This week a patient was referred to therapy because of neck pain. I quickly determined she had a mechanical derangement of her cervical spine. Something was locked in the upper cervical region that prevented her from rotating. Her complaints were inability to sleep and turn her head. Once a manual therapist, always a manual therapist, I guess. ...

I believe I've mentioned being a certified McKenzie therapist in my former (pre-neuro) life. I still use those skills, particularly when one of my horses needs some work. However, I generally don't talk about it. I like to avoid those ''why aren't you doing that?'' questions. Nor do I want to spend my lunch time fixing someone's back or ...

Today was one of those days. There is a full moon. Healthcare workers often joke about the effects of the full moon on their patients. I believe there is something to that, which means my patients gets more of a workout than usual. I am used to brain-injured people being difficult, making inappropriate statements and being confused. I shrug it off ...

This week I found myself at an outpatient orthopedic clinic treating work-related injuries. The clinic was one of several in the area. They have agreements with many local industries to provide medical and therapy services to injured employees. The injured worker sees the doctor at the clinic, is given a script for therapy and starts as soon as ...

Once in a while I work with patients who have a diagnosis other than stroke. Two or three weeks ago, I evaluated a young man who'd had a TBI and was in the ICU. I later re-evaluated him following transfer to the rehab unit. Last week his rehab doctor noticed he had some ROM issues and decided to address them. Because I was the evaluating ...

Physical therapists spend a lot of time teaching patients how to do things. We teach home programs. We teach precautions. We teach safety. We teach how to use devices. The list of things we teach is almost endless. And right after we teach it, we document it. That documentation always includes some form of the phrase, ''return demonstration.'' A ...

Over the last few weeks, the stroke service has had a run of patients who have had strokes after stopping warfarin therapy. The reason was usually to have an outpatient surgical procedure. Because warfarin thins the blood the surgeons have the patient stop the therapy a few days prior to the procedure. They resume the drug once the risk of ...