Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews
Interview on the Bo Knows Podcast - themanualtherapist.com

I recently had the pleasure of being interviewed by Dr. Bo Babenko on his Bo Knows Podcast.
The Future of VR and Telehealth - Immergo Labs Demo - themanualtherapist.com


I've been working with Immergo Labs recently, providing feedback on the UI and software experience.
Untold Physio Stories - Tongue Tied - themanualtherapist.com


In this episode, we're joined by special guest all the way from Australia, Darron Goralsky. He goes over a recent case of tongue tie that resulted in dramatic improvements in UQ complaints. Is this something you routinely rule out for UQ and TMJ issues? Let us know in the comments or reach out on social media!




Untold Physio Stories is sponsored by


Helix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Use code MMT2 to get your sample and get an additional revenue stream for your practice. Click here to get started.


Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual


My PT Insurance - Insurance just got easier. check out the self employed and employed plans. Easy sign up and coverage that follows you wherever you practice in the United States. Save $20 if you sign up using our link.


Keeping it Eclectic...

Geriatric PTs: Prevent Frailty with Diet - themanualtherapist.com


Geriatric PTs: Prevent Frailty with Diet 

By Dr. Sean M. Wells, DPT, PT, OCS, CNPT, ATC/L, CSCS, NSCA-CPT, Cert-DN

Most physical therapists (PTs) that work with older adults know the importance of preventing their clients from reaching frailty. From falls, femur fractures, to loss of function, frailty can mean a significant change in the quality of life but also potentially earlier death. Doctors of Physical Therapy (DPT) offer older clients an array of treatments from strength exercises, therapeutic activities, balance programs, and functional exercise to mitigate the effects of frailty. But what if we could do more to help our older patients?

New research out of Harvard, and published in the Journal of Gerontology, demonstrates that diet plays a key role in the development of not only frailty but also depression in older adults. The Framingham Heart Study Offspring cohort provided the data used in the study, which include 1,701 non-frail individuals who provided information on their diet and depressive symptoms at the start of the study. They were followed for about 11 years when frailty status was reassessed. Not surprisingly, the researchers found a link between an inflammatory diet and an elevated risk of frailty, which was somewhat greater among individuals with depressive symptoms.

Another key finding was that an inflammatory diet in older adults with depressive symptoms might hasten the onset of frailty. The exact mechanism of this connection is not fully understood, but the researchers suggested that the inflammation may affect the gut biome and/or the brain's ability to remove inflammatory wastes. Regardless, worsening depression in older adults is not a positive thing. As PTs we understand how depression can rob our clients of performing activities, engaging socially, and the deleterious impacts of these withdrawal behaviors.

The important question remains: what did the inflammatory diet consist of? The authors cited most of the foods were considered ultra-processed foods that were rich in saturated fats, refined carbohydrates, and low in fruits and vegetables. Such a diet includes:

  • French fries, potato chips, and other fried foods
  • Cakes, donuts, and pies
  • Processed meats, burgers, and milkshakes
  • Candy, white bread, and pastries

Researchers in the study point to the importance of consuming a mostly plant-based diet, like the true Mediterranean diet. Such a diet is low in the above foods and rich in flavanoids, which can prevent fraility. So in the end, DPTs need to step up there game! It's time for us to start talking with our older clients about their dietary patterns. Use simple tools like fruit and vegetables screens, mini-nutritional assessment to screen for malnutrition, and refer our older adults to registered dieticians so they can formulate a meal plan that focuses on health plant food, not ultra-processed junk.

Now approved in 40+ states for CEUs!


If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60!



Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

Learn more online - new online discussion group included!


Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. 
  • NEW - Online Discussion Group
  • Live cases
  • webinars
  • lecture
  • Live Q&A
  • over 600 videos - hundreds of techniques and more! 
  • Check out MMT Insiders
Keeping it Eclectic...

Junk Plant-based Diets and What PTs Need to Know - themanualtherapist.com


Junk Plant-based Diets and What PTs Need to Know

By Dr. Sean M. Wells, DPT, PT, OCS, CNPT, ATC/L, CSCS, NSCA-CPT, Cert-DN

Over the last several years we have seen the literature explode in regards to the health benefits of eating a predominantly plant-based diet. From lower rates of heart disease, diabetes, and even cancers, it would seem that plant-based diets can really make a significant impact in our physical therapy patients. Unfortunately, big agriculture and corporations have seen this growth as a potential new market for them to gain more money. As such, many major food producers are now producing many of the common unhealthy foods in their own plant-based type variety.

