I am a blues lover ... sing the blues, play the blues, either way I enjoy it. Austin's a great place for live blues music - and admittedly one of my original reasons for moving here. But there is another type of blues that I don't enjoy quite so much - let's call that the summertime blues. When I think of summer in Austin, I think of the heat.

In order to survive a summer of training in the heat, you've got to have some strategies. We all know that training in the heat can become a real challenge. It seems harder to maintain your training pace – if anything, you may feel like you’re running slower. You’re lethargic. Perhaps it just seems like a lot of work. You can't go out early enough in the morning to avoid it. You feel like you can't drink enough to make up for it. So training in the heat is tough - that's a given. But what can be done to make the situation as good as possible?

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I am a strong believer in the power of language. Language isn't just about "words" - it's also about the personal meanings that we derive from those words. As we all realize, saying what you mean may not be the same as meaning what you say. Add to this the idea that "the meaning of words" and "what it translates to in pop culture" are oftentimes two totally different entities.

I bring this up today because of a great example of this phenomenon - the word "wellness". If we look at the literal meaning of "wellness", here is what we'd find (italic emphasis is mine):

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Surprise ... it's quiz time ...

Consider this scenario: you've been running for a few weeks now, and you've noted a little discomfort in your thigh whenever you run. It's starting to limit your running, and you really don't want to stop training if at all possible. Off the top of your head, who's the first healthcare provider you'd go to see (if insurance and other issues weren't limiters) to resolve this problem?

Wait ... don't tell me the answer just yet. This will all make more sense in a moment. Read on, please.

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The basis for today's post comes from a discussion earlier this week regarding basic training principles. If you pick up any triathlon, cycling, or running magazine, you will invariably note some mention of "base training" or "aerobic base training" or some other form of doing long, slow work to "build a base" early in the season. During this time period, intensity (in the form of intervals, tempo work, etc) is considered "taboo". The prevailing thought is that you need to build an aerobic base upon which to then superimpose a few weeks/months of interval-based work prior to racing.

Of course, the premise sounded good - back when we all believed that the aerobic system was the primary limiter to performance.

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Seven down, and six to go. No further waiting ... let's get on with number 8 ...

8. Principles And Practices - Stephen Covey, in his "Seven Habits Of Highly Effective People", discusses the concept of "principles" versus "practices". Principles are the "why" we do something, whereas practices are the "what" we do. Much of our time is spent thinking in terms of practices - or as many educators and clinicians will say, "having more tools for the toolbox". I think this is misguided at times. A screwdriver can't be used for everything, nor can a hammer. It is the decision making skill of when to use what tool that is ultimately key - and of course this comes down to learning how to think and process clinical information.

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In the midst of trying to summarize some of the key elements of clinical practice and reasoning for PT and PTA students, I've found myself pulling together many of the practical aspects of "being a clinician" that I've learned over the years. After 19 years of clinical practice, there are certainly a number of things I wish I'd learned in school! In many practitioners' training, much time is devoted to the "practices" - the "what" to do - as opposed to the "principles" - the "why" to do. Very little time is devoted to the art and science of learning how to think.

So if David Letterman has his "Top 10" list - I now have my "Top 13" list. Why 13? It's my lucky number, of course!

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Clinical reasoning is much like being part of a crime scene forensics unit. The diagnostician (be it a chiropractor, orthopedist, neurologist, physiotherapist, massage therapist, etc) has a goal - of putting the pieces of the puzzle together, establishing hypotheses, testing these hypotheses, and using good methodical clinical reasoning in the process. Much like a crime scene investigation, the evidence has to form a picture that can be subjected to scrutiny. In the days of yore, they called this the "scientific method".

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