When you’re just beginning your physical therapy career, there are so many paths you can take, it can feel a bit overwhelming. Some people will advise you to become a generalist, while others encourage you to find a niche as soon as possible. Others will tell you to do whatever it takes to pay off your loans ASAP.

It’s OK! Take a step back, breathe, and smile. You’re entering a career with endless opportunities to improve others’ lives and find personal fulfillment. There’s no one prescription for success, but there are certainly steps you can take to ensure you build a successful, enjoyable career as a PT.

Here are five steps to take to find success in the ways that matter to you.

1. Take Time for Introspection

Pretty much everyone has an opinion about what a new grad physical therapist should do, but the only one that really matters is your own. Take some time to consider who you are, and make your career decisions based on what you will find most fulfilling in your career. Questions like the following can help guide your process:

• What do you want out of your career?
• Are you seeking achievement? Work-life balance? Financial independence? Leadership opportunities?
• What makes you feel passionate and capable? Is it a particular setting? Patient population?
• Do you enjoy the marketing aspects of practice? Are you an educator at heart?
• What are some absolute deal breakers?
• Do you refuse to see more than 16 patients per day?
• Are you fundamentally opposed to using ultrasound or working on Saturdays?

These are just a few of the many questions to ask yourself at the beginning, and it’s OK if you don’t have all the answers this moment. Introspection should be an ongoing process, where you continually check in with yourself and your loved ones; this ensures that you’re always making decisions that are true to who you are at your core.

Finding the right leadership opportunities can be challenging when you’re a new grad, but MedBridge has created a 5-part leadership series. It’s an ideal way to kick-start your confidence and polish up your resume as you work toward your professional goals.

The rest of the post can be found at MedBridge's blog here!

We've partnered with MedBridge to bring you unlimited CEUs from the comforts of your home or office. Use promo code OMPT or click here to save subscribe to a yearly rate of only $250, saving you $175/year! MedBridge has seminars for PTs, OTs, DCs, ATCs and SLPs!

The Eclectic Approach is on MedBridge!

The Eclectic Approach has 4 courses on MedBridge, you can check them out here! If you've ever wanted to take one of my courses, but couldn't make them live, these are the next best thing, plus you get CEUs for them!

The course pages are here

The Eclectic Approach to TMD Part A and B
The Eclectic Approach to Clinical Neurodynamics Part A and B

Keeping it Eclectic...

Don't look for flaws. Look for ability-- Greg Lehman

This past weekend I had the opportunity to attend a course with Greg Lehman (@GregLehman) at Entropy Physiotherapy in Chicago, IL. I think I first became familiar with Greg after hearing him on the Chews Health podcast last year discussing the intersection of biomechanics, pain, and movement. Since then I have followed his blog and resources on his website, http://www.greglehman.ca/. For anyone who may be unfamiliar with Greg, he did his Masters in biomechanics under renowned spine biomechanics researcher Stu McGill, and then went on to chiropractic college followed by physio school. 

Even with his prestigious background, Greg delivers content without ego, almost in a self-deprecating manner, yet still full of conviction and veritas. Although most of the course attendees likely already were of a certain mindset prior to attending the course, Greg challenged the "gestalt" of our current way of thinking--regardless what we may have learned in school, the way many of us have been practicing for years, or what very charismatic and convincing thought leaders in our field may have us believe.

Greg's website provides two excellent and free resources for clinicians that I highly recommend. The first is his pain fundamentals workbook, which he indicated is currently being updated, and the second, is his guideline to treatment fundamentals. I often email the "pain fundamentals" manual directly to patients to complement some of the education provided during treatment sessions, especially for some of those concepts that are more challenging for people to embrace. There are some other good resources out there as well, including Mosley and Butler's Explain Pain, and Adriaan Louw's Why Do I Hurt. But when we are attempting to do something as difficult as changing people's thoughts, opinions and behavior, especially when it is something that many people may be resistant to, I find it harder to convince people to pay for something. That's another reason why this free resource is so beneficial. And as Greg stated several times during the weekend, "sometimes it's better for your patient to get this information from someone else other than you."

Before we get too much further, here's just a few words about Entropy Physiotherapy:

Co-owned by Sarah Haag and Sandy Hilton, this is the second time I've attended a course there, and it won't be the last. The first was last summer for a one-day workshop on the "customer life-cycle" with none other than Jerry Durham (@Jerry_DurhamPT), who by the way, will be back again along with Jeff Moore (@jeffmooredpt) May 20-22 for "The business of managing low back pain". I highly encourage everyone to attend. 

