Healthy Wealthy & Smart

On this week’s episode of the Healthy Wealthy and Smart Podcast, I welcome Dr. Claire Hiller to the show to introduce us to dance medicine and how physiotherapists can break into the industry. Dr. Hiller is a physiotherapist specializing in dance injuries and her current research interests at the University of Sydney include further development of the Cumberland Ankle Instability Tool, prevalence and impact of chronic ankle problems, predictors of chronic ankle instability, dancers' lower limb injuries, and dance footwear.   In this episode, we discuss: -Common injuries of the spine, knee, and ankle seen in dancers -In-depth analysis of the lateral ankle sprain vs the high ankle sprain and differential diagnosis -Pre-pointe assessments and when to give your dancer the green light -How a medical professional can effectively collaborate with dancer, dance teacher, and parent -And so much more!   Dr. Hiller encourages physical therapists to pursue their interest in dance medicine by taking continuing education courses regardless of their current background. She states, “Physical therapists and other allied healthcare professionals are trained to watch people move… Dancers are very forgiving, if you even show a glimmer of the fact that you have an understanding of just the basics that go into dance, and you know what to look for and how to look for it, and you understand the body and how it moves and how it all connects, then you can be just as good if that’s the field you want to go into.”   In dancers, lateral ankle sprains usually don’t occur in isolation and a full ankle assessment is necessary for a realistic prognosis back to sport. From her experience, Dr. Hiller has found, “Dancers will often do something at the base of the outer part of their foot. Dancers can also have a high ankle sprain component again because they are coming down from a [demi-pointe position] and that’s often missed. People will go back far too soon if they have that. It’s a really important injury to stay longer off than even your lateral ankle sprain.”   Dr. Hiller believes that parents should be tuned into their child’s complaints of pain and advocate early on for preventative care. “Some ways of training is you power on through everything. The life of a dancer is to live with pain, to be able to cope with pain. When you have pain, it is nothing unless you’re laid out on the floor and can hardly move. If your child is complaining of pain, and their consistently complaining of pain, don't wait till they are nagging you that they’re having pain. Listen to them when they start to say they have pain in my back, pain on the side of my knee, pain in my ankle, pain in my foot.”   Physical therapists have the training to facilitate a safe progression to pointe. Dr. Hiller illustrates this role, “A pre-pointe assessment is about whether your child is actually ready for that step of putting your pointe shoes on. It’s not just about being able to put the pointe shoes on and balance, you’ve got to be able to have the strength and the control at a certain level before you can safely get up on your pointe shoes. And not just safely, once you get up there and actually be able to do something and enjoy it.”   For more about Dr. Hiller: Dr. Hiller has been awarded a Postdoctoral Fellowship at the University of Sydney to study ankle sprain and instability. Her current works aims to build on her doctoral studies which included: the development of the Cumberland Ankle Instability Tool (CAIT), an objective measure of functional ankle instability; finding bilateral changes following unilateral ankle sprain; and proposing a modified model of chronic ankle instability. Dr. Hiller is also a practicing physiotherapist with a special interest in dance injuries. She has been involved in convening specialist interest days at the International Association of Dance Medicine and Science Annual Meetings and recently co-convened the 4th International Ankle Symposium.   Current research interests include: further development of the CAIT, prevalence and impact of chronic ankle problems, predictors of chronic ankle instability, dancers' lower limb injuries, and dance footwear.   Resources discussed in this show: International Association for Dance Medicine and Science Harkness Center for Dance Injuries Dance Movement Therapy Association of Australasia  National Institute of Dance Medicine and Science (NIDMS) Ausdance Healthy Dancer Canada - The Dance Health Alliance of Canada Performing Arts Medicine Association (PAMA)   Articles mentioned in today's podcast: 1) Liederbach MJ et al (2008) Incidence of anterior cruciate ligament injuries among elite ballet and modern dancers. American Journal of Sports Medicine 36: 1779-1788 2)Sman AD et al (2015) Diagnostic accuracy of clinical tests for ankle syndesmosis injury British Journal of Sports Medicine 49:323-329  3) The Hazards of Ankle Sprains NYT July 25th 2016   Dr. Hiller invites you to reach out via email (claire.hiller@sydney.edu.au) and connect with researchers, clinicians and students interested in dance related research at Dance Research Collaborative!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!  

