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Allan Besselink

Reflections On Voodoo And Physical Therapy

Monday, 19 September 2011 13:13 Written by Allan Besselink

VoodooBack in January 2010, the NY Times published an article entitled “Treat Me, But No Tricks Please”. It got a lot of physical therapists fired up, and it even prompted a response from the American Physical Therapy Association. And it made me chuckle about many things I have known for a very long time.

The firestorm of debate started when Dr. James J. Irrgang, a researcher in the Department of Orthopedic Surgery at the University of Pittsburgh and President of the Orthopedic section of the American Physical Therapy Association at the time, noted that “there is a growing body of evidence that supports what physical therapists do, but there is a lot of voodoo out there, too”. He also noted that “You can waste a lot of time and money on things that aren’t very helpful”.

Fast forward to 2011. I am now in the midst of preparing a 3 hour presentation entitled “Mechanisms Of Therapeutic Exercise Progression” for the Texas Physical Therapy Association’s Annual Conference in October. This will be my third consecutive appearance at their Annual Conference. What I have been reminded of – as I have reviewed a topic high on evidence-based cellular physiology research and low on practical application by clinicians – is that Irrgang was indeed correct. Sadly, not much has changed in our profession since this article was published, even with the responses and outrage it generated.

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Laramie: The Longhorn Twilight Zone

Thursday, 17 September 2009 21:09 Written by Allan Besselink

Early morning in LaramieA road trip to Wyoming. I knew it had the makings of something wild and crazy as soon as it was placed on the schedule. A team with a record of 4 – 8 last season. Locale: Laramie, Wyoming – population 27, 204 – or about one quarter of the size of DKR Texas Memorial Stadium in Austin. It had all the makings of – strange.

Would it be the Wild West … or the Twilight Zone?

As it turns out, it was a game of two halves – a great Twilight Zone episode if ever there was one. In the first half, there were crazy calls by the refs – for example, an unsportsmanlike conduct call for … well, I am still trying to figure out what that call was all about. The real Longhorns must have still been on the bus, because with 1:32 left in the first half, they were down 10 – 6. Yes, it was an ESPN upset special waiting to happen.

Then James Kirkendoll reminded everyone that the Longhorns really were the higher ranked team - his spectacular 25 yard catch putting the Longhorns up 13 – 10 at halftime. Whew. A short sigh of relief.

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What Is Competent Self Care (And Why Do I Care)?

Friday, 16 September 2011 12:20 Written by Allan Besselink

Scaffolding: Not just for construction workers anymoreNote: This is an update on a post from 2007. Read the original post here.

The system of health in this country is faced with some significant problems. First of all, it is not a system of health at all – it is a system of illness. Our current system emphasizes "prevention" and yet we still have an increasing rate of chronic medical conditions. For example, 57% of adults are overweight, with 1 in 4 having a body mass index of 30 - a level that is considered obese. We would like to believe that our medical system is the best in the world – but we spend 50 percent more on health care than any other country in the world and yet rank only 15th in preventable death, 24th in life expectancy, and 28th in infant mortality.

I’d say that is sufficient testimony to the failure of the system of “health” we currently have in place in the United States.

How many health-related issues do we experience that can be readily dealt with on the basis of self-care strategies alone? And does an effective system of health require a bunch of providers applying interventions, or can patients apply many of those strategies themselves?

There is a solution that will involve not only systemic change, but cultural change as well. It’s name is Competent Self Care. What is Competent Self Care, and why should any of us care?

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Town Halls, Liars, And A Call For Civility

Sunday, 13 September 2009 11:51 Written by Allan Besselink
Lincoln Memorial Washington DCIt’s time for a call for civility. And truth. And intelligent discussion. And passionate debate. And solutions. At this point in history, the last thing we need is a call to arms. We need a call for civility.

If you’ve been anywhere near a TV or newspaper or online discussion forum, you’ve been witness to perhaps the most childish, boorish, inane, insane behavior this side of reality TV. Oh, I forgot, it IS reality TV. This isn’t “Survivor” or “Big Brother” - it’s our very own town hall meetings, and Congress, and countless self-proclaimed “mavericks” and “patriots” espousing words of wisdom on cable TV. We’ve all seen or heard it lately … “death panels” (a classic Palin-ism there) … carrying an assault rifle to a town meeting because you have the “right” to bear arms … not sending your kids to school because the President has a “socialist agenda” for them (when he tells them to "stay in school”, “pay attention” and “listen to your parents”) … the sign at a town hall that stated “Bury Obama Care With Kennedy” … or how about comparing the President to … Hitler? Ahhh the irony on that one.

This has all become ridiculous. Stupid. Tasteless. Classless. And, in my eyes, terribly un-American. Since when have these behaviors become acceptable?

If I didn’t know better, I would think that all of this starts to look like the fall of the Roman empire. We are now a country in denial. And despair. And fear.

How so?

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Recovery-Centered Training: A New Model Of Human Performance

Wednesday, 14 September 2011 21:13 Written by Allan Besselink

Helsinki Stadium track and fieldThe mechanisms of exercise physiology have been described in great detail over the past 30 years. The sports medicine and sports sciences research is growing in leaps and bounds. So why is it that with all the “advances” in the science, athletes continue to sustain training-related injuries at an alarming rate?

Is it because coaches continue to advocate traditional training approaches based on old research or anecdote? Or is it because very few attempts have been made to synthesize and integrate it into a unified “big picture” approach to human performance? In a system such as the human body, how could there be so much disparity between approaches to training? Why has so much attention been given to “genetics” and so little to “consistent training principles”?

After many years of reviewing the sports sciences and sports medicine research, I began integrating the research into a more unified approach. This started with a focus on the running and cycling literature. But it also expanded to some reading on systems thinking and chaos theory, fields of study far removed from the sports sciences realm.

By 1999, I had synthesized many diverse avenues of thought into what I have termed “Recovery-Centered Training”, a new model of human performance.

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RunSmart Book

Where To Buy RunSmartUp 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.

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Clinical Orthopaedic Rehabilitation "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.

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Allan Besselink

Allan Besselink, PT, DPT, Dip.MDTAllan 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.

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