A photo of the class at Entropy Physiotherapy. (Check out the good-looking guy in the middle in the green shirt. No, not that guy in front. No, no--that's Ryan Smith (@RyanSmith_ATC) standing in the back. I'm talking about the guy sitting in the mid.....nevermind).

Entropy is a very inviting and comfortable space for attending a course. Class size tends to be smaller so it makes for a more intimate interaction with not only the instructor but also the other attendees. Sarah and Sandy are fantastic hosts and not just because they make great coffee. When you consider the quality of instructors that are brought in, from Greg Lehman, and Jerry Durham, to Mike Stewart and and Diane Jacobs, compared to a weekend SFMA course that costs around $1000 for a weekend, less than $400 for the quality and value you receive is quite the bargain. For upcoming courses, check out the link here: 2016 Entropy Physiotherapy course line-up


And now, here's Greg:

I know what you're thinking. Greg Lehman must really have to go to the bathroom. Either that or he's demonstrating the latest dance craze sweeping across Canada, (which I can't be sure of since he didn't expressly say that he wasn't). Well, you'd be wrong on both counts. He is in fact demonstrating a reasonable exercise for someone with anterior hip pain to train into. (Cue record screech). 

But isn't that just an unbelievably horrible and "faulty" movement pattern? It depends. It might be a good way to load the joint and tissues in a novel way to stimulate an adaptation response. Depending on the activity or demands of the individual, many people may find themselves at some point in a similar position. Wouldn't it be good to prepare the body for this movement so instead of being perceived as "threatening," it has already become accustomed and desensitized to the the position? 

It was somewhat unsettling, yet at the same time welcoming, to be confronted with a challenge to concepts that have become so commonplace not only in physical therapy, but in general movement practice and the strength training community. I admittedly had fallen into the trap of "diagnosing," "correcting," and "treating" "abnormal" movement patterns. Yet, some of those lingering doubts and questions I had are what drew me to Greg's approach and way of thinking. 

When the student is ready, the teacher will appear-- Chinese proverb

The concept of what is the right way to move or what constitutes a good movement may be like the Matrix--the wool that's been pulled over our eyes to keep us from seeing the truth. The truth, in fact, might be that there is no spoon. What or who truly defines a good or bad movement? Could it be that there is no faulty movement unless there is pain? Could there just be movement?

Woah!

There is no easy answer. And many things that will help contribute to our understanding are still unknown. As usual, what we think we know is always changing. The key is that we keep welcoming and adjusting to that change. 

Here are some highlights of my takeaways from the weekend. 

On Movement:

• Knee valgus and spinal flexion aren't inherently "bad"
• the lumbar spine goes through significant flexion in exercises such as the squat and kettlebell swing even when trying to maintain "neutral spine,"
• Degeneration and damage are poorly related to pain, so how can we define a faulty movement pattern?
• We can't extrapolate biomechanics for heavy lifting to regular activities like sitting and texting
• Movement preparedness trumps movement quality
• The best movement screen is one that tests what the person does or needs to do and determines if they can do it
• Movement screen needs to be specific to the sport, e.g. golf swing, gymnastics
• Are you human? Then you're not dead. You can load and you can adapt
• When someone has a painful movement:
• Change it and the movement is desensitized
• Increase tolerance to that movement
• It's more about movement OPTIONS and less about ideals
• creates variety
• shows patient they can move without fear
• demonstrates that they have the ability to move
• builds confidence and self-efficacy
• modifies symptoms
• desensitizes painful movement while body adapts
• Muscle activation is analgesic (short-term)
• Movement is good. Moving differently increases confidence
• Rehab must match the demands of the patient's goals
• No movement is off limits forever!
• Meaningful movement trumps remedial movement
• Alternatives to "correcting" patterns--break the pain habit with NEW movement options
• Example--how many ways can you perform a single-leg squat?
• The best exercise just may be the one you're NOT doing

 Confront people with their strength!-- Greg Lehman

On Pain:

• Pain is normal! Maybe acceptance is the key. If we shift what it means to have pain, maybe that in and of itself is de-threatening
• Pain is more about sensitivity than injury
• Pain tells us little about the state of the tissues
• Pain is an alarm. What does a fire alarm going off tell you?
• fire?
• smoke?
• where located?
• how intense?
• or just a test of the system?
• When something hurts, there are two options: 
• change/avoid it. 
• adapt to it
• Movement and pain get wired together--Pain can become a habit
• We can use "conscious uncoupling" with concept of neuroplasticity
• modify the movement and repeat to form new habit
• load sensitized area in "novel" positions and patterns
• load/move in ways that are similar to painful movement but shy of pain
• retrain previously painful movement 
• Context and expectation fuel sensitivity
• Pain science helps people think differently about their situation
• If pain is an opinion of the brain, we need to help change their opinion

