The Opioid Solution Starts with Awareness

We have an epidemic on our hands in the US.

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.

Continue reading “The Opioid Solution Starts with Awareness”

CHINGFORD STUDY: OSTEOARTHRITIS AND METABOLIC FACTORS

This was first posted on The A&G Project Blog


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.

Remi & 7 Things We Learned in One Week of Parenting

 Remi Hendrix Rogers Swanson

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.

Continue reading “Remi & 7 Things We Learned in One Week of Parenting”

Your Body State is Your Mental State

this post was originally published on agmovementproject.com


The mind-body connection is nothing new.

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.

Continue reading “Your Body State is Your Mental State”

The 3 Most Powerful Words

this article was originally posted on the A&G Project


“When nothing is certain anything is possible”

-Many Hale


When asking important questions, one of the best answers we can get is…

”I don’t know”

Why is this so powerful?

It’s like opening a door to a new pathway.

The pain of thinking you know...when you really don't.  He would have been much better off answering "I don't know if that's a glass door" (source)(image source)

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.

Continue reading “The 3 Most Powerful Words”

2017 Hits : Vol. 1 : Ephemerality

click here for this edition’s table of contents


Ephemerality

  • 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”

2017 Hits : Vol. 1 : Other Good Stuff

click here for this edition’s table of contents


 

Other Good Stuff

  • “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”

2017 Hits : Vol. 1 : Intermittent Fasting / Time Restricted Eating

click here for this edition’s table of contents

Intermittent Fasting / Time-Restricted Eating

  • 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.

Think about how many lives could be saved, how much quality of life would improve, and how much money our country could salvage if everyone understood and implemented this… Continue reading “2017 Hits : Vol. 1 : Intermittent Fasting / Time Restricted Eating”

2017 Hits : Vol. 1 : Diet

click here for this edition’s table of contents

Diet

1) Eat spicy food.  Live longer.

2) Addictions come in many forms.  

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.”

3) 10 portions of fruit and vegetables a day will help you live longer

4) Mushrooms are the best. They’re the 3rd food kingdom we rarely think about.  They’re biologically distinct and nutritionally unique.  Eat more of them. It s good for everything.

5) I will always support coffee research.  

“These results suggest that caffeine has a specific benefit for memory during students’ non-optimal time of day – early morning.”

And they’re now finding it helps to block chronic inflammation.

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.”

10) Medicine is better understood through a historical lens.  The Case Against Sugar.

“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.




 

2017 Hits : Vol. 1 : Social & Communication

click here for this edition’s table of contents

Social & Communication

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.

2. Tell people in pain to find a social circle and get optimistic.  

“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.”

4. Read this one.  Why facts don’t change our minds.

“sociability is the key to how the human mind functions or, perhaps more pertinently, malfunctions”.

5. When you have expectations on how it should be, you’ll never see how it is.  

“Research on marriages with high levels of conflict finds that more than half of the couples in these marriages have disputes involving the failure of one or both partners to conform to unspoken expectations. (Philpot 2001)” Continue reading “2017 Hits : Vol. 1 : Social & Communication”

2017 Hits : Vol. 1 : Exercises & Movements

click here for this edition’s table of contents

Exercises & Movements

  • “The more voluntary suffering you build into your life, the less involuntary suffering will affect your life.” -Tim Ferris

1. A nice way to use the wall to progress lateral loading during a lunge.

2. I like this external cue to assist with spinal dissociation in quadruped.

3. The great Pete Hwang displays a nice quadruped sit out exercise.

4. Sam Hodous shares a 4 part physioball anterior core exercise progression (1, 2, 3, 4).

5. I like this quadruped hip extension lift off.  And I like it even more that it’s the general population in the video.

6. Christine Ruffolo expands on hip internal rotation mobility

7. Solid hamstring eccentric progression from a simple bridge walk out to a single leg slide out.

8. I like this bird-dog row progression from Zack Long.  Building strength on stability is always a good idea. Continue reading “2017 Hits : Vol. 1 : Exercises & Movements”

2017 Hits : Vol. 1 : Training / Strength & Conditioning

click here for this edition’s table of contents

Training / Strength & Conditioning

  • “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”

2017 Hits : Vol. 1 : Physiology Influencing Psychology

click here for this edition’s table of contents

Physiology Influencing Psychology

  • “if I can interfere with a posture then I find I’m free of both the emotion and the thought tied to that posture.” –Jerry Brewster

1) Here’s an article I wrote on how our physiology can dictate our psychology.  It also summarizes an important study on breathing and emotions.

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.

3) Having an emotion and feeling an emotion are two different things. Listen to this 8 minute talk from Antonio Damasio. Continue reading “2017 Hits : Vol. 1 : Physiology Influencing Psychology”

2017 Hits : Vol. 1 : Psychology, Mental Health, Mind Training

click here for this edition’s table of contents

Psychology, Mental Health, Mind Training

  • “Stress is now the achiever word for fear.” -Tony Robbins

1) Empathy and self-control reside in the same area of the brain.  

“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.”

2) Develop some authentic pride to become a better person.  

“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.

5) “Catch them when they’re good. It reinforces the good behavior and builds self confidence” -Ivan Joseph Continue reading “2017 Hits : Vol. 1 : Psychology, Mental Health, Mind Training”

Fall Hits 2016: Psychology, Neuroscience, & Pain

Click here for this edition’s Table of Contents


 

  • “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.”

9) It’s a dynamic system.  It’s all connected.  “increased levels of inflammatory cytokines are associated with increased rates of depression and psychosis, and that treatment to reduce cytokine levels can reduce symptoms of depression”

10) Marvin Minsky on why our brain doesn’t separate emotion and thinking.  It’s all emotional states.  And emotional states bias thinking.  “The word beautiful means I’m in a state where I can’t see all the flaws in it.”

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.”

13) We need physical contact for our well-being.  “The answer is that interpersonal touch is a crucial form of social glue.”

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.”

22) Reorganize your pain neurotag:

1) Explore/Find safe movement

2) Go for a walk outside #justamemory

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…

29) +2000 patient study shows that expectations dictate outcomes

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

35) It’s an epidemic

 

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.




 


 

9 Ways to Increase Your Chances of Getting into Physical Therapy School

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”