physical therapists – Page 2

The Foot and Ankle Complex: Understanding the Science Behind Both Movement and Dysfunction

Chris Gellert/1 October 2020/ All MFN blog/

The foot is where movement begins, from the initiating of simple functional movements such as sit to stand or walking, to climbing stairs, to more complex dynamic sport movements such as playing soccer, football, rugby, and tennis. The ankle and foot complex require proper mobility in order for the body to initiate movement or change direction. In this article, we will review the anatomy of the ankle, common injuries to the ankle, functional assessments and training strategies to work with clients with previous injuries.

Interesting Times for Interested People

Dr. Mark Kelly/6 April 2020/ All MFN blog/

So, we are all shut in our homes and are not supposed to go to work, movies, or restaurants to dine in, and we can’t even watch live sports on TV. Life is so bad, and unfair… or is it?

I have decided to look at the bright side of this event, and see it as an opportunity. While many are not in my particular position, and are actually out of job and income due to this pandemic, I want you to reframe it. Change the paradigm of this being a negative, to this being a time for catching up, reflecting, and perhaps actually changing yourself.

We all have parts of our lives that need attention. In today’s current society, it is basically impossible to be all things to all people, including ourselves. We must try to balance job, family, social contact, social media, our own diet, hobbies, medical attention, our education — professionally or otherwise, our spirituality, and even our environment. Having balance in a variety of areas is true wellness! We are often so busy teaching and preaching the benefits of fitness and wellness to others, we deny it to ourselves. I remember doing a self-survey several decades ago by some program discussing the “wellness wheel”, which many of you have probably heard of. The survey was showing areas that needed attention. (Back then I had a very lop-sided wheel, and it is not much better now.) The wheel consisted of a mnemonic (6 components. It has shifted slightly in past few decades, but the pneumonic still works well: SPICES.

Old Wellness Areas	New Wellness Areas
S-ocial	Social – all interactions with people outside of ourselves
P-hysical	Physical – our physiological status
I-ntellectual	Intellectual – includes cognitive and emotional health
C-ognitive	Career – includes educational and skill acquisition and financial health
E-motional	Environmental (could include emotional) – clean, organized?
S-piritual	Spiritual – interactions with entities beyond people

I want to use this as a time to clean up many things that have been neglected — both around my house and inside “my house”, my physical body and mental space. I may even use this opportunity to shift my professional pursuits away from academic teaching to wellness coaching. Maybe I can chat on the phone more, spend time with my daughter, or spend more time cooking or reading. Whatever it is, start doing it now!

If nothing else, this has opened the world’s eyes to the need to stay healthy. It has shown people the need to be sanitary and practice good old-fashioned health care techniques, like washing hands and not running out of toilet paper! (Sorry, had to throw that one in!)

As an educator in both physical health and medical applications, we are perfectly positioned to show the communities we live in how to harness the power of exercise for both preventative and rehabilitation purposes. I have learned many new applications for teaching online and most people are focused on coming together for the “greater good”, and this is a breath of fresh air.

Good luck and stay healthy as you address the holistic health agenda in our society.

Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

The Lumbar Spine: Understanding the Science Behind Both Movement and Dysfunction

Chris Gellert/11 February 2020/ All MFN blog/

The spine is a complex structure, comprised of nerves, connective tissue, bones, discs, muscles and other essential integrative components. Whether it getting out of a chair or car, lifting or carrying items, some 29 muscles around the pelvic girdle and lumbar spine, provide stability. In this article, we will review the anatomy of the spine, common injuries to the lumbar spine, functional assessments and training strategies to work with clients with previous injuries.

Prescription for good health diet and exercise flat lay overhead with copyspace.

A New Era Begins

Phil Kaplan/3 December 2019/ All MFN blog/

The rallying cry is, “Let’s change healthcare!” From all corners of the medical universe, there is agreement that change is necessary. The biggest questions are, “What is the change?” and, “Who will make it happen?”

