tag:blogger.com,1999:blog-61752062766983974712024-03-21T15:11:42.147-07:00Post Rehab BlogThe "PostRehabBlog" is for post rehab professionals that wish to develop a profitable post rehab practice as well as establishing safe and effective fitness programs for clients with musculoskeletal, cardiovascular, neurological and metabolic disorders.Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.comBlogger84125tag:blogger.com,1999:blog-6175206276698397471.post-47131645651604649992008-11-28T18:41:00.000-08:002009-03-30T19:49:13.748-07:00The Post Rehab Blog Has Moved!!You can find the Post Rehab Blog now at <a href="http://www.postrehabblog.com/">www.postrehabblog.com</a>. Please visit us there for information to help you build a profitable post rehab practice and effectively manage a wide range of medical exercise clients. Happy Holidays!!<br /><br /><div style="text-align: center;"><a href="http://www.postrehabblog.com/">www.postrehabblog.com</a><br /><br /><br /><br /></div>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-26599478518264054712008-09-16T14:36:00.000-07:002008-09-16T20:02:48.370-07:00Do you know the post rehab scope of practice?As post rehab fitness grows and gains acceptance by medical professionals it is important to make sure you understand the services and activities that fall within the scope of practice for the post rehab professional. The practice of all medical disciplines is closely regulated by a board of examiners usually appointed by the state or provincial legislature or governor. The board specifically outlines the educational requirements, licensing procedures, accepted treatment and procedures practitioners may use in their manage of patients. At this point, no state or provincial legislature has established a scope of practice for the post rehab professional. We have established a scope of practice for our Medical Exercise Specialists, Post Rehab Conditioning Specialists and Medical Exercise Program Directors. We teach this in every post rehab workshop we offer. Continue below to look review the post rehab scope of practice. Our next post will review the red flags indicating a client needs evaluation and/or treatment by a licensed medical professional.<br /><br /><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieQwyfX3zY6BNerHESSHLWU8qOufJXSAqNMK2SMFzG3Ho_wze-UTUXHe7hySgxxajpeSQx11UdC5WQzexbuFyyLh4bU0KjjsDWz6VZfdM0gX6t1Bc0TlOTo5Qxa4zSHPSPlp3E3okRbS47/s1600-h/scope_logo_bullets01.jpg"><img style="cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieQwyfX3zY6BNerHESSHLWU8qOufJXSAqNMK2SMFzG3Ho_wze-UTUXHe7hySgxxajpeSQx11UdC5WQzexbuFyyLh4bU0KjjsDWz6VZfdM0gX6t1Bc0TlOTo5Qxa4zSHPSPlp3E3okRbS47/s400/scope_logo_bullets01.jpg" alt="" id="BLOGGER_PHOTO_ID_5246738785127572994" border="0" /></a><br /></div><br /><br />Please click the link below to listen to our podcast titled "The Post Rehab Scope of Practice".<br /><br /><span style="font-style: italic;">Dr Mike<br /><br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P9f0962b740af5f66df84db7c492ce1b1YVp8QVREZmt1&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" height="20" width="206" frameborder="0" scrolling="no"></iframe><br/><a rel="enclosure" href="http://www.audioacrobat.com/export/P9f0962b740af5f66df84db7c492ce1b1YVp8QVREZmt1.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" width="72" height="16" border="0" alt="MP3 File" /></a></div><br /><!-- AudioAcrobat.com Player code END --><br /><br /></span>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-32175621025642648362008-09-16T01:28:00.000-07:002008-09-16T01:28:00.578-07:00The knee meniscus - Where is it and what does it do?The menisci of the knee are the most important structures in the knee. The cruciates are important to knee stability but the menisci are most important because at this point, the menisci cannot be repaired or regenerated. There are two menisci, the medial and lateral, found in each knee. The larger of the two menisci is the medial. The most often damaged of the two is also the medial meniscus. For more more detailed anatomical review of the knee menisci, please click the link below to our video outlining the knee meniscus.<br /><br />Dr Mike<br /><br /><br /><object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/ucVRGTFw7K0&hl=en&fs=1"></param><param name="allowFullScreen" value="true"></param><embed src="http://www.youtube.com/v/ucVRGTFw7K0&hl=en&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="344"></embed></object>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-442590839536403002008-09-13T19:40:00.000-07:002008-09-15T22:59:56.838-07:00ACL Graft - Hamstring or Patella Tendon?Tiger Woods recently underwent an ACL reconstruction using a hamstring graft. But many professionals athletes have the ACL reconstructed using the patella tendon graft. Why use the hamstring tendon opposed to the patella tendon?