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Specific Adaptation To Imposed Demands PDF Print E-mail
Monday, 09 April 2007
I was originally exposed to the concept of the SAID Principle, or "Specific Adaptations To Imposed Demands", via exercise physiology. From a cellular perspective, this simply means that the tissues of the body, be they muscle, bone, tendon, cartilage, or ligament - adapt to the demands imposed upon them. For example, weight bearing activities foster an in crease in bone density, and strength training fosters muscular strength and power development. Both are examples of very specific adaptations that the human body makes in order to adapt to the demands placed on the system.

But all cells respond to stimuli.
Tags:  Thoughts Concepts Mechanisms Principles Training
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Heavyweight Championship PDF Print E-mail
Tuesday, 03 April 2007

It's like the heavyweight championship of the orthopaedic physio world ... and I can just hear the ring announcer now ...

"In this corner, wearing the white trunks ... from various authorities worldwide ... weighing in at 180 pounds ... 'Manual Therapy' ...

"And in this corner, wearing the blue trunks ... the challenger ... also weighing in at 180 pounds ... hailing from New Zealand ... 'Mechanical Diagnosis and Therapy' ...


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The Revolution Starts ... Now PDF Print E-mail
Monday, 26 March 2007
A revolution in the world of health ... is needed. And it needs to start ... here ... and now.

Let's face it - as it stands right now, the current system of health care, injury prevention, and health promotion - faces some tremendous problems. From the provider side, if you are providing exemplary care you're no better off than if you provide average or outdated care. You don't get paid any more or less for the quality of your work. From the payor side, we're told that "well care" is covered - but this typically amounts to an annual check-up and not much else (if that). From the patient side - I may not want to partake in any of this because they (the powers that be) either aren't going to pay for it, or the cost is exhorbitant (without health insurance), or they're just going to tell me to rest and take some pills anyways. And from the health promotion side - well, good sound educational programs are hard to find and even harder to have reimbursed by a third party payor.
Tags:  Thoughts Professional Issues Health Care Mechanisms Education
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Limiters Of Performance PDF Print E-mail
Monday, 19 March 2007

The debate over limitations in human performance has been waged for decades. In the endurance sports world, the commonly-held perception is that the cardiovascular system is the primary limiting factor. The belief expressed by many endurance sports coaches is that maximum VO2 and lactate threshold are the primary culprits - and thus, we need to track and scrutinize the appropriate training parameters - namely, heart rate.

But here are some thoughts to refute those claims - to take our focus away from the past and turn it towards the future.



Tags:  Coaching Insights Endurance Training Coaching Mechanisms
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Roadblocks To Care PDF Print E-mail
Monday, 12 March 2007

There seems to be a growing aversion to the medical system in recent times. Why are people so hesitant and apprehensive about accessing medical care for anything other than chronic or life-threatening conditions? I certainly see it regularly when interacting with active people. Why is this so?

I am not sure I have that answer completely - but let me propose a few potential reasons.

Just like any other enterprise, there needs to be a value added benefit to going to a clinician for care. The "customer experience" starts from the moment they contact the office. You're on hold waiting for the next customer service representative. A frustrating start, for sure. Let's say you get lucky - and don't have to wait to schedule an appointment. Is the provider of your choice on your insurance plan? Or will this be an (oftentimes exhorbitant and inflated) out-of-pocket expense? Now I have to balance the potential cost-to-benefit ratio of the experience.



Tags:  Self Care Professional Issues Health Care Rehabilitation
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The Tarnished Ivory Tower PDF Print E-mail
Monday, 05 March 2007

The Ivory Tower of Academia. If you've been involved with the educational system in any way, shape, or form, you've at least seen it off in the distance. Perhaps you've occupied it's courtyard, or maybe even resided inside it's walls.

The Ivory Tower - is tarnished.

Last time I looked, academia and education were about teaching and learning. There is plenty of good research literature to indicate that adults learn primarily by interaction, by doing, by being actively involved in their own learning process. In effect, it is much the same way that children learn most effectively. As Bob Pike would say, adults are just babies with big bodies.



Tags:  Education Principles Mentoring
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McKenzie And Systemic Mechanical Diagnosis PDF Print E-mail
Tuesday, 27 February 2007

This week marks the 13th anniversary of my first McKenzie course. I would bet that your first thought would be "why remember something so seemingly trivial - it was just a course"! But in our lives, we remember moments in time that shaped us and our perspective on the world. That four days in February 1994 was one such weekend.

What made it so? In the span of four days I was presented with a large volume of research - that contradicted much of what I'd been taught in school. This was, at first, unsettling - but the "scientist" in me decided that you can't simply discount the literature and that if it was all about "being a better PT" then I better sit down and do some homework to understand how all these issues fit together. It pushed my "comfort zone" ... and started me down a path that changed not only my career but my personal life perspective as well.


Tags:  McKenzie Concepts Evidence-Based Principles Mechanisms
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Payment For Performance PDF Print E-mail
Tuesday, 20 February 2007
Within the past few weeks, I've found myself reflecting upon the health "care" system as we know it now. Having been within the physical therapy profession for almost two decades, I've seen trends come and go, and I have watched some things remain (curiously) stagnant. Buzzwords are here and gone, and the cost of health care is skyrocketing nonetheless.

So here's an idea I was pondering recently. It has to do with the payment of services in the medical and healthcare realm. My idea may at first seem unorthodox - and I am certain it will make a lot of people angry - very angry.
Tags:  Concepts Principles Health Care Evidence-Based Issues
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Balance And Perception PDF Print E-mail
Tuesday, 13 February 2007

I've found myself considering the concept of "balance" a lot recently - not so much in the "maintain a vertical posture in space" realm, but more so with regards to "muscle imbalance". The idea of muscle imbalance isn't what causes me great consternation so much as the perceptual reality defined by someone who has "it".

Allow me to explain.

Patients will generally come into our offices with three primary issues - I am in pain, I am unable to move as I normally would, and I have lost some level of function because of one (or both) of these issues. At this time, the perspective is essentially one of "help me understand this problem so I can move on with life".



Tags:  Clinical Mentoring Self Care
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Do We Have The Evidence? PDF Print E-mail
Wednesday, 07 February 2007

The talk of the town (in Anytown, USA) is "Evidence-Based Medicine". If you're in the health professions, I am sure you've become familiar with the phrase. The same holds for those in health insurance - and clinical research. "The evidence" is driving everything these days.

For the record - I am a true believer in the power of good clinical research. I do think that as clinicians we need to provide care based on true evidence-based medicine. We must hold ourselves to high standards of practice, and we must continue to challenge our thought processes and clinical reasoning skills - as uncomfortable a process as this may be. It involves reflection on our practice patterns and perhaps even challenging our belief systems - about our role in patient care or the methods we advocate.



Tags:  Clinical Education Evidence-Based Health Care
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