towards bad morals…Continue reading “2017 Hits : Vol. 1 : Other Good Stuff”
Definition: intermittent fasting or time-restricted eating is an umbrella term for diets that cycle between periods of fasting (no eating) and periods of non-fasting (eating)
I’ve been experimenting with intermittent fasting for several months now.
I first heard about it when I was in grad school. One of my clinical instructors quoted a study that showed the only proven way to prolong life was through fasting.
Recently, I’ve been seeing more and more studies, blogs, and people talking about intermittent fasting. My friends Seth Oberst and Jeff Ford have both told me about the profound benefits of this “diet”. So like all health interventions, I thought I’d take a look at the best study out there…an experiment on myself.
At first I was skipping breakfast and only eating from 12pm-8pm.
This was terrible. It really threw my system off. I didn’t feel great. I didn’t have any energy. And I gained weight.
But I was responsible for a big part of this failure. By the time I got home from work around 5:30 I was starving. I started eating a ton of pre-dinner snacks as I was cooking dinner. Then I’d over serve myself for dinner and finish it. I was essentially eating most of my calories between 5-8pm.
Then I read some studies on the circadian cycle and how important it is when it comes to diet and weight loss (future post on this in Vol. 2). So I started trying to simply cut down the hours of eating per day. I started to trim the hours back from the latest meal. I tried to make my last meal earlier in the day.
An 8 hour cycle isn’t socially possible as a physical therapist. I can’t eat my breakfast eggs while working on someone’s shoulder. Well, maybe if it was a breakfast burrito, but that wouldn’t be good for business.
So instead I try to eat my last meal before 7pm. It usually ends up being a 10-11 hour feeding time. I also try to prepare a shake a couple times a week and skip dinner to cut the feeding time down even more.
With this type of early time-restricted feeding I’ve had a lot more success. It allows me to reap the benefits without sacrificing my social life or developing orthorexia nervosa. I feel better, have lost some weight, and have more energy.
And another important benefit…it makes day-drinking much more acceptable!
1. Some of the general benefits of Time-Restricted Feeding:
Weight loss, improved health, decreased morbidity, increased mortality, and more freedom in diet
The last benefit is worth pondering. By using time-restricted feeding as the global focus, it allows for individual variability in the details. In other words, it doesn’t limit specific foods or cause a purge from prolonged suppression. It allows people to use whatever diet works for them (paleo, vegetarian, ketogenic, etc.) in a more efficient manner.
2. Here’s a list of some of the specific benefits
Increased human growth hormone, improved insulin sensitivity, better cellular repair, improved gene function, increased metabolic rate, reduced inflammation/inflammatory markers, reduced LDL cholesterol/ blood triglycerides//blood sugar/insulin resistance, increased BDNF, increased rate of nerve cell growth, and improved resistance to oxidative stress
3. It can prevent heart disease, cancer, obesity, metabolic syndrome, diabetes, neurodegenerative diseases (alzheimer’s), and increase lifespan.
“Cravings for gambling, food, sex and drugs all seem to activate the same brain networks, according to new research published in the journal European Neuropsychopharmacology.”
6) Diet and mental health are very interconnected.
“New research finds that increasing fruit and vegetable consumption may improve psychological well-being in as little as 2 weeks.”
7) Over 90% of serotonin is produced in the gut. How you eat affects your mental health. One method of improving gut and mental health is using probiotics:
“According to researchers, probiotics can help relieve symptoms of depression, as well as be beneficial in helping to treat IBS.”
8) Drinking more water is one of the easiest things we can do to improve our health. Here’s 7 benefits, plus ways to help others gain access to clean water.
9) This is a phenomenal concise summary of the dangers of processed foods by Robert Lustig. Here’s just one of the many gems:
“Furthermore, 11 nutritional properties distinguish processed food. (1) Too little fiber. When fiber (soluble and insoluble) is consumed within food, it forms a gelatinous barrier along the intestinal wall.This delays the Intestine’s ability to absorb nutrients,instead feeding the gut microbiome. Attenuation of the glucose rise results in insulin reduction. Attenuation of fructose absorption reduces liver fat accumulation.”
