Monday Memo 6/19/2017

The Monday Memo

June 19, 2017                                                                           PITT DPT STUDENTS

Personal Training & Physical Therapy

 

The two years I took between my undergraduate education and beginning physical therapy school at Pitt was perhaps the best decision I’ve ever made. I didn’t realize it at the time, but the experience that I received over those 26 months allowed me to develop skills that will be valuable during my career as a therapist. The mentors I cultivated over that time, both in person and online, helped me to recognize that the two professions don’t have to work in isolation. Rather, I think it’s incredibly important to blend the two. Whether you approach it from a patient education standpoint or integrate strength and conditioning protocols into the therapeutic plan, there is an immense amount of value in successfully integrating both aspects into patient care.

At the end of the day, professionals in both fields have very similar goals: To improve the function and performance of the person standing in front of them. Therapists typically work with a population in pain, with the ultimate goal of moving them out of the symptom modulation phase, improving upon the impairments found in the physical exam, and returning the patient to their desired level of participation. The trainer works on the other end of the spectrum to help improve their client’s body composition, performance goals, and overall resilience. At the end of the day, both are attempting to make significant changes in their client’s level of function.

We know that Americans don’t exercise enough. We know that sedentary lifestyles only accelerate our body’s natural degenerative process. We know that a lack of physical activity and progressive overload results in a gradual weakening and deterioration of your body’s tissues, eventually leading to injury/pathology. We know this because as therapists and trainers, we are exercise professionals. We live and breathe this culture of physical activity, but, unfortunately, the majority of our patients do not. It’s important to educate your clients: Inform them of the benefits of physical activity and impress upon them the vast effect it will have on their personal lives.

In addition, encourage active modalities over passive methods during your therapeutic plan. There is always a reason to default to moist heat to warm up body tissue and prepare it for work, but an active warm-up can accomplish this same goal while also increasing calorie burn, circulation, muscular function, and more. If your client is seeing you for a lower extremity injury, show them how to train their upper body and trunk in a safe and effective manner. An injury doesn’t always mean you should stop training and there is plenty of research that shows benefits to the involved limb when you continue to train the uninvolved side.

At the end of the day, physical therapists are experts in the human movement system. We understand the human body, biomechanics, and the effect of physical activity (or lack thereof) on your body. If we want to elevate our profession, our outcomes, and our patients, we need to do a better job of educating them on all things health and fitness. We also need to embody this belief ourselves. Be an example for your patients and practice what you preach. How often are you strength training? Performing some sort of cardiovascular exercise? As cliche as it sounds: Be the change you want to see in the world.

Charles Badawy, SPT, CSCS, USAW,

Pitt DPT Class of 2019

June 19, 2017 |

Monday Memo 6/12/2017

The Monday Memo

June 12, 2017                                                                           PITT DPT STUDENTS

Patient Adherence

 

As is typical with most physical therapy students, I had a very active and healthy lifestyle growing up. I was a competitive swimmer in high school and spent nearly 20 hours a week in the pool training. I got into triathlon, weightlifting, and played intramurals throughout my academic career at Virginia Tech. My personal interests always revolved around physical activity and training, so naturally pursuing a career in health care made sense.

Like many, I figured I would apply to medical school upon graduating, but I slowly started to realize that physical therapy was much better suited for me. This profession gives you the opportunity to analyze a patient’s movement system, determine the best course of treatment, and help initiate their path to recovery. This path may include some passive methods, such as employing the RICE method or prescribing orthotics, but these typically lead us to the more effective and vitally important method that we utilize: active therapeutic exercise.

Your TherEx protocol is the “meat and potatoes” of your therapeutic protocol. This is what will provide true adaptation to your patient’s issue. At least for me, it’s also the aspect of PT that as a clinician you are most excited about. You’re creating an exercise regimen that will help the patient grow stronger, safer, and more resilient, and all they have to do is follow your instructions! What could go wrong?

