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Fall sports season is upon us yet again so it’s always good to remind ourselves as clinicians and remind parents, coaches, players with whom we interact about the very real risk of concussion, or sport related concussion (SRC) as it is sometimes described in the literature. I recently pulled out an older JOSPT volume and was perusing through it when I ran across a great review article dealing with SRC. I read through it and thought it was worth sharing on the cusp of so many sports starting back with the new school year.

The Potential Role of the Cervical Spine in Sports-Related Concussion: Clinical Perspectives and Considerations for Risk Reduction.

Essentially, the authors highlight the prevalence and risks related to SRC. But what made this article interesting and applicable to us as PT’s is the fact that the authors were pulling studies that looked at potential modifiable factors to help decrease risk of SRC. Once those factors are identified, then preventative exercises could be incorporated to help maintain risk reduction.

What were the things that were identified? Factors such as neck strength, neck girth, and neck posture were all factors that can modify SRC risk. The authors cited good evidence that increased strength and neck girth help reduce risk of SRC. In fact, one study in this review showed that for every 1 lb increase in neck strength, the sports-related concussion risk decreased by 5%. The reviewers also cited that may be why there is a sex difference. Females tend to have higher rates of SRC than males likely related to the strength and girth component. The other fascinating factor was forward head posturing. Most student athletes have forward neck translation due to phones, tech, etc. just like most people have this posturing. But in one cited study that flexion/extension imbalance decreased the strength ratio in the neck thus increasing head acceleration during impact.

I believe this is pertinent information. I am finishing post surgical rehab on two football players in order to return them to the sport by the fall and need to make sure that before they are done we go over some of this information and the exercises. We need to make sure that when we are treating athletes, we don’t forget about the potential concussive forces they will face. We can prepare both men and women (especially women since they are at greater risk) by working on posture exercises and neck isometrics, the important components identified in this study.

I hope you found this helpful and I hope that you incorporate this information for the health of your patients.

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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There are many verses that discuss the reality that our work as Christians matter and that it has eternal significance. We are called into our vocations to work hard and work will for the benefit of others and so that God gets glory. And even if we don't see significant reward, we know that honoring God will result in heavenly reward.

I recently saw this quote from Daniel Doriani and it just gave me pause and challenged me afresh that my vocation has immense purpose in God's Kingdom. Yours does too. So, I hope you are encouraged and challenged by this wisdom.

I especially appreciate the call to love our co-workers and customers (patients) because when we love people different from us or  love them while they are going through a hard time, that is the essence of the Gospel. And when people are curious as to why we do that, we have an answer for this hope and love we profess. I hope we remember that we are serving the Lord as we work and love others. Watch how that changes your perspective this week! 

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Jason

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There are always a plethora of articles and studies to draw from to enhance our skills and PT practice but every once in a while there is a study or report that is really fascinating with huge implications. That report came out a few weeks ago from the nation’s top doc, the U.S. Surgeon General, Vivek Murthy.

While there are many health reports that come from this office to address overall health needs of the nation, this most recent advisory report was very illuminating not only from the identified health risks but also because of the societal impacts. What health condition might be of so much importance? Turns out it is loneliness.

Yes, loneliness. At first glance, my thought was, “Really?” But as I continued to read the report I was both fascinated and heartbroken. Fascinated because of the research that cites the very real physical, physiological, and mental health effects associated with isolation and loneliness. Heartbroken because it highlights very clearly that we have strayed from God’s design for relational community. We may be more connected than ever before in history but we are actually more isolated and lonely. And that has devastating effects on us as the report details. We were designed for relational community and yet it is eluding us as we run further and further from God’s original intent.
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But the fascinating part was all of the studies and research that has been conducted for many years, actually. This problem was identified years ago but we are seeing more fruit and fallout in recent days.. Just read this summative passage from the article relating to the epidemiology of isolation and loneliness:

​Click Here to Read the Full Report

So, you get an idea of the scope of this problem. A scope so large that the U.S. Surgeon General labeled it an epidemic. Now, a lot could be said about all of these things and indeed, in the article, much more detail is provided and there are proposed solutions. But, I want to try to provide a meaningful perspective from the Physical Therapy or rehab point of view. How can we, as PT’s, engage this epidemic? How can we learn from this information and apply it to our practice? Let me offer a few ideas. These are by no way exhaustive, but just some thoughts to help get you thinking about applying this information.
 