“Thinking of obesity as an energy-balance disorder is as meaningless as calling poverty a money-balance problem”
“obesity is not an energy-balance disorder but a disorder of excess fat accumulation and so, clearly, a hormonal and metabolic disorder – the result of an ‘endocrine disturbance’, as it was phrased in the 1930s by Eugene Du Bois, then the leading American authority on metabolism. By this logic, the foods we eat influence fat accumulation not because of their caloric content but because of their macronutrient content, the proteins, fats and carbohydrates they contain. This paradigm attends to how organisms (humans, of course, in particular) orchestrate the careful ‘partitioning’ of the macronutrient fuels they consume, determining whether they will be burned for energy or stored or used to rebuild tissues and organs.”
“By this way of thinking, refined sugars are indeed toxic, albeit over the course of years or decades. We get fat and diabetic not because we eat too much of them – although that is implied tautologically merely by the terms ‘overconsumption’ and ‘overeating’ – but because they have unique physiological, metabolic and hormonal effects that directly trigger these disorders”
“Bauer argued that fat cells are clearly being driven by these factors to hoard excessive calories as fat, and this in turn would deprive the rest of the body of the energy it needed to thrive. In this hormonal/regulatory conception, excessive fat-accumulation causes hunger and physical inactivity, not the other way around.”
“if insulin is a fat-forming hormone and Type 2 diabetes is a disorder of insulin resistance, it then follows that high circulating levels of insulin in the blood, rather than insulin deficiency, could be the cause of the disease and obesity as well.”
“Perhaps the obese get that way not because they eat too much or exercise too little, but because they have elevated levels of insulin or their fat tissue is excessively sensitive to the insulin they secrete”
“The sugars and refined grains that make up such a high proportion of the foods we consume in modern Westernised diets trigger the dysregulation of a homeostatic system that has evolved to depend on insulin to regulate both fat accumulation and blood sugar. Hence, the same dietary factors – sugars and refined grains – trigger both obesity and diabetes. By focusing on the problems of eating too much and exercising too little, public health authorities have simply failed to target the correct causes.”
11) Obesity is one thing. Diabetes is another. The sugar epidemic is going to cause ALOT of problems in the future. Not only for our health, but also for our economics.
The main reason I do this blog is to share knowledge and to help people become better clinicians/coaches. I want our profession to grow and for our patients to have better outcomes. Regardless of your specific title (PT, Chiro, Trainer, Coach, etc.), we all have the same goal of trying to empower people to fix their problems through movement. I hope the content of this website helps you in doing so.
If you enjoyed it and found it helpful, please share it with your peers. And if you are feeling generous, please make a donation to help me run this website. Any amount you can afford is greatly appreciated.
1. Social interaction is an important aspect of health. Specifically, the people you are around the most influence your decisions more than any health practitioner can in one visit. Researchers are starting to wonder if this social support is an easy change that healthcare is not taking advantage of. Here in this article they introduce a 5 step ladder to social support.
“An optimistic outlook, positive coping strategies, and strong external social support are common characteristics found in individuals who returned to sport after hip arthroscopy for femoroacetabular impingement.”
3. Nature AND Nurture.
“When preschoolers spend time around one another, they tend to take on each others’ personalities, indicates a new study by Michigan State University psychology researchers.”
“Give people what they want and they will like you for now. Give people what the need and they will value you forever.” -Simon Sinek
1. This is a phenomenal response to those who say exercise doesn’t help you lose weight. So much good stuff in this article.
“To sum up, training and diet work synergistically. You need both, and stalls in weight loss can often be countered by doing whichever one you aren’t.”
2. “We should contraindicate people from exercises, not exercises from people” -Eric Cressey shared a valuable post on individualized exercise prescription and the variables that matter.
3. If this was in pill form everyone would take it.
“Elderly women who sit for more than 10 hours a day with low physical activity have cells that are biologically older than their chronological age by eight years compared to women who are less sedentary, research shows.”
4. Squats and ankle dorsiflexion get a lot of attention. But what about squats and hallux extension? For this, try the hack squat. “The Hack squat will also mobilize your toes and strengthen your calves, as well as open your chest and hips. Together with prying goblet squats and Cossack squats, it is helping me on my quest to the roadkill split and side split.”Continue reading “2017 Hits : Vol. 1 : Training / Strength & Conditioning”
“I believe he is suffering from memories” -Sigmund Freud
1) Greg Lehman is giving away his latest pain science workbook, Recovery Strategies. It’s a very indepth source on pain with a self-assessment at the end.