<br /><br />We know the patella tendon draft is 110% (research estimates) stronger than the original ACL but some surgeons still prefer the hamstring graft. This is because the hamstring is vascularized immediately and the hamstring does not cause as many issues with the development of scar tissue. The patella tendon is the stronger of the two grafts but the patella tendon is stronger but it must re-vascularize after the surgery. Re-vsacularization is vitally important to the stability and resiliency of the new ligament. The patella tendon graft does have a slightly higher incidence of scarring but the durability of the graft makes it very attractive for use with athletes. <br /><br />The selection of the graft may be affected by the age of the client, the degree of knee instability and the preference of the surgeon. The outcome studies on the use of the two grafts doesn't show a significant advantage for either. Physician preference and comfort are usually the deciding factor in graft selection.<br /><br />For you the PRP, the most important knowledge our need regarding the graft selection is the intensity level of progression the graft can tolerate. Usually the patella tendon graft and tolerate greater forces at the 4-6 month mark than the hamstring graft. But overall, the functional outcomes for both grafts are the same. With both grafts caution with the last 30 degrees of open-chain knee extension is important. <br /><br />Dr MikePost Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-27940265385103193562008-09-09T21:23:00.000-07:002008-09-15T22:59:17.762-07:00The ACL - Where is it and what does it do?The recent ACL rupture in Tom Brady's knee and the reconstructive surgery that Tiger Woods recently underwent has highlighted the ligaments of the knee. There are 4 primary ligaments of the knee. These include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). The cruciates are major stabilizers in the knee. The ACL is important in maintaining stability in the knee during dynamic activities such as cutting, turning, pivoting and changing direction. The ACL prevents the anterior translation of the tibia beneath the femur. The tear of the ACL allows the uncontrolled movement of the femur on top of the tibia. That uncontrolled movement may cause menisical damage. Meniscal damage may lead to arthritic changes in the knee. Click the link below to watch the review of the major ligament structures in the knee.<br /><br />Dr Mike<br /><br /><br /><a class="abp-objtab" href="http://www.youtube.com/v/gsh60qUu6To&hl=en&fs=1" style="padding-left: 425px;"></a><a class="abp-objtab" href="http://www.youtube.com/v/gsh60qUu6To&hl=en&fs=1" style="padding-left: 425px;"></a><object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/gsh60qUu6To&hl=en&fs=1"><param name="allowFullScreen" value="true"><embed src="http://www.youtube.com/v/gsh60qUu6To&hl=en&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" height="344" width="425"></embed></object>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-90669905595237886012008-09-04T22:53:00.000-07:002008-09-15T22:57:24.516-07:00Quadriceps ReviewThe quadriceps in the most important muscle group in the lower extremity. The four heads of the quadriceps are innervated by the femoral nerve. The quadriceps acts to extend the knee. Click the link below to watch the review of quadriceps function and anatomy.<br /><br />Dr Mike<br /><br /><br /><object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/RNLI6NwWiNc&hl=en&fs=1"></param><param name="allowFullScreen" value="true"></param><embed src="http://www.youtube.com/v/RNLI6NwWiNc&hl=en&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" width="425" height="344"></embed></object>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-21491831257452186862008-09-01T06:29:00.000-07:002008-09-15T22:27:30.670-07:00Post Rehab Programming to Increase RevenueThe summer is over and schools are opening. Thoughts now shift to education and getting back into the groove of work, study and exercise. This fall is a great time to offer group based post rehab programming such as the Dynamic Back School or Women's Fitness 101. These two programs are easily introduced in a club or private studio setting and they will allow you to capture a new group of clients. The group based approach to the client with medical issues will allow you to tap into the medical market at a lower price point but with an opportunity for significant revenue. We recommend a $180-225 fee per participant in the back school or Women's Fitness 101. These programs are delivered in six sessions over a 30-day period. The thirty day approach is very attractive to medical professional who are usually very reluctant to refer patients to long-term fitness programs. In my next blog post I will explain the Dynamic Back School. <br /><br />Dr MikePost Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-16735349231544305422008-08-30T06:21:00.000-07:002008-09-15T22:23:23.838-07:00Do you know the symptoms of mild knee arthritis and how those symptoms translate to x-ray studies?As many of you know I am an avid golfer and a former army paratrooper. Between the acl rupture and meniscal damage sustained during my army career and the wear and tear on the right knee from my quest to over take Tiger's number 1 ranking, (I dont think Tiger has much to worry about), I have a low level effusion (swelling) of the knee. I have no pain but occasionally a feeling of stiffness after playing more than 18 holes. My knee's tolerance level seems to be about 18 holes of golf before effusion begins. Steep inclines, hitting out of sand traps and just the 18 holes of compression on the knee seem to be the major issues. I have no feeling of giving way or instability.