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. ...

No matter where I am, I hear the old school/new school discussion. In simplest terms, it's a comparison of how we did something years ago compared with how we do it now. In more unkind terms, it can become a condemnation of those who went to school back in the day or new graduates. It came home to me how different the thinking is last Friday. I ...

Anyone who reads my blog with regularity knows the last year has been a struggle for me. I lost my beloved job. I was fired for being ethical. I encountered more than my share of unethical and self-serving people. During all of that, I hung on and kept going to work. Every so often I made a difference to someone, which kept me going. For the ...

I'm a peer reviewer for the Texas continuing education program. I review submissions for neuro, geriatric, acute and general so I get to see a lot what is being proposed for continuing education. Texas has a specific form that must be completed for each course submitted for review. It includes speaker qualifications, specific goals, a statement of ...

Recently I took on another challenge, writing a CEU module. When I agreed to do it, I thought no problem. This is what I teach. I already have an outline and references. I can just fill in the words. After I started writing, I realized something. When I teach, I have lots of material to cover so spend little time on any one thing. The CEU module ...

Last week I questioned what the definition of skilled therapy was. I had worked with several patients the previous weekend whose only deficit was the need for supervision. I've realized I wasn't clear in describing those patients. All of them had been on caseload for a while. Previous safety issues, such as Berg and Tinetti scores, had been ...

I've been noticing a disturbing trend lately. More and more facilities are considering the need for supervision as a need for skilled therapy. Back in the day, patients referred to SNFs and outpatient had an obvious need. They had trouble walking. They couldn't transfer. They'd recently undergone total joint replacement. The knowledge and skill of ...

One of the presentations I attended at CSM discussed ways to increase motor learning by empowering the patient. They gave an example where one group of patients was asked to help decide which picture to hand in the waiting room prior to assessment. The other group just did the balance test. The patients who participated in picking the picture did ...

Now that I'm home from CSM, I've had an opportunity to process all of the information. Most of the presentations were excellent. Those that weren't purely theoretical had a common theme. We have to maximize what we do because we're spending less and less time with patients. We have less time to spend because there isn't money to pay for our ...

SAN DIEGO -- Just like my fellow ADVANCE blogger Lauren, I'll be attending the APTA Combined Sections Meeting in San Diego. CSM happens this week so I'm already in my hotel. I've registered and picked up my materials. I attended my pre-conference workshop on item writing. I'm ready for things to begin. Unlike most of my fellow therapists, the ...