Awareness, Identification, Education. This is maybe a little bit obvious, but we should digest this information and share it with our colleagues. We all interact extensively with other people and we are a very relational profession so once we recognize and understand the value of this information, then we should definitely share it with our colleagues. Have a lunch meeting to discuss it. But then once we are aware we need to apply it to our patients and identify those patients that maybe exhibit the characteristics of loneliness and educate that with this information. Again, we will have that opportunity because we are a very relational profession spending extensive time with patients.
 
Be Gracious. By this, I mean, think about your patients and be patient with those who seem more interested in conversing than exercising. We have all had the patient that we think is just coming to hang out or talk with us. That patient may report not really getting better despite objective improvement. This report helps shed light to the fact that maybe combating loneliness is  actually the case for a particular patient. Many of our patients may be finding a sense of community as they interact with us.  Recognize that the patient may be coming more for social interaction and less for physical ailment so let’s be gracious and sensitive to that need and not dismiss the patient or discharge the patient prematurely thinking they just don’t want to get better. Maybe they are just struggling more psychosocially.
 
Take opportunities to invite patients to your Christ-centered community. I think for me this has been the greatest wake up call. People need community. God is a trinitarian God. God made us in his image to not only need but desire community and relationship. As this report highlights clearly, we thrive with community but crumble in isolation. In a world where authentic relationships are lacking, you and your church have a tremendous opportunity because God has designed the perfect antidote to loneliness and isolation in christian community. That is your church, your community group, or Bible study. Let’s not be selfish but invite those that are lonely into our community. Let’s pray that through these invitations, these individuals will encounter the true God that desires personal relationship with them and will never leave them nor forsake them.

What are your thoughts? As you process this information, how will you apply it to your life, family, and professional practice? I would love to hear your ideas so feel free to comment!

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

Time to blog seems to be eluding me these days with the hustle and bustle of life, work, and family responsibilities but I’m happy to have a post ready that I’ve spent some time thinking about and which I hope will be beneficial to you. I've been working in the field of physical therapy for over a decade now and have experienced many different types of work environments and had many different interpersonal confrontations. Some of those have been good and some have been more challenging. But through it all, I have discovered some key concepts that have really helped me find success both in my work and personal life. So, I’d like to share four guidelines with you today to encourage you as you walk through your different career and life stages.

Be a Blessing to Others. This is something that sounds easy but requires some diligence because our natural default is to worry about ourselves. This can be especially true in our workplaces as healthcare providers. Being a blessing to others requires the selflessness described in Philippians 2:3-4 where Paul writes and says to do nothing out of selfish ambition but consider others more significant than yourself. It means being helpful and speaking encouraging words to those around you. It also means that sometimes we just have to listen well to those around us and be understanding. There will be fruit from being a blessing to others because you will become someone that others want to be around and that is a gift that can be used to point others to Christ.

Work Hard. Success in life and the workplace requires us to do good work and to work hard doing that good work. Be someone that sets an example of a good work ethic and do your very best as working unto the Lord. Again, the scriptures instruct us in this in Colossians 3:23 where we are told that whatever we do, we are to work at it with all our heart as unto the Lord and not men. Sometimes that may mean going above and beyond your designated responsibilities but set an example of a good, gospel work ethic and combat the laziness that might surround you. You will benefit in the long run.

Have a Good Attitude. We live in a fairly negative society where complaining reigns supreme. But adopting a grateful, positive attitude will take you far in life and in your healthcare workplace. As a believer, we have much to be thankful for because no matter what our day has been like, or how others have treated us, we have the love of Jesus Christ and an eternal hope. We can have joy in a world of disgruntled, negative attitudes. Yes, things can be challenging but we are instructed to do everything without grumbling and complaining (Phil 2:14-15). And because of Christ in our lives, we can say with the psalmist that this is the day the Lord has made! Let us rejoice and be glad in it (Ps 118:24)! My pilot dad always told me growing up, “Jason, in life, your attitude determines your altitude.” So cultivate a good attitude in the midst of negativity by keeping your eyes on Jesus and watch how the Lord uses you for his purpose.

