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.

A very happy New Year to all who follow and share this platform! My holiday season was a blast spending time with family and rewatching Christmas through my young children's eyes. It is always so special. So, I hope you also had a wonderful holiday season and are excited and looking forward to fresh start with this new year.

I wanted to start off the year by sharing a very recent study that focused on neurological conditions. It's been a little while since we've had a focused study for my neuro PT's out there, so I hope this will be of some value to improve your neuro practice right at the start of the new year.

Blood flow restriction (BFR) has been in use in many aspects of strength and conditioning and orthopedic care for quite some time. The physiologic principles are sound and when it is used with the right patient, at the right time, for the right reason, there are good results in functional recovery and improvement. And that's why this study from the Journal of Neuro PT caught my eye. The researchers in this study decided to apply BFR to patient's with Parkinson's Disease (PD).

BFR Training in People with Parkinson's Disease

The researchers recruited patients with PD, obtained some baseline functional measures (I won't list them all here, they are documented in the article), and then had them go through some treatment sessions using BFR with reassessment after a time period.  The researchers found that there was significant improvement in many of the baseline measures and that that contributed to improvement in function. So, BFR may be a feasible and fairly low overhead treatment that can enhance treatment sessions for patients who have PD. Definitely read through the article to gain further understanding of the parameters and results. But, it could be a great adjunct therapy for you to use. The authors also make sure to site the further follow up studies on efficacy are warranted but this study is a step in the right direction.

Jason

**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.

Happy holiday season everyone! Hard to believe that this year is nearly gone. So much has happened over the last year in my life and I'm sure in yours as well.  And as we set aside time this month to pause and give thanks, there are some things for which I am particularly thankful this season that I will share here. 

First and foremost, I am thankful for this little platform, meager as it is, because it has now been operational for 5 years! Last month was the 5th anniversary of PTs on Mission and the corresponding book that I wrote and published entitled, "Rehab the World." It is hard to believe that amount of time has gone by already, but I have enjoyed consistently writing, educating, and sharing with y'all. I am also especially thankful for all those, like you, who have subscribed and have been encouraged by this platform or by the book. I have always thoroughly enjoyed hearing from you and it makes my heart happy to hear how this platform has affected you in your practice, career, and life as a follower of Jesus. I truly am so thankful for that because that has always been the underlying "why" of this mission since the idea developed 5 year ago.

I am also very thankful for my family. As crazy and loud as it can be and as often as it may interrupt my selfish wants and desires, I have been given an incredible gift of a loving spouse and 6 growing and energetic children. It has not all been easy, especially this year as my youngest son was diagnosed with a genetic condition known as NF1, which can have wide-ranging effects, but overall, my family life has been enjoyable and fun. God has been graciously watching over my son day by day and so far is having minimal side effects. My kids have learned to intercede for others as they pray for their little brother. And I have peace knowing that if there is any physical delay he might experience, God has given me the skillset to help him. And Laura has been rock solid and supportive in so many aspects of my daily clinic work and maintaining this platform even as she sacrificially, lovingly, and excellently manages our household. Family truly is a gift and I am especially thankful for mine this season.

Finally, I am thankful for Jesus. He is my loving savior that is patient and forgiving, and strong. He is the beacon of hope that a lost, anxious, and hopeless world needs. In such unstable and uncertain times I am thankful that He has already overcome the world and we can face our days with confidence and courage. I read this passage the other day as I was reading through Isaiah and I found it incredibly uplifting. 

​"The Lord is exalted, for he dwells on high; he will fill Zion with justice and righteousness, and he will be the stability for your times, abundance of salvation, wisdom, and knowledge; the fear of the Lord is Zion's treasure." Isaiah 33:5-6.

It is a great comfort that the Lord will be the stability for our times and I am immeasurably thankful for the gift of salvation through Jesus so that I can serve the one true God in my clinical work, on this platform by empowering you, and in the daily rhythms of my family. Have a wonderful Thanksgiving this year and take time to reflect on all the things for which you can be thankful this season.

Jason

​**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.

Wow! So the back to school season is no joke this year! We are almost 2 months in and I am just getting my feet underneath me. I blinked and it had been almost 2 months since posting. It didn't seem like that but I guess with the start of school and all my kids' activities, time just flew by. I'm sure many of you might feel the same way.