<br /><br />Here's your post rehab challenge. Develop an exercise program for a 46 year old male he can perform at home. You have a Bowflex, a stationary bike, dumbbells from 10-50 pounds and a Swiss ball. The program goal is at the end of 18 holes there is minimal effusion with no residual stiffness the next morning. Take a look at the x-rays below for a look at arthritic changes that causes a mild effusion in the knee. The knee on the right shows narrowing along the lateral joint line and if you look closely you will see mild osteophytes (bone spurs) right at the joint line. This x-ray shows the early stages of osteoarthritis of the knee.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZDRf_KVQQftTCJsGNGaGtOygV4q6CvoNx86_WNK6zEy-zOoeAFnYnx2c-l2SiY08cPXkWxq_lpU1wZW4MG9CsWEEsfkoGqD-6p_urxDIwgELkIHWP7Sg8PMC372xFAMapsux4S4AUWFTE/s1600-h/mdb.jpg"><img style="cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZDRf_KVQQftTCJsGNGaGtOygV4q6CvoNx86_WNK6zEy-zOoeAFnYnx2c-l2SiY08cPXkWxq_lpU1wZW4MG9CsWEEsfkoGqD-6p_urxDIwgELkIHWP7Sg8PMC372xFAMapsux4S4AUWFTE/s400/mdb.jpg" alt="" id="BLOGGER_PHOTO_ID_5246484563984867778" border="0" /></a><br /><br /><br />Dr MikePost Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-76075559948279567142008-08-28T02:21:00.000-07:002008-08-28T02:21:01.043-07:00Post Rehab Tip #14 - When do I use McKenzie or back extension exercises?McKenzie or back extension exercises are best used with clients diagnosed with lumbar disc herniation. The goal of McKenzie exercise is to centralize radiating pain into the low back and then eliminate the pain. In recent years I have noted the shotgun use of McKenzie exercise on all lumbar post rehab clients. The McKenzie exercise concept should be used with discogenic clients in a very structured process. There are 3 exercises associated with the McKenzie concept. They are:<br /><br />1) Prone Lying<br /><br />2) Prone Prop<br /><br />3) Prone Press-Up<br /><br />These exercises, properly used with strategies to minimize spinal flexion and prolonged sitting, will make a significant difference in managing the post rehab lumbar disc herniation client after their discharge from physical therapy or chiropractic care. Click the link below to watch my demonstration of the McKenzie exercise sequence.<br /><br />Dr Mike<br /><br /><a class="abp-objtab" href="http://www.youtube.com/v/wBOp-ugJbTQ&hl=en&fs=1" style="padding-left: 425px;"></a><object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/wBOp-ugJbTQ&hl=en&fs=1"><param name="allowFullScreen" value="true"><embed src="http://www.youtube.com/v/wBOp-ugJbTQ&hl=en&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" height="344" width="425"></embed></object>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-75370254686577462372008-08-27T02:55:00.000-07:002008-08-27T11:35:08.723-07:00Post Rehab Referrals - How do I contact physical therapists, physicians and chiropractors?The lifeblood of any post rehab or medical exercise practice is developing referral relationships with local medical professionals. Approaching physical therapists, chiropractors and/or physicians requires an organized process as well as understanding the needs of these referral sources. You must develop a post rehab/medical exercise marketing package and presentation to maximize your chances of establishing a referral relationship. Once you make your presentation but referrals aren't coming in you must ask yourself four questions. The organized approach, the contents of the post rehab marketing package and the four questions are included in my recent interview with David Gilks, MEPD. Please click the link below to listen and learn how to contact medical professionals.<br /><br /><br />Dr Mike<br /><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P38c7837e643d34b462a93e542589ba4fYVp8QVREZmJy&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" frameborder="0" height="20" scrolling="no" width="206"></iframe><br /><a rel="enclosure" href="http://www.audioacrobat.com/export/P38c7837e643d34b462a93e542589ba4fYVp8QVREZmJy.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" alt="MP3 File" border="0" height="16" width="72" /></a></div><br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-67333850350709252622008-08-26T18:37:00.001-07:002008-08-26T19:02:20.732-07:00I referred my client to a physician but he never came back. How do I get my client back?In an earlier blog post I discussed a problem many post rehab professionals encounter, the loss of a client when you refer the client to a medical professional for an evaluation. Here are three strategies you can use to prevent the loss of your client.<br /><br />1) Send a letter of introduction to the medical professional. This letter should be given to the medical professional by the client and not given to the front desk staff or nurse. This letter will introduce your client and outline the exercise program you developed for the client as well as listing the client's complaints. In the letter request the evaluator to contact you with recommendations for modification of the client's exercise program.