2) Which bias do you want to confirm? Derek Griffin thinks we should use this research to support SiMs not DiMs. Support your patients beliefs that they’ll get better. “Humans update self-relevant beliefs to a greater extent in response to good news than bad news.”
4) Pain science education is much more than what the practitioner knows. The key component is communication. Especially being able to read people and perceive how they’re reacting to what you’re saying. Very similar to how a comedian develops their jokes.
2) What’s the difference between a physiological response to a stimulus and a conscious emotional reaction? Are we really angry, or are we just labeling an unconscious physiological process that we can’t consciously understand? There’s research out there that supports this train of thought.
“Empathy depends on your ability to overcome your own perspective, appreciate someone else’s, and step into their shoes. Self-control is essentially the same skill, except that those other shoes belong to your future self—a removed and hypothetical entity who might as well be a different person. So think of self-control as a kind of temporal selflessness. It’s Present You taking a hit to help out Future You.”
“While a desire for authentic pride pushes people to put in the kind of work that might earn them higher grades, hubristic pride pushes people to work hard when doing so might impress others”
4) 50% of people “remember” events that never occurred. This is a problem, especially with today’s social media frenzy and the fake news problem.
1) It’s complex. It’s more than insurance coverage. It’s more than lifestyle. It’s about the lack of equality. It’s about the lack of opportunities for certain groups. It’s about people not having the things that many of us take advantage of everyday. One study shows that “alow socioeconomic status is so damaging to health, it reduces life expectancy by 2.1 years.” In some areas I’m sure this number is much higher. #values #compassion #helpthoseinneed
The Knowbodies Interview, Asheville Beer, & The Guitarist Analogy
1) The Knowbodies are three physical therapist that have created a podcast to help create healthier and more informed society. They cover a great breadth of topics, from equine therapy to dentistry to sleep. And now they have a rambling PT that can’t pronounce his -ings.
I recently did an interview with them on how I manage and appraise information. It was great experience. They asked great questions and were a pleasure to talk to. It was also interesting to hear the different questions each of them had. They all have their own style and approach towards interviewing. This allows the listeners to gain all these perspectives in one listen.
2) I wrote an accompanying blog post on dealing with information overload. Part 1 goes over some of the problems. Part 2 gives 6 tips on how to better manage and appraise information. I think these articles can be valuable for anyone that wants to improve their information digestion. Here’s the quick tl/dr summary:
1. Create Categories of Categories of Categories
2. Write it down
3. Actively Control Your Informational Environment
1) Wim Hof, aka “The Iceman”, is a very prominent and influential figure who has been an advocate of using focused breathing techniques and cryotherapy to change…well, everything if you ask him. His methods have been around for a while now and many have had very positive results utilizing his principles. Here are some articles and information on Wim Hof.
2007: He climbed to 6.7 kilometres (22,000 ft) altitude at Mount Everest wearing nothing but shorts and shoes, but failed to reach the summit due to a recurring foot injury.
2009: In February Hof reached the top of Mount Kilimanjaro in his shorts within two days.Hof completed a full marathon (42.195 kilometres (26.219 mi)), above the arctic circle in Finland, in temperatures close to −20 °C (−4 °F). Dressed in nothing but shorts, Hof finished in 5 hours and 25 minutes.
2011: Hof broke the ice endurance record twice, in Inzell in February and in New York City in November. The Guinness World Record is now set for 1 hour and 52 minutes and 42 seconds by Hof. In September, Hof also ran a full marathon in the Namib Desert without water. The run was performed under the supervision of Dr. Thijs Eijsvogels.
3) Here’s one of his famous studies where he was injected with toxins and was able to control his autonomic immune response.
“Hitherto, both the autonomic nervous system and innate immune system were regarded as systems that cannot be voluntarily influenced. The present study demonstrates that, through practicing techniques learned in a short-term training program, the sympathetic nervous system and immune system can indeed be voluntarily influenced. Healthy volunteers practicing the learned techniques exhibited profound increases in the release of epinephrine, which in turn led to increased production of anti-inflammatory mediators and subsequent dampening of the proinflammatory cytokine response elicited by intravenous administration of bacterial endotoxin. This study could have important implications for the treatment of a variety of conditions associated with excessive or persistent inflammation, especially autoimmune diseases in which therapies that antagonize proinflammatory cytokines have shown great benefit.”Continue reading “2017 Hits : Vol. 1 : Clinical – Wim Hof & Cryotherapy”
“We get resourcefulness from having many resources. Not from having one very smart one.” -Marvin Minsky
Meditation can scare people. I think it’s because most people don’t really know what it is. They think it’s a medium that turns people into monks. Or they think it’s simply the act of having no thoughts. These two ideas couldn’t be further from the truth (no pun intended).
