Friday, November 26, 2010

Im Thankful for These Links

I have recently streamlined my RSS reader and wanted to share my favorites with the rest of you lovely people out there, enjoy! In no particular order:

1) MoveItNPs I happen to be a 'contributing author' but Ben Braxley is worth getting to know, read up and join the movement.

2) Eric Galvez --> Mass Kickers Cancer survivorship is no joke, Eric is another great person to get to know so go read!

3) Crossfit and MobilityWOD This is the movement of the future in health/fitness in my opinion. It comes across a little intimidating but with the help of KStar at MobilityWOD and "scaling" this really is for everybody and it is all free. My biggest problem with it is they have so much information it is tough catching up!

4) Chris Johnson PT An endurance athlete himself Chris is leading the way in training/treating this unique population of athletes.

5) Fusion Performance Training A "performance coach"/PT who comes out with some quality material worth reading. He also has The View

6) Mike Reinold Despite his Boston affiliation this man is a leader in progressive sports/ortho PT, keep it going Mike.

7) Optimum Sports Performance Quality content coming from a massage therapist/CSCS

8) Simply awesome PT geek/art stuff: Street Anatomy

9) EIM Team A group that really wants to change things for the better in our profession, always a quality read.

10) Eric Cressey is another leader in fitness specifically in the world of Baseball but his lessons carryover to most other aspects of fitness.

Do you have any blog(s) (other than this one) that you think is of vital importance (please share in the comments below)?

There are a bunch of other PT links that I will try to throw in another post. There is always reading of JOSPT or AJSM as well; lifelong learning is no joke. I have a few non-PT links I frequent but will have to share that at a later date as I have to go catch a flight to Las Vegas where I am taking an Emergency Response Course. Hope you are ready to work off all the damage you did at Thanksgiving dinner :)

Thursday, November 25, 2010

Proximal Hamstring Avulsion Case Report

Quick review of the following article:
Surgical and Therapeutic Management of a Complete Proximal Hamstring Avulsion After Failed Conservative Approach

What information do you take away from reading a single article other than the main findings?

I like to see which outcome measures were used since there seems to be so much variability throughout the medical field. In this study they used the LEFS which seems to be a very popular scale. They also use the SportCord test which I actually had not heard of before this article (google was not much help to find more information about it, but they do describe the test in the article).

The patient had a Hamstring Repair using an Achilles Tendon Allograft. The article describes a new protocol that is criterion based and considers the basic tissue-healing process. They also add early loading to prevent secondary atrophy. The patient ended up having 25 sessions over 7 months to reach all goals. Despite her great outcomes she chose not to return to softball. The authors emphasized proximal control and lumbopelvic stabilization exercises which was lacking in the literature previously. They mention neuromusuclar control often which is a fairly subjective concept but a critical one that is beginning to be emphasized more often in the literature more recently.

Despite the "low level evidence" this provides it is a very useful article to have in the utility belt as a clinician.

Monday, November 15, 2010

Another Career Day at my High School

This past Saturday morning I went to talk to young men and women at my high school to give them an idea of what Physical Therapy is all about. My big messages at these events always include the following:

1) The story of how I got to my career
2) General overlook at the very dynamic field that is PT
3) This career may not be for you but make sure you find something you love to do. A great way to do this is to volunteer and intern with as many different fields that could be potential fits for you (I spent time with the following disciplines: chiropractor, orthopaedic surgeon, EMT, athletic training, personal training, physical and occupational therapy)
4) No matter what career path you choose you should still be aware of healthy living and how to save a life (this video is a scare tactic that should drive the point home)

A view of Brooklyn Tech's auditorium from the gym. The auditorium is the second largest in New York State (2nd only to Radio City Music Hall)

Saturday, November 6, 2010

NYC Marathon

Such a great event. So much energy, brings the whole city and so much of the world together.

This will be the first year since 2005 that I will not be at the finish line medical tents. I will miss the environment, it is fun.