<br /><br />2) Contact the medical professional's office the next day to find out if exercise modifications are warranted and/or if the client needs medical treatment. Also, thank the medical professional for assessing the client.<br /><br />3) Contact the client and ask the outcome of the evaluation visit and the recommendations given to the client.<br /><br />One of these three actions will allow you to obtain the information you need to modify the client's exercise program and avoid the loss of your client. Sometimes medical professionals may dismiss you because they simply don't understand you want to be involved in the management of the client's condition. This is where clearly outlining your role/scope as well as the benefits exercise offers to the client (without exercising the affected area) can win the day and develop a referral relationship with the medical professional. I can't say this will happen in 100% of the cases but it will help establish you as <span style="font-weight: bold; font-style: italic;">the</span> post rehab professional in your community.<br /><br /><span style="font-style: italic;">Dr Mike</span>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-43840350952657199312008-08-25T01:33:00.000-07:002008-08-25T01:33:00.603-07:00Post Rehab Practice Builder...Developing an Affiliate ProgramHave you heard of affiliate program many Internet marketers use to promote their products and skyrocket their revenue. Well David Gilks, MEPD owner of Core Essentials of Naniamo, BC developed his own affiliate program to market businesses owned by clients that use his studio and post rehab training services marketing his business to potential new clients. David's affiliate program titled the "Inner Circle - Platinum Card Advantage" is a unique marketing concept and this is the first time I have heard of it used to market post rehab services. Click the link below to listen to my interview with David. If you want to develop an affiliate program in your practice join our "Post Rehab Profits & Protocols" program by going to <a href="http://www.profitsandprotocols.com/">www.profitsandprotocols.com</a>.<br /><br />Dr Mike<br /><br /><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P60b13c2d793328574964e4798a470452YVp8QVREZmN8&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" frameborder="0" height="20" scrolling="no" width="206"></iframe><br /><a rel="enclosure" href="http://www.audioacrobat.com/export/P60b13c2d793328574964e4798a470452YVp8QVREZmN8.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" alt="MP3 File" border="0" height="16" width="72" /></a></div><br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-70156402370955215852008-08-24T22:14:00.000-07:002008-08-24T22:14:00.270-07:00When I make a referral to a medical professional my client never comes back, what do I do?I am a strong advocate for referring clients in your post rehab practice to a medical professional for evaluation if you encounter a situation beyond your scope of practice. But more post rehab professionals are noting the complete loss of the client referred. The medical professional may advise the client simply to discontinue exercise or institute a program of treatment for the client without communicating the findings of the assessment and/or recommenndations for treatment. I can see how this can be very frustrating for the post rehab professional. In your attempt to act professionally by making a referral to lose the client annd receive no communication. I would certainly feel used.<br /><br />I would follow up with the client directly and find out what recommendations were made. If you have made a referral and sent along a letter of introduction with your client, you certainly deserve to know the outcome of the visit. In this situation, I will admit this is not professional conduct on the part of the medical professional. Medical professionals regularly receive referrals and common practice is to send a follow-up report to the referral source with recommendations and a thank you. I can only guess the medical professional may not feel a referral from a fitness professional warrants a follow-up report. In one of my next blog posts I will note a strategy that will help you eliminate this situation and make it easier to communicate with medical professionals.<br /><br />If you have encountered this issue, please share your experience with other post rehab professionals by commenting here on the Post Rehab Blog. Thanks.