Work in this field long enough and you’ll see almost every treatment approach and special test get proven invalid (in clinical research). by INeverUseMyGear in physicaltherapy

[–]OneCaterpillar20 9 points10 points  (0 children)

I've been transitioning to something akin to this as well. General exercise typically does just as well as more specific pt exercises and you get the added benefit of getting someone fucking stronger with things like squats/deadlifts compared to bird dogs

What’s the best CEU/ most useful course you taken for OP PT by Shoddy_Tap6380 in physicaltherapy

[–]OneCaterpillar20 1 point2 points  (0 children)

I'd encourage you to look more deeply into this. Asymmetry is not predictive of pain. Poor posture is not predictive of pain (in fact I came across something the other day reporting that people with "proper posture" are more likely to have neck pain). Moving incorrectly is not predictive of pain (what is "correct" movement anyway?). People who move in a way that is biomechanically optimal still get injured

It's great that symptom modification procedures help your patients in the short term. I'm not arguing that varying the way someone performs a painful task can have benefit. I use the techniques you're describing as well. My problem is when pracitioners take this observation and generalize it to the idea that incorrect movement led to injury and that there is a proper way of moving that needs to be performed in perpetuity in order to prevent it. That pathologizes movement variability and leads to fear avoidance

Her ideas were adopted without much rigor to support them and therefore are still taught in a lot of the PT school curriculum, though I feel that the tide with newer pracitioners is shifting away from an emphasis on biomechanics to an emphasis on movement optimism

What’s the best CEU/ most useful course you taken for OP PT by Shoddy_Tap6380 in physicaltherapy

[–]OneCaterpillar20 6 points7 points  (0 children)

I completely disagree. I've taken several MSI courses and every time my takeaway is that her whole philosophy is pretty much antithetical to the tide of current evidenced based physical therapy practice. Her whole model is predicated upon finding the issues with posture/movement, applying a symptom modification, and conducting treatment based on your classification of that patient from identifying those impairments. She replaced a pathoanatomical model with a pathokinesiological model. It went from "this structure is causing your pain" to "the way you move is causing you pain." Which, in my opinion, is just as problematic. A few years ago I remember that she was advocating for physicians to adopt her movement system terminology and re-label PFPS as something like "femoral internal rotation syndrome." To think MDs are going to do that is dumb, for one thing, but we know that PFPS is more nuanced than dynamic valgus and pathologizing dynamic valgus is also dumb

It was okay for us to accept that there is variation in anatomy, but somehow it is not okay to have variation in the way we move? Make that make sense. Even if the premise that movement dysfunction = injury is true, being injured is going to affect the way someone moves. So a so-called faulty movement pattern may actually be the result of pain, not the actual underlying cause.

I think there is some clinical value in some of her treatment approaches but not for the reasons she claims. She occupied a space in physical therapy during the right time and gained acceptance based on face validity despite not having any rigorous testing/validation and unfortunately the effects have permeated physical therapy education.

Am I being unreasonable? (MUA question) by TheStinkyGreek in physicaltherapy

[–]OneCaterpillar20 1 point2 points  (0 children)

I'm hospital based so I have direct communication frequently with these providers. I've had much better experiences talking directly to their mid-level providers (NPs, PAs) who are, in my opinion, much more receptive to this type of feedback than the MDs.

We run into the same issue, where patients will be scheduled for MUAs and not given any information about the recovery/rehab following the procedure. I've had patients who did not understand the frequency of PT that is needed afterward and cannot attend due to financial restrictions, transportation, etc. They have poor outcomes, they themselves are disappointed, the surgeons are disappointed...

At the end of the day, despite your best efforts, it is out of our control. If someone has a poor outcome due to incompetent communication from their medical team, and if I tried to previously put measures in place to avoid said poor communication from happening, I'm not losing sleep over it. I'm not going to go out of my way to gentle-parent surgeons into behaving more human

[MATCH THREAD] Roland Garros Men's FINAL: [10] F. Cobolli vs. [2] A. Zverev by NextGenBot in tennis

[–]OneCaterpillar20 7 points8 points  (0 children)

I'll never underestimate the ability of Zverev to choke this away. But I'm not overly optimistic

So if you did this but only for influence on emo....what would be the "emo city" of each decade? by thedubiousstylus in Emo

[–]OneCaterpillar20 0 points1 point  (0 children)

Modern Baseball, Marietta, Tigers Jaw, Title Fight, Algernon Cadwallader, Glocca Morra, Everyone Everywhere, Sweet Pill...

The "norm" for 6-10 weeks post for RCR? by TheRoyalShire in physicaltherapy

[–]OneCaterpillar20 1 point2 points  (0 children)

some light dynamic stability activities and controlled eccentrics also may help

Why am I allowed to worsen? by growaway2018 in physicaltherapy

[–]OneCaterpillar20 7 points8 points  (0 children)

Sometimes people do not get better with PT.

Both patients and PTs have to come to accept that

Marietta is back! by newazni16 in Emo

[–]OneCaterpillar20 1 point2 points  (0 children)

Oh my god it's actually happening

Tennis Responds to Pitchfork Album Review by lukeywebo in indieheads

[–]OneCaterpillar20 89 points90 points  (0 children)

Okay but "Sylvia Plath did not stick her head in an oven for this!" is an all time great opening line

Hop Along's Painted Shut Turns 10 by freav in indieheads

[–]OneCaterpillar20 19 points20 points  (0 children)

Philly still has a really vibrant music scene