For example, it has been long known that sausage and hamburger meat can promote atherosclerosis and possibly even gastrointestinal cancers. Much of this has to do with the fact that they are loaded in saturated fats, contain minimal fiber and other phytonutrients, and may contain carcinogens. Despite this, food producers have been working heavily in the lab to produce burgers and sausages that smell, taste, and even bleed like real food. This has resulted in most likely similar unhealthy outcomes such as elevations of LDL, inflammation, and a promotion of weight gain with a consumption of these ultra processed plant-based foods. For instance, in a 2019 cohort study with a n=105,159 adults over a 5-year period, researchers observed that a 10% increase in the consumption of ultra-processed foods was associated with a higher risk of heart disease and cerebral vascular accidents (CVA). https://pubmed.ncbi.nlm.nih.gov/31142457/

So ultimately what should physical therapists do? We want to make sure patients are eating predominantly plant-based diets, however, many of them aren't quite ready to transition completely off of meat due to not knowing other sources of protein. This is where educating patients on the benefits of other sources of protein that are not common in our Western diet. One major source of protein include legumes: Beans are way underutilized in America, they are most likely canned and full of sweeteners. They are so many varieties of beans including kidney, white, black, and the list goes on! Lentils and edamame are another great source of protein that offer some variety and different phytochemicals. For some, tofu and tempeh may be a bit strange or foreign. However, when incorporated with soy sauce or into Asian dishes, tofu can be very delicious and is usually packed with protein, iron, and calcium. Lastly, it should be pointed out that many patients consume highly refined grain products. Whole grain products like whole wheat, pasta, brown rice, faro, and quinoa are usually packed with complex carbohydrates, protein, and fiber. Whole grains can offer an additional source of protein and nutrients that refined products cannot.

In the end, doctors of physical therapy (DPTs) need to be aware that junk vegetarian and plant-based diets do exist. Our major job should be to focus on getting patients off of the processed junk and onto whole foods, like legumes, whole vegetables, and whole grains.

Here's a nice article summarizing some good dietary points for PTs to share with patients:

If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60!



Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

Learn more online - new online discussion group included!


Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. 
  • NEW - Online Discussion Group
  • Live cases
  • webinars
  • lecture
  • Live Q&A
  • over 600 videos - hundreds of techniques and more! 
  • Check out MMT Insiders
Keeping it Eclectic...

Untold Physio Stories - Skeptical About Shoe Inserts - themanualtherapist.com


Are you skeptical about products that claim to benefit everything from foot pain all the way up to shoulder tightness? We are! However, using the Barefoot Science insoles helped a recent case of sciatic pain and tingling after a camping trip where Erson was using ill fitting flip flops. Has anything like this ever happened to you?


Untold Physio Stories is sponsored by


Helix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Use code MMT2 to get your sample and get an additional revenue stream for your practice. Click here to get started.


Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual


My PT Insurance - Insurance just got easier. check out the self employed and employed plans. Easy sign up and coverage that follows you wherever you practice in the United States. Save $20 if you sign up using our link.



Keeping it Eclectic...

[RESEARCH] Lumbar Flexion and Kinesiophobia - themanualtherapist.com


Goal of the Study?

This study aims to assess whether someone is generally fearful of painful movement or is it related to a specific task. It is common for those with chronic low back pain to experience an avoidance and fear of movement, likely because the movement has triggered a pain episode in the past. In this research paper published in Pain Reports1, the authors sought to see if kinesiophobia ( fear of movement ) is related to a specific movement or is it related to a general fear a person has developed.

Why are they doing this study?

One of the problems regarding questionnaires that are often used to evaluate fear avoidance is they do not replace an astute clinician who carefully assesses the presenting patient’s movement. Establishing an assessment strategy for the fear of specific movements would be more helpful.2

“The self-reported questionnaires administered before performing a particular
movement may not reflect the “actual” fear during the movement
because the questionnaires evaluate fear of general movement, not
the target movement.”

 

What was done in this study?

To better understand which movements may contribute to kinesiophobia, the researchers looked at 51 people and monitored lumbar flexion (bending forward). They used two accelerometers attached to the top and bottom of the lumbar spine and evaluated task-specific fear.

Lumbar Flexion Fear Avoidance Task-specific

Evaluation of lumbar flexion and task-specific kinesiophobia

What did they find?

Task-specific fear was significantly more related to the kinematics of lumbar flexion, particularly in the speed of return to the starting position. In their 2 measures,task-specific fear and general kinesiophobia, they found task-specific fear was more closely related to peak angular velocity of the return from bending forward rather than fear avoidance general questionnaires.

 

Why do these findings matter?

The researchers of this paper concluded that specific tasks should be considered when fear of movement is part of the clinical picture for chronic low back pain patients.

At Dynamic Disc Designs, we believe the pain onset from flexion likely relates to instability, and if a patient with chronic low back pain can be shown the mechanical cause and the solutions to reduce pain, then a reduction in fear of the specific task can empower patients about their movements. Consider our L2-5 Hypermobility Dynamic Disc Model as a teaching tool.

Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!

Learn more online - new online discussion group included!


Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. 
  • NEW - Online Discussion Group
  • Live cases
  • webinars
  • lecture
  • Live Q&A
  • over 600 videos - hundreds of techniques and more! 
  • Check out MMT Insiders
Keeping it Eclectic...

Untold Physio Stories - Inhibition vs Weakness - themanualtherapist.com


How do you know the difference between inhibition and weakness when someone tests weak? If any kind of reset automagically and dramatically improves a manual muscle test from a 1/5 to 4/5, it's inhibition. You can't rapidly cause hypertrophy! Listen to this case and let us know what you think.



Untold Physio Stories is sponsored by


Helix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Use code MMT2 to get your sample and get an additional revenue stream for your practice. Click here to get started.


Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual


My PT Insurance - Insurance just got easier. check out the self employed and employed plans. Easy sign up and coverage that follows you wherever you practice in the United States. Save $20 if you sign up using our link.


Keeping it Eclectic...