Helpful Hints for Breast Cancer Survivors – An Occupational Therapist’s Perspective

Naomi Aaronson/2 August 2019/ All MFN blog/

Occupational Therapists are trained to help people with illness or disability learn how to maintain their daily lifestyle. These daily routines help us feel in control of our lives, and illness forces us to change and become more dependent on others. There are ways to modify and adapt so that we can regain a greater sense of mastery over our lives even while undergoing treatment. Remember to first check with your physician to make sure that you receive medical clearance to engage in the following activities.

Here are some suggestions:

woman with pink cancer awareness ribbon 1. Take care of yourself by balancing work, rest, play and treatment. You may need to shift priorities and delegate responsibilities to others if able. It’s OK if the house is a little dirty.

2.Fatigue is the greatest side effects suffered after cancer treatment. However, research has found that exercise during treatment can actually counter the fatigue. Exercise improves quality of life, enhances function, and gives one a sense of control. Even starting with 5 minutes of exercise a day can be beneficial. The less you do, the more fatigue you will feel.

3. If you have received a TRAM FLAP reconstruction, putting on shoes and socks may be difficult. Assistive devices such as long shoe horns or stocking aides may make the process easier.

4. Peripheral neuropathy is another side effect of chemotherapy regimens. Loss of balance and loss of sensation in the hands and feet is a concern. Take measures to reduce risk of falls by removing area rugs, clear and place non-skid mats in the bathtub, and use nightlights. Larger pens with a wider circumference or with grippers can help to hold a pen when hands are weak.

5. Calm your nerves by using techniques such as deep breathing, meditation, and yoga which assists with lymphatic flow, pain, and are great stress relievers.

6. Conserve your energy by using carts to carry items instead of making several trips to the refrigerator when cooking. Use frozen vegetables instead of fresh to avoid the work of chopping. Sit while you perform tasks. Store items that you need regularly nearby.

7. Try to use both hands as a team rather than relying just on the unaffected arm for daily tasks such as bed making, dishwashing or lifting. If you recently received surgery, it is better to slide objects if possible rather than lifting them.

8. Finger fitness is important if chemotherapy has caused weakness. Special exercises can help you to maintain or improve the dexterity and strength in your hands.

9. Short rest breaks of 5-10 minutes during every 30-40 minutes of task can help to conserve energy for more enjoyable activities.

10. Velcro is one of the greatest inventions. Find shoes that use Velcro if unable to tie shoelaces.

Naomi Aaronson is an occupational therapist and fitness instructor who specializes in breast cancer recovery and rehabilitation. Naomi believes that exercise is essential in recovery. Her mission statement includes the following, “take back your body and improve your physical and emotional health.” Visit her website, recovercisesforwellness.com

Senior woman with help of physiotherapist

The Space Between Fitness and Medicine: Where “the Good You Do For Others” Brings the Reward you Deserve | Part 2

Phil Kaplan/24 April 2018/ All MFN blog/

In our first part of this three-part discussion, in addressing the topic of financial reward, I asked you to ponder the value of restoration. What, I prompted you to consider, is the value of helping someone who has moved along the dis-ease continuum, gradually leaving health in the proverbial rear-view-mirror back toward divine health?

It isn’t an easy question to answer. We can tackle it by considering all of the dollars those who incur inflammatory issues, chronic challenges, and cellular degradation will have to invest in maintaining function and comfort. We might also attempt to place a monetary value upon lost quality of life. We might even consider the simple question, “what would someone pay to rediscover health” considering their fear and apprehension of the alternative, and from that extrapolate the value.

If you are willing to believe that personal trainers with advanced education and the development of a complementary skill set can have immeasurable impact upon “the unwell population,” one perspective becomes clear.

The trainer versed in restoring health commands a far greater value than the personal training mainstream.

That’s important.

STEPPING UP A LEVEL

As in any field, a specialist with enhanced value will serve his or her marketplace best by finding a direct line of contact with those in need of their specialty.