The answer: A lot.
For instance, the patient may not do it. Unless you have the opportunity to work with the elite athletic population whose paychecks are on the line, you’ll be fighting the constant battle of patient adherence. Your patients are busy. They have jobs. They had kids. They have other interests and other priorities, and completing your 3×10 sit-to-stand protocol is likely very low on the totem pole.

We know how important exercise is. We understand the consequences of working a desk job 50-60 hours a week and coming home to eat a microwaveable meal and sit on the couch for the remainder of the evening. It is up to us to create patient buy-in; and to educate the public on the importance of regular physical activity and adherence to our therapeutic protocols.

This concept applies to all therapeutic settings: in-patient neuro, outpatient ortho, pediatrics, etc. We must work everyday to connect with our patients and show them how improving their functional deficiencies will lead to improved participation in the activities that they truly care about. Our goals and protocols must be patient-centered. They must be dedicated to helping the patient get back to the activities of their choice. This will not only enhance patient adherence, but also result in improved outcomes and reduced healthcare costs further down the road.

 

  • Charles Badawy, SPT, CSCS, USAW,

            Pitt DPT Class of 2019

June 12, 2017 |

Monday Memo 5/30/2017

The Monday Memo

May 30, 2017                                                                           PITT DPT STUDENTS

Welcome to Graduate School

 

The new class of future physical therapists will arrive at Bridgeside Point 1 this Friday for the very first time as Pitt DPT students. Looking back on my own orientation session nearly one year ago, I remember how excited I was to start my own journey, especially at a university as highly regarded as Pittsburgh. I had spent the past 4 years preparing for school: Working stints as a rehab aide, a strength coach, a personal trainer, and volunteering weekly at a therapeutic riding center. These experiences were instrumental in creating the student I am today.

 

However, with personal experience comes bias. This is even more true while you’re developing as an individual, a professional, and a clinician. Early on in your career, you have a very limited sample size to work with which means every experience holds a greater degree of influence over your perspectives, thoughts, and beliefs. As you begin your educational journey as an SPT, these beliefs will shape the way you view your classes, the experiences you have in clinic, and the research you perform in an effort to improve as a clinician.

 

It’s vitally important to maintain perspective, understand that the science and research is ever evolving, and nobody, including yourself, has all the answers. That being said, with any profession or skill there is a major theme that you must follow to reach the highest level of achievement: Keep an open mind and master the basics. “But the basics are boring, they’re dry”. It may take memorization and repetition day in and day out, but in the end this is where the master clinicians are made.

 

Keep this in mind over your next three years in Pittsburgh. Check your bias at the door when you walk into your first Anatomy class and start fresh. Relearn muscular origins, insertions, and actions. Keep an open mind to new ideas, new treatment methods, and continuously challenge your pre-existing beliefs. Pittsburgh will arm you with the tools to critically appraise EVERYTHING in the field of physical rehabilitation and determine the application to clinical practice. It’s up to you whether or not you want to use them. You’ll likely be a much more effective therapist if you do.

 

 

  • Charles Badawy, SPT, CSCS, USAW,

            Pitt DPT Class of 2019

May 30, 2017 |

Monday Memo: 2/6/2017

The Monday Memo

February 2, 2017                                                                           PITT DPT STUDENTS

Optimal Care vs. Acceptable Care

 

If you’re a clinician, you probably want to provide your patients with the absolute best possible care in order to help them regain control over their bodies and lives. This is exactly why the research arm of the physical therapy profession exists — to bring us the most relevant evidence that will help guide our treatment and equip us with the most effective therapeutic strategies to reach our goals. In an ideal world, every method we use would be backed with Grade-A research, but is this always possible?

 

Oftentimes, a skilled therapist has devised a comprehensive plan for their patient that has been guided by the initial evaluation. It’s inevitable that we will encounter resistance from our patients, either as a result of their busy lives or from their preconceived notions. There are more than a few barriers that may prevent us from giving our patients what can be considered “optimal care,” including jam-packed work schedules, varying patient values, lack of equipment, and more. The challenge for us is to consider how we can navigate these barriers and adjust our plan in order to provide the patient with the most effective strategies available at the time.

