Walt Fritz, PT/Foundations in Manual Therapy Seminars

Conclusions and Relevance In this cohort study of adult patients with chronic pain, physician empathy was associated with better outcomes over 12 months. Greater efforts to cultivate and improve physician empathy appear warranted.

Physician Empathy and Chronic Pain Outcomes This cohort study of adult patients with chronic pain assesses the association of physician empathy with patient outcomes, including patient-reported pain, function, and health-related quality of life.

Edinburgh, Scotland, 6-7 December 2024.

Registration is now open for this UK class. This is the only 2024 chance to catch this workshop, which will be a small group event. The website has much information on the class, including new peer-to-peer videos that capture clinicians' experiences applying the work taught in the workshop. Questions? Please let me know.

When looking at the need/benefit of exercise as we age, the evidence is clear. Here is a quick and easy read that may incentivize you to increase your activity, specifically for those in the 70+ age bracket.

A remarkable “sliding doors” moment for physical function with ageing The 1998 flick Sliding Doors contrasts two alternate futures of the main character (Gwyneth Paltrow) after a seemingly minor twist of fate (whether she catches a train or misses it).

https://www.medscape.com/viewarticle/cholesterol-denialism-pseudoscience-2024a100083z?form=fpf

Cholesterol Denialism is Pseudoscience Early research on cholesterol's role in atherosclerosis warranted skepticism, but there is no place for modern-day doubters given the supportive evidence for lipid lowering, writes Chris Labos, MD.

Edinburgh, Scotland. Just confirmed. Registration will open next week for the small group class. Seat availability is limited, so don’t delay.

Join Walt Fritz, PT, for this ASHA CEU-approved class that targets the patient populations of the speech pathologist, vocal health clinician, physio, massage therapist, and osteopath. Learn a gentle, patient-led approach to manual therapy to help in the remediation of voice, swallowing, oral motor, tongue-related, breathing, and related disorders. This class works from a solid evidence base and introduces the learner to how a shared decision-making (SDM) model of touch-based intervention impacts far more than the local tissues and structures. This class is heavy with hands-on learning and demonstrations that allow you to view an SDM-based model of manual care in action.

At today's Voice Foundations Symposium, I had the pleasure of speaking with some SLPs who'd taken my Foundations in Manual Therapy: Voice and Swallowing Disorders class in the past. One of my favorite comments came from a CF-SLP who said that she started using the work immediately upon returning from the class and discovered that the conversation and dialoguing she learned in the class were almost more important than the actual hands-on work. This comment caused a broad smile to cross my face, as these are my core beliefs.

Manual therapy, massage, and soft tissue manipulation are helpful, but they lack a context that makes them applicable to the patient. They are just things we (the clinician) feel are important, but dialoguing allows us to incorporate shared decision-making to ascertain whether the work is important to them. There is a big difference between those two perspectives. Shared decision-making requires us to step down from the role of the expert and into the role of the partner.

Dialoguing in the Foundations in Manual Therapy Seminars approach When clinicians sign up for my Foundations in Manual Therapy: Voice and Swallowing Disorders seminar (or any other seminar I teach), they expect to learn a n...

Just added
We will teach the Foundations in Manual Therapy: Voice and Swallowing Disorders seminar in Singapore on October 29-30, 2024. Seats are available for this and the Hong Kong locations. However, the Nagoya, Japan class is completely filled.

The reduction in muscle tension/cessation of muscle contraction has been historically handed over to others to "release." However, studies show that cortical involvement is necessary for it to occur. While we, the therapists, play a role, don't overstate it. Might we be acting as a surrogate to allow our patients to discover ways to change patterns?

Brain Activity Underlying Muscle Relaxation Fine motor control of not only muscle contraction but also muscle relaxation is required for appropriate movements in both daily life and sports. Movement disorders such as Parkinson’s disease and dystonia are often characterized by deficits of ...

https://podcasts.apple.com/us/podcast/003-walt-fritz-explains-myofascial-release-therapy/id1457396073?i=1000434837952

‎VocalScope: 003 - VocalScope: Walt Fritz explains Myofascial Release Therapy, his approach to the work and the potential for this manual therapy to impact the voice. on Apple Podcasts ‎Show VocalScope, Ep 003 - VocalScope: Walt Fritz explains Myofascial Release Therapy, his approach to the work and the potential for this manual therapy to impact the voice. - Apr 13, 2019

Promoting physical activity to patients

-What you need to know
Benefits to health start at just 30 minutes of physical activity a week, but more than a quarter of UK adults fail to achieve this
Physical activity can reduce all cause mortality more effectively than medication

Risk of harm from moderate physical activity is small, while the adverse effects of inactivity and sedentary time are clear
The health benefits of physical activity are proved and wide ranging, exceeding that of any drug. The Academy of Medical Royal Colleges has described physical activity as a “miracle cure.”1 Meanwhile, inactivity contributes to as many deaths in the UK as smoking2 and is the fourth leading risk factor for mortality worldwide.3 More than 25% of adults in the UK are inactive, doing less than 30 minutes of physical activity a week.2 Clinicians are uniquely placed to help their patients to become more physically active, and even a brief discussion within a consultation can lead to change.

