The world of musculoskeletal care is a strange animal if ever there was one. It is a world of imbalances and mal-alignments, asymmetry and inflexibility. Or so we are taught, and have been for decades.
The world of musculoskeletal care is is also the same realm that would benefit most from an understanding of clinical anatomy, statistics, and logic.
Diagnosticians are always seeking some relationship between a patient's signs, symptoms, and some particular patho-anatomical entity. But the problem lies in the realm of normalcy. You see, abnormal is, without question, the new normal.
The concept of periodization has been around for quite some time in the sports world. Coaches build training schedules around "periods" of training and recovery in a cyclical fashion.
However, the more perspectives you read on periodization in the training world, the more you realize that certain elements of it have been a little bent and twisted out of shape. More on that later.
But at least periodization actually exists in the world of sport training. We know that the timing of training sessions is important. Recovery is critical as training adaptations require time without subsequently "de-training". So what makes injury recovery any different?
A thousand words. It's about 4 pages of a novel. Or two of my blog posts. Or a scant few minutes of your precious time, depending on how quickly you read.
We've all heard that a picture is also worth a thousand words. An image, combined with a moment of quiet reflection, can conjure up plenty of meaning - without saying a word.
I wonder how many words silence is worth? I guess it all depends on the context.
June 4 is National Running Day, a day to celebrate the sport of running. As a coach and physiotherapist, I work with runners on a regular basis. Contrary to popular belief, running injuries don't occur because of mal-alignments or muscle imbalances. They are typically a function of some common training mistakes. Running injuries will, however, be counter to the full enjoyment and appreciation of running, the sport.
If you are already a runner, today is a great day to spread the word and to get out and enjoy the sport. If you are thinking about starting a running program, then there is no better time than the present! As the saying goes, a journey of a thousand miles begins with a single step. In order to make that first step just that much safer and more enjoyable, I present to you seven tips for new runners.
I was sitting on the living room floor. It was the summer of 1984. The decision in question was spread out in front of me: two pieces of paper that, frankly, held my destiny and future.
One of those pieces of paper was an acceptance letter from Queen's University. The second piece of paper was an acceptance letter from Ryerson. It was what was contained on each that was most important.
It was a decision being made at the ripe-old age of 18 that would ultimately have an impact on, well, the rest of my life.
One year ago today, the world lost not only a physiotherapist but a true visionary as well: Robin McKenzie.
In retrospect, I consider myself very fortunate to have had the opportunity to meet Robin McKenzie and to watch him assess and treat patients live. It was an experience that I look back on fondly and that words fail to describe. I still laugh when I recollect his telling the tale of legendary patient Mr. Smith in such a matter-of-fact and unassuming way.
Today, I can attest that his vision and insights live on stronger than ever. Here are some personal reflections on McKenzie, MDT, and what we really stand to learn from his legacy.
Physical therapy is the future of health care. There. I said it - a pretty strong stance, indeed, given where we currently stand in the world.
The future of health care is going to be directly related to activity, lifestyle, movement, exercise, and ultimately, function. And who better to lead the fray?
There is just one problem with my premise. Physical therapists need to choose to believe it - and to have the guts to take ownership of it while acting in accordance with it.
Evidence-based. Evidence-informed. Best evidence. These are just a few of the catch phrases that litter the medical community these days. For every phrase, there is probably at least one analogy to best describe it. Perhaps the one that is most bothersome and annoying is that which is used for "evidence-based practice": the three-legged stool.
If you aren't familiar with it, the evidence-based practice stool stands on three legs. Each is considered to be equally important. The legs are best available research evidence, clinical expertise, and the patient's values, needs and preferences.
So how could I not support a model of evidence-based practice such as this? How could I become annoyed with such an analogy?
I have been a photographer for many years. It all started with an Instamatic, progressing to a 35 mm SLR, a point-and-shoot digital camera, and now to a digital SLR. I think I had my first camera when I was 9 or 10 years old. Having a camera in my hands is a natural feeling for me.
Photography was almost my chosen profession. It was that or physical therapy. Yes, a strange dichotomy and a very intriguing story to go along with it. I'll share that tale at another time, but suffice it to say we all know which pathway I took.
I appreciate the challenge in taking the best photo possible. It is all about being in the right place, at the right time. Part of it is the creative aspect of putting colors and tones and lines in an image artistically. But part of it is a technical process. You have to select the right lens for the task at hand.
It is a call to action that has resonated with me for years. It is a call to action that I have used repeatedly, having even written a blog post of the same title last year.
The Right To Choose.
It was a great day when physical therapists in Texas adopted this phrase as a rallying cry for consumers. Simple - and to the point. The next legislative session in Texas is in 2015, and consumer awareness can't begin a moment too soon.
In a country founded on free markets, you would expect consumer choice to be a primary element in health care. My question to you, the reader, is simple: does a patient have the freedom and the right to select their health care provider freely and of their own volition? The answer, in the vast majority of states across this great land, is a resounding "no".
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Allan Besselink, PT, Dip.MDT has a unique voice in the world of sport and health care, one that has been defined by his experiences as physiotherapist, mentor, McKenzie practitioner, coach, innovator, author, educator, patient, and athlete. Read more about Allan, contact him, get updates via email, or connect with him on Twitter, Facebook, Google+ and LinkedIn.