As 2009 comes to a close in the next few weeks, I would like to reflect back on a few things that I learned, or at least strengthened my understanding on, this year. It is a practice that I try to perform each year and recommend you do as well. I feel that it helps me focus my energy and prepare for the upcoming year. Please comment on this and share with me what you learned this year.
1. Posture plays a significant role in upper extremity function.
Its been well documented that posture plays a role in function. As an example, now that i have you sitting in front of your computer, slouch as much as you can (as if you weren’t already!) and try to elevate your arm. How high do you go? Now sit up straight and elevate your arm again, goes up all the way doesn’t it? I get that, there is research to support changes in subacromial space, increased impingement etc.
What I am talking about is function – how a simple thing like tightness of the pec can tilt the scapula, which inhibits the lower trap. But let’s not stop there, try this one. Sit in your chair and slouch again. Now anteriorly tilt your pelvis. Isn’t it amazing how you can not slouch when you pelvis is tilted? Looking at the body as a whole is an amazing approach. learn, understand, and apply the concepts of the upper and lower body cross syndromes into your patient care. Read more about these concepts from Vladimir Janda in this nice article from Phil Page.
Figures from Chaitow: Muscle Energy Techniques, 3rd edition, with permission
Another interesting note, I recently tried out this cushion that helps you sit more upright. It’s called the Tush Cush, hilarious! It helps you site with an anterior pelvic tilt. It really works, you sit better and you back feels better. A great product for those that drive or sit a lot that experience any spine or shoulder pain. I am actually using it as I type this!
2. Trigger points are real and can be managed.
I am going to take some heat for this and I have already heard from people that disagree. I have witnessed many soft tissue structural issues that occur from acute and chronic postural adaptations that respond well to trigger point therapy. Haven’t you had a knot in your upper trapezius / levator that felt better and improved your neck and shoulder motion after you self-massaged the area? I have.
There isn’t a lot of science behind the theories just yet, but there is more every year. The Journal of Bodywork and Movement Therapies is working towards improving this as well. I’ve mentioned it in my post on the Essential Reading List, but you really need to check out some of the work of Leon Chaitow. He is not the only person with this thought process, there are many, many more. But Leon does a great job putting the info together in a practical way in his books. He also summarizes the available efficacy well. Here is a good video of one of his technique:
3. There are a lot of great resources on the internet to learn new techniques and share ideas.
As I grew this website over the last year, I found many more great resources on the web. The majority appear to be from strength and conditioning specialists, but there are a some by athletic trainers and physical therapists as well. Some have a small cost (but are worth it) but most are free resources.
Take advantage of these resources, they are only getting better every day.
I try to share what I find each week in my Stuff You Should Read articles. Be sure to fill out the form below to sign up for my newsletter.
4. Online continuing education is effective and a great way to further our skills.
If you remember back to earlier posts here, I have been saying that I think online continuing education is the wave of the future. Don’t get me wrong, the live seminar/lab structure will never be replaced, but more and more people will begin to explore online education. There are many pros – study at your own pace, go back and forth as you see fit, combination of video, reading, and interaction, and the fact that you don’t loose a whole weekend!
I have started some webinars this (and will do more, I know it’s been awhile). These are live presentations that I perform from a distance. I have my past webinars recorded and available at AdvancedCEU.
I also just finished my first 7-week online continuing education program on the Recent Advances in Evidence-Based Evaluation and Treatment of the Shoulder. I didn’t know what to expect but the response was huge. This was a great experience and I will continue to grow this program, will likely start another one in either January or March (Let me know what you would prefer). UPDATE: You can now start this program anytime at ShoulderSeminar.com.
See some of the responses from participants around the world:
- “I’ve been a PT for 18 years and have grown confident in my treatment of all shoulder injuries. I have a strong reputation in the Cape Cod community as the shoulder PT. This course was humbling. I have never been as excited to treat shoulder patients then I have been during the past 6 weeks due to this course. Mike’s video presentations, assigned research reading, and knowledge on the discussion board made me think differently about how and why I treat shoulders the way I do. His knowledge has challenged me and opened my eyes to things I need to consider for evaluation and treatment and what I need to do better. He has fine tuned all my treatments. I’m a better PT now, and my patients will get better results. It’s amazing that I’m most excited about shoulder treatment now than at any other point in my 18 years experience. Thanks Mike.” – Jim Hawley, PT Hyannis, MA
- “The course was FANTASTIC!!!!! I learned a lot and i hope there are more courses like this one! Great experience!” – Eduardo Corrêa – Salvador/Brazil
- “Mike Reinold’s Online Shoulder Course is not one to miss. The information from this 7 week course is a great clinical foundation for all clinicians that see patient’s with various shoulder pathologies. You will definitely walk away a better clinician and provide better care for your patients after taking this course.” – Megan Eorio, DPT Danville, CA
- “Mike’s course does a brilliant job of integrating the most recent evidence based practice with current surgical techniques and rehab of the surgical and non-surgical shoulder patient. He brings together a very organized learning experience that offers the participant the flexibility to move at their own pace and access to open discussion with a diverse, very knowledgeable cross-section of therapists. This course organized the approach I will take with my shoulder patients in the future.” – Christine Panagos. Portland, Oregon.
- “This online course was a great learning experience for me. It definitely expanded my knowledge on shoulder pathology and treatment techniques. I was able to interact with some of the best clinicians in the country without leaving my home. I highly recommend this course and look forward to future online courses taught by Mike Reinold.” – Christie Gaston, PT, DPT Homewood, IL
- “This course provided an unbelievable amount of content, focused on recent research, regarding the shoulder joint. If you complete this course, with all presentations and readings, you will have a very thorough understanding of the shoulder joint. It was great to have the ability to review the material at any time, from anywhere, via the internet format. Also, the ability to interact with a leader in our field for over 6 weeks is incredible!!” – Carlyle Schomberg, Waynesville, NC
5. It is easy to get consumed by work, there are more important things in life.
You can thank my now 1 year old daughter for this one. I am guilty of being consumed easily, not just in work but really anything I set myself to do. My motto was always, “I’ll work hard now so that I can afford to slow down when I need to in the future.” Well, that time is now. My goal of 2010 is being consumed with the important things in life. A friend of mine once told me, when our careers are all said and done, the only people that will truly remember you accomplishments are your family.
Have a great holiday season and an even better 2010!
Photos by bigpresh and thomasbrightbill