Anyway, the other day I was listening to some music and a song came on that used a bible verse as the main chorus. Their song was entitled The Joy by The Belonging Co. It's a fairly upbeat song with a  really catchy chorus that just echoed the scripture verse repeatedly. The verse is from Nehemiah 8:10:

And this simple phrase has stopped and made me ponder. See, at this point, Nehemiah was like the governor as the Israelites were rebuilding the walls of Jerusalem and Ezra was the acting priest. At this moment, Nehemiah had Ezra and the Levites come out with the book of the Law from God and they begin to read and teach it to the people. And the people respond and are broken as they hear what God has done for them. They begin to mourn. But Nehemiah, Ezra, and the Levites encourage the people saying that today is a holy day. A day for renewal. So, do not grieve. For the joy of the Lord is your strength. Powerful. I've never really considered that one way we draw strength is from the joy of the Lord. But what is it?

As I've considered that question and thought about how this applies to my life and my work, I think the joy of the Lord is the attitude that comes from the confident knowledge that you and I are children of God. It is embracing the gospel message that you and I were dead in our sins and a slave to sin but that while we were in that sinful state, Jesus came. He took the punishment we deserved for that sin by dying on the cross and then resurrecting back to life conquering death and offering eternal life for all who believe in His name. It means that, because of what he's done for me and you, we can now persevere and complete the things he has called you and I to do in our lives (much like the exiled Israelites returning to Jerusalem to rebuild the walls) whether challenging or easy. Joy, for what he has done and how he watches over us, leads to strength in our lives! So, remember today as you live and work that:

The joy of the Lord is your strength when you feel worn out at work and want to give up.

The joy of the Lord is your strength when you may have to deal with a difficult co-worker or boss.

The joy of the Lord is your strength when you have an opportunity to share the gospel and you may not know what to say.

The joy of the Lord is your strength when you are emotionally exhausted from ministering to patients.

The joy of the Lord is your strength before you walk in the door to your home to serve your family after a busy work day.

The joy of the Lord is your strength as you make managerial decisions for your clinic.

The joy of the Lord is your strength when you are treating an ungrateful, demanding patient.

The joy of the Lord is your strength when you go through company changes or when looking for a new job.

The joy of the Lord is your strength even when you have a great day that is not stressful!

I hope you find this as encouraging as I have found it to be in my personal life, work life, and family life and I pray that you begin to discover the strength found in the joy of the Lord!

Jason

**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.

There are so many studies out there and many of them corroborate each other when a certain topic is explored. For instance, there are many studies out there on the benefit of walking for a myriad of ailments. We know walking is good for mental health, cardiovascular health, and helps with blood sugar. As we study the topic of walking an it's affects, it becomes apparent we were made to move and walking is an integral part of that design.

Walking and low back pain have also been studied extensively showing great benefit, but recently a massive study was released on walking and chronic back pain. Again, it corroborates a lot of what we know, but the sample size is huge so, to me, it seems like a landmark study of which all therapists, physicians and even the general public should be made aware. What is the study?

Volume and Intensity of Walking and Risk of Chronic Low Back Pain.

It came out of JAMA just about a month ago and the researchers did a massive analysis of walking volume and intensity on the risk of chronic low back pain. We all know chronic low back pain is an incredible expense on an individual financially, physically, and emotionally. And that's what makes this study all the more pertinent. In this population cohort study with over 11,000 participants, the researches set out to answer this question: Are daily walking volume and walking intensity associated with the risk of chronic low back pain? And what did they find? A resounding, emphatic yes! A higher volume of walking per day (measured in minutes per day) had a 23% lower risk of chronic low back pain. Lots of walking almost acts like a protector. This information definitely needs to be shared, taught, and practiced.

So, not only do we need to educate our patient's on the importance and benefit of walking during an episode of back pain. But we also need to educate patients that a high volume of daily walking actually has a substantial decrease in one's rise of chronic low back pain. Walking for the win again! So, let's practice this ourselves and use this information to encourage folks to get out and walk.
Jason

**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.
​
My pastor has been walking us through the book of Jonah over the past several weeks and we made it through the third chapter this past Sunday. It’s a pretty unique start of a chapter as it’s almost like deja vu from the first chapter. Let’s take a look and then I’ll tell you how this applies to our therapy/rehab workspaces.

Certainly an interesting passage and you might be wondering how this applies to you rehab job life. Well, here are two big takeaways for me from that sermon and I hope they will be as impactful for you in your life as they have been for me.

