Monday Memo 11/21/17

Chest-Supported Y w/ External Rotator Emphasis
As a former competitive swimmer, I’m no stranger to shoulder pain. It’s been a problem I’ve had to deal with for a long, long time dating back to my junior year in high school and my first experience with physical therapy. It’s common knowledge in the strength/therapy world that there are three areas that deserve extra emphasis when preventing shoulder injury.

  1. Scapular Stabilizer Function
  2. External Rotator Function
  3. Thoracic Mobility

While the Chest-Supported Y has always been a staple exercise for training stability of the scapular (shoulder blade), there is a very simple tweak to help tie in those external rotators.

 

Enter today’s exercise: The Chest-Supported Y w/ External Rotator Emphasis!

By adjusting your grip and holding the end of the dumbbells that is closer to your pinkie, you create a very unique effect!

 

What this adjustment does is provide a moment arm that provides an INTERNAL ROTATION torque to the glenohumeral joint. In response, your EXTERNAL ROTATORS must work extra hard! In addition, apply TEMPO to these movements, emphasizing a pause at the top and a slow, controlled descent.

 

With this simple tweak, your classic lower trap exercise becomes a potent way to also integrate external rotator function as well. It’s tweaks like these that can create highly efficient & effective (p)rehab programs!

 

For best results, I like to precede this movement exercises that emphasize controlled rotation through the shoulder and thoracic spines, such as Thoracic Bridges, Prone to Supine Primal Rolls, and Kettlebell Armbar Variations!

 

Charles Badawy SPT, CSCS, USAW
University of Pittsburgh – Class of 2019

 

BONUS: This tweak can very easily be applied to other scapular stability exercises such as Prone T’s, W’s, & V’s! Give them a shot!

November 21, 2017 |

Monday Memo 11/13/17

Physical Therapy in Portland

  Three weeks ago, four of my classmates and I had the opportunity to attend the National Student Conclave in Portland, Oregon. As Mercer-Marquette Challenge representatives for the University of Pittsburgh, we were offered the opportunity to travel and participate in this conference, which is solely focused on student PTs and PTAs. While at the conference we attended several different sessions that focused on various areas of physical therapy, student leadership, and professional development.

 

There were courses on navigating our post-professional career and residency options, keeping our foot out of our mouth as new PTs, building a career in travel PT, adaptive sports, lymphedema, and how a beer changed one PT’s life. There were many courses to choose from and there was something that piqued each of our interests during each workshop session. Along with the talks, there was an exhibit hall with recruiters from across the country. We spent time each day in the exhibit hall talking with different companies and finding out which groups might be a good fit for each of us when we graduate. I was fortunate enough to have a connection with a company from the exhibit hall and just had a follow up phone call with them to discuss options as I near graduation.

 

In addition to the conference, there were several opportunities for us to get out and explore Portland. Portland’s motto is “Keep Portland Weird”, and the city did not disappoint. There was a PT Pub night the first night of the conference that supported the Mercer-Marquette Challenge and ended up being an excellent opportunity to network as well. Also, we attended a PT PAC party the next evening that supported the PT political action committee, which advocates for our profession at the federal level. The evening after the conference was over, we were able to take time to check out Rogue Brewery and have dinner across town. We also took time to explore the cultural district and took a ride up a gondola to get a view of the city.

 

The trip was an excellent blend of professional development and exploration of a new city. I encourage any student PTs to consider attending the conference in the future as a way to enhance your networking skills as well as a chance to explore the world of physical therapy outside of school.

-Annie Martucci

November 13, 2017 |

Monday Memo 10/30/17

Just Dance!

This weekend, I was given the chance to attend the PPTA conference at Seven Springs resort and listen to a lecture about osteoporosis and bone health. While at the conference, I was amazed by all the different treatments and treatment techniques that could be performed to increase the quality of life for patients with Osteoporosis. However, it got me thinking about other, more everyday treatments, our patients might be carrying out in their daily lives. Thinking of what two of my favorite television characters, Meredith Grey and Cristina Yang, do when they need some therapy and my mind immediately thought of dancing. Having been volunteering for the Yes, You Can Dance class for people with Multiple Sclerosis for the past few months, I couldn’t believe that I hadn’t thought about that sooner.

One of the best decisions I have made in my physical therapy school career thus far has been to volunteer for the Yes, You Can Dance class. It has taught me so much not only about working with people with Multiple Sclerosis, but also myself and my identity as a future physical therapist. Although this class benefits me tremendously as a mentor, the benefits for our students are also insurmountable. Various studies show the carry over of dancing in patients diagnosed with musculoskeletal impairments to increased functional ability. Dancing has also been shown to be the only physical activity that helped to decrease the risk of dementia and improve mood. Each patient is so passionate about dancing and it has been a wonderful experience to see them become better, more confident dancers each week.

