It's Going Tibia Alright

They say that physical therapy is part art, part science, and today I'll be focusing on the artistic half of that fraction. Specifically, the question of patient motivation, and getting clients to "buy in" to their own therapy and recovery process.  First, what is motivation anyway? Google defines it as follows: mo·ti·va·tion  /ˌmōdəˈvāSH(ə)n/ noun the reason or reasons one has for acting or behaving in a particular way. "escape can be a strong motivation for travel" the general desire or willingness of someone to do something. "keep staff up to date and maintain interest and motivation" The English word "motivation" stems from the Latin movere , meaning "to move". So in essence, motivation is whatever moves one towards a goal or objective. According to Maclean et al., "certain conceptualizations of motivation can have negative effects on patient care[...] when motivation is regarded as a quality of the patient’s personality a...

The trapezius muscle (the wide, kite-shaped muscle that runs from the back of the head to the shoulders and the lower mid-back) is one of the muscles most commonly affected by trigger points  (Donnelley et al., pg 80). TrPs in this muscle are most commonly activated by sudden trauma such as an MVA, whiplash, or a fall, but they can also result from poor ergonomics or posture, or even improper sleep positions. Most trapezius TrPs can be treated (at least partially) with self-pressure release and self-stretching (the exact nature of which will vary depending on where exactly the trigger point is located; the upper, middle, and lower fibers of the trapezius pull in different directions, and therefore perform different functions).  The pain referral patterns of trapezius TrPs can be extremely varied. For example, "[t]rigger points in the middle trapezius muscle can refer pliomotor activity, or 'gooseflesh'" to the region of the opposite triceps and elbow (Donnelley et al...

A trigger point, or TrP, is commonly defined as "a hyperirritable spot in a taut band of skeletal muscle that is painful on compression, stretch, overload, or contraction of the tissue which usually responds with referred pain that is perceived distant from the spot" (Donnelly et al. 2019, pg 2). In layman's terms, a tight knot of muscle which hurts A LOT when you touch it. Trigger points are some of the most common musculoskeletal diagnoses: a most people will experience a trigger point at some point in their lives (Donnelly et al. 2019, pg 2). Etiology "People who frequently experience stress and anxiety may be more likely to develop trigger points in their muscles" (Myofascial pain syndrome - Symptoms and causes, 2020). An acute injury to a muscle may cause trigger points to develop at a later time, but one should also be aware that "[r]epetitive motions and poor posture also may increase your risk" of developing trigger points (Myofascial pain synd...

Since there has been only one topic of conversation for approximately the last 349 years, it seems germane to approach the subject from a healthcare perspective. Specifically, how do we as healthcare workers avoid contracting the SARS-CoV-2 novel coronavirus ourselves, and avoid passing it on to our patients and loved ones? Well, I'm glad ya asked. According to the CDC , infection prevention and control (IPC) practices begin before patients and staff even enter the building. The simplest way to minimize infection is to keep people from entering your clinic unnecessarily by conducting telehealth PT sessions instead of in-person ones whenever possible. If telehealth is not feasible (for example, the patient's insurance won't cover it, or the patient cannot safely stretch or exercise alone due to poor balance, etc.), then IPC practices should include 1) limiting and monitoring the entrances that staff and patients can use, 2) sanitizing doorknobs and keypads after each use, ...

Well, here we are.  I think it's fair to say that 2020 has not met with the expectations of even one human being. Obviously, there's the whole "global pandemic" thing going on (major bummer), and the economy is limping along, sports are on hold, socializing is suspended, vacations are verboten , family gatherings have been flummoxed, and doldrums are the new de facto . Everyone, all seven billion of us, is on tenterhooks waiting to see what's coming down the pipeline in 2021. Still, you've got to laugh, don't you? There's an old Yiddish proverb that I'm fond of: “Man plans, and God laughs.”  I think that's a great lens through which to view this hot mess of a year. Boy howdy, were we wrong about e v e r y t h i n g that happened! Well, almost everything: I did graduate from Macomb Community College like I expected, it just took five extra months, and the job market is looking a lot more anemic than I had hoped, even in an essential field lik...