<br /><br />Dr MikePost Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-67200526438632785782008-08-24T15:14:00.000-07:002008-08-24T19:55:15.038-07:00When do I begin exercise after a cortisone injection?The post rehab professional is often faced with managing the post rehab client after a cortisone injection. I just got back from teaching our first post rehab skills workshop. During one of the workshop breaks the participants asked when is it safe to begin exercise after cortisone injection. First, understand cortisone injections are an attempt to break the "pain/inflammatory" cycle associated with an injury. Once the pain cycle is broken, exercise is used to strengthen and stabilize the area. Wait at least 24 hours before beginning any exercise after cortisone injection. The injection itself may cause pain. If the client has pain beyond the 24 hour period, wait until the pain from the injection has completely subsided before beginning exercise. Contact the client's physician or physical therapist before you begin exercise. Start with gentle exercise and a gradual increase in intensity based on the client's tolerance. Gentle ROM and stretching exercise followed by light resistance activities for the first one or two sessions after the injection is my recommendation then you can gradually progress back to the levels the client was able to tolerate before the injection. Remember, the cortisone is used to break the pain cycle to allow strength and stability training. The cortisone may completely eliminate the client's pain but the underlying pathology is still present. Progressive strength and stability training is a major factor in the resolution of the condition. If later during the course of the post rehab program the client's symptoms re-appear, contact the client's physician immediately for program guidelines or possible referral for further evaluation.<br /><br /><span style="font-style: italic;">Dr Mike</span><br /><br /><br />Dr MikePost Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-46289092549500952752008-08-24T00:16:00.000-07:002008-08-24T08:54:23.934-07:00Post Rehab Tip #13 - What documents do I need for insurance reimbursement?When seeking insurance reimbursement for post rehab services contact the client’s insurance claims adjuster. You will need the following documents when you make the contact:<br /><br />a. Signed post rehab referral for the client's physician<br />b. Post Rehab Program Goals (functionally-based)<br />c. Post Rehab Program Design (include duration, frequency & number of sessions)<br />d. Post Rehab Assessment<br /><br />Securing insurance reimbursement for post rehab services requires more than having these documents on hand. How to negotiate the insurance reimbursement maze is reviewed in detail in our <a href="http://web.mac.com/medfit/PostRehabToday/Insurance_Reimbursement.html">"Insurance Reimbursement for Post Rehab Professionals"</a> workshop. Dealing with insurance carriers is becoming part of the daily life for post rehab professionals. This and other streams of post rehab income are reviewed in our podcast titled "Multiple Streams of Post Rehab Income". Follow this link to listen in our how to develop multiple streams of income in your post rehab practice - <a href="http://www.multiplestreamsofpostrehabincome.com/">Multiple Streams</a>.<br /><br /><br /><span style="font-style: italic; font-weight: bold;">Dr Mike</span><br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P05fedeff56b02de01b2ad26a817bed68YVp8QVREYWd9&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" frameborder="0" height="20" scrolling="no" width="206"></iframe><br /><a rel="enclosure" href="http://www.audioacrobat.com/export/P05fedeff56b02de01b2ad26a817bed68YVp8QVREYWd9.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" alt="MP3 File" border="0" height="16" width="72" /></a></div><br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-42450956284181116092008-08-22T02:09:00.000-07:002008-08-22T02:09:00.571-07:003 Keys to Managing Post Rehab Bicipital TendinitisTendinitis, regardless of the region affected, occurs often with athletes. Managing the bicipital tendinitis client is challenging but if following the "3 Keys" you will see a positive functional outcome. The 3 keys are:<br /><br />1. Eliminate bicep activities until receiving approval from physician or therapist.<br /><br />2. Strengthen the rotator cuff and scapular musculature.<br /><br />3. Avoid overhead activities or any activities that increase pain.<br /><br />Follow these 3 keys and you will develop safe and effective programs for the post rehab biceps tendinitis. Please click the link below to listen to my discussion of 3 keys. <br /><br /><span style="font-style: italic;">Dr Mike</span><br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=Pe1087724454a92b5785f303fb6e91a37YVp8QVREZmJx&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" height="20" width="206" frameborder="0" scrolling="no"></iframe><br/><a rel="enclosure" href="http://www.audioacrobat.com/export/Pe1087724454a92b5785f303fb6e91a37YVp8QVREZmJx.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" width="72" height="16" border="0" alt="MP3 File" /></a></div><br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-18040264722274413192008-08-21T02:36:00.000-07:002008-08-21T07:13:28.524-07:003 Keys to Managing the Post Rehab LCL SprainWe spoke about managing the MCL post rehab client and now we will discuss managing the LCL post rehab client. Some of the keys are same for the MCL but there is one important distinction. The 3 keys are:<br /><br />1) Limit knee flexion to less than 90 degrees.<br /><br />2) Strengthen the quadriceps and hamstrings.<br /><br />3) Avoid activities that increase swelling and/or pain.