At it's simplest, treatment is merely manipulating load/stress and then asking the person to adapt-- Greg Lehman

On Treatment: 

• Our treatments and interactions can be simple to yield complex result
• Mindset shift--at its core, most everything we do is the same. (ART, Mulligan, McKenzie, insert your treatment paradigm of choice). 
• We facilitate an adaptation and find the right trigger for that for that individual
• Is it all just graded exposure?
• You cannot mobilize/manipulate in a specific direction. The skin-fascia-bone interface is friction-less, so the only force that can be applied is perpendicular to the direction of motion. (Bereznick, Ross, and McGill 2002)
• Manual therapy is like jump-starting a car. What do you do after that? Do you just let the car sit there? No! You drive it. So get moving!
• We are not machines, however. We adapt to appropriate stress and increase our resilience
• How do we know an impairment is an impairment? Must relate to activity
• Static stretching might not be as bad as we think!
• Based on recent research
• Greg challenged his own bias on this topic
• It may not matter how you correct a movement. The right way to do it is the one that is pain-free!
• The body adapts--not immediately and not infinitely so we must respect this

As always, thanks for reading.

-Andrew

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...

Subscribe to our mailing list and get the free ebook - The Rules of the Reset

Hey guys,
  At the Nxt Gen Institute, we have some exciting things going on that we wanted to share.   

Upper Quarter Manual Therapy Videos



We have uploaded high-quality recordings of our upper quarter manual therapy content (which is taught and reinforced in our COMT and Manual Therapy Fellowship programs).   These videos are for sale for streaming/download on our vimeo page for only $29.  Recorded by Mike Timko, PT, MS, FAAOMPT, these are the first of a series of videos that will be released by Nxt Gen this year.   If you are considering a COMT or Fellowship, this gives you a test-drive for a very affordable price.


The Athletes Mind: Treatment Principles for Runners and Strength Training

On April 2nd, our friends Chris Johnson and Francois Prizinski will be teaching "The Athletes Mind: Treatment Principles for Runners and Strength Training" in Charlotte, NC.   This course is an amazing product of human possibility. With the emergence of advanced imaging techniques, our understanding pain science, and neuroplasticity, we can offer a comprehensive introduction of rehabilitation perspectives for the athlete and chronic pain suffers alike. This course will introduce the brain circuitry errors that occur in pain sufferers and the management scheme to induce adaptive neuroplasticity for optimal motor output and human performance. This course covers perspectives in the running athlete along with principles behind strengthening to induce cortical change. The course expands from a biopsychosocial approach to motor control which contains significant clinically relevant content to apply immediately into practice.

This course is open to PTs, SPTs, ATCs or anyone else who treats athletes.   Get 20% by using promocode "Spring2016" at checkout.


Certification in Temporomandibular Management



  Finally, Dr. Erson Religioso is leading the 2nd cohort of participants in a Certification in Temporomandibular Management.   We have identified a lack of knowledge by many in the screening and treatment of this condition which may be affecting many of your upper quarter patients, especially those with concurrent headaches and/or cervical dysfunction. The Eclectic Approach uses movement screening via a modified Movement Screen as well as a Repeated Motions Exam to help classify the patient and find relevant movement and motor control issues.

This program places a strong emphasis on modern Pain Science Education and home exercises is used to make the patient independent of passive care. Manual therapy uses The EDGE Tool for Instrument Assisted Soft Tissue Manipulation or IASTM, as well as joint mobilization for the upper cervical spine and TMJ, function mobilization, and thrust manipulation of the cervical and upper thoracic regions.

Get $150 off by using promocode: "CertTMM2016" at checkout by 4/1/2016

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...

Subscribe to our mailing list and get the free ebook - The Rules of the Reset

I often get asked what I think of commercial model x, or system y. While there are definitely courses I would recommend for novice clinicians, there are more that I would no longer recommend.

I last wrote 5 Recommendations for Continuing Education sometime in June 2012. In fact, it was my first Top 5 Fridays Post! While some of the recommendations remain the same, there are changes.

At the beginning of each year, I take a look at where I want to develop myself professionally and my weaknesses. I then come up with a list of courses I want to take that year.