There are a few debates about what the marathon actually does to/for the body. An orthopaedic surgeon I heard speak recently advocated that no one over 150 pounds should ever run endurance events. Some of the healthiest people I know have run most of their lives. That debate will have to continue. In the meantime, good luck to all the runners tomorrow... Layer up!


I took this picture towards the end of the marathon (About mile 25.5). These guys dressed up like the Blues Brothers and walked right by me at a nice leisurely pace. Begs the question of people doing these marathons for fun. If you have a >5 hour time it seems to take away from the athletic accomplishment. The experience no matter what pace you go seems to be one of the best and I am highly motivated to push my surgically repaired knee to try this marathon next year.

Monday, November 1, 2010

National Student Conclave

Yesterday I had a chance to participate in a task panel at the National Student Conclave in Cherry Hill, NJ. The title of the Task Panel was: What You Can Expect As You Transition From Student To Professional Status: A New Professional Panel Discussion. We had a semi-diverse group including a PT only 1.5 years out of school who ha started his own practice in California. Another panelist took part in a PhD program in New Zealand investigating hip OA among other topics.

The students seemed to get a good amount of information out of the hour long discussion. While many of the same answers that could be expected were given about lifelong learning, the importance of mentorship, risk management, 'ethics in the real world' I had to get on my soapbox and make sure I advocated for involvement in APTA. My biggest take home message was how each of those students should not only be members but maintain active involvement in the organization. I believe this is the a major way we will grow as a profession. When asked about how the APTA has helped me as a New Professional I had to applaud the APTA again for all the work they do on Capitol Hill which we do not always see. I have been fortunate enough to see it firsthand as a member of the Student Board of Directors a few years ago and having a good friend currently working with APTA.

Great event, thank you again to APTA for inviting me to partake.

Guest Post: Interview w/Dr. Hewett RE:ACL

Hi, I would like to introduce myself, my name is Sasha Sibree. I’m a Physical Therapist in Denver, Colorado. BoDPT has kindly allowed me to do a guest blog post, I would like to thank him for the opportunity.

Basically I wanted a way to combine two of my interests – building web sites and furthering my Physical Therapy knowledge.

So what I did was go out and interview a whole bunch of rehab experts, and then make those interviews available, free of charge, on my web site PhysicalTherapyContinuingEducation.Org.

Here are some excerpt from a recent interview with Dr Timothy Hewett about his work with ACL Injuries and Prevention.

PhysicalTherapyContinuingEducation.Org: Is there a different mechanism, when comparing males and females, in non contact ACL injuries?

Dr Timothy Hewett: So, what we’ve done is we’ve looked at the mechanisms of how men and women tear their ACLs. Basically, if you look at the mechanisms, in women especially, there are four common components.

As the woman lands her knee buckles inward. The knee is relatively straight when she lands. Most if not all of her weight is on a single foot or single leg. And her trunk tends to be tilted laterally. In other words, her center of mass is outside of her foot base of support.

These mechanisms also occur in men but, for instance, the exaggeration of the positioning of the trunk is much greater in women than men. We’ve published several studies on this. We published last year, in the British Journal of Sports Medicine, a study showing the relationship in women between the amount of trunk lean and the risk of ACL tear.

I’ve also done collaborations with the biomechanics lab at Yale where we’ve showed in varsity athletes, women who are not good at sensing the position of their trunk in three-dimensional space, or allow greater motion of their trunk following a perturbation or disturbance of their trunk, have greater risk of future knee ligament and ACL tears.

Dr Hewett shares a ton of great information in this 46 minute interview. Including expanding on the four different components, the best way to screen for t “at risk” athlete, and what interventions can decrease their risk.

I invite you to visit my site at Physical Therapy Continuing Education.Org to listen to or download the entire interview.

Thanking you,
Sasha Sibree PT
Physical Therapy Continuing Education.Org