Specialized Physical Therapy

Sweet patients often give me a boost in the middle of my long days, and yesterday was a 12.

So, I had just finished the history taking part of an evaluation with a 76year old lady who I haven’t seen in around 5 years. She had moved from a chair to the table and I was going to start the physical examination when she says “I’m sorry, can I stop you for a minute? (Sure, what is it) “how are your wife and daughter, Is everything good, and how old is your daughter now?”
So I spent a minute or two telling her what was going on in our family, answered a few more questions, showed a few pictures from our latest adventure, and then back to work.
So sweet,
and she’ll get back to her fitness walking and gardening before long, so it’s a win-win.

We are hiring a part-time administrative assistant/receptionist. Please send resumes to [email protected]

They call high-blood pressure the silent killer, but what I really worry more about is a stroke. Therefore I have been on medication for my Isolated Systolic Hypertension for a few years now after keeping it barely under control with exercise, nutrition, and supplements. I don’t like medication, but I like to feed myself and wipe myself, which are two things I have done for patients post-stroke.
If you have high blood pressure and it is not controlled with medication, I suggest you speak with your physician and take their advice before it’s too late.

I do not have sufficient knowledge to agree or disagree with this sign at my physicians office, or to give any specific treatment, but doing something is better than doing nothing!!

We agree with this,
If you would like to find out if we can help you it will take 2-3 visits over 2 weeks.

This is a great post from a physical therapist in Nashville.
The only little modification I would make is that not every patient needs manual therapy.

“Ive tried PT and it didn’t work.”
“They had 3-4 other patients running around and we did some ice and some estim but I didn’t really feel better.”
I love my job so much and we have helped some incredible people but some PTs are terrible at what they do.
3 sets of 10 with a band, table exercise, ice and e stim will not get you to where you want to go.
IF YOU ARE NOT GETTING ANY WHERE WITH YOUR PT PLEASE FIRE THEM AND FIND A NEW ONE.
There are so many great PTs out there who are breaking the status quo and who are appropriately teaching patients to move better and get stronger.
Make sure that your PT is helping you lift, run, bike, etc and teaching you how to do those things not avoiding them.
Therabands are great but if you want to deadlift you need to lift weights not just play with bands.
Instead of the list above you need
1️⃣Someone modifying your activity for you not removing it completely
2️⃣A little bit of manual therapy but not an entire session of it ( cupping, dry needling, soft tissue work, joint manipulation etc)
3️⃣Heavy dose of teaching you to move better( fixing your squat pattern, overhead lifts etc.)
4️⃣Heavy dose of corrective exercise to get you stronger ( mobility work, strength work, stability work)
5️⃣Work on prevention so this doesn’t come back in the future.
——
👋Tag someone who would appreciate this
👍Like and save if you found helpful
👇Post questions or comments below
————————————————







#615

Very true

Discipline will help you reach your short-term and end goals.

So true, rarely do we address shoulder blade pain that is a shoulder blade problem!

Differential orthopedic diagnoses include a strain/pull/tear to any of the muscles in the area (there are many) and a shoulder joint derangement. It’s rare that you injure one of those muscles - and shoulder joint derangements only infrequently refer pain posteriorly to the shoulder blade. Can a frozen shoulder refer pain back there as well? Sure. But that’s not usually going to be the chief complaint of someone with a frozen shoulder.

The joints in the cervical spine and the thoracic spine can refer symptoms to many areas, and the shoulder blade is a big player. With altered electricity coming from irritated spinal nerves, it’s not uncommon to find spasms or trigger points in the shoulder blade muscles. Those findings are the symptoms, not the culprit. Local weakness can also be a finding due to spinal nerve irritation. I find that in nearly every case I’ve seen in which the person complains of shoulder blade pain (or ache or tightness), we can fix it with repeated or sustained movements of the spine - in the sagittal, frontal, or transverse plane.

This is why many people with sciatica exhibit profound glute weakness that improves rapidly with appropriate treatment. I’m surprised when there is extremity pain and I Don’t find weakness.

If you or a loved one are experiencing buttock or leg pain, call is now for evaluation so that we can teach you how to resolve this and prevent recurrence!

A muscle can only achieve optimal strength & efficiency if it’s getting an undisturbed supply of electricity. I hear loads and loads of people talk and talk about problematic weak glutes. I usually don’t find weakness. Instead, I find that it’s almost always inhibition - a fuse box (spine) problem. Most low back problems are at the levels L4, L5, S1. Is it any surprise then that the nerves to the glutes may be compromised? There does not have to be back pain for a nerve irritation to be present.

