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​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!!**

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​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!!*** 

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It truly is the most wonderful time of the year. A time to celebrate and a time to reflect. I’ve been doing some advent reading with the family this season and it has been so good to remind ourselves of not just the story of Christmas but also the entire redemptive plan of God leading up to Christ’s coming. It truly is the greatest news that brings the greatest joy for all people: that Savior has come to rescue us.

And not just to rescue us but to give us a real, tangible hope and joy in a weary, sin-worn world. And that is what we need. What our families need. What our patients need. And what the world around us needs. Gospel hope. Gospel joy. C.H. Spurgeon captured this well when he said:

I encourage you to be joy-bringers and hope-bringers to all those with whom you interact this Christmas season. Yes, take time to rest and recharge from the daily routine of work and life. Enjoy time with family and friends but also fill your heart and soul with the incomprehensible gift of God with us so that you can be a beacon of God’s love and mercy to all people. Merry Christmas!!

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.

Another Thanksgiving season is upon us and brings with it the focused time to think about gratitude and thankfulness. It seems that negativity and grumbling are the prevailing attitudes in our day which can be hard to resist. We can easily get caught up in the the negatives but to our own detriment. As Christ followers we are to be the most thankful and joyful people on the planet. And to that end, here are a few things that we, as physical therapists can be thankful for this year.

We can be thankful for our jobs. Any job or clinic work comes with its positives and negatives. And believe me, as I am going through an electronic systems overhaul in my place of work, it has been very easy to fall into the rut of grumbling, complaining, and negativity. But the reality is, that change is temporary and I can even be thankful for the upgrades. But anyway, maybe you are in a new workplace, or have been at a clinic a long time. We can still be thankful that we have a job and are still able to work, take care of, and minister to all of our patients. Not only that but our jobs are providing for our spouses, families, friends, and others in the community. It is good to recognize God’s common grace in providing the positions we have to be a blessing to others around us.

We can be thankful for our colleagues. Some of us may work with an amazing team. Others of you may have more difficult relationships in your work space. But regardless, we can be thankful. Thankful for the encouragement and fun that our colleagues can provide to us during the routine of the work week. Thankful for the opportunity you have to invest in your colleagues and for them to invest in you. And even thankful for those colleagues that may be more challenging because God may be using them to refine you and change your heart so you can see how best to interact with them.

We can be thankful for our patients. We see all kinds of people but we can be thankful for each and every one because I believe God brings the patients to us for his will and purpose. Many are hurting physically and God has brought them to us for physical healing. Many have emotional or spiritual hurt underneath the physical pain and God brings them to us to reach those areas while we try to help them physically. We are God’s vessels of his work as he brings us patients. We can be thankful that God is using us for his purposes in our work as we treat patients.
 
We can be thankful for Jesus. And lastly, yes, we can be thankful for our Savior. He is with us and gives us eternal hope no matter our circumstances, our work situation, our life situation. We can turn our eyes to him and let the negativity and complaining of the world around us fade away. We can bask in his great love and have an attitude of thankfulness because he loves us no matter what and died for us so that we can have life. Rest in that this season and be thankful. Pray for an attitude of gratitude and let the joy of the Lord wash over you and your family.

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.
​
In today's installment of journal club, we are going to discuss a topic that I have not mentioned much on the blog but one that is definitely important in the rehab world. And that is helping overhead throwing athletes get better and return to their sport with the help of a throwing program. So many of our athletic patients play sports that require some type of shoulder or throwing movement and there is a high incidence of shoulder and elbow injury across age brackets within these sports.

So, we need to consider a couple of things when thinking about taking care of our overhead athletes when they are injured and the first one is biomechanics.  We need to make sure that we are assessing the posture of the overhead athlete. In fact, this is the first and primary place that I start when I am seeing an overhead athlete in the clinic. Oftentimes fixing the posture improves an athlete's throwing mechanics.  Then, we want to make sure we look at the strength of the different muscle groups in the throwing extremity. We must be thorough here to find any imbalance that could lead to injury. Finally, we need to assess their overhead/pitching mechanics. It can be very useful to use your phone for slow motion capture so you can break down the different phases and assess where joints are in the movement pattern. There are many excellent courses to help you learn about different phases and the mechanics behind them but these are 3 key things to consider from a biomechanical standpoint.

The other consideration is a good throwing program. Once symptoms are under control and mechanics have improved, we need to introduce the actual sport movement patterns in a controlled way. And recently in a course I was taking, a really good throwing program from Kevin Wilk was outlined and I wanted to share it as a resource for your usage in your clinic.