 

An expert clinician must be able to skillfully develop alternative therapeutic exercise options, educate the patient to help change or guide their beliefs, and create a therapeutic environment where the patient feels comfortable and cared for. No two patients will present the same, so you must equip yourself with the skills to manage a variety of personalities and belief systems. This is your challenge as a therapist — How well can you adjust on the fly and deviate from your plan, while still providing care that will improve the status of your patient?

-Charlie Badawy
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Social Media Updates
  • #DPTstudent –  WEDNESDAYS , 9-10pm EST!   Check out #DPTstudent page for details!
  • Unite Physical Therapy Students – If you haven’t yet, please check out the “Doctor of Physical Therapy Students” Facebook page. More than 9,500 students have already joined!
  • Our own page! Pitt Physical Therapy, thanks to the Social Media Team, has created an official PittPT Facebook page!
  • #SolvePT (meets on Tuesdays Twitter from 9-10pm EST)
  • Follow @Pitt_PT on Instagram!
February 6, 2017 |

The Monday Memo: 1/30/2017

The Monday Memo

January 30, 2017                                                                           PITT DPT STUDENTS

The Birmingham Clinic

When you picture yourself treating patients in a Physical Therapy clinic, what does it look like? Do you see adjustable treatment tables, a plethora of free weights, ankle weights and therapy balls? What about treadmills, stationary bikes, or trampolines?

 

I’ve had access to these tools at all of my previous clinical internships, and when I pictured myself at a clinic, those tools have been in that image, without question. This semester I am at the Birmingham Clinic, an amazing interdisciplinary facility that is now offering Physical Therapy for uninsured patients. Because Birmingham is a free clinic that relies on donations, our treatment space consists of two basic tables, a few rolls of theraband, two stretching straps, and a couple pairs of free weights. The presence of numerous health professions means our physical space is busy and limited.

 

What I have realized is that the amount of equipment or space does not change the quality of care we can provide. The space does not alter my evaluations or treatment sessions. In essence, I find myself spending more time teaching my patients how to do exercises at home by using items that they may already have, or by being creative. Many of my treatments now focus on functional exercise. Warm ups consist of repeated sit to stands, as compared to five minutes on the treadmill. Doing this kind of warm up is effective from a comprehensive strength and cardiovascular stand point, but it also gives me the opportunity to provide cues on technique for such a fundamental movement. By taking a patient who is deconditioned outside to improve endurance and practice assistive device technique, I’m given the opportunity to navigate real world challenges with him or her such as potholes, gravel, cars and curbs of unexpected heights. Creative strength training that involves exercises crossing multiple joints and incorporation of core stabilization provides a physical and cognitive challenge for the patient.

 

Having to be innovative and flexible with the minimal physical space, lack of exercise equipment, and serving patients with complex medical histories or no knowledge of the English language keeps me on my toes and teaches me something every day. Realizing that all we truly need to help our patients is the knowledge and skills we can teach them, without necessarily needing high tech equipment or fancy gyms, is empowering and rewarding. The only tools we need, we already have, and anything additional to our disposal is a welcome asset, not a prerequisite.

 

If you know anyone, patient or otherwise, who may be worried about losing their medical insurance in the future, please point them toward the Birmingham Clinic in the South Side for free comprehensive care.
– PT services offered Mondays and Wednesdays 12:30-4pm
– https://www.dom.pitt.edu/dgim/phcup/clinics.html
– 412-692-4706

 

– Neele Holzenkaempfer, DPT Class of 2018

Social Media Updates
  • #DPTstudent –  WEDNESDAYS , 9-10pm EST!   Check out #DPTstudent page for details!
  • Unite Physical Therapy Students – If you haven’t yet, please check out the “Doctor of Physical Therapy Students” Facebook page. More than 9,500 students have already joined!
  • Our own page! Pitt Physical Therapy, thanks to the Social Media Team, has created an official PittPT Facebook page!
  • #SolvePT (meets on Tuesdays Twitter from 9-10pm EST)
January 30, 2017 |