Our God is a God of Second Chances. This fact is just super encouraging. Jonah totally bombed his first assignment and fled and disobeyed God. But God brought him back and the word of the Lord came to Jonah a second time. The same word as the first time! God gave Jonah another opportunity.
 
I don't know about you but there are times when I miss opportunities to share the love of Christ or to serve a colleague who may need encouragement or to pray for a patient. Sometimes the logistics of the day or the busyness of the caseload create interference and I may willfully or unwillfully miss something that God has called me too. I'm sure you have felt that too. But our God is a patient and persistent God. He does not give up on us. In fact, God's word says that He will be faithful to complete that good work in you which he started. (Phil. 1:6) So, realize that today, he has given you a second chance to do what he has called you to do in your life, family, and in your workplace. 

Maybe that means you need to specifically pray for a patient. Maybe that means you need to invite a colleague to your church or small group. Or maybe that means that you need to share the good news of the Gospel with a patient or patient's family member that God has specifically placed on your heart. Don't be discouraged! As long as the sun comes up, you have another opportunity because our God is a God of second chances so, let's make the most of that truth.

Jonah Took a Day's Journey into the City Proclaiming the Word of the Lord. The other striking thing about this chapter that came out of our small group discussion was that Jonah walked through the city for a whole day's journey. The city was so large that it took multiple days to cross but he began work his way through the city delivering the message that God wanted the people to hear. During that entire day’s journey, he likely visited markets, wandered through public places, and went into shops or inns to proclaim the message God gave him. Well, we too, walk through our own cities on a daily basis. It could be the actual city that you live in as you serve your city and neighbors and visit restaurants and shops.
 
But we also talked about scaling that down so as not to be too overwhelmed and ineffective. After all, many of the cities we live in are massive! But we can think of our workplaces as "cities." As you walk through the halls of your hospital, or the gym and office spaces of your outpatient clinic, or the lobby of your rehab center, or someone's neighborhood as you arrive for a home health visit, you can proclaim God's message of salvation and of your changed life to those around you. You can do this in your attitudes, actions, and words. We have incredible freedom and opportunity to be a light in our sphere of influence and our rehab work spaces. Let's commit to take advantage of that but also rest in the encouraging reality that should we fail, God gives second chances.

Jason

**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.
​
Today on the blog I ran across a really good article from the JOSPT (Journal of Orthopedic and Sport Physical Therapy). And I thought it was unique because it actually focused more on the geriatric population. If you have been following this blog for any length of time, you might know that the Journal Club posts cover a wide range of types of PT because I know many of you are not Orthopedic/Sports Med like myself.

And that is great! We need folks to specialize in all different fields of PT study and practice. But as I was thinking through all the different articles over the years, I don’t think I’ve ever discussed focusing on the elderly. We’ve covered all kinds of neuro studies, pediatric studies, orthopedic studies, and even some psychosocial studies, but nothing in practices for treating the aged population. So, I am happy to include an article focused on the geriatric population today.

Aging Strong: Should We Be Utilizing Resistance and Plyometric Training In Our Older Adult Patients?

What I appreciated about this brief article is that it is succinct. The other cites a few great studies for the analysis on the safety of using such treatment, the cost benefit analysis of incorporating this type of approach in your rehab plan, and some practical, evidenced based general guidelines to help an older adult start utilizing resistance and plyometric activities.

Now, you might have a good guess as to the answer and conclusion already, but I think you will find some of the rationale and guidelines helpful in your own practice, wherever that may be, as you interact and treat patients above 65. If you have additional comments, thoughts, or experiences in this field, I would live to hear from you!

Jason

**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.
​
​You might be living under a rock if you have yet to hear about AI. In just a few short years since ChatGPT first debuted there has been a literal explosion of AI companies, chips, and bots. It is one of the most rapidly expanding technologies in recent history and it is creating seismic changes in our lives, our culture, and in the healthcare workforce. And with no current or pending legal guard rails in place, essentially Pandora's box has been opened.

In healthcare, AI has already been deployed for more efficient EMR note writing by capitalizing on its incredibly fast language model capabilities. It has been tested in radiographic analysis and is actually quite good. I know this because I was talking to the nurse of one of our orthopedic surgeons and the doctors were playing around with AI analyzing radiographs. It was astonishingly good. So, why would I talk about that on the blog today? Well, I recently went down a rabbit trail learning about AI and stumbled across an interesting video in which the tech commentator was arguing that one must really begin to use, understand, and contemplate how this technology could be used in one's respective field or risk becoming obsolete. So for me and you, that means thinking about AI in Physical Therapy.