In broad terms, meditation is the practice of quieting the mind and improving awareness.
In the realm of health and quality of life, meditation can lead to improved working memory, less emotional reactivity, decrease biases, increased focus, relationship satisfaction, enhanced self-insight, and improved brain function (among other things).
1) Being able to attenuate force efficiently is extremely important. A loss in variability or efficiency in shock absorption can cause the forces to be absorbed in a maladaptive manner. #ConservationOfEnergy
2) Uncontrolled motion is always a problem. Especially at end-range. “Groups differed in ankle biomechanics, but not non-weight-bearing ROM or strength. During stair ascent, the IAT (insertional Achilles tendinopathy) group used greater end-range dorsiflexion (P = .03), less plantar flexion (P = .02), and lower peak ankle plantar flexor power (P = .01) than the control group”
“Usually, the best exercise is the one that creates the largest effect with the minimal risks” -Stuart McGill
Cervical
1. It’s more than a chin-tuck and lift. “Elder women with cervicogenic headache had significantly reduced rCSAs of the rectus capitis posterior major and multifidus muscles compared to controls (p < 0.05). Larger amounts of fat infiltrates were also observed in the rectus capitis posterior major and minor and splenius capitis muscles in the cervicogenic headache group (p < 0.05). There were no changes in the size and fat infiltrate in the cervical flexor muscles (p > 0.05).”
2. This is a solid collection of exercises from the Prehab Guys for cervicogenic patients. I really like the cueing in the quadruped deep neck flexor exercise.
3. The neck influences the rest of the spine. “Head posture was found to significantly influence low back muscle endurance within subjects (p < .001), with extension yielding the highest endurance scores (boys = 186.6 ± 66.2 s; girls = 192.1 ± 59 s), followed by a neutral posture (boys = 171.3 ± 56.5 s; girls = 181.7 ± 57.3 s), and flexion (boys = 146.2 ± 63.8 s; girls = 159.8 ± 49.3 s).”
Thoracic
4. I had a patient who complained of bilateral hand numbness when she was washing her hair. The MD diagnosed her with bilateral carpal tunnel syndrome. She got better with treatment directed at her thoracic spine, shoulders, and neurodynamics. Moral of the story: the patient will give you the answer in the history and if something is bilateral you should probably look proximal.
Lumbar
5. The veins leaving the vertebral bodies are the only veins in the body that lack valves. They may act as hydraulic shock dampeners. Which is another reason why a healthy cardiovascular system is such an important variable in low back patients.
6. I see this all the time in the clinic. The hip and the back are always related. A recent study on LBP patients gives us research ammo for our empirical evidence, “On physical examination, 81 (80%) had reduced hip flexion; 76 (75%) had reduced hip internal rotation; and 25 (25%) had 1, 32 (32%) had 2, and 23 (23%) had 3 positive provocative hip tests.”
7. If you have a patient that is flexion intolerant, but can’t tolerate the traditional prone press-up, try this quadruped transition (learned from Erson). I find it much less compressive.
8. A picture is worth a thousand words. Or a postural assessment is worth a prediction regarding health and falls. “Forward-stooped or knee-flexion deformity relates to lower quality of life. Limited extension in the lumbar spine is a significant predictor of falling.”Continue reading “2017 Hits : Vol. 1 : Clinical Spine”
This is a collection of information to help improve health and movement. It includes articles, videos, and quotes that I have found helpful in studying the human species. Due to the complexity of this subject matter, I have tried to include a variety of variables that can influence the dynamic system.Continue reading “2017 Hits : Volume 1 : Table of Contents”
1) I heard this quote from Tim Ferris’s weekly update. Something I definitely need to embrace. ““Reading, after a certain age, diverts the mind too much from its creative pursuits. Any man who reads too much and uses his own brain too little falls into lazy habits of thinking.” – Albert Einstein
2) James Cameron was right. The trees are connected through an underground web. They do talk to each other. Here’s a great TED talk explaining this complex system.