Comprehensive Guide to Return Overhead Athletes to Full Function and Throwing Program

This program outlines a few important exercises but what I found more helpful was the throwing program on page 6-8. Kevin breaks the program up into 3 phases and each phase is appropriately gradual with increasing force and distance. This particular throwing program provides really helpful background information as far as criteria to start the program and if in the program when to progress or regress as well. I especially appreciate the inclusion of just athletic practices like jogging for a warm up. And while this particular program is focused on baseball players, I think there is a lot of crossover for other overhead athletes. You will just need to be creative and tailor it to your patient's sport.

Take some time and look through the program and see if it will be helpful to you. We spend a lot of time rehabbing shoulder and elbow injuries in throwing athletes and weekend warriors so we want to make sure that we are returning them at the appropriate time confident and ready to go!

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.

If you have followed this blog for any length of time, you have probably noticed that my frequency in publishing content related to PT faith and professional practice has ebbed. This slowing is in no way related to a lack of desire to continue or burnout. It is mostly related to some major life events that have occurred so far in 2024. So, I don’t often report on personal topics but thought I would give a bit of an update on what’s going on in my household and life.

The biggest change that has occurred this year is that my wife and I were blessed and thankful to welcome another baby into our home this past April! AND it was a little boy! If you didn’t know, I was very girl-heavy in my family, so the Lord was kind and gave my only son a little brother to balance out his four sisters. If you did the math, yes, I have 6 children in total now and am blessed beyond measure. I won’t deny that there is definitely craziness and stress that comes with a large family, but that doesn't mean it is not a gift. Maybe, I’ll write a blog in the future about having a large family as a PT because folks ask me about that quite often. But all that to say, adding another baby and restarting the baby phase has taken extra time and energy, especially as our older children are involved in different summer activities.

The second update in my life right now is more work related because my company is merging with another health system. I was working at a local, independent academic center, but times in healthcare are getting harder and harder so bigger, more established systems are merging with smaller struggling systems. And that is exactly what has transpired for me. A larger, more expansive healthcare system out of Atlanta has agreed to absorb my hospital and all of our  outpatient clinics. It’s certainly been a long process but currently we are in the major portion of the transition - actually training on and switching over every single system from workflow management to EMR to human resources. Needless to say, it’s been a lot of work outside of my normal patient care time as we roll into a completely different company. So, that has taken some time away. I have also gained some insight on work attitudes going through a merger process and will likely share some of what I’ve learned and struggled with through this process in a future blog post. I believe more of this will be happening to smaller, independent health systems and clinics.

Lastly, something that is really exciting and I am super pumped about! Over the past year I have been working at building an online course for the general public! As a PT, you often get asked to solicit advice for pain problems, particularly knees and backs. I’m sure you’ve experienced this, “Oh, you’re a PT? Hey, my back has been bothering me lately, do you think you could…?” So, since healthcare can be complex to navigate and insurance companies are becoming increasingly difficult to deal with, I decided to attempt to take my clinic sessions directly to the patient/consumer. It’s certainly a new idea for me and I don’t know if it will be successful but the pilot course focusing on the comprehensive management of back pain will hopefully be released soon (targeting end of summer) and if successful may lend itself to additional courses!

So, lot’s going on but I hope to continue to consistently blog about faith at work, research, and physical therapy but likely at a lesser rate. I would love to hear from you if you think some of the blog ideas sound interesting or just how your summer is going. Thanks for reading and following!
​
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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Just recently, our small group was discussing the story in Mark chapter 12 of Mary anointing Jesus’ feet with an expensive concoction. We discussed the cynicism and criticism of some of the eye witnesses that didn’t understand this act of worship and highlighted that it is so easy for us to embody that same cynicism and critical spirit because of a lack of love in our heart for Christ and for others. And because many of us in our small group are health care providers, we then applied that to not only our families but also our healthcare workplaces. It was at that point that one of our members brought up a recent paper he had read regarding this very topic.

As he shared, it was incredibly applicable and I requested that he send me the full article so I could also read it. The title instantly grabbed my attention. “Love Your Patient as Yourself: On Reviving the Broken Heart in Medical Ethics." And wow, what a fascinating essay it is. It reminded me very much of the surgeons general report on loneliness that came out a year or two ago because the authors very much identified a problem, provided the historicity behind the problem and even went so far as to invoke the necessity and importance of the fall of the explicitly Christian worldview as a component of the problem. I always find it intriguing when problems are identified in humanity and others recognize the value of the explicitly Christian worldview, even if those identifying these problems are not believers in Jesus or followers themselves.

