Welcome to Health Care POV | sign in | join
Raising the Bar in Rehab

60 Things Every PT Should Know

Published November 11, 2008 10:53 AM by Lisa Catenacci
A while back I emailed the faculty and staff in the Marquette PT Department and asked them to help me compile a list of things every PT should know. I got back a nice variety of responses--and here they are. 

Do you have anything to add? Leave a comment and I will gladly add it to the list!

  • 1. You have to know some Bob Dylan songs
  • 2. Articularis Genu?
  • 3. You won't know all of the anatomy all the time
  • 4. I'll know my song well before I start singing
  • 5. Don't have your patients do anything you wouldn't have your mom do
  • 6. Rodney Dangerfield muscles: Brachialis and Soleus
  • 7. Morale is to the physical as three is to one
  • 8. Know pain, no gain
  • 9. Know the 17 muscles that have attachments to the scapula
  • 10. Volunteer for something in your professional organization
  • 11. Come back annually to MU in July for the reunion weekend CE course
  • 12. Donate to the PT Faculty Student Scholarship Fund on an annual basis (even if it's only a little bit, as over time it can really add up)
  • 13. Take the time to recognize support staff, aides and others who help make your life easier
  • 14. Share updates of your e-mail address with the department so you are notified of upcoming conferences, or other department news
  • 15. Start saving for retirement right away!
  • 16. Know when to hold a patient's hand and when to kick a patient's behind
  • 17. Know how to use electrical stimulation for pain relief and muscle contraction
  • 18. Know the effect of a longer external moment arm on the internal torque necessary to hold an object in isometric static state
  • 19. Know that chiropractors are our friends (NOT)
  • 20. Gait is 60 percent stance, 40 percent swing...or is it the other way around?
  • 21. A muscle only knows how to shorten and to resist being pulled part
  • 22. You gotta love the quadriceps....
  • 23. Torque makes the world go 'round
  • 24. A muscle CANNOT produce a torque if it either pierces or parallels the axis of rotation
  • 25. The gluteus maximus is aptly named
  • 26. If at first you don't succeed, re-evaluate your hypothesis
  • 27. Look before you leap-observe the patient's attempts before you jump in with instructions
  • 28. Know thyself-and know that patients know themselves better than you do, so listen to them
  • 29. Patience is a virtue-be in control of yourself and your session
  • 30. Unto thine own self be true-despite what others may want you to do
  • 31. PT = people touching, not physical terrorism (despite what your patients might say)
  • 32. No evidence doesn't mean that nothing works
  • 33. "On Old Olympus Towering Top A Fine Vested German Viewed A Hop"
  • 34. Know that professional membership in the APTA is critical and benefits the entire profession
  • 35. Know your Practice Act and who to contact for questions
  • 36. Know your Code of Ethics and Guide for Professional Conduct
  • 37. Know how to legally and ethically supervise PTAs and support personnel
  • 38. Know what autonomous practice really means
  • 39. Know what direct access really means to us as licensed professionals
  • 40. Know how to use EBP appropriately
  • 41. Don't procrastinate and leave your documentation until the end of the day
  • 42. Regardless of your busy schedule, take the time to get to know your patient. They will lead you to the answers
  • 43. Make it a goal to learn something new about physical therapy, or try a different treatment technique once a week
  • 44. Passion for Vision 2020 is contagious. Educate your fellow co-workers on the goals and Vision of the APTA and how they can be involved
  • 45. Do not pre-judge your patient's level of function based on age (Sometimes the 80 year olds can run circles around the 40 year olds!)
  • 46. Take pride in knowing every day you go to work you will somehow make someone's life better!
  • 47. A cough is only effective as the deep breath that precedes it
  • 48. Perform five consecutive deep breaths with a 3 to 5 second end-inspiratory "hold" to magically raise a patient's desaturated SpO2 within 10 to 15 seconds after completion
  • 49. Controlled exhalation by your patient promotes mobility, especially when they are fearful and/or in pain ("whistle while you work")
  • 50. Utilize the "reverse action" principle for recruiting the inspiratory accessory muscles by stabilizing the head/neck and/or the upper extremities to provide some assistance/respite to the Diaphragm
  • 51. Perform the "Fuzzy Navel" test and check for "inspiratory paradox" among other things:
  • a. When the ribs move inward rather than outward on inspiration, it may herald the fatigue of the Diaphragm and/or length-tension inappropriateness of it (flattened out or loss of the Zone of Apposition)
  • b. Inspiratory Paradox may be the first change of fatigue to be seen and the first sign to indicate recovery when it is no longer observed
  • c. The abdominal muscles are relaxed (passive), not active, during a normal resting expiratory phase as elastic recoil of the lungs and ribcage take place
  • 52. Auscultate and pay attention to tubular vs. vesicular sounds with or without "crackles" to identify between fluid, atelectasis, fibrosis or normal, respectively
  • 53. Routinely remove your patient's shoes and socks during your PT initial evaluation:
  • 54. Inspect for condition/length of nails, pitting edema, ulcers, bunions, hammer toes, suppleness of the forefeet, etc.
  • 55. "Augmented abdominal breathing" can be used as a diaphragmatic inspiratory assist strategy to control for anxiety & panic
  • 56. Use of an oscillatory fan can help prevent/relieve anxiety or panic
  • 57. Routinely check your patient's pulse rate and rhythm at rest, with activity, and into recovery
  • 58. An irregularly - irregular pulse rhythm almost always will be atrial fibrillation
  • 59. Indicators for function ("red flags") to pay close attention to:
  • a. FEV1.0 (<1.25 liters)
  • b. 6MW (<300 meters)
  • c. Unable to rise to a standing from a 17" seat height without arms helping requires > or = to 3-5 in lb torque/lb body weight
  • d. +Trendelenburg (Wall Test) when lateral pelvic stabilizers< 3-5 in.lbs. torque/lb. body weight
  • e. An MEP > (+)100 cm H2O from TLC is needed for effective cough force.....the more positive the MEP the better up to a point
  • f. Check your patient for protective sensation of the feet of at least 4-5 grams of force
  • g. An MIP of <(-)50 cm H2O from near RV is likely to have a patient to require some ventilator assistance to avoid fatigue/failure......the more negative the MIP the better
  • h. And so many others!
  • 60. Work-to-rest ratios get smaller (i.e. more rest than work ) as a patient's functional tolerance deteriorates

1 comments

...85% of medical school graduates fail to demonstrate competency on a musculoskeletal exam (Freeman) and only 1/3 of US medical schools require ANY coursework on musculoskeletal medicine...yet the AMA resists direct access because????

Christie, PT November 12, 2008 8:11 PM
IL

leave a comment



To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Captcha
Enter the security code below:
 

Search

About this Blog

Keep Me Updated

Recent Posts