3) “Lack of sleep can negatively affect memory, emotional processing and attentional capacities. For example, sleep deprivation has been shown to disrupt functional connectivity in hippocampal circuits (important for memory), and between the amygdala (important for emotion regulation) and executive control regions (involved in processes such as attention, planning, reasoning and cognitive flexibility).“
4) Turn your phone screen black and white to break the addiction. “Emotions and attention are tied to color perception, so what if everyone removed the color from their phones? “
5) Keep earning your title. A great read from Derek Sivers. This is why I’m skeptical of taking advice from “clinicians” that don’t have a current practice.
1) Repetition = Persuasion. One of the benefits of a checklist assessment type of examination is that it is repeatable and consistent. This not only makes it clinically effective, but it makes it repeatable and consistent. So instead of chasing a different pain path every time the patient comes in, you repeat the assessment, repeat the clinical reasoning, and repeat the treatment approach. Instead of confirming their hypochondriac wonders by chasing pain, persuade them with repetition and consistency. So stay consistent and keep repeating yourself (more than just words). Repetition = Persuasion.
2) Create the “curiosity gap”. “Our results suggest that using interventions based on curiosity gaps has the potential to increase participation in desired behaviors for which people often lack motivation,”
3) Friendship is an important aspect of health, “It appears that both in and out of stressful situations, the daily presence of bond partners actually regulates the system that manages the body’s hormones, reducing an individual’s overall stress. While active support of a bond partner reduces glucocorticoid levels the most, their mere presence also leads to less stress.”Continue reading “Fall Hits 2016: Social & Communication”
2) Eric Cressey gives some tips on tall athletes and reminds how adding a reach into exercises, like the lateral lunge, can help promote the transverse plane.
“Shame cannot survive being spoken…and met with empathy” -Brene Brown
I recently listened to Brene Brown’s The Power of Vulnerability. I was hesitant at first. It seemed like a self-help book about the latest pop-psychology trend. Plus, I had watched the TED talk and thought it was suffice for the subject.
However, I quickly learned that my prejudgements couldn’t have been more wrong. By the time I finished the book I had a new perspective on vulnerability, learned things about myself I didn’t want to know, and developed new skills to cultivate compassion and empathy for others.Continue reading “Fall Hits 2016: Brene Brown, Vulnerability, Shame, Empathy, & Compassion”
“Nothing is either good nor bad but thinking makes it so.” -Shakespeare
Psychology, Mental Health, Mind Training
1) Buy a djembe and drum up some good vibes.. “When viewed holistically, communal drumming creates a physical and emotional experience of belonging that addresses one of the core psychological components of depression: feelings of isolation, alienation, invisibility and worthlessness.”
2) “What people are paying attention to doesn’t just reveal who they are… it makes them who they are in that moment”’ –Robert Cialdini
3) Your narrative identity is important. Is your life a contamination story? Or a redemption story?
4) Dropping forms. “Well, consistency is good, right? Only to the degree that we want to be who we have been.”
5) A different kind of medication – “A single dose of psilocybin, the active ingredient of magic mushrooms, can lift the anxiety and depression experienced by people with advanced cancer for six months or even longer, two new studies show.”
6) Sleep and the circadian cycle continues to show its importance in research. This latest research shows how disrupting the circadian cycle can lead to “helplessness, behavioral despair, and anxiety-like behavior”
7) Looking at trees decreases your stress more than looking at buildings #GetOutside
8) Want to soothe your cognitive dissonance (both conscious and unconscious)? Put on some music. “Thus, because we constantly grapple with cognitive dissonances, we created music, in part, to help us tolerate – and overcome – them.”
11) A crime-plagued McDonald’s in Dallas started playing classical music. Their crime rates dropped dramatically. Environment matters.
12) The body-mind connection is real. Here’s a classic study to support it “In study 1, participants who briefly held a cup of hot (versus iced) coffee judged a target person as having a “warmer” personality (generous, caring); in study 2, participants holding a hot (versus cold) therapeutic pad were more likely to choose a gift for a friend instead of for themselves.”
14) People are apart of your enviornment too. “Partners of people with depression are more likely to suffer from chronic pain, research has found.”
