Low back pain is now officially the poster child for health care mythology. It has come to represent all that is wrong with the health care world and many of the practitioners that work within that world. It reminds us of all that is wrong with reimbursement models. It is a fine example of paying lip service to clinical guidelines and research.
And with that said, all of these things that low back pain now represents are being perpetuated because it is now part of the collective psyche of the masses. It is now on TV, going out to millions of viewers.
Thank you, Dr. Oz and Dr. Phil.
It just happens that chiropractic care is the theme of both of these episodes. But it is not the chiropractic care that concerns me – it is the value system espoused and the promotion of passivity in a world of spinal pain that should be promoting active solutions that foster patient independence.
April 20 was the one year anniversary of Texas HB 637 receiving a public hearing – the first ever for a bill related to direct access to physical therapy - with the House Public Health Committee. Actually, it was more like the wee hours of April 21. Close enough.
The committee finally listened to the voice of patients and physical therapists across Texas, although it was a very brief and albeit unsuccessful listen. A one hour hearing at 2:00 am doesn’t tend to attract the general public that are up in arms over these sorts of things, but I digress. With that said, we are now one year later and a mere 8 months before the start of the next legislative session.
Last week there was an interesting editorial piece in the Austin American-Statesman entitled “Texas GOP's health care bill isn't like Obamacare”. It was written by Senator Jane Nelson, author of SB7 (the bill in question) and chairwoman of the Texas Senate Committee on Health & Human Services. If words and espoused principles mean anything at all, and oftentimes they don’t in politics, then we might actually be able to envision Senator Nelson supporting the efforts of physical therapists in the Texas Senate this upcoming session.
This is the 14th in a series of RunSmart videos. The series is on-going, with a new video released on a biweekly basis. These videos complement the material presented in the book “RunSmart: A Comprehensive Approach To Injury-Free Running”. The full series of videos can be found here. A compilation of the first 10 videos will be available on Vimeo as well.
For those of you that are interested in a more interactive learning environment, consider attending a Level One (half day), Level Two (one day), or Level Three (two day) RunSmart program. The Level One program is 4 hours and focuses on basic training principles, running mechanics, and injury prevention. The Level Two program is 8.5 hours and focuses on performance optimization and training program development. The Level Three program is a two day, 15 hour program that includes a comprehensive approach to running injuries. The next Level One program will be offered in Austin on June 3, 2012. The next Level Three program will be offered in Reno, Nevada on May 5 – 6, 2012 at the University of Nevada.
In this video, I discuss the issue of beliefs and science in the world of running. Much of what is done in the running community is driven by beliefs more than science, which becomes problematic from not only a performance perspective, but also from the perspective of injury prevention and injury recovery as well.
It is a fairly regular occurrence these days - back pain in NBA players. A quick Google search reveals plenty of big names: Derrick Rose, Metta World Peace, Amar’e Stoudamire, Carmelo Anthony, Larry Johnson, Dirk Nowitzki, and Larry Bird. That was just pages 1 and 2 of the search. There have been plenty of careers that have ended abruptly due to back pain.
While we’re at it, let’s tally up the annual salaries of those individuals, or better yet, the salary-per-game. Multiply this by the number of games lost to injury. I hope your calculator can handle a lot of zeros.
The most recent addition to the Hall Of Pain is Dwight Howard of the Orlando Magic. He is out with “back spasms”. He has missed five of the last 7 games prior to Saturday, April 14th. That can’t be a good thing when your team is fighting for a playoff spot and playoffs begin April 28.
The NBA and its teams need a solution to the back pain epidemic. Allow me to introduce you to Mechanical Diagnosis And Therapy, or MDT.
This news report just in from the world of sport: muscle imbalances - those crazy anomalies that plague athletes everywhere – have been caught defying homeostasis. Not only do they cause every sport injury known to man (or are believed to do so anyways), but they are now defying homeostasis. Homeostasis! Can you believe it? What makes this turn of events more troubling is that they are demanding greater pay for their treatment. Health care experts are reporting that this is sure to become a troubling development for lawmakers in an upcoming November election cycle.
A little satire goes a long way. But the real world isn’t far off this when you hear coaches and clinicians describe “muscle imbalances”. The term is a misnomer at best, and a blatant excuse for interminable treatment at worst.
Self talk has a huge impact on our performance and proficiency, efficacy and effectiveness, in life and in sport. What we tell ourselves, after years and years of programming, defines who we are. We become self-fulfilling prophecies simply by the words we utter within our own minds.
The 2012 Masters gave us a great example of golf - and self talk - all at the same time. Some of it was obvious, some of it less so. Self talk can be reflected in the words that are heard by the media, and sometimes they are found when we read between the lines.
Take three examples: Bubba Watson, Sergio Garcia, and Tiger Woods.
Does McKenzie’s derangement syndrome fit into a traditional patho-anatomical model? And if not, does it matter anyways?
With the derangement syndrome, we witness lasting changes in movement characteristics, strength, reflexes, and dural signs after the performance of directional preference movements. Mechanical and symptomatic responses to mechanical loading strategies, consistent with the operational definitions of McKenzie’s derangement syndrome, exist throughout the musculoskeletal system. The problem lies in providing a clear and consistent systemic or anatomical foundation to explain the phenomenon.
It is my proposal that the central nervous system may in fact provide the basis for McKenzie’s derangement syndrome, and may also provide yet another reason for MDT as a systems-based approach to musculoskeletal care.
Up to 60% of runners will sustain an injury within any given year. Poor running mechanics, in conjunction with poor, ineffective and outdated training methods, can pose a significant injury risk. "RunSmart" was written to address these issues in the running community.
"Running Injuries: Etiology And Recovery- Based Treatment" (co-author Bridget Clark, PT) appears in the third edition and fourth editions of "Clinical Orthopaedic Rehabilitation: A Team Approach" by Charles Giangarra, MD and Robert C. Manske, PT.
Allan Besselink, PT, DPT, Ph.D., Dip.MDT has a unique voice in the world of sports, education, and health care. Read more about Allan here.
Top 5 finalist in three categories: "Best Overall Blog", "Best PT Blog" and "Best Advocacy Blog".
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