In the sentence above, “need” is the key word.

While it’s oft been said that personal trainers are a luxury or a privilege, with an appropriate adjustment in perspective, those who have slipped into the largest segment of our adult population, the unwell market, might consider any therapeutic resource, if wellness is a goal, a “need.”

Now that I’ve mentioned it a few times, I’ll provide a general description of the market I’m referring to as “unwell.” Then I’ll help you see the opportunity to step up, to meet this population in an arena where they “need” you. I’, to command a value in line with a well-justified fee, and . . . here’s the biggie . . . to provide them the service they will truly benefit from.

WHO ARE THE UNWELL?

Let’s be really clear here. I’m not suggesting the opportunity lies in training “sick people.” I’m suggesting the largest, most opportune market share is made up of many American adults between the ages of 35 and 65. They aren’t “sick” in a clinical sense. They work. They drive their kids to school. They shop in the malls and grocery stores. They eat in the neighborhood restaurants. They pump gas in the same gas stations you do and they frequent Starbuck’s, Chipotle, and the local pizza place.

They don’t have need for hospitalization or chronic care . . . but they’ve slipped, moved along what I’m calling the dis-ease continuum. They’ve begun a process of maladaptation, a movement away from healthful homeostasis, and while many haven’t yet been diagnosed (many have), their bodies have become imbalanced. Whether it’s a hormonal imbalance, thyroid irregularity, blood sugar elevation, hypertensive condition, hypercholesterolemia, or chronic inflammation of one or several bodily systems, they have moved into a place where innate homeostasis is no longer their “norm.”

Not sick, at least not clinically, but not well. What’s alarming is, I’m describing near 65% of the adult population over the age of 45. Yes, the market is vast.

If the unwell were being cured of their ailments or remedied by the conventions of medicine, I wouldn’t see the “need” as being this opportune. All I need to share is a single statement to help you see why there’s a desperate need for a new type of health practitioner, one who masters the exercise and eating intervention. Here’s that statement.

In a society where chronic disease is most treated with pharmaceutical intervention, there isn’t a single medication that will cure any chronic disease.

Read that again. While there exists a wild array of meds to manage conditions and change biomarkers, there isn’t one that will cure the plight of the unwell.

Conversely, there is an extensive body of evidence to demonstrate the power we have over shifts in blood sugar, blood pressure, and hormonal disruption when we strategically employ a variety of exercise modalities and guidance in the realm of supportive nutrition.

If the demand is great, the “need” remains unfulfilled, and the greatest potential lies in the skill set we, as fitness professionals, have access to . . . our value escalates above virtually any conventional yet impotent “cures.”

THE LEVEL 2 TRAINER AS A CORRECTIVE HEALTH SPECIALIST

If we consider a “Level 1” trainer someone who is qualified, credentialed, and able to provide safe and effective exercise prescription to a healthy population, let’s consider a “Level 2” someone who can effectively target this Unwell niche and deliver improvements in biomarkers, condition, and quality of life.

The Level 2 trainer can identify his or her “ideal client avatar.” Moving forward I’ll refer to the Ideal Client Avatar as an “ICA.”

In establishing a presence and a track record with the Unwell, the enhanced personal trainer (enhanced with a higher level of education than the standard and an ability to implement positive change in the unwell) can justifiably command fees in line with other health practitioners, medical practitioners, and specialists.

In setting a fee structure, there should be a professional standard, a relationship-based fee that is consistent, one that exceeds “an industry standard.” Remember, if you deliver above the standard, you deserve reward above the usual.

HOW DO YOU STEP UP AND CREATE AN AUDIENCE?

Marketing, for the Level 2 trainer targeting this niche is not as haphazard as “pass out cards, talk it up in the gym, and talk to everyone about what you do.”