15) “Most of the bad feelings you have are caused by irrational beliefs. Next time you’re feeling negative emotions, don’t focus on the event that you think “caused” them. Ask yourself what belief you hold about that event. And then ask yourself if it’s rational”
16) Intermittent fasting continues to gain momentum…skip breakfast to decrease depression.
17) 3 Things That Successful Cultures Share: 1) Good People 2) Dedication to Improvement 3) Social Facilitation
“uses social facilitation to foster an environment of continuous improvement and accountability to the team”
18) Writing your story is good for your mental health – “Professor James Pennebaker has shown that just 20 minutes of writing your story for 4 days has the power to dramatically improve your life. It helps people overcome anxiety, tragedy and heartache. Those who wrote about their problems felt happier, slept better, and even got better grades.”
Neuroscience
19) Cortical representation is interesting. These researchers are asking better questions: “That we found no relationship between S1 representation and the duration of CRPS signs and symptoms is intriguing and raises some novel possibilities: is the difference in S1 representation between hemispheres pre-morbid and does it reflect a vulnerability to CRPS onset? Or might the difference between hemispheres arise early on in the disease, for instance soon after injury or during immobilisation?”
20) Now we can tell our significant others that it’s for an altered state of consciousness -“rhythmic sexual stimulation – if intense enough and if it lasts long enough – can boost neural oscillations at correlating frequencies, a process called “neural entrainment.”
Pain
21) This is some good shit. “Swearing can add emotion and colour to a description, salience to a statement or be used as a means of acceptance – the willingness to break a cultural taboo in front of others creates an atmosphere of informality and a sense of community. Swearing can also act as a cathartic means to cope with pain.”
23) “Age, anxiety, catastrophizing and insomnia associated with MSK pain severity” -Derek Griffin
24) “Optimism decreased the negative influence of pain catastrophizing on shoulder function, but not pain intensity.” #BePositive
25) This is one of the better pain articles I’ve read in awhile – “It is important to clarify here that although we talk about the mind, thinking and emotions in relation to pain, the actual experience of pain emerges in the person and is felt in the body or the space in which the body should reside (for many biological reasons). The notion that pain is in the brain or in the head is nonsense. And, we are more than a brain.”
26) This is a great article on Dr. Sarno with plenty of links regarding pain science and the biopsychosocial influence.
“Furthermore, Dr. Sarno also began to see associations between emotional distress, early life adversity, and certain personality profiles (notably perfectionism and the need to please) and the onset of back pain and other so-called functional syndromes, such as headaches and irritable bowel syndrome. And most importantly, he found that when a patient is diagnosed with having a psychosomatic illness and given a clear understanding of that process, many people have dramatic resolutions of their symptoms, even if they were of a long-standing nature.”…”Over time, a few other physicians and therapists began using Dr. Sarno’s methods and they had equally impressive results. Research studies came out showing that most people with chronic back pain do not have a clearly defined medical explanation and that MRIs are abnormal in the majority of adults who do not have back pain. Studies of surgery for back pain have not shown better results than non-surgical interventions. Injections for back pain have not been shown to be better than placebo injections. Studies of brainimaging show that physical pain and emotional pain are equivalent and that emotionally laden regions of the brain (rather than somatosensory areas) are activated in chronic back pain. And emerging research shows that psychological interventions that target emotionsare showing significant results.”
27) How do you adapt to millions of years of harsh and painful conditions? Evolve the ability to dim sensory perception to modulate pain. “Evolutionary tweaks to the amino acids in their pain receptors make naked mole rats extremely insensitive to pain after they are born.”