So, to begin to familiarize myself with the professional and academic capabilities of this new tech, I turned to the latest and greatest AI model, Grok 3. I opened an account and began to play around with it. First in a fun and silly way, and then in a very real, academic, and professional way. And the results were just mind boggling. It was simply incredible. So, I decided to post the conversation I had and the information Grok provided to me as a means to help us begin to think outside of the box about how this technology can be utilized as a tool in our field so that we don't become obsolete.

What was my experiment? I decided to ask Grok a PT related question. I have directly copied the interaction below with no changes. It really is fascinating to read through Grok's response because the detail, analysis, recommendations, differential diagnosis, and summary was produced in about 3 seconds. Take a look.

Me: Ok Grok - I have a physical therapy question. This patient has shoulder pain. Can you assess this picture of the patient's posture?

Grok: I’d be happy to help with your physical therapy question by assessing a picture of the patient’s posture. However, I can’t see any image yet since you haven’t uploaded one. If you’ve got a photo of the patient showing their shoulder posture—ideally from a side, front, or angled view—please upload it, and I’ll analyze it for clues about their shoulder pain.

In the meantime, while I wait for the image, I can give you some general thoughts. Shoulder pain often ties to posture issues like forward head position, rounded shoulders, or uneven shoulder height, which can strain muscles (like the trapezius or rotator cuff) or pinch nerves. If you’ve got details about the pain—where it’s located, when it started, or how it feels (sharp, dull, etc.)—that could help me narrow things down once I see the picture. Go ahead and share the image whenever you’re ready!

Me: Uploaded two images of me sitting in poor posture with no added cues.

Grok: Thanks for sharing the images! I’ll analyze the patient’s posture in both views to assess potential contributors to their shoulder pain. Let’s break this down systematically.

### Posture Analysis

#### **First Image (Side View, Sitting)**
- **Forward Head Position**: The patient’s head is significantly forward relative to their shoulders. This posture often strains the upper trapezius and levator scapulae muscles, which connect the neck to the shoulder. Over time, this can lead to tension and pain in the shoulder region.
- **Rounded Shoulders**: The shoulders are rolled forward, which is evident from the curvature of the upper back (kyphosis). This position shortens the pectoralis major and minor muscles, pulling the shoulders forward, and can overstretch the posterior shoulder muscles like the rhomboids and posterior deltoid. This imbalance often contributes to shoulder pain, especially if the rotator cuff muscles are also weak.
- **Upper Back Kyphosis**: The upper back is excessively rounded, which can compress the shoulder joint space and irritate structures like the rotator cuff or bursa, potentially leading to impingement-related pain.
- **Sitting Posture**: The patient is slouched, with their pelvis likely tilted posteriorly. This can reduce lumbar support, further encouraging the forward head and rounded shoulder posture, creating a chain of misalignment that affects the shoulders.

#### **Second Image (Rear View, Sitting)**
- **Shoulder Asymmetry**: The right shoulder appears slightly higher than the left. This could indicate tightness or overactivity in the right upper trapezius or levator scapulae, which are common culprits in shoulder pain. It might also suggest compensatory posture if the patient is experiencing pain on one side and subconsciously elevating that shoulder to reduce discomfort.
- **Scapular Position**: The scapulae (shoulder blades) are difficult to assess in detail due to the shirt, but the rounded posture suggests they may be protracted (pulled forward) rather than sitting flat against the ribcage. Protraction can weaken the scapular stabilizers (like the serratus anterior and rhomboids), leading to poor shoulder mechanics and pain.
- **Spinal Alignment**: The upper back kyphosis is again visible, reinforcing the forward tilt of the shoulders. There’s no obvious lateral spinal deviation (scoliosis) from this view, but the asymmetry in shoulder height could hint at a functional imbalance.

### Potential Causes of Shoulder Pain
Based on the posture, here are some likely contributors to the patient’s shoulder pain:

1. **Muscular Imbalance**:
   - **Tight Muscles**: The forward head and rounded shoulders suggest tightness in the pectoralis major/minor, upper trapezius, and levator scapulae. These muscles, when tight, can pull the shoulder joint out of alignment, leading to strain or impingement.
   - **Weak Muscles**: The posterior shoulder muscles (rhomboids, middle/lower trapezius, and rotator cuff muscles like the infraspinatus) are likely overstretched and weak due to the rounded posture. This weakness can cause instability in the shoulder joint, contributing to pain.