Thanks for tuning in to the Healthy Wealthy and Smart Podcast! Coming to you from Chicago, Drs. Sarah Haag, Sandy Hilton, and Jason Falvey join me for Part 2 on our discussion all about sex! You can check out Part 1 from CSM in Anaheim, California here in case you missed out!   In this episode, we discuss: -Broaching the subject of sex with your patients -Recalibrating sex after surgery and childbirth -Rising rates of sexually transmitted diseases in the older adult population -How a bladder diary can help those with persistent UTI -And much, much more!   Sex has multiple health benefits outside what is commonly perceived and can be utilized as exercise. “There is so much that sex is good for cardiovascularly, musculoskeletally. It’s just awesome for so many reasons mentally. When we talk about population health and things that keep people moving and happy—that’s a good one.”   Sex is an important activity of daily living and can be a tool for clinicians to implement into their home exercise program. “Pleasurable movement is one of the things that help you get back to normal movement. So if you can make this make sense and feel good, it’s probably going to be one of the first and well motivated things you’re going to do in an exercise program.”   After patients have undergone surgery, surgical restrictions are not you’re only guiding tool for sex. “Always let pain be your guide, if it hurts, don’t do it. Sex is never supposed to hurt—it’s supposed to be amazing.”   We tend to forget about the vital functions our pelvic organs perform every day. “Peeing and pooping and sex, they are all very basic bodily functions and we can start to forget about it. If I ask any of you how often you peed today, you would have to think really hard and I betcha 10 bucks you’d be wrong with whatever you guessed. You can go pee mindlessly.” Today's guests: Sandy Hilton PT, DPT, MS: Sandy graduated from Pacific University (Oregon) in 1988 with a Master of Science in Physical Therapy and a Doctor of Physical Therapy degree from Des Moines University in December 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995. Sandy has teaches Health Professionals and Community Education classes on returning to function following back and pelvic pain, assisted with Myofascial Release education, and co-teaches Advanced Level Male Pelvic Floor Evaluation and Treatment. Sandy’s clinical interest is chronic pain with a particular interest in complex pelvic pain disorders for men and women. Sandy is also pursuing opportunities for collaboration in research into the clinical treatment of pelvic pain conditions. Sandy brings science and common sense together beautifully to help people learn to help themselves.   Sarah Haag PT, DPT, MS, WCS Cert. MDT, RYT: Sarah graduated from Marquette University in 2002 with a Master’s of Physical Therapy. Sarah has pursued an interest in treating the spine, pelvis with a specialization in women’s and men’s health. Over the past 8 years, Sarah has seized every opportunity available to her in order to further her understanding of the human body, and the various ways it can seem to fall apart in order to sympathetically and efficiently facilitate a return to optimal function. Sarah was awarded the Certificate of Achievement in Pelvic Physical Therapy (CAPP) from the Section on Women’s Health. She went on to get her Doctorate of Physical Therapy and Masters of Science in Women’s Health from Rosalind Franklin University in 2008. In 2009 she was awarded a Board Certification as a specialist in women’s health (WCS). Sarah also completed a Certification in Mechanical Diagnosis Therapy from the Mckenzie Institute in 2010. Most recently, Sarah completed a 200 hour Yoga Instructor Training Program, and is now a Registered Yoga Instructor. Sarah plans to integrate yoga into her rehabilitation programs, as well as teach small, personalized classes. Sarah looks at education, and a better understanding of the latest evidence in the field of physical therapy, as the best way to help people learn about their conditions, and to help people learn to take care of themselves throughout the life span.   Jason Falvey PT, DPT, GCS: PhD Student Jason Falvey was awarded a Kendall Scholarship from the Foundation for Physical Therapy in 2014 and a Fellowship for Geriatric Research through the Academy of Geriatric Physical Therapy in 2015 to support his research examining the role of home physical therapy in enhancing function and reducing re-hospitalizations for medically complex older adults. He is also the primary investigator on a research grant from the American Physical Therapy Association, Section of Health Policy and Administration looking at the role of physical therapists in models of transitional care for older adults after acute hospitalization.   Resources discussed in this show: Oswestry Disability Index Finding a pelvic health PT Holly Herman     Make sure to give Jason Falvey , Sarah Haag , and Sandy Hilton a follow on twitter!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and as always stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!