In order to establish your position, you’ll want to have four. Four strong successes. Four living examples of the value you deliver, and finding those four requires a bit of front-end work. Once you have your four you have a sound foundation upon which to build. The question, therefore, that merits consideration is . . . how do you “break in.” Where do your “four” come from.

I’ll make it step by step.

Note that everything that follows is based upon the assumption that you have received extraordinary training, that you’ve established a level of education complementary to your base credential, and that you’re positioned to initiate and maintain a practice with a revised focus on empowering clients to reverse the imbalances inherent in chronic disease. This is a prerequisite of paramount importance and although I won’t invest any more time in addressing it here, don’t allow my failure to repeat and reiterate this point as an indication its any less than vital.

STEP ONE: Define your Ideal Client Avatar. If you have a personal connection to a given condition or population (i.e. a relative with diabetes, a personal history with thyroid issues, etc.) and you have a passion for helping others who you feel are kindred spirits, that’s where you should best direct your marketing. You can’t “market well” until you define your ICA. This is a “must” in turning your ambition into financial security (and it’s the step most who seek to elevate their careers miss or ignore). Your ICA may not be based on your personal experience, but rather on where you see the greatest opportunity or where you have the greatest inroads. Devote time to getting clear on your ICA. It’s the true key to successfully “Stepping up to Level 2.”

STEP TWO: Determine your fee structure, your promise, and your offer. You don’t want to approach each prospective client with an open negotiation, nor do you want to exhibit uncertainty. As any business owner, design your foundation. What, precisely, are you promising each client? How are you compensated for that? What, precisely, is the person considering retaining you, supposed to do now, as a point of commitment.

STEP THREE: Choose a location, an affiliation, a network, and a social media platform where you can “meet” your ICA and spread the word. This is far simpler than it sounds. In outlining your ICA, simply as the question, “where do I find him (her)?” This is marketing at its core. Don’t think “medical.” Think real life. Where can you do a talk, a workshop, a presentation, knowing your ICA sits in the audience. I realize this is the intimidating step . . . but it’s also the one that brings you to human connection, and ultimately to commitment and money exchange. Perhaps in the future I’ll share an entire article devoted to “finding your ICA in the real world.” For now, accept that you have the answer to the question, you have the ability, and all it takes is a bit of courage and determination.

STEP FOUR: Create your Four. Do your thing. Work your magic. Use your skill set. Bring about change. Documentable change. Once you have your first four successes, you begin to build what I call an Arsenal of Evidence, and from that point on, the marketing challenge is replaced by magnetic appeal.

STEP FIVE: Build your business confidently, massively, professionally, and without limit.

This 3-part piece is intended, not to be a complete primer for business building, but to give you a sense of both the opportunity and your ability.

In creating a distinction between the progressive trainer willing to study, learn, and elevate, I’ve used the term “Level 2,” not to suggest any elite status, but to demonstrate a clear escalation in earning potential. Before I conclude this second part of the piece, I’ll outline a few elements of what I’m calling The Level 2 Trainer.

FIVE DISTINCTIVE ELEMENTS OF THE LEVEL 2 TRAINER

You are a specialist among a given population
You command fees above the norm
You have a consistent promise and offer
You have a track record and consistently grow a marketing / referral base
You understand and recognize the value in the potential you have as a guide to empower others to move away from chronic disease and back toward divine health

Is there a level above the Level 2 trainer? Yes. And the sky’s the limit. Literally. More to come in Part 3!

This is 3 part series. Read part 1 here, and part 3 here

Phil Kaplan has been a fitness leader and Personal Trainer for over 30 years having traveled the world sharing strategies for human betterment. He has pioneered exercise and eating interventions documented as having consistent and massive impact in battling chronic disease. His dual passion combines helping those who desire betterment and helping health professionals discover their potential. Email him at phil@philkaplan.com

Are You BUILT TO LAST?