28) Sure, diagnoses and biomechanical talk can cause fear. But it can also cause ease, understanding, and social belonging. “These results are indicative of social exclusion of patients with pain for which there is no clear medical explanation.” And remember that loneliness is linked to increased pain…
30) I like using the LANSS questionnaire. I have my patients with signs and symptoms of central sensitization fill it out. It helps them understand that what they’re feeling is normal. It helps them feel that others have these symptoms too. See #28
31) “Insomnia and short sleep duration are risk factors for developing chronic pain” -Mary O’Keefe
32) People always like videos
Opioids
33) Regarding Opioid Induced Hyperalgesia, “Your biology fights back and says, ‘I’m blindfolded to pain by all these chemicals. I need to be able to sense pain again.” -Martin Angst
34) But let’s not throw the baby out with the bathwater…”There is no question that in many cases opioids have been used inappropriately (prescribed too much or too little, given at too high or too low of a dose) for many individuals suffering with pain. But, it is also a very effective drug for many people in pain. Opioids help reduce acute nociception and can potentially reduce the risk of developing chronic pain for those in the more acute phase. They can also be an effective part of a comprehensive chronic pain treatment for some. My hope is that those of us in the physical therapy profession educate ourselves properly and understand how to talk to our patients about the use of opioids, because they will ask us.”-Korzy Zimmer
36) Ask your patients if they take any pain medication. Educate them on how to use medicine after surgeries and injuries. Be a responsible provider.
The main reason I do this blog is to share knowledge and to help people become better clinicians/coaches. I want our profession to grow and for our patients to have better outcomes. Regardless of your specific title (PT, Chiro, Trainer, Coach, etc.), we all have the same goal of trying to empower people to fix their problems through movement. I hope the content of this website helps you in doing so.
If you enjoyed it and found it helpful, please share it with your peers. And if you are feeling generous, please make a donation to help me run this website. Any amount you can afford is greatly appreciated.
1) Environment matters. Want to know more about your patient’s environment? Look at their significant other. “Doctors tend to treat people as individuals, guided by the need to ensure patient confidentiality. But knowing about one partner’s health can provide key clues about the other’s. For instance, signs of muscle weakening or kidney trouble in one may indicate similar problems for the other.”
“Spend less time trying to amass all the information and more time better defining the problem so you can find the right information.”
“For simple decisions without many factors involved (What soda should I buy?) be rational. For very complex or weighty decisions (Am I in love?) trust your gut.”
“A new study from researchers at Rice University, George Mason University and Boston College suggests you should trust your gut — but only if you’re an expert”
“A good decision now is better than a perfect decision in two days”
we’re eating out more, portion sizes have increased, we drink a lot of sugar, healthier foods cost more, our vegetables are mainly potatoes, too many of our meals are like dessert, we’re bombarded with ads for unhealthy foods
“If you want to be interesting, you have to be interested.”
1) “The authors examined whether facial expressions of emotion would predict changes in heart function… Those participants who exhibited ischemia showed significantly more anger expressions and nonenjoyment smiles than nonischemics.”-Eric Barker with 4 ways to improve your body language
2) Proxemics and personal interactions – very interesting
3) Want to give a better speech? Practice in front of your dog “Addressing a friendly and nonjudgmental canine can lower blood pressure, decrease stress and elevate mood — perfect for practicing your speech or team presentation.”
5) “researchers at the University of Virginia School of Medicine have determined that the immune system directly affects – and even controls – creatures’ social behavior, such as their desire to interact with others….The relationship between people and pathogens, the researchers suggest, could have directly affected the development of our social behavior, allowing us to engage in the social interactions necessary for the survival of the species while developing ways for our immune systems to protect us from the diseases that accompany those interactions.”Continue reading “Late Summer Hits 2016: Social & Communication”
“Once you understand the feeling and purpose of a position, change one thing….. then change one more.” -Christine Ruffolo
1. The squat is not the same as a deadlift. The tibia should go forward (if you have ankle dorsiflexion). Mike Robertson even cues knees first at times for this reason.
3. How to prevent choking: practice under pressure, self-disctraction, don’t dilly-dally, express your emotions before you start. For a better understanding check out my Coaching & Cueing series.
4. When done correctly, the push-up is an incredibly difficult exercise that works the whole body. If you’re only feeling your arms or chest, you should read this article from GMB.
“Perception and perspective are often the fundamental difference that control human behavior and the quality of our lives” -Tony Robbins
Psychology, Mental Health, Mind Training
1. “In the midst of the widespread support and criticism of psychoanalysis there has been significant progress in its use as a valid approach to treatment. If for no other reason than to gain an important historical perspective on mental health treatment Freud’s psychoanalytical theory is worthy of study.”
2. Fake it till you make it. “People using self-talk, for example telling yourself “I can do better next time” – performed better than the control group in every portion of the task.”
3.Curiosity – the bias killer. “Neither intelligence nor education can stop you from forming prejudiced opinions – but an inquisitive attitude may help you make wiser judgements.” Maybe we should focus on the questions and creating the curiosity/knowledge gap?