If we prove that your nerves are indeed working well (which we do by clinically moving your low back, and sometimes hip, repeatedly - not by looking at an image), and your glutes are still problematically weak, then we can begin all those glute exercises such as squats, lunges, donkey kicks, clamshells, crab walks, sidelying leg lifts, lateral step downs, bridges, and so on. If a professional wants to diagnose “weakness,” then he/she better have first at least ruled out inhibition. Not only does that save months of work, but it gets at the real diagnosis.

It has been 5 years since this attack that began a few hundred yards from our clinic.
For a time, our city was United.

Remembering Chattanooga's Fallen Five, 5 years after their deaths It has now been five years since one of the darkest days in Chattanooga's history. On July 16th, 2015, a man opened fire at a military recruitment center on Lee Highway before driving down Highway 153 and Amnicola Highway. The man drove through the gates of the Naval Operations Service Center and op...

Thankful for the mentorship of Paul Swart, who always takes my call when I have a challenging patient.

Today we discussed the worst Nerve Root Entrapment I have ever seen.
-constant below knee symptoms
-ipsilateral shift
-(+) crossed SLR
-uninsured

Specialized Physical Therapy has required face coverings since resuming in clinic visits two months ago. Hamilton County now requires face coverings according to the following graphic.

Every visit to our office is 30-45 minutes of individual time with a licensed provider. We believe face coverings reduce the risk of transmission during this prolonged close contact,and do not want to risk the health and safety of our patients.

We continue to encourage telehealth visits when appropriate for the condition, in order to reduce unnecessary traffic through our office. We have been providing virtual care for individuals outside our area for over two years, and are thankful for how this prepared us for the transition due to COVID-19.

If you have been waiting to address a musculoskeletal/orthopedic condition, call our office and let’s discuss the best choice for your individual situation. We want to see you back to doing what you enjoy, with those you love.

I am not saying that there is no problem or that we should be reckless in the handling of this pandemic.

We are seeing patients in office, with extra cleaning and everyone wearing masks. We continue to provide virtual Telehealth visits as we have for over two years which are very effective.

If your assessment doesn’t reveal the need for manual therapy or hands on assessment each visit, we encourage the telehealth option to reduce risk of transmission.

The data is being skewed and is hard to interpret, but we need to consider the big picture, not just the sound bites.

When we look at the pandemic, we need to look at multiple data points to understand what's really happening. Right now, the mainstream is pointing to the increasing cases and trying to scare everyone that it's so bad.

But that's only part of it.

We also need to look at hospitalizations and deaths. If those aren't spiking, then what we're seeing is a result of increased testing capacity. They've been saying they wanted to increase it and now they have.

Of course, there have also been reports of people registering for a test, not actually doing it, and getting a positive.... And some people are getting tested multiple times. There is a lot going on.

Supposing the case increase is entirely real, we should have seen the deaths spiking about two weeks after the cases started to. But in the country as a whole, we're not. They're still falling sharply.

This could mean that we're discovering that most "cases" are very mild and the illness is not as deadly for most as we thought. (They have been saying it's mostly younger adults testing positive now.)

But at any rate...this is one important data point right now that the media is NOT reporting. They're giving you a slanted, fear based view of things. Ask why.

Michael Jordan: ‘I can no longer stay silent’ As a proud American, a father who lost his own dad in a senseless act of violence, and a black man, I have been deeply troubled by the deaths of African-America…

What Now America, What Now?
On this anniversary of D-Day and the great sacrifices made, will we sacrifice for those among us in need?

I serve the poor and needy in some small ways, mostly addressing health disparities. At times in my life I have served more, sacrificed more, done more.

Regardless of what we think of the protests, law enforcement, racial disparities, economic disparities, politicians, COVID-19; will we sacrifice to make things better?
They did, and they have since been called the greatest generation; what will we be called?

It has been a rough few months, and brutal two weeks, but what now?

Do we desire to go back to life as it was before, or do we hope for more?

If we hope for more, what will we DO to make that a reality?

What will You do? do you plan to do anything? Don't just demand that others change, look to make a change yourself.

I want to do more.

D-Day 76th Anniversary // We Still Remember Jack Foy reads the prayer that Franklin D. Roosevelt gave just before the invasion of 76 years ago on June 6, 1944. We have been tak...

This is true for many things, including your health!

I love this simple explanation of what we see every day, but often surprises our patients!

