Archive for the ‘What is rehabilitation?’ Category

Physical Therapy’s role in Genetics

Saturday, December 5th, 2009

 

The December 2009 PT in Motion magazine has the cover story: "Rooting Out Genetic Links" by Eric Ries. A beautiful cover, but once again a reactionary perspective with little vision of our role in rehab affecting genetics…why are we always so passive?

 

The article concludes quoting Steve Wolf, PT, PhD, FAPTA: 
 
For Wolf, heightened awareness cannot come fast enough, given the frantic pace of scientific discovery.
"It's only a matter of time—some people say less than 5 years—before human stem cells and other progenitor cells start being produced that can change the way in which a pathological gene is expressed," he says. "These things are happening. We must be prepared to deal with them."
 
Too late! It has already happened and we're standing on the sidelines waiting for the genome to act rather than stepping up to work with the genome!
 
UPDATE: May 2010 U of Michigan reports PTSD and its role in gene expression
 
What if PT's had clinical skills within their scope of practice that had been shown to "manipulate"…(I guess technically mobilize as manipulate is now to mean high speed, low amplitude thrust) gene expression?
 
Well, I had the honor of introducing Dean Ornish, MD as our keynote speaker at our 2009 Symposium on Yoga Therapy and Research. In the TED talk below Dean describes how using education, movement with awareness, breathing exercises, group social connection and interaction and nutritional changes in a positive social setting it has been demonstrated you can modulate genetic expression in men with prostate cancer. Here's the research article

Hmmmm…does that sound like the scope of practice of any profession we know and care about?

 

Don't just imagine rehab altering genetic expression….empower your clients today!  …and we got excited when we started moving facet joints!!! 

Isn't this amazing???!!

Now…do we "flex" or "extend" the genes?…the next great debate!

The importance of being Present at Work

Sunday, November 29th, 2009

In the past rehabilitation professionals have focused on the "parts" of workplace safety and comfort. We made equipment changes, ergonomic assessments and prescribed compensatory exercises. 

Our job was to winnow down to the finest "parts" and then apply fixes to those parts. We did this even as we knew the most important predictor to recovery from work-related injury or pain was job satisfaction and a feeling as though one was making a useful contribution at work.

We now realize that was short sighted and simplistic. If we are going to be more than "band-aid" therapists, then it is incumbent that our lens broaden and we address the "whole" person…not just the body, but mind, heart and soul! 

This is where ErgoPresence enters the picture.

Quite simply how the person relates to their "work" generates postural habits and dominant breathing patterns.

If those individuals find work stressful or spiritless, the systems collapse through an absence of presence and awareness at the worksite.

No amount of stretching or strengthening or even taping will sustain such a powerful systems effect. Remember at 12 breaths/min that is 720/hr or 5760 dysfunctional movements per 8 hours.

If this person sits dis-spirited and dis-interested at her clerical position for 8-9 hrs/day, can you see the collapse toward the mouse and phone in her structure? If she never breathes from her diaphragm because she's bored/frustrated or chatting online, when will her pelvis return to a more functional balance so the tape for the knee pains can be discontinued?

We need to help our clients see how the soul connection provides heart to power the seat…it is all connected and only the competent therapist of the 21st century will broaden their skill set to generate ErgoPresence.

 

For more on ErgoPresence visit this page.

 

What do you do to generate ErgoPresence for yourself and for your clients?

Mirror, Mirror…Who is the most creative of all?

Sunday, November 22nd, 2009

Re-Habilitation: "To make fit to live in (again or for the first time)"

Each person or organization brings unique circumstances to rehabilitation. Cookie-cutter approaches and statistically average group responses to clinical trials may suggest a general direction, but are void of any creativity in a complex situation. 

So what is a creative response?

And who is the most creative of all?

These, like the Queen's own inquiry re: fairest, are actually deeply spiritual questions. They ask, Who am I? What am I? and their answers then generate drive and motivation to act/move in response.

These are questions that I as a professional must ask as part of my development of clinical mastery (pillar of EBM), as well as How creative do I think my client's are?… and therefore, What is their role?(second pillar of EBM:  Patient Values), and then finally, what's been done, accepted AND published in the literature? (3rd pillar, Levels of research)

We've got it all backwards right now in PT for sure, and in organizational management as well. Our constrained perspectives limit us to only what has been done, shutting out "What could be?" Those of us in creativity work can tell you that's a big dead end to creating a future that is "fit to live in." Whether one is living with an ACL deficient knee, an aggressive carcinoma or a dysfunctional job in a dysfunctional company in a dysfunctional economy.

So who is the most creative of all?

Here are a couple thoughts that when I came upon them resulted in the comfort box being not only stepped out of, but broken down, recycled and dispersed back into a whole new raft of perspectival (dictionary says that's a new word) containers that I use today:

  1. Creativity is the ability for an organization, system or individual to adapt to the environment…easy enough.
  2. The individual human is now sub-ordinate in evolutionary chain to the more influential and dominant top of the life chain: Multi-national corporations (See Senge et al, Presence, 2004).
  3. Single cell organisms while less complex, are faster at evolution/adaptation and have a broad and robust communication organizational net: see Swine flu etc.

So where does that leave us? 

The good news is we're right in the middle as a holon…composed of trillions of single cell organisms (both "us" and our "flora") AND we together compose the multi-nationals. 

So be sure you do your personal mindbody practice, because as Peter Senge (2004, p. 234) says,

 

"We may not be able to change the larger systems overnight, but we can commit to the continual development of awareness and the capacity to choose. That’s why personal cultivation is so important. It keeps you sensitive and in the matrix."

 

Now, go get your mirror, ask the questions, and let me know what you hear!

 

What is “altered” sensation? Can it be “trusted”?

Wednesday, November 18th, 2009

Here is a fascinating piece on sensory experience, learning and function.

18 min TED talk but has the potential to shift how you think about working with client's, their sensations and the utility of those "abhorrent" perceptions.

 

It is only when we "know" for sure that we become dangerous to ourselves and others. What if we celebrate and share the experience of our clients and investigate together what is "real" vs what is wrong?

Amazing things happen "right before our eyes"!

 

What have you seen?

The Future of Private Practice Physical Therapy

Saturday, November 14th, 2009

It's quite an honor to be featured by my peers in this Month's APTA Private Practice monthly magazine IMPACT. This is a new series titled "Member Spotlight" and I got to be the test subject….fun! 

I really enjoyed the breadth and type of questions they asked….the questions seemed to give a nice perspective on a person  beyond just business. What do you think? What question would you like to answer? I'm curious to hear where you think rehab in general can go/should go/could go….

Check out the full feature and let's push the edge on bringing forth the best possible future for rehabilitation!

http://matthewjtaylor.com/mjtimpact09.pdf

Neither Hero or Sage

Saturday, October 24th, 2009

The recent APTA branding campaign depicts the physical therapist as both hero (heroine since >65% are women?) and sage. I'm sorry, but this strikes me as a rather adolescent, egocentric worldview for a profession. My experience is the client is the hero/heroine and we have success when we both recognize and utilize the sagacity in each of us. When I need to be a rescuer to be me, I diminish myself as well as usurp the healing power of the client. Certainly my experience and expertise bring additional resources to be shared in service….but as soon as I'm the helper, the client becomes the helped.

Hero brand 4x3

Rescuer???

No thanks…if I need to be the rescuer, then I am in fact the one that needs "rescuing." How does it strike you as either a professional or client?