<br /><br />These 3 keys are very similar for the <a href="http://postrehabblog.blogspot.com/search/label/MCL%20sprain">post rehab management of the MCL client</a>. Listen to my discussion of these 3 keys by clicking the link below.<br /><br />Dr Mike<br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P70cc5267463e469051564ced09c2f969YVp8QVREZmNx&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" frameborder="0" height="20" scrolling="no" width="206"></iframe><br /><a rel="enclosure" href="http://www.audioacrobat.com/export/P70cc5267463e469051564ced09c2f969YVp8QVREZmNx.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" alt="MP3 File" border="0" height="16" width="72" /></a></div><br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-19826767195483702942008-08-20T14:08:00.001-07:002008-08-20T14:25:32.188-07:003 Keys to Managing the Post Rehab Achilles Tendon Rupture ClientThough we often see Achilles tendon ruptures in the middle-aged population, it is seen in athletes. Once the tendon has healed from the surgical repair or via conservative treatment, this client will need a post rehab program after discharge from physical therapy. The 3 keys to managing the Achilles rupture in a post rehab setting include:<br /><br />1) Improve and maintain ROM<br /><br />2) Increase strength and power in the gastroc and soleus<br /><br />3) Improve stability for return to functional activities<br /><br />Follow these 3 keys to establish a safe and effective post rehab program for the Achilles tendon rupture. Click the link below to listen to my description of these 3 keys.<br /><br />Dr Mike<br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=Pefb39a1660d0f2793f659e587aec94a6YVp8QVREZmN2&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" height="20" width="206" frameborder="0" scrolling="no"></iframe><br/><a rel="enclosure" href="http://www.audioacrobat.com/export/Pefb39a1660d0f2793f659e587aec94a6YVp8QVREZmN2.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" width="72" height="16" border="0" alt="MP3 File" /></a></div><br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-50808208622377157462008-08-20T04:57:00.000-07:002008-08-20T04:57:00.270-07:00Post Rehabilitation - The Future is Bright and ProfitableAAHFRP offered the first post rehab course, the Medical Exercise Specialist workshop, in Washington, DC in 1994. The acceptance and usage of post rehab services by fitness participants, health clubs, medical professionals and insurance carriers has exceeded our wildest dreams. Our hope was to expose fitness professionals to the basic concepts in exercise management of common medical conditions. Now post rehab fitness has become a standard part of the rehab management model and we see more physical therapy clinics and hospital-based fitness facilities adding post rehab and medical exercise programs throughout North America.<br /><br />The future of post rehab fitness and medical exercise services are bright. The aging of the baby boomers and the overwhelming numbers of hypertensives, diabetics and other chronic diseases will heighten the need for post rehab fitness and medical exercise services. Within the next decade we will see university exercise physiology and kinesiology programs offering concentrations in medical exercise and post rehab fitness. We will also see physical therapy clinics, sports medicine centers and hospital-based fitness centers establishing the "medical exercise specialist" or "post rehab conditioning specialist" as job titles within the organization with various levels of specialization and training. Insurance carriers will embrace medical exercise as a standard component of treatment for conditions such as diabetes, hypertension and other cardiovascular disorders. The same will be true of post rehab fitness for conditions such as osteoarthritis and disc herniations along with some surgical procedures including acl reconstructions, laminectomies and total joint replacements. Post rehab services will be utilized after physical therapy and chiropractic services once the client is medically stable and has received the maximum benefit from the treatment provided by the licensed medical professionals. Though insurance reimbursement will become common place for post rehab services, group programs will increase as insurance reimbursement decreases per session. Medical exercise specialists and post rehab conditioning specialists will become staff members in physical therapy clinics and sports med centers but licensure is quite a way off. States will begin registering fitness professionals. To obtain insurance reimbursement, post rehab professionals must hold the MES or PRCS certification as well as a personal training certification.<br /><br />The next decade will one of tremendous growth for the post rehab arena. Opportunities will abound and income will grow but so will administrative tasks such as writing progress reports, documenting sessions and authoring progress summaries. This means a cottage industry will develop around post rehab fitness. Software programs, administrative workshops, liability insurance plans, practice management workshops and even lawsuits will become part of the post rehab phenomenon. Just think of it, higher incomes, greater respect from medical professionals, higher liability premiums and the need to practice defensively. Welcome to the medical community.Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-58360698799153054962008-08-20T00:13:00.000-07:002008-08-20T00:13:00.722-07:00Post Rehab Tips #12 - Levels of AssistanceSometimes you will receive a referral to work with a client that requires assistance with balance, transfers and ambulation. You must be aware of the three levels of assistance. The levels of assistance are:<br /><br />a. Maximal Assistance<br />b. Moderate Assistance<br />c. Minimal Assistance<br /><br />Click on the link below to listen to the definition of each level and how impact on the post rehab program.<br /><br /><br /><span style="font-style: italic;">Dr Mike<br /><br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P507079dcd84c3277893d4ef75ea4405aYVp8QVREYWdx&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" height="20" width="206" frameborder="0" scrolling="no"></iframe><br/><a rel="enclosure" href="http://www.audioacrobat.com/export/P507079dcd84c3277893d4ef75ea4405aYVp8QVREYWdx.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" width="72" height="16" border="0" alt="MP3 File"/></a></div> <br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-32611024150360465522008-08-19T03:57:00.000-07:002008-08-19T05:29:55.046-07:003 Keys to Managing the Post Rehab Rotator Cuff ClientRotator cuff injuries are common in sports requiring overhead activities. The tear of the rotator cuff can be both painful and functionally limiting. The exercise management of rotator cuff tears is based in 3 keys that include:<br /><br />1) Strengthen the rotator cuff muscles.<br /><br />2) Avoid overhead activities and increase the subacromial space.<br /><br />3) Strengthen the periscapular musculature.<br /><br />These 3 keys form the foundation of a safe and effective post rehab program for the rotator cuff tear client. These keys will optimize the possibilities of a positive functional outcome. Click the link below to listen to the discussion of these 3 keys.<br /><br /><span style="font-style: italic;">Dr Mike<br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P7bc5efd53fd8e464acfeec517a155b40YVp8QVREZmN3&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" height="20" width="206" frameborder="0" scrolling="no"></iframe><br/><a rel="enclosure" href="http://www.audioacrobat.com/export/P7bc5efd53fd8e464acfeec517a155b40YVp8QVREZmN3.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" width="72" height="16" border="0" alt="MP3 File" /></a></div><br /><!-- AudioAcrobat.com Player code END --><br /></span>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-66399137771675272752008-08-19T01:55:00.000-07:002008-08-19T03:56:54.574-07:00Post Rehabilitation Red Flags.........when should you refer or proceed with caution?<div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5Dmup73pPQWLzah_zyD2b8KuDty5rqbJNDvOpBqbT2Pyn-wl2Y6X2KPBAAobmNeGLmZ_VMBRc_Aplv1nuWm1sEo2sf3EH_XHtBMIh6czh6g-eRzRGUsyH3RMhyX4-PTuCCbWW3oBEQ68v/s1600-h/red_flags_bullets01.jpg"><img style="cursor: pointer; width: 465px; height: 330px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5Dmup73pPQWLzah_zyD2b8KuDty5rqbJNDvOpBqbT2Pyn-wl2Y6X2KPBAAobmNeGLmZ_VMBRc_Aplv1nuWm1sEo2sf3EH_XHtBMIh6czh6g-eRzRGUsyH3RMhyX4-PTuCCbWW3oBEQ68v/s400/red_flags_bullets01.jpg" alt="" id="BLOGGER_PHOTO_ID_5235193519548967554" border="0" /></a><br /></div><br />When should you refer your client to a medical professionals? Do you know the signs your client needs an evaluation by a licensed medical professional? If you are not 100% sure, then using our post rehab red flags might be helpful. These red flags are reviewed in each of our post rehab workshops and these are a vitally important concept all post rehab and corrective exercise professionals must embrace and understand. The red flags are listed above. When you see these red flags, as a post rehab professional, you must refer the client to a medical professional or modify the client's exercise program. It's up to you, the post rehab professional, to determine is a referral or program modification is necessary. For more information on the post rehab red flags go to <a href="http://www.postrehabfoundations.com/">www.postrehabfoundations.com</a>.<br /><br /><span style="font-style: italic;">Dr Mike</span><br /><br /><br /><div style="text-align: center;"><br /></div>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-46180557841695904952008-08-19T00:06:00.000-07:002008-08-19T00:06:00.675-07:00Member Spotlight - Focus Integrated Fitness<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.focusnyc.com"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgO_B251n4RfxXPnXRgQ-O7QRkW73xc_3xptFDLZb2Umv6Q06OttABJtbWvHr8DGYqEPRh90sveXptlJTPuZxJSj6JE0Fey0kNrbSyb-62PmNiV1UgvG9HJwV21d8fsKpLXAcJNg1HLeJAM/s400/Focus_Logo.jpg" alt="" id="BLOGGER_PHOTO_ID_5235189885808046834" border="0" /></a><br />Our members in the spotlight for this segment are the owners of <a href="http://www.focusnyc.com">Focus Integrated Fitness</a> of New York City, Gabe Valencia, MES and Joe Masiello, MES. Gabe and Joe bring a very unique approach to the development of fitness programming and the education of personal trainers. This is a great interview. Every post rehab professional and anyone interested in developing their own fitness facility should listen. Please click the link below to listen to this fantastic interview.