“The sign of a good doctor should be how many patients he can get OFF medications, not how many he puts on.”
1. NYTimes writes a story about surgery being no more, if not less, effective than exercise. Yet still being popular. Interesting that they didn’t interview a physical therapist in this article. You think that might be apart of the problem? #GetPT1st
2. Addiction is a serious problem in our country. Know where to get more information – Addiction Resource & ASAM
3. The slow catastrophe of antibiotics – “At least 23,000 people die as a direct result of antibiotic-resistant infections, and many more die from other conditions that were complicated by an antibiotic-resistant infection, the agency says.”
“Muscles drive the motions, motions drive the joints, joint position drives the CNS.” –Charlie Weingroff
1. “If we aren’t physically fit, maybe our environments are perceived as more threatening than they really are so we become more rigid and tense in an effort to protect us from too much movement that could be dangerous. It’s a perceived mismatch between us (our self-image) and our environmental demands. The bigger the gap between what we need to do and what we think we need to do, the more tension and threat we will perceive.” -Seth Oberst and Ben House with an article on autonomics
2. “Hypertrophy of the masseter muscle often causes tension type headache. This review concluded that conservative treatment such as counselling, exercises, occlusal splints, massage and manual therapy are the best way to treat TMDs. ”
3. Unless you’re getting paid to play, what’s the rush? “Athletes who wait at least 9 months after an anterior cruciate ligament reconstruction and/or regain quadriceps strength compared with the uninjured limb may be at lower risk for reinjury than those who fail to meet these criteria.”
4. It’s changing the expectations, educating on the long term recovery, and teaching tissue remodeling principles – “Metabolic activity evident six months after an Achilles tendon rupture”
5. If you’ve been reading this blog you know the importance of isometric contractions to reduce pain. Here’s another study supporting this empirical finding. One thing I have found clinically is that it’s important to re-assure the patient that the discomfort they feel from the isometric contraction is okay and is safe. Sometimes there’s a delay in the pain reduction.
6. This doesn’t really fit what I see clinically. “Subjects with LBP displayed less lower lumbar extension than control subjects during prone extension. These differences should be considered when evaluating and prescribing prone extension” Maybe the take-home point is that people with LBP have poor motor control and a loss of segmental spinal dissociation that leads to decreased extension? Maybe it’s high-threshold strategies or guarding against a perceived threat? Or maybe like the study says, it’s just less motion and poor movement. Regardless, quadruped cat-camel seems like a safer way to assess this rather than forcing end-range in a painful patient.
7. Christine Ruffolo goes over ankle plantarflexion from an isolated joint ability (CARs) to a full functional use. Worth the read. I really like the idea of using an unloaded knee flexion to add some degrees of freedom to the system.
This is a collection of information to help improve health and movement. It includes articles, videos, and quotes that I have found helpful in studying the human species. Due to the complexity of this subject matter, I have tried to include a variety of variables that can influence the dynamic system.
In an attempt to avoid information overload, I’ve separated the information into different categories.
I will post each category separately to make it easier to scroll through.
The links below will be added over the next month as they are posted.
Feel free to follow me on social media to keep up to date on the latest postings.
Making this information accessible for everyone takes a great deal of effort and time. If you have the resources, please consider a donation. Your support to maintain this website is greatly appreciated.
1) I often have athletes come into the clinic that have been aggressively stretching their hips or shoulders. They keep getting tight, keep stretching, and keep getting injured. I have found that the culprit for these injuries is usually not a mobility problem. Instead, it is often the result of a poorly tied knot.
2) Mike Cantrell teaches you about rib cage dynamics in these 2 videos (1, 2). Great stuff for anyone that enjoys learning about anatomy, biomechanics, and movement.
I loved my undergraduate time at the University of Tennessee. Probably a little too much, because I wasn’t accepted into any PT schools the first time I applied. One program even recommend that I try a different profession.
In the following year I worked hard to gain experience, volunteer, retake some science courses, and contact schools. The 2nd time around I was accepted into multiple schools. I ended up at one of the top schools in the nation, graduated with a 3.8, and now have one of the best jobs in the city. Continue reading “9 Ways to Increase Your Chances of Getting into Physical Therapy School”
(