Think the Best of Others. In dealing with colleague or patient relationships, it is easy to make a quick judgment, focus on a negative interaction, or come into an interaction with a negative bias by justifying yourself. Many times we just assume the worst in someone as if the individual we are interacting with has a personal vendetta against us, but that is likely not the case. We never know what someone may be walking through in their own life and need to have grace and compassion in difficult situations. But working to think the best of can really offset any potential misunderstanding and thinking the best of others is a way to help combat those condemning thoughts.

I hope these four guidelines inspire you today and help impact both your daily and work life. And through them, I pray that others would see a difference and give you an opportunity to give an account for the hope that you have in this dark and hopeless world. Thanks for reading and if you found it beneficial go ahead and share it!

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

Welcome back to a new year! We are kick starting this year with a Journal Club blog because in doing some research for my own institution on PT services, I ran across an interesting article. We all understand the necessity of rehab services in the hospital. Many studies have documented the important benefits of early mobility provided by PT.

This study, however, looked at the frequency of PT services provided to determine essentially if there was a dose response on outcomes and length of stay. And low and behold, there is evidence that additional PT services have a dramatic impact on not only the health and outcome of the hospitalized patient but also on how long that patient stays in the hospital.

Additional PT Services Shorten Hospital Stays

The researchers in this particular study conducted a systematic review and metanalysis or available studies to uncover any evidence that PT can help decrease length of stay. They found that there is moderate evidence that additional PT services reduced subacute length of stay by about 3 days and some evidence that it can reduce acute length of stay by almost a day. The authors confirmed that PT services improve overall self care and ADL’s with no additional adverse events.

All in all, this study highlights that PT is valuable in acute and subacute PT care and that there is growing evidence that additional visits and services in those settings can not only improve health, self care tasks, and ADL’s prior to a patient's discharge but can also shorten their time window which will keep them less sedentary. I hope you find this study useful and helpful to your department or institution.

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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Christmas is here and it truly is the most wonderful time of the year. I recently took my family ice skating at the local park one evening and it was a wonderful time. The park was filled with Christmas lights, music, and of course an outdoor ice rink, which, yes, is unique for Georgia because it’s typically pretty warm over Christmas but this particular night was quite wintery. It was a quintessential holiday experience and it brought so much joy and happiness to me and my family as we made a Christmas memory together.

Similarly, but so much more so, this season brings much joy and thankfulness in my heart because of the dedicated time pondering the reality that God looked down from heaven in compassion and sent his son to this broken world to redeem it. He became one of us to free us from sin and sins death penalty. This season leads my heart to praise and worship our creator because he made a way of salvation through Emmanuel. God is actually with us!!  What. A. Joy!!! Reflect on these words from Spurgeon:

​“Look! Here is the subject of your joy. The God who made you, and against whom you have offended, has come down from heaven and taken upon himself your nature that he might save you. He has come in the fullness of his glory and the infinity of his mercy that he might redeem. Do you not welcome this news? Will not your hearts be thankful for this? Does this matchless love awaken no gratitude?...Oh I pray you adore the incarnate God and trust in him.”

I hope and pray you are filled with all joy this Christmas season as you worship God this and are filled with joy because of this great news!!

Jason

​***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

Welcome to our new subscribers!! And if you haven't joined the conversation on Facebook, then find us @ptsonmission to continue to receive updates, encouragement, and information. Finally, tell a friend if you are benefiting from this site.

Another Thanksgiving is upon us and I am ready for the break from routine that it brings. I love this holiday because of its simplicity. Thanksgiving does not have the marketing or commercialization as other holidays like Halloween or Christmas, which may be why it seems to get lost in our current cultural moment. Instead, it is built around being with family and friends and orienting our hearts and attitudes in a positive direction. A direction of thankfulness. We should never lose sight of or skip this holiday. It is good for us to give thanks.
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We give thanks for many things during this holiday season, or at least we should. Many of the things we give thanks for are temporal things or provisional things. Ask any child or adult what they are thankful for and you will hear answers like, family, friends, shelter, toys, food, job, etc. This is right and good because every provision that we have is supplied by God, our Maker. Many Puritan prayers also reflect the thankfulness of the temporal things in life. Take this brief passage from a prayer of thankfulness in the book Valley of Vision:

​I bless thee for:
the body thou hast given me, for preserving its strength and vigor, for providing senses to enjoy delights, 
for the ease and freedom of my limbs, for hands, eyes, ears that do thy bidding;
for thy royal bounty providing my daily support,
for a full table and overflowing cup,
for appetite, taste, sweetness,
for social joys of relatives and friends,
for ability to serve others,

​And it continues on about tangible, practical things for which to be thankful. But I am especially thankful for something else this year. Something else that I read in Psalm 103 just the other day. It’s neat how sometimes when we read a passage, each time we read it something new jumps out at us. And for me, this happened specifically in vs 10. This time reading it, it gave me pause to be especially thankful during this season. Listen to what David writes:

“He does not deal with us according to our sins; nor repay us according to our iniquities.” Ps 103:10

Did you catch that? God does not deal with us according to our sins. He does not repay us according to what we actually deserve. Wow. If that statement doesn’t generate thankfulness and love for Jesus this season, then I don’t know what would! Bless the Lord because in his great love he sent Jesus to take the punishment for our sin that we deserved and gives us life everlasting if we repent and believe. Thinking about this truth will certainly stir a heart of gratitude and thankfulness.
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So, while we gather with family and friends and give thanks for all that we have been given, don’t forget to be thankful for the spiritual realities that we have as believers and for the unfathomable character qualities of our God. For by them, your soul is secure in Christ and you can be truly thankful. Maybe start by reading and re-reading Psalm 103!

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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It’s been a little while since “Journal Club” has featured an article for the hard working neuro therapists in the world, so I thought I would remedy that situation this month and post a neat little review article focused on stroke recovery.

This article takes a slightly different approach to return to activity. It does not focus on interventions and treatment options to return a patient to a desired level of function. It actually assesses the different environmental factors that contribute to resumption of a patient’s desired activities. And for that reason, I thought it was interesting.

Environmental Factors that Influence Resumption of Desired Activities in Patients Post Stroke

A systematic review of both qualitative and quantitative data was performed and analyzed and the researchers discovered some interesting factors. Some of the findings were somewhat obvious. For example, adaptive equipment and education were two big components to resuming desired activities. But there were also some factors that I hadn’t thought about before like transportation availability and easy to navigate environments. 

The researchers also looked at barriers to resumption of activities and identified an interesting factor: the negative attitudes and behaviors of others. I thought that was particularly eye-opening and a good challenge for us as PT’s to be encouraging and uplifting in our speech and actions. We may be the few people speaking life to help our stroke patients return to desired activities in a world that is much more negative and communicates annoyance and burden for those living post-stroke.

I hope this article helps you really treat the whole person when it comes to post stroke rehab and I hope it gives you some good non-treatment or intervention ideas to address with patients and their families.

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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I am very thankful to have Megan Mobley back on the blog today as she discusses how her faith impacts her work as a PT school professor. She recently detailed some of her PT work in a burn unit and now has been gracious enough to answer similar questions but in regards to her new position in the world of academia. I hope you find it insightful and encouraging!

1. Where did you work? Describe your work population.

I recently (July 2021) became an assistant professor in the physical therapy program at Augusta University. My main responsibility is teaching second year Doctor of PT students in the following areas of PT: hospital-based, critical care, wound management, scar management, and neurological rehabilitation (acute, inpatient rehab and outpatient). I am also involved in serving the department on the Admissions and Student Affairs committee, and I will eventually be involved in research projects.

2. What do you enjoy about working as a faculty member at a PT school?

I love teaching! Practicing PT in a very specific area led me to a lot of teaching opportunities (continuing education courses, guest lecturing at PT schools, and traveling to new burn centers around the US). I love the hunger for knowledge that the DPT students have as well as their excitement for a career in physical therapy!

3. What are some of the unique physical, emotional, or spiritual challenges of teaching in a PT program?

Academia is quite different than practicing in the hospital/clinic. Each of the faculty have their individual agenda and responsibilities for the day. We are all spread out in our own offices, and I miss the days of several therapists gathering around the PT office in the hospital to share lunch together or tell jokes while we documented at the end of the day. The OT department is upstairs compared to me co-treating with an OT in the hospital. Other professions are mainly available through email for collaboration versus sharing a therapy office with other professions. We team teach our courses (usually with 1-2 other faculty members), so that helps me not feel as isolated. I want the students to succeed, and I have not had formal training in how to teach, so that puts some emotional pressure on myself to make sure that I am delivering the content well. In a few years, I will most likely pursue a Doctor of Education degree (EdD).

4.  How does your faith impact your work and how you view your student/colleague interactions?

Being in this position is very humbling. PT school was a difficult time for me. It was the first time when I struggled in school and really had to fight for something that I wanted. It is quite humbling to be on the other side of the desk. I want to support the students as best as I can with their academic needs as well as their emotional needs. They are not just PT students – they have lives outside of school, which sometimes adds stress to an already stressful chapter of their lives. When a student has to retake a written or practical test, I want them to know that I want to use this opportunity to bring them up to speed on specific material that they had trouble grasping initially. I always try to ease their anxiety and stress level, and let them know that I am here to support them!  
 
I also do not take this opportunity for granted. The opportunities that I have had in my PT career to specialize in a very specific area of PT, and work for a hospital company with burn centers around the country, provided me with countless experiences and helped develop the skills that I need to teach these physical therapy students.

5. Briefly describe a story in which you really felt like you ministered to either a student or colleague patient and their family.

Since beginning last summer, I have had two students cry in my office. They were so stressed out about school and other personal factors that it led them to shed tears. I just sat and listened. I wanted to be sure that they felt heard and their feelings were validated. It is important that we see them as people with other responsibilities and relationships outside of this department. These interactions bring back memories of when I was a student, and my professor did the same for me. I am so thankful that the Lord led me here to be there for current PT students!

Megan

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***

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In the world of Physical Therapy, like many other professions, education is a large component. We teach so many things to our patients. We teach them about movement mechanics, tissue healing, and pain science. We teach them anatomy, proper exercise form, the benefits of exercise, and many other facts for healthy living. The patient education component to our profession is, what I think, sets us apart from many other health care professions.

Many of the topics that we teach to our patients are complex and can be difficult to understand and we have to be sensitive to all types of ages and educational levels. So, how can we take many of these big concepts and make them more tangible? Enter analogies.

Analogies are a literary device in which a comparison is made between two things for the purpose of explanation and clarification. They are helpful in making more difficult or abstract ideas easier to understand. This is crucial to helping our patients understand their mechanical or physiological problems and without it, can leave the patient questioning if an intervention is necessary. When a patient truly understands the “why” well, compliance is certain to follow. 

So, what are some keys to creating good analogies? Here are two that I have thought about and learned from one of my colleagues who is really good and creating analogies for patient education.

Keep it simple. We don’t want to get too wordy because then the comparison can get lost. We want to share the comparison in a simple way with simple language that really highlights the comparison to bring better and more complete understanding.

Make it Relatable. This is where one of my colleagues really excels. He can convey his education concepts with the perfect analogy tailored to the patient. So, for example, it wouldn’t necessarily benefit an athlete to use the language of a welder. And likewise, we would want to try to explain a therapy concept using the characteristics of plumbing to a patient who is a plumber and not a pilot. And if you can’t come up with a career or work specific analogy, that’s OK. Just make sure that it is something generally relatable that most individuals would understand.

It’s also important to pick up analogies from your colleagues. I’ve incorporated many analogies that I have heard from others that resonate with patients. I think analogy sharing is an important part of clinic cohesion and that translates to patient experience. So, what are some of the analogies that you use when educating patients on certain topics? Let’s share!

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***