Nicholas A. DiNubile, MD/20 April 2018/ All MFN blog/

Lately I can’t go to the gym without someone coming up to me looking for advice because in their efforts to remain fit and active they have hit a roadblock. Something hurts- a sore knee, achy shoulder or bad back that goes out more than they do. Ditto for my practice where I have seen a significant increase in exercise related ailments. I should give out orthopedic frequent flyer miles.

I’m an orthopedic surgeon specializing in sports medicine who has also had a life long interest and commitment to exercise. What I have learned over the years is that the far majority of exercise related ailments are preventable with some simple measures. That is why I wrote FrameWork- Your 7 Step Program for Healthy Muscles, Bones and Joints, as well as the FrameWork “Active for Life” series (Rodale Press).

Exercise is essential for maintaining optimal health, and being sedentary is just not an option, yet many individuals run into difficulties in their quest to be fit. Just about anyone can get into trouble, from young, fit and seemingly indestructible, to older and somewhat “beat-up”. We all bring “weak links” to the gym or out on the field. I‘ve learned this from working not only with my sports medicine patients but also athletes at the highest levels, including professional and Olympic. I have also learned the harder way, personally. A high school football injury that came back to haunt me, and a more recent low back issue.

The key is to find those “weak links” before they find you!

The human body does, and will, breakdown, especially when often pushed to the break point. Some of us are more vulnerable than others. And many of our “weak links” are of our own making. Workouts, activities or sports that leave imbalances in your frame, overuse, inadequate recovery, and so much more, mostly preventable factors. Musculoskeletal ailments have surpassed the common cold as the #1 reason people seek medical care in this country. It is no wonder for many, that workouts can be a challenge. Also, as Arnold Schwarzenegger so wisely said in the FrameWork forward, “I have really come to appreciate how the body is a dynamic, ever-changing structure that is different at different times. At 30 you need a different approach to fitness than when you were a teenager”. His workouts have evolved with him and even the Terminator himself has had to visit the repair shop. So, how can you be more durable, with less risk of breakdown? FrameWork offers 7 easy steps that can benefit everyone, young and old.

In FrameWork, I outline a 7-Step comprehensive plan for optimal health and durability. In Step 1, a unique self- test (take the interactive on-line version of the self-test) asks the question “are you built to last?” and finds your individual “weak-links” (we all have them). These “weak-links” or points of vulnerability may be old injuries or ailments, suboptimal nutrition, genetics, lifestyle, workout design, mindset and more. They are like hidden land minds, just waiting to be found, waiting to rear their ugly heads and put you on the sidelines, rather than in the game.

Step 2 thru 7 allow you to customize a program for your unique frame (based on the self-test and your own history) focusing on balanced workouts, frame-friendly nutrition and the important role of recovery and mindset. The program combines healing and restorative methods from the worlds of rehabilitation, martial arts, and yoga in a way never presented before. A “troubleshooting” section teaches you how to prevent, treat and safely work (out) around the “Top 20” sports medicine ailments from tendinitis and knee problems to back pain and pinched nerves. I also offer an insiders view of safely navigating the healthcare system, including a look into the very promising future for those with stubborn musculoskeletal issues. Most importantly, I use stories, drawn from my experience treating many wonderful athletes, entertainers and my many patients to help you better understand, and listen to your body- so that you can extend the warranty on your frame and it will be there for you when you go the distance. Remember, longevity and durability, two sides of the same optimal health and aging coin, are very different. We are certainly living longer and better, but without durability, problems are certain as we age. Fortunately many are preventable!

Find your “weak-links” and get a body that’s “Built to Last”.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.

Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA

senior man having a massage in a spa center

What is an Allied Healthcare Professional?

Jaclyn Chadbourne/20 March 2018/ All MFN blog/

Whether it’s exercise, nutrition, or massage therapy you are seeking, finding the right person to do the job can be incredibly challenging. The area known as allied healthcare professionals can be a challenging one to navigate.

The professions that require a state or national licensures, such as physicians, nurses, or physical therapists, help to provide checks and balances on who should and should not be providing a service to any individual. However, there are many professions within our healthcare community that are poorly understood and many times misrepresented by individuals with minimal certifications or credentials.