Today’s show is with Dr. Kelly Starrett where he answers audience questions concerning how he optimizes human performance. Kelly is a coach, physical therapist, author, speaker, and creator of the blog Mobility WOD. Kelly’s work across these mediums has reached large audiences and revolutionized how athletes think about human movement and athletic performance.   In this episode, we discuss: -Allied relationships between physical therapists and strength and conditioning coaches -Do anatomical variations impact ideal posture and movement? -Why we should be taking a 30,000 foot view in our culture -How Kelly reconciles pain science and biomechanics in his physical therapy practice -How to build a large platform with the use of social media -And so much more!   Kelly advocates that every human should be incorporating a mobility regime into their day to day lives. He states, “What does it mean foundationally to be a human being, what are the things we should be able to do? We remain agnostic about the way you want to train, but you better have a movement practice or at least express full range of motion if you plan on moving fast, lifting heavy, going up and down stairs, or picking up your kid.”   Kelly stresses that enhancing movement is a continual process and every day is a movement screen. “We don't expect movement competence to happen overnight. This is a process but eventually we should all be moving better and better and better because that is what it means to acquire skills as a human. It takes 10,000 repetitions as a baby to integrate a movement pattern. That means we have some tolerance in the system to buffer some less than ideal biomechanics. Overtime we should be refining that.”   Kelly challenges the physical therapy profession to focus more attention on educating the public on preventative care. He stresses, “When you have a fever, you take some Tylenol. If you have a cold, you don’t go see your doctor. If you have a cut, we teach people basic first aid. [Physical therapists] are not doing a good job teaching basic first aid around the body to everyone.”   We also discuss Kelly’s widely successful online fitness platform and the best ways to target and gain influence in your own local community. He states, “People are looking for advocates, they are looking for help… if you set out to influence a bunch of people, you influence no one. It’s not authentic, it’s not real. Solve a set of problems and be of use to your community and people will find you.”   For more about Kelly: Kelly Starrett is a coach, physical therapist, author, speaker, and creator of [mobilitywod.com], which has revolutionized how athletes think about human movement and athletic performance.   His 2013 release, Becoming a Supple Leopard has become a New York Times and Wall Street Journal bestseller. [His] blog was voted #4 in Outside Magazine’s Top 10 Fitness Blogs of 2011, Breaking Muscle’s Top 10 Fitness Blogs of 2011, and Health Line’s Top 100 Health Blogs of 2011. Kelly and his work have been featured in Tim Ferris’ Four Hour Body, Competitor Magazine, Inside Triathlon, Outside Magazine, Details Magazine, Power Magazine, and the Crossfit Journal.   He teaches the wildly popular Crossfit Movement & Mobility Trainer course and has been a guest lecturer at the American Physical Therapy Association annual convention, Google, the Perform Better Summit, the Special Operations Medical Association annual conference, police departments, and elite military groups nationwide.   Coach Kelly Starrett received his Doctor of Physical Therapy in 2007 from Samuel Merritt College in Oakland, California.   Before starting his own physical therapy practice at San Francisco CrossFit, one of the first 30 CrossFit affiliates, he practiced performance-based physical therapy at the world-renowned Stone Clinic. In his current practice, Kelly continues to focus on performance-based Orthopedic Sports Medicine with an emphasis on returning athletes to elite level sport and performance.   Kelly’s clients have included Olympic gold-medalists, Tour de France cyclists, world and national record holding Olympic Lifting and Power athletes, Crossfit Games medalists, ballet dancers, military personnel, and competitive age-division athletes.   Kelly’s background as an athlete and coach includes paddling whitewater slalom canoe on the US Canoe and Kayak Teams, and leading the Men’s Whitewater Rafting Team to two national titles and competition in two World Championships. In his free time Kelly enjoys spending time with his wife Juliet and two daughters, Georgia and Caroline, surfing, paddling, Olympic lifting, hot-tubbing, and so-you-think-you-can-dancing.   Resources discussed on this show: Stand Up Kids Chris Powers Dan Pfaff Functional Movement Screen Lorimer Moseley David Butler Greg Lehman International Spine and Pain Institute PTPintcast   Kelly welcomes you to stop by his clinic in San Francisco, California and see what he’s all about. You can find more from him at Mobility WOD and follow him on twitter