2. **Shoulder Impingement**:
   - The rounded shoulders and forward head position reduce the space in the subacromial area (where the rotator cuff tendons and bursa sit). This can lead to impingement, where the tendons or bursa get pinched during arm movements, causing pain, especially with overhead activities.

3. **Referred Pain from the Neck**:
   - The forward head posture can strain the cervical spine, potentially irritating nerves that refer pain to the shoulder (like the C5-C6 nerve roots). This might present as a deep ache or burning sensation in the shoulder.

4. **Scapular Dyskinesis**:
   - The protracted scapulae suggest poor scapular movement, which can disrupt the rhythm between the scapula and humerus during arm motion. This dyskinesis can strain the shoulder joint and lead to pain, especially if the patient performs repetitive or overhead movements.

5. **Compensatory Posture**:
   - The elevated right shoulder might be a compensation for pain on that side, as patients often lift the shoulder to reduce pressure on irritated structures. Alternatively, it could indicate a habit of overusing the right side (e.g., carrying bags, using a mouse), leading to chronic tightness.

### Recommendations for Physical Therapy
Here are some steps to address the posture and potentially alleviate the shoulder pain:

1. **Postural Correction**:
   - **Education**: Teach the patient to sit with their head aligned over their shoulders, shoulders relaxed, and upper back straight. A lumbar roll or support can help maintain a neutral pelvis while sitting.
   - **Chin Tucks**: To correct forward head posture, have the patient perform chin tucks (gently pulling the chin back to align the head over the shoulders) for 10 reps, holding each for 5 seconds, 2-3 times daily.
   - **Scapular Retraction**: Encourage scapular retraction exercises (squeezing the shoulder blades together) to counteract rounded shoulders. For example, seated rows or wall angels (standing against a wall, sliding arms up and down while keeping the back flat) can help.

2. **Stretching Tight Muscles**:
   - **Pectoralis Stretch**: A doorway stretch for the chest (standing in a doorway, arms at 90 degrees, leaning forward) can open up the tight pectoral muscles. Hold for 20-30 seconds, 2-3 times per side.
   - **Upper Trapezius/Levator Scapulae Stretch**: To stretch the right side, have the patient tilt their left ear toward their left shoulder while gently pulling the right arm down and behind them. Hold for 20-30 seconds, repeat on the other side.

3. **Strengthening Weak Muscles**:
   - **Rotator Cuff Strengthening**: External rotation exercises with a resistance band (elbow at the side, rotating the arm outward) can strengthen the infraspinatus and teres minor, improving shoulder stability. Aim for 2-3 sets of 10-15 reps.
   - **Scapular Stabilizers**: Exercises like prone Y-T-I raises (lying face down, lifting arms in a Y, T, and I shape) can strengthen the middle/lower trapezius and rhomboids. Start with 2 sets of 10 reps for each position.

4. **Manual Therapy**:
   - Soft tissue mobilization or massage to the upper trapezius, levator scapulae, and pectoralis muscles can help release tension. If the right shoulder is more elevated, focus on that side to address the asymmetry.

5. **Pain Management**:
   - If impingement is suspected, avoid aggravating movements (like overhead reaching) initially. Ice or heat can help with pain, depending on whether the pain feels inflammatory (ice) or muscular (heat).

6. **Functional Assessment**:
   - Assess the patient’s shoulder range of motion and strength to confirm if impingement or rotator cuff issues are present. Tests like the Neer or Hawkins-Kennedy impingement tests (if you’re a clinician) can help. Also, check for cervical spine involvement by testing neck range of motion and looking for referred pain patterns.

### Additional Questions
To refine the assessment further:
- Which shoulder is painful (right, left, or both)? The right shoulder’s elevation suggests it might be the culprit.
- What type of pain is it (sharp, dull, burning)? Sharp pain might indicate impingement, while a dull ache could be muscular or referred.
- When did the pain start, and what activities make it worse? This can help identify if it’s related to a specific injury, repetitive motion, or posture over time.

This posture analysis points to a combination of muscular imbalances and poor alignment as likely contributors to the shoulder pain. Addressing the forward head, rounded shoulders, and shoulder asymmetry through targeted exercises and posture correction should help. Let me know if you’d like to dive deeper into any of these areas!