This article offers a practical guide to help clinicians discuss physical activity within a consultation, including how to address concerns patients may have about becoming more active and how to help them overcome barriers to change.6

-What do we mean by “physical activity”?
Although exercise and physical activity are sometimes used interchangeably, they have distinct meanings. In practice, although exercise may be a more familiar term to people, it can also be off putting to some: you don’t need to be doing exercise to be active.

Physical activity, defined by the World Health Organization, is “any body movement performed by skeletal muscles that expends energy,” whereas exercise is “physical activity with the primary purpose of improving or maintaining physical fitness or performance.7” Moderate intensity physical activity “requires a moderate amount of effort and noticeably accelerates the heart rate,5” leads to faster breathing and feeling warmer, …

Promoting physical activity to patients # # # What you need to know The health benefits of physical activity are proved and wide ranging, exceeding that of any drug. The Academy of Medical Royal Colleges has described physical activity as a “miracle cure.”1 Meanwhile, inactivity contributes to as many deaths in the UK as smoking2 and is...

Cardiorespiratory fitness is a strong and consistent
predictor of morbidity and mortality among adults: an
overview of meta-analyses representing over 20.9
million observations from 199 unique cohort studies (full-text link).

WHAT THIS STUDY ADDS
⇒ This study identified 26 systematic reviews with
meta-analysis representing over 20.9million
observations from 199 unique cohort studies.
Cardiorespiratory fitness was strongly and
consistently protective of a variety of incident
chronic conditions and mortality-related
outcomes.
⇒ Gaps in the literature continue to exist, with
limited evidence available among women,
and certain clinical populations. Several
health outcomes could benefit from future
meta-analyses, including specific cancer
types, especially among women (eg, breast
cancer) and mental health conditions beyond
depression.
HOW THIS STUDY MIGHT AFFECT RESEARCH,
PRACTICE OR POLICY
⇒ Given the strength of the predictive utility of
cardiorespiratory fitness across many health
outcomes, cardiorespiratory fitness would be
a valuable risk stratification tool in clinical
practice.

Conclusion We found consistent evidence that high
CRF is strongly associated with lower risk for a variety of
mortality and incident chronic conditions in general and
clinical populations.

https://bjsm.bmj.com/content/bjsports/58/10/556.full.pdf?fbclid=IwAR2Jaodfw6tbNDCkH0IOVFcbnEqS2N7yaPDI7eBOUMPU3LQVm5-YC-D9VVM

bjsm.bmj.com

Conclusions
Manual therapy interventions should include both passive and active, person-empowering interventions such as exercise, education, and lifestyle adaptations. These should be delivered in a contextualised healing environment with a well-developed person-practitioner therapeutic alliance. Teaching manual therapy should follow this model.

https://chiromt.biomedcentral.com/articles/10.1186/s12998-024-00537-0?fbclid=IwZXh0bgNhZW0CMTEAAR1XIMUyrovDFb4X4U5mYhppsT39jmUSsCeA5M1APJ2QhqaWr1vPbvkBTd4_aem_Abyn_qli6fuKK25_KdE-5w6iCC-svlKPnlq4njj0aPDKQPPVLA-VLUb8TwmPcY93HUbx6NjzI5XXSMxIYyh6i4x4

A modern way to teach and practice manual therapy - Chiropractic & Manual Therapies Background Musculoskeletal conditions are the leading contributor to global disability and health burden. Manual therapy (MT) interventions are commonly recommended in clinical guidelines and used in the management of musculoskeletal conditions. Traditional systems of manual therapy (TMT), including...

Back pain: not a couch potato problem? 🤯 Say what now?

Most people believe that sedentariness is a huge risk factor for back pain, but a new study says “nope!”

And I for one am glad to hear it! As I wrap up another long week mostly in my chair.

Lemmers et al. studied a few hundred back pain patients for a year, measuring activity levels with questionnaires (maybe not ideal, but the main one here has been validated with accelerometry).

They found that sedentariness at the start was clearly NOT linked to disability a year later, not even a little bit. More or less sedentary just didn’t make a difference.

https://www.sciencedirect.com/science/article/pii/S2468781224000493

The other side of this coin: people also assume that extra exercise will improve the prognosis, but … nope again! Not in this data.

To be more precise, they did KINDA find a benefit to higher activity levels, but only a tiny bit… so little that “the finding is not clinically relevant.” Not exactly a strong win for those who choose to exercise with back pain — although there are, of course, always OTHER good reasons to exercise.