Allied healthcare professionals are thought to make up roughly 60% of the healthcare workforce by providing a range of diagnstic, technical, therapeutic and direct patient care and support services that are critical to the other health professionals they work with and the patients they serve. All categories of allied healthcare require either registration by law to practice or post secondary degree or higher education. Click here for more information about allied healthcare professions.

Is it time to re-assess who you trust with your healthcare needs?

It is essential to know the credentials and education of anyone you are trusting for information or advice whether it be an accountant, lawyer, dentist or teacher. Healthcare is no different, but there are many misunderstood healthcare professions.

Distinct from nursing, dentistry or medicine, allied healthcare professionals make up approximately 60% of the health workforce. Examples include athletic trainer, exercise physiologist, paramedic, and massage therapist. Many times, these professionals are those you are referred to by your physicians to help manage your healthcare needs daily, weekly, and monthly. National and state licensures ensure that certain healthcare professionals uphold the standards and scope of pratice that is pertinent to their level of education.

Multiple allied professions remain to establish this key aspect of standardized care which simply means that certain professions are more susceptible to individuals claiming a level of expertise or knowledge that can be misleading or confusing to the general population. For example, as a Clinical Exercise Physiologist, I clearly understand the difference between my skillset and that of a personal trainer; however, to the general public, both professions provide guidance with exercise. Due to lack of established licensure exams, it is unclear to many people that some Exercise Physiologists (like myself) have a Master’s Degree, while others may have earned a weekend certification. It is incredibly important for you to understand the roll of any healthcare professional from which you seek treatment and advice as well as their experience and background in relation to your particular healthcare needs. Accessing information about these resources from a knowledgeable professional can help to ensure proper connection to an individual that is appropriately educated to effectively meet your needs.

Jaclyn Chadbourne, MA, CES has worked within the allied health profession as a Clinical Exercise Physiologist for 15 years. She is currently the Director of Research and Development at Universal Medical Technology, and serves as Adjunct Faculty at University of New England DPT Program

Success in Life & Business… It’s a Matter of Touch

Dr. Steve Feyrer-Melk/3 August 2017/ All MFN blog/

I am sure you would agree that effective communication plays a significant role in relationships with clients, customers, patients, partners, family members, colleagues, friends, etc. But what about when those individuals are away from you? Do you fill that void effectively and systematically or do you leave it to chance?

Maximizing success in life and in business is dependent upon a complete relationship. To optimize your success you must see your time away from others just as important as the time you spend with them.

Let me explain. Your spheres of relationships are continually changing from both your perspective and from the perspective of others. As a result of these shifting viewpoints, the strengths or weaknesses of these bonds fluctuate and unless you systematically inject yourself into the relationship, you leave success and happiness to chance.

So how do you step-up and make sure you are not rolling the dice when it comes to your success? Simply put, by implementing real, honest, and effective “touches” you can maintain your presence the way that you want it to be. These “touches” are small, short, targeted, and balanced communications that fill the relationship gap that will maintain and even grow trust, loyalty and commitment. Found in various forms, these individualized gems can be phone calls, text messages, video calls, written letters, cards, etc. And the frequency? This depends on each situation but I recommend 14 to 21 days as the sweet spot to offer the best balance.

Remember, to maximize your success, “touch” everyone regularly in a way that will positively inject your influence and not allow chance to control of the outcome.

Reprinted with permission from Dr. Steve Feyrer-Melk.

Steve Feyrer-Melk, MEd, PhD, is a powerful, passionate, and trusted authority in Lifestyle Medicine who is bringing an innovative, refreshing, and successful approach to proactive health care. Dr. Steve co-founded the Optimal Heart Attack & Stroke Prevention Center where he crafts and hones real-world programs for immediate impact. Dr. Steve also serves as the Chief Science Officer of Nudge, LLC, a lifestyle medical technology company.