 

As PT’s, we can think of our patients like our dance partner. Just like with a dance, as physical therapists we work together with our patients to accomplish specific goals or specific dances moves to continue with the dance metaphor. Both require having a sense about how your partner/patient can move so you can set them up for success, both in your treatment program or in the dance number you are performing. These activities also require developing the trust of your patient or partner. Without that trust as a dancer, your partner might not be able to perform to the best of their ability for fear that they might fall or that they might make a mistake (but really in dance there are no mistakes, only ‘creative changes’!). Without that bond of trust that we establish as physical therapists, we might not be able to get all the information we need from our patients to treat them to the best of our ability. Great dancers are great because they are passionate about what they do and great physical therapists are no different. Being in a person-centered profession, it is that passion w­hich allows us to establish these relationships and be better clinicians as a result.

-Teresa Toomey, SPT

 

 

 

October 30, 2017 |

Monday Memo 10/23/17

Hippo-what? Therapy?

 

I became interested in learning about this funny word because I grew up with horses and have seen some of the benefits they provide to people. It wasn’t until recently that I discovered physical therapists can use horses as a type of treatment. I began volunteering at a local farm outside of Pittsburgh where I have learned more about this type of therapy.

 

Hippotherapy can also be described as Equine Assisted Therapy, or therapy with the help of the horse. The professions of occupational therapy, speech-language pathology, and physical therapy can use evidence-based practice and clinical reasoning to manipulate the movement of the horse in order to achieve a functional outcome for patients. It is most commonly used for children with disabilities, but others who have suffered from a stroke or spinal cord injury may benefit as well. This is usually done with one person leading the horse, and two people walking on either side (one of which is the therapist), next to the patient. Typically, only a saddle pad and surcingle are used instead of an actual saddle so that the patient is not separated from the horse’s movement.

 

This works because the horse’s pelvis moves in the same three planes as the human pelvis. In other words, sitting on a walking horse sends your brain the same signal as when you are walking. This reciprocal movement activates the central pattern generators of the brainstem; for some, this is the first time the patient’s brain has received the sensory input of walking. This type of therapy is not done in isolation, it is in addition to the patient’s plan of care.

 

There are numerous movements you can do with a horse to reach a certain outcome with a patient. There is a huge benefit simply of walking in long straight lines on the horse because of the reciprocal movement. If the patient requires more sensory input, the horse can increase its speed or the patient can be placed on the horse facing backward. If a patient has a right sided hemiparesis, the horse could walk in tight circles to the right to increase activation of the right neuromuscular system. The stopping and starting movements of the horse work the patient’s flexors and extensors which can greatly improve trunk control.

 

I believe having a basic understanding of this type of treatment is important as students of  physical therapy. The horse can facilitate neuromuscular movement that our own modalities and treatments cannot, and it may serve a future patient of yours well to remember.

-Mallory Weiss, SPT

October 23, 2017 |

Monday Memo 10/16/17

A Student’s Reflection on The Scully Lecture 

 

In the Scully lecture, Dr. Delitto discussed a hot topic issue that our country, the opioid epidemic. Each year many people go see their doctor for low back pain (LBP). While some patients get a referral for physical therapy, even more receive pain medications. The question I’m sure many of you are asking is “Why isn’t everyone being referred to PT?” or “Why don’t patients just come see us first?” As physical therapist, it seems obvious that we can best treat these individuals and provide them with the best care, but how do we get everyone else to see it this way?

 

As I am beginning to realize, it is going to be a slow process of building our brand and getting people to recognize physical therapists as first contact practitioners. Although this won’t happen overnight, we should not take a back seat in the meantime. As young professionals, we now have the opportunity to shape this brand and the profession that we will be working in for years to come. For one, we can use social media to share our experiences as physical therapists and inform others about what we do. This is one of the most accessible resources available to us, one that we are all familiar with, and best of all, it’s free!  As physical therapists, we can also make sure to be active in the community, whether it is participating in sports for individuals with disabilities or screening runners at a local race. The more contact we have with people, the better we can educate them about what we do. Individuals who have been to physical therapy are more likely to go to a physical therapist as a first contact provider in the future. Lastly, I encourage you all to become involved with the APTA. As our professional organization, they support us through legislative advocacy, clinical practice guidelines, and campaigns for public awareness.

-Robert Jesmer, SPT

October 16, 2017 |