~ Paul Ingraham, PainScience.com publisher

Web version of this post, if you'd like to link to it directly:
PainScience.com/blog/back-pain--not-a-couch-potato-problem.html

We are very proud to report that current MA Voice Pedagogy student Walt Fritz, PT/Foundations in Manual Therapy Seminars has recently had an article accepted for publication in the bimonthly journal Current Opinion in Otolaryngology & Head and Neck Surgery (Lippincott Williams & Wilkins – LWW).

Walt’s article is titled ‘The mechanism of action for laryngeal manual therapies: The need for an update’ and will be published in an upcoming issue.

Congratulations, Walt!

Working from an evidence-based perspective, there is an expectation that to provide the best level of care, published research should act as our blueprint. However, when one reads a study, the specifics are often too vague or encoded in jargon, making application difficult. Manual therapy papers suffer this fate, with most vaguely alluding to the methods used, rendering the application spotty, at best. While the study posted here suffers the fate of many papers where the mechanisms of action are poorly researched, the methods used and outcomes achieved are clearly stated. Photographs included in this study allow the curious clinician to have a tangible starting point from which to begin treatment.

Open access, with the full-text version available at the link.

Manual Therapy of Dysphagia in a Patient with Amyotrophic Lateral Sclerosis: A Case Report Amyotrophic lateral sclerosis (ALS) is an incurable rare neurodegenerative condition, with 45% of cases showing the symptom of dysphagia; its clinical signs are atrophy, weakness, and fasciculations of the facial muscles, tongue, and pharynx. Furthermore, dysphagia is the main cause of aspiration pn...

Trigger point therapies might be helpful, but it is likely due to secondary or relatable/contextual impacts. This short article unpacks an entire industry.

https://blog.apsoc.org.au/2018/01/08/behold-the-mighty-trigger-point/?fbclid=IwAR3JqFuMw1lRswtBfn-AujrU6x9AzqvRY5LAIUFaAkQ7B0IFCYsqCH83ul0

Behold the Mighty Trigger Point By Dr John Quintner, Prof Milton Cohen and Asaf Weisman PT MScPT Some clinicians are still endeavouring to prove that myofascial pain is a distinct localised clinical entity attributable to “trigge…

The American Hotel in Lima, NY, is asking for your help. This regional landmark, which has existed in its present form since 1861 and had earlier incarnations beginning in 1790, is rebuilding its front porch/portico. Given the cost of renovations, the Reynolds family has humbly asked for help from the community to support the restoration and preservation of this historic hotel. As my physical therapy office sits directly across the street, I can observe the current state of the updates and appreciate the efforts going into the project.

Please consider even a small donation to help keep this Upstate New York institution viable.

Donate to Join Pat Reynolds to Restore Lima's Landmark, organized by Patrick Reynolds 5/17/2024 Today the concrete was poured for the pillars and the new ste… Patrick Reynolds needs your support for Join Pat Reynolds to Restore Lima's Landmark

It's been 14 years since I last taught in Alaska, so I'm looking forward to my visit there this August. Providence Health is bringing me up to teach two classes, and I'm looking forward to teaching both classes and having time to tour Alaska during the summer. I will teach my Foundations in Manual Therapy: Voice and Swallowing Disorders class CEUs approved by ASHA, AKPTA, and NCBTMB (AK OT CEUs are pending). Providence also asked me to create a bespoke 2-day class specifically for PTs, OTs, and MTs, and I've done so with the new Foundations in Manual Therapy: Whole Body Seminar.

For those unfamiliar with my work, I teach from a non-manipulative form of manual therapy that drives intervention from patient perspectives. Using a form of shared decision-making, the patient and therapist combine their experiences to define effective treatment. Current best practice states that manual therapy should not be seen as a standalone intervention, and we cover these perspectives in the workshops. The Voice and Swallowing Disorders class covers interventions for dysphonia, dysphagia, tongue-related disorders, oral motor limitations, globus, GERD, breathing issues, and related problems. The Whole Body Seminar will dive into neck and back-related problems, fine motor/upper extremity dysfunction, headaches, and TMJ-related issues.

Both classes have limited space, so if you are interested, you can find out more on the website.

We are finalizing an Introductory class in Edinburgh, Scotland, on Dec. 6-7, 2024. Watch for a few more international classes coming over the next few months.

https://youtu.be/1StIA9_ItD8?si=ui_BmFryTELXVTw_

Voice Foundations Southern California Chapter Spring 2024 Meeting I was asked to present to the SoCal Chapter of the Voice Foundations to share information on manual therapy's utility with voice disorders.

https://youtu.be/LChI3YkXoMY

Learn more at www.WaltFritz.com.

Highlights from a Foundations in Manual Therapy: Voice and Swallowing Disorders Seminar. Learn more and find a class near you at www.WaltFritz.com. You can also inquire about bringing this class to your facility worldwide. Inquire at www.WaltFrit...