I often describe it as “unlocking the joint.” Too often people think that if they can’t flex their elbow, they need to keep flexing it to increase that motion. Or if they can’t extend their hip, in order to achieve more extension, they need to stretch a lot into that direction.

Sometimes ... but not usually. In most cases, to get a joint moving well in either one or more deficient directions, another direction of movement is needed to “unlock” other directions. We call this a joint’s directional preference. When I evaluate a patient with a joint that’s not moving fully, I look for a joint’s directional preference and, if found, prescribe that for the person’s home program.

It’s unbelievable how many people repeatedly practice toe touching to get more motion (more flexion), but only actually improve their toe touching ability once they repeatedly move their spine in the opposite direction (extension).

Another example of why imaging should not be relied on for clinical decision making.
Interesting point is that they stated full thickness tears and OA are more common in the symptomatic shoulder... 10% more common.
STILL not relevant to me
“Well Mr. Jones, you have a full thickness tear of your supraspinatus and there is a 10% chance that it matters... let’s go repair it surgically”
Said no one, ever!!

https://www.jshoulderelbow.org/article/S1058-2746(19)30234-4/fulltext Are you surprised? “Most abnormal MRI findings were not different in frequency between symptomatic and asymptomatic shoulders." How could you incorporate this sort of information into your assessment, classification, education & management of patients with shoulder pain? https://www.mckenzieinstitute.org/ 🤔

Thank you to our wonderful patients for nominating us for Best of the Best Physical Therapy Group! Will you take a moment to add your vote?

Check out Specialized Physical Therapy, PLLC. Vote for your favorite businesses by July 5 for a chance to win $500!

Food for thought

From “Overtreating Chronic Back Pain: Time to Back Off?” In Journal of the American Board of Family Medicine, Vol 22 No 1.

Makes me wonder why - despite these recommendations - so many patients are still being prescribed imaging such as MRI and x-ray. Do other clinicians see the same research and recommendations I see? There is a time and place for imaging of the low back ... and it’s rare.

Pushing harder isn’t always better, every person and case is unique. But if you need more force in the clinic, then you need it at home and at work!

MDT uses the principal of the least force required to do the trick (fully reduce the derangement and abolish all pain and restore range of motion)!
Where possible the patient provides the force independently to promote autonomy and empower the patient to self-manage.
Sometimes we need a helping hand, or foot the produce the required amount of force!
-Management

Malawian Teen Taught Himself How To Build A Windmill From Junk, Brought Power To His Village, ALL Learned From Library Books! | Urban Intellectuals Get this boy in a prominent position, make him famous, let him inspire! We are joining a call from Anonomous who posted a very simple message, they say the media is blacking out the importance of Malawian Teen William Kamkwamba. He taught himself how to build a windmill from junk, brought power to h...

Too often chronic pain is written off and sent to Pain Management, but it is often MECHANICAL pain that is best treated with MOVEMENT.

“Chronic” describes a timeframe (the exact timeframe varies somewhat depending on whom you ask). Pain can persist for many reasons, however. Not getting the correct diagnosis and treatment is certainly a big factor why people have persistent (chronic) pain. If someone says you have “chronic pain,” ask more questions. Ask for a real diagnosis. Why is this pain persisting? What is causing this persistent pain? In many cases, even though the pain has been there for a long time, it is rapidly reducible once you get the right diagnosis and treatment.

So-I haven’t had time to read this all yet, but it is so true including preventing recurrence of musculoskeletal conditions.
Self-Care first is so essential and it is NOT selfish, it allows you to care for others!!

Self-Care Is Not An Indulgence. It's A Discipline. Self-care is not an indulgence. It's the ongoing practice of keeping ourselves physically and emotionally healthy.

MRI isn’t bad, if you need it, but most don’t!

https://buff.ly/2BPuSgh The evidence just continues to grow: “Imaging in LBP may be associated with higher medical costs, increased healthcare utilization and more absence from work.” https://www.mckenzieinstitute.org/

I don’t think I have anything to add to this truth!!

MYTH BUSTED: Exercise isn't harmful for people with knee osteoarthritis Advice to rest and avoid pain is commonly provided to people with knee and other joint pains - advice that is often wrong, and harmful.

Just one more reason everyone needs to find an appropriate level and form of exercise, regardless of the injuries or medical conditions they experience!

New study offers 'strongest evidence' yet that exercise helps prevent depression Does physical activity reduce depression, or does depression reduce physical activity? A new study has found that it's the former, with exercise having a protective effect against depression.