Monday, May 12, 2008

First Hand Information Gives Clarity

I had an interesting conversation with a kinesiologist working in a physical therapy clinic about the role of the rhomboids and lower trap in shoulder and mid-thoracic dysfunction. During the conversation she quoted the work of Dr. Shirley Sahrmann, PhD, PT of Washington University in St Louis, MO. Dr Sahrmann's work on identification and treatment of postural and muscular imbalances is standard learning for physical therapists. During the conversation I noted this young lady either misunderstood or left out key components regarding Dr. Sahrmann's guidelines for the management of the mid-thoracic region. When I asked questions to clarify her understanding (not to embarrass or ridicule her, but to make sure she was following the appropriate exercise guidelines for her client) she noted she never attended a seminar or read Dr. Sahrmann's book “Diagnosis and Treatment of Movement Impairment Syndromes”. She obtained her information from a colleague that attended a Sahrmann seminar.

For fitness professionals’ credibility is a key in establishing relationships with medical professionals. Attending workshops taught by medical professionals and reading textbooks for medical professionals will significantly improve your understanding of medical conditions and your ability to develop safe and effective post rehab program for clients. This will go a long way toward your credibility. The point I am trying to make is educate yourself and understand all aspects of a rehab philosophy if you plan on incorporating it into an exercise program. The subtle nuisances are lost when you use second-hand information rather than authentic information from the author. Important points are lost when the concept travels by word of mouth. I recommend reading articles and/or texts from these authors as well as attending workshops that focus on the concepts they developed.

• Vladmir Janda, MD (start with Janda's compendium which you may purchase at www.optp.com)
• Shirley Sahrmann, PT, PhD (we mentioned Sahrmann's book earlier)
• Robin McKenzie, RPT (McKenzie's technique for managing discogenic back pain produced lumbar extension as a means of treating radiating pain.)
• Greg Johnson, RPT (founder Institute for Physical Art - the institute offers a great course titled “Functional Orthopedics”. I don't think non-therapists are eligible to take the course but it is a fantastic workshop.)
• Frank Noyes, MD & Bob Mangine, RPT (Cincinnati Sports Medicine Center - their spring sports med symposium at Hilton Head, SC is the best and most comprehensive out there.)
• Philip Greenman, DO (Dean of the Michigan State University College of Osteopathic Medicine - his textbook “Principles of Manual Medicine” is a must read for massage therapists, physical therapists and chiropractors.)
• James Andrews, MD & Kevin Wilk, RPT (Alabama Institute of Sports Medicine – Andrews and Wilk have developed rehabilitation guidelines for a wide range of orthopedic surgical procedures.)
• Stuart McGill, PhD (Waterloo University - his research in spinal function is fantastic. Dr McGill's book is titled "Low Back Disorders".)
• James Cyriax, MD (the father of orthopedic medicine. His book the “Textbook of Orthopedic Medicine” is a classic text for physical therapists and chiropractors)

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