But what is that problem? What is the brokenness in our current healthcare system? A lack of love.
Let that sink in. According to the authors, it is not information, it is not technology. It is not interpersonal communication but a deep, gnawing emptiness of love for people.

The authors go on to discuss several cases of patients who expressed frustration of not being “seen” (in an emotional sense of the word) and just being treated as projects or experiments or cattle in interactions within the healthcare system. They then begin to look at why this ecosystem has shifted so dramatically and discuss that the shift away from healthcare in the home when physicians would make house calls and form deeper relationships may have played a role. They discuss how the movement away from the “art of healing” to the more objective “scientific pursuit” has impacted our healthcare landscape and how industrialization began to shift guiding principles from relationship - love and care - to expert and scientist in which bodies are more experiments than humans. Truly fascinating observations!

They then, quite shockingly, point to the fact that what is missing is true love. Not feelings or affirmation or approval, but true, sacrificial love and care for our fellow suffering humans. They note that selfishness, pride, prestige, and greed have all replaced and undergirded our current system as true virtues have been left in the dust and buried in the name of progress. And according to the authors, the only way to fix the brokenness and recapture the heart of American medicine is to bring back the virtue of love by pointing to many truths and principles that are directly and uniquely embedded in the Christian worldview.

I for one, completely agree with their analysis and think they are spot on. If we look around, we can see the same kind of pervasive negative attitude the authors describe and maybe you have even experienced that cold, calculated attitude yourself as a patient. So, then the authors offer a few suggestions to begin to fix the problem which included different ethical education in medical schools and more time serving the underprivileged in our communities.
 
But, I think they miss the mark in their suggestions because while they rightly identify that what they want to see is found in the Christian worldview, they stop short of the real solution. We have removed so much of truth and God in our educational institutions so, if we are to recapture love in patient care, we should concurrently bring back bible study and/or encourage students to attend church and seek truth and faith found in Christianity. In short, a revival of the heart needs to not only occur but should be encouraged.

And here’s where you and I come in as believing physical therapists (or other healthcare providers if you are reading this). You and I are the only ones who can truly love others in the way the authors advocate for, because we recognize Christ first loved us. So, we need to live and share that good news. As practitioners who spend extensive time with patients, who pay attention, we have the capacity to truly have an impact and bring love back into the main of the American healthcare ecosystem.

The world has rejected true, worthwhile values while simultaneously longing for them because of the emptiness and darkness around them. It’s time we lead the way in bringing them back. Treat your patients excellently. Serve your patients well. Love your patients well. And let them know that you are able to do that because of Jesus, the only way.

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.

One of the big ways physical therapists have an impact on patients in the clinic and in the community is through careful and thoughtful patient education. I try to make sure patient education centers on explaining concepts through relatable analogies and applicable studies. I have found that if you can cite and explain applicable studies in an accessible way, you can have a very positive impact. Today, I am going to provide one of those “go to” studies, if you will, that provides great information and helps me help my patient connect the dots on low back pain.

Most everyone will deal with low back pain and it can appear for a variety of reasons but one of the most common reasons is repetitive loading. And there are some many daily activities that have high loads that can ultimately result in pain over time. Enter this Rholmann study.

Activities of Everyday Life with High Spinal Loads

So, Rholmann has published several studies regarding low back pain and force load but I have always appreciated this particular study because it centered on daily forces affecting the spine. This is a small sample size, but essentially they took patients and began to quantify daily force loads in an effort to better develop post-op spinal treatment and provide general understanding to force loads through the spine.

After all the data and numbers were crunched (the study design is fascinating to read but I’m going to provide the nuts and bolts) essentially, they found 10 daily activities that have very high force loads which are listed in the chart in the study (Make sure you check out that graph). Those were then compared to a baseline force of walking.

This is important because we can begin to educate patients about why proper lifting techniques are important. We can make patients aware of how often these force loads occur and how that can affect the tissue physiologically and lead to failure/pain if not balanced by healthy exercise. I also find it re-affirming that walking is not very forceful on the spine and is yet again proof that in chronic pain or other pain situations we need to encourage patients to walk.

I would highly encourage you to look through the charts and graphs in this study and begin to incorporate this information into your patient education to make it more impactful and relatable. I hope you find it as helpful as it has been for me and my 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!!***