<br /><br /><span style="font-style: italic;">Dr Mike</span><br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P2486d870a780873a5536b055be69bc24YVp8QVREYWtw&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" frameborder="0" height="20" scrolling="no" width="206"></iframe><br /><a rel="enclosure" href="http://www.audioacrobat.com/export/P2486d870a780873a5536b055be69bc24YVp8QVREYWtw.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" alt="MP3 File" border="0" height="16" width="72" /></a></div><br /><!-- AudioAcrobat.com Player code END -->Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-89737387727788862762008-08-18T08:10:00.000-07:002008-08-18T09:10:42.772-07:00Corrective Exercise.....when to correct or when to refer?As post rehab courses and guidelines proliferate, knowing when to appropriately use corrective exercise techniques and post rehab training programs seems to get lost in the discussion. Simply the presentation of a client with a postural fault, muscular imbalance or pain is sometimes not enough of a reason to begin corrective exercise. A thorough medical history and assessment on the client must be completed first. Also, discussion with the client's physician or physical therapist is required to ensure you have the full picture before proceeding with exercise. Its interesting that few corrective exercise or post rehab courses really focus on the pathology and assessment of these postural faults, pain and/or imbalances but they do readily encourage exercise. Remember, posture and pain may be the result of a long-term condition or fault and what we see is not what is really going on with the client. The introduction of corrective exercise can exacerbate a dormant condition. Sometimes pulling the string of a postural fault may cause the breakdown of other faults and result in the client having more pain. Now it is important to get to the underlying problem but if you can't anticipate the possible complications, then you shouldn't begin corrective exercise without a thorough history, assessment and discussion with the client's physician. Remember, what is you see is not what you get in posture or with pain. Though a thorough assessment, medical history, x-rays, CAT Scans and MRI's are not 100% accurate, these allow us to eliminate possible conditions. Then we can start to correct faults with a better understanding of possible causes. I am not saying corrective exercise is not great for clear cut postural faults which are easily corrected. But in the back of your mind you should always think, what other complications might be causing the pain or fault and have I given enough consideration to these complications. What you see with human posture and pain is seldom what you get. If you see red flags, talk to the client's physician or therapist. We will discuss the post rehab red flags in our next blog post.<br /><br /><br /><span style="font-style: italic;">Dr Mike</span>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0tag:blogger.com,1999:blog-6175206276698397471.post-53850329393821610132008-08-18T00:12:00.000-07:002008-08-18T00:12:01.018-07:003 Keys to Managing the Post Rehab Low Back Pain Exercise ProgramBack pain affects 80% of the American population at some point in their lives. For many, this back pain becomes a constant part of their lives. The exercise management of chronic low back pain (LBP) is an important skill the post rehab professional must master. LBP is seen in both the athletic and non-athletic populations. There are 3 key components of the exercise program for the chronic LBP client in a post rehab setting. The 3 key components are:<br /><br />1) Cardiovascular training with appropriate levels of support.<br /><br />2) Spinal stabilization including techniques in lifting, pushing, pulling and carrying as well as flexibility training.<br /><br />3) Lower extremity strengthening.<br /><br />These 3 components must be included in each LBP client's exercise program design. Include these 3 essential components and you will see positive outcomes with your LBP clients. Click the link below to listen to my discussion of these 3 key components.<br /><br /><span style="font-style: italic;">Dr Mike<br /><br /><!-- AudioAcrobat.com Player code BEGIN --><br /><div class="aaplayer"><iframe src="http://www.audioacrobat.com/playweb?audioid=P465f4aa2672c19cd298628496deef59aYVp8QVREYWp9&buffer=5&shape=6&fc=FFCC00&pc=AAAAFF&kc=888800&bc=FFFFFF&brand=1&player=ap28" frameborder="0" height="20" scrolling="no" width="206"></iframe><br /><a rel="enclosure" href="http://www.audioacrobat.com/export/P465f4aa2672c19cd298628496deef59aYVp8QVREYWp9.mp3"><img src="http://www.audioacrobat.com/images/buttons/downloadmp3.gif" alt="MP3 File" border="0" height="16" width="72" /></a></div><br /><!-- AudioAcrobat.com Player code END --><br /></span>Post Rehab Bloghttp://www.blogger.com/profile/08371245191071296440noreply@blogger.com0