_Disclaimer: Grok is not a doctor; please consult one. Don't share information that can identify you._

Wow. I am not even joking. I directly copied that over. And I was completely blown away. It is practically an entry level response. It surprised me that it was able to draw the connection between posture and shoulder pain - something I intentionally tried to not cue. I didn't even ask it for recommendations of exercise! Pretty amazing. And this brings us to the changing of healthcare. Each field will have to wrestle with the best way to utilize this tool and not let it run wild. So,  how do we do that in PT? Well, we need to brainstorm.

Could we use it to provide us a health overview prior to seeing a patient? Could we use it to better track and analyze outcomes data? Could we use it to create a more seamless patient experience? Could we create detailed and more specific HEP's more rapidly? Could we use it to help us more rapidly explore differential diagnosis? I don't know yet, but rest assured, we must be creative to use this technology well.

But, we also must remember, and I think this point resonates with me most when considering the future of our field with the ever expanding AI tech, is that compassion, empathy, and connection are not inherent in these technologies. That is what really sets our field apart. There is a massive relational component that we must never lose sight of in our clinics or rehab workspaces. We must capitalize on the human element of our work and not just the rehabilitation process of our work. And even more so for us as therapists that want to be a light of the glory of the gospel of Jesus Christ to those humans that we interact with that are going through hardship and are in need of a Savior. That is a lasting and powerful message. Would love to hear y'alls thoughts!

Jason

**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.
​
​At my church, we recently completed a series on the beatitudes. In this introduction to the sermon on the mount, Jesus begins by teaching about the blessing of living an upside down or counter-cultural life and one of the blessings we discussed at length was from Matt. 5:9 which says blessed are the peacemakers for they shall be called sons of God.

Now, our pastor discussed the big issue behind that statement which is that the main focus of our peacemaking is bringing people to be at peace with God by sharing the gospel of Jesus to those around us. That is something we should strive to do in our workplaces with the colleagues and patients with whom we interact everyday. There are many hopeless and searching people around us.

But one of the other ways this teaching works itself out is by living peaceably with those around us. It's easy to see that we live in a society of deep division and argumentation. We even have a name for it, cancel culture. Our society is one that almost glorifies derision and antagonism, yet God tells us to live at peace with those around us and that through a peaceful attitude we may bring many to be at peace with God. As we were discussing this passage on Sunday, it really reminded me of what Paul instructs the Romans:

We have an admonition as Christ followers to live at peace with those around us to the best of our ability and as long as it does not compromise the Gospel truth. And here is where the rubber meets the road. How do we do that? How do we work to live peaceably when we may have co-workers who are difficult or negative or antagonistic? Or how do we create a peaceable environment in our clinics when we have patients who are being rude or challenging? Enter the wisdom from my Pastor on the practical steps to live at P.E.A.C.E. with those around and thereby be witnesses to the Gospel of Jesus Christ. It was very impactful for me so I thought I'd share it with y'all as this is something everyone one of us will encounter in our respective fields of healthcare. 

P: Purpose To Walk In The Spirit And No Longer Live In The Flesh. (Gal.5:16-25)

E: Endeavor To Be Understanding Rather Than Being Understood. In other words, be a good listener. (Phil. 2-3:5, Prov 14:29)

A: Attack The Problems And Not The People. We often tend to believe the worst about others and the best about ourselves but that is misguided. (Prov 15:1-2). And try to engage your mind before you engage your mouth. (Eph 4:29)

C: Confess Your Own Faults And Own Sinful Attitudes. (James 5:16)

E: Elevate Reconciliation Over Resolution. In other words, in humility, value the person over the conflict or disagreement. 

Remember, it is as much as it depends on you. You do your part with the power of the spirit to live to be a peacemaker. You can't make others be peacemakers until God works in their hearts and lives. Be willing to take the risk of peacemaking and start you day in prayer and spirit power to be a peacemaker in your home, your clinic, or your hospital.

Jason

​**Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.
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Welcome back to the blog and another installment of journal club. It has been quite some time since an article from the neuro world has been featured but I recently ran across a couple of newer ones that I thought were fascinating. So, here is a shout out to all my neuro rehab friends.

This particular article centers on the handling of interventions for patients with Parkinson's disease. We understand that oftentimes patients with PD have motor problems especially when trying to perform other motor or mental tasks. In other words, gait performance can worsen when performing another task which can lead to loss of balance or at worst, a fall. So, this study aimed to assess a standard treadmill training program against a dual task training program to see if executive function could improve.

Improving Executive Function in PD from Journal of Neuro PT

The researchers divided participants into the two groups and went through 16 sessions of training across 8 weeks. Then, outcomes were assessed and compared. As you might have guessed in this randomized controlled trial, the dual task training group displayed improvement in executive function during gait (better able to handle cognitive tasks while moving). And this makes sense. The brain is incredible and through neuroplasticity, when challenged appropriately can and does improve.

Now, one of the interesting things is that this dual training helped with cognitive function during ambulation (better able to safely and continually walk without deviation while thinking and processing), but it did not have a significant impact on layered motor movement. In other words, there was still slow gait when other motor movements were required of the patient.

So this is important information for the treatment of patients with PD. It is very important to incorporate specific dual task cognitive work while exercising/walking, but you must not neglect to continue to work with exercise movement and motor plans for a holistic approach. I encourage you to read the whole article and I hope it benefits your practice.

Jason

***Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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.

If y'all are like me, you may have interest and joy in traveling. It is fun to visit new places or go visit old friends in other parts of the country. However, traveling can also present numerous challenges, especially when you or a patient are experiencing spine pain. I know personally that I deal with spine pain when I travel, especially long distances (like my flights overseas for mission work). I've also received numerous questions in my career about the best way to manage pain during travel because often a patient books the trip before they develop pain and now must manage that throughout the duration of the trip.

Today, I have decided to share some of my most crucial patient education points when it comes to helping your patients (or you) manage spine pain during any kind of travel whether that be by car or by plane (my favorite way to travel, although I'm sure I'm writing to some folks who love a good road trip too!). I hope that this not only helps you but also provides you with some relevant and impactful educational prompts for your patients as well. 

Make Sure Your Seat is in a Good Position. Super simple, yet often difficult. I always educate my patients and remind myself that car seats, plane seats, etc are horribly designed. They are usually bucket style seats to some degree and reverse nearly every natural curve of our spine. They don't support where we need it and over-exaggerate support where we don't need it. So, start by trying to slide the chair back so you can sit a little more forward with your feet on the floor and a comfortable distance from any pedals.

Use a Lumbar Roll. An actual lumbar roll. I've found that the seats that the advertised built-in lumbar (back) support is not really nearly adequate to provide the necessary postural support for your spine. Using an external low back foam roll or half foam roll support can greatly help maintain good upright posture when traveling and help manage any pain. This goes for autos or airplanes.

Flip your car headrest backward. I used to get neck pain and headache onset fairly quickly on a road trip and that had to do with the fact that our headrests kick our head way way more forward than it actually needs to be which in turn creates more stress on the neck tissues and can lead to headache, pain onset or increase in pain. I've found and my patients have reported that this simple fix can really help get your head back over your shoulders and keep your spine in a good, less painful position.

Use an angle seat wedge. My mom actually discovered this as we were talking about how to manage her back pain. She had planned a multi week road trip and, after discussing it together, decided to buy a travel seat wedge. This helps take out some of that "bucket" angle and again allows you to sit more upright as well as have better placement for your back support. Bonus: they are not super expensive! It was an experiment, but it totally worked and greatly assisted her travels and now doesn't travel without it.

Get up and move/stretch. Whether driving or flying, it is crucial if you are dealing with spine pain to get up and move and stretch. Maintaining a poor static position is a sure fire way to increase or worsen any spine pain. If I am driving, I stretch/move every time I stop for gas or a potty break (which there are many when you road trip with 6 kids). I will even stretch when I am waiting at an airport gait. It induces some funny looks sometimes, but it is totally worth it to feel better. And then, also make it a point to walk the aisle of an airplane every 20-30 min. My patients and I have had good results with that plan - also keeps the blood flowing well.

So, those are my 5 key patient education points for traveling with spine pain. It focuses a lot on finding a way to keep the spine in a good postural position and avoiding static positions that increase pain by getting up, stretching, and moving around. And as you can probably tell, I practice these myself because, I am not immune to spine pain just because I am a PT and neither are you. I hope you find these tips helpful and plan to use them in your patient interactions.

Jason.

***Check out my book "Rehab the World" written for Physical Therapists and other rehab professionals 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!!***