Building self-determination in our patients “What I find so hard to understand is how I continue to improve without seeing you regularly!”These words, paraphrased based on my memory, were recently said to me by a patient. I frustrate new patients when they ask me how frequently they should be seen, and I reply with a… Continue Reading
Active cancer and manual therapy
Active cancer and manual therapy Walt Fritz, PT, Foundations in Manual Therapy: Voice and Swallowing Disorders Seminars May 23, 2022 Input encouraged on what I know to be a contentious topic. From a recent question about the safety of manual therapy used when a patient has active cancer, I endeavored to collect data on this… Continue Reading
Visual impacts of manual therapy
Internal views of externally applied interventions are a great way to see how touch may impact. Nothing guarantees change, but knowing what we know about patient perspectives and inclusion if we are able to reach and create awareness to centers responsible for voice and swallowing disorders, our chances of introducing change is quite good. Thanks… Continue Reading
Manual therapy to the retrolaryngeal “gutters”
Manual therapy to the retrolaryngeal “gutters” Accessing the area in front of the spinal transverse processes, for the past 28 years, I’ve used a manual therapy technique taught to me in 1994 as an anterior cervical technique for neck and arm pain. Though fraught with outdated concepts of cause and effect, the hands-on sequences proved… Continue Reading
Review of Inner Jaw Self-Treatment Tools
Review of Inner Jaw Self-Treatment Tools In the quest to offer more self-treatment options/solutions to patients with jaw-related issues (TMD, radiation-induced trismus), specifically for accessing the interior mandibular (aka pterygoid) region, I tested three products. From the perspective of treatment, placing a finger into the area between the ramus of the mandible and upper row… Continue Reading
Wedge Revival
Wedge Revival Recognize these? Various professions use pelvic wedges to “balance the pelvis” or other more nefarious (manipulative) usages. In my early training, I was presented with a decidedly biomechanical model of causation and intervention. If the body is misaligned, this was seen as the cause of problems, along with restricted fascia and emotional stuck-ness… Continue Reading
Riffs and mods
Riffs and Mods Most of us learn manual therapy (MFR, massage, trigger point work, etc.) from a specific paradigm, one that defines a protocol or sequence. That sequence is based on the perception of tissue-based problems and tissue-based solutions. MFR was said to be non-protocol-based, but even they define their terms and rules: always wait… Continue Reading
Are we the modality? A common denominator
Are we the modality? A common denominator The longer I exist in the world of manual therapy, the more I see little difference between styles of work or modalities. Despite claims of unique access to single tissues or pathologies, all manual therapy is performed in remarkably similar ways. What are the underlying qualities of each… Continue Reading
Putting patient preferences and values back in EBP
Putting patient preferences and values back in EBP Evidence-based practice (EBP) has been the accepted norm in medicine and rehabilitation for nearly 30 years, though exploration began of its concepts in the early 1970s (Zimerman, 2013). EBP consists of three elements: the best available evidence, the clinician’s knowledge, and skills, and the patient’s wants and… Continue Reading
Mastery: A Dangerous Concept
Mastery: A Dangerous Concept Recently Scott Dartnall, RMT, and I sat down for a talk on the concept of mastery in manual therapies. Keeping humble not only benefits our reputation but also keeps us from avoiding errors. With a higher call for adherence to evidence-based practice (EBP) models of care, clinicians are often caught between… Continue Reading
Flipping the Script
Flipping the Script: Shared Decision-Making Hi new patient, I’m the expert. I a physical therapist (no DPT, sorry) with 35 years of experience. Those years include a ton of continuing education and independent research. They include tens of thousands of patient-contact hours. I’ve been an educator in the continuing education field since 1995. With all… Continue Reading
The myth of the micro-managing client
The myth of the micro-managing client We’ve all had clients or patients who seem to want to script or control the session, telling us what to do, how long to do it, and always asking for different levels of pressure—telling us how to do our job. What to do about this person?? How about listening… Continue Reading
Complexity; simplified
Complexity; simplified Causation in manual therapy scenarios is often discussed as tissue (or pathology) specific issues. But causation is complex, and in this podcast, I joined Rani Lill Anjum, Ph.D. in philosophy at the Norwegian University of Life Sciences. Rani has authored several books, including Rethinking Causality, Complexity, and Evidence for the Unique Patient, which… Continue Reading
Person-Focused Manual Therapy and the Singer
Person-Focused Manual Therapy and the Singer Recently, I had the extreme pleasure to take part in a Facebook Live interview with Rachel Lynes, from The Sing Space. We unpacked a wide range of topics, including does fascia matter, how manual therapy impacts the singer (from tissues right up to the brain), and many more. We… Continue Reading
Downplaying pathology.
Downplaying pathology. One of my favorite podcasts is Dr. Oliver Thomson’s Words Matter. Through his podcast, Dr. Thomson addresses a wide range of topics relevant to my practice, both as a physical therapist as well as an educator. While an entire hour spent unpacking concepts surrounding the way a clinician approaches a patient presenting with… Continue Reading
Rules and Recipes: Moving on from older models of manual therapy
Rules and Recipes: Moving on from older models of manual therapy As I sat at the head of my treatment table this morning, looking down at my patient, I viewed their right leg in external rotation while at rest, I flashed back to my training. This patient is seeing me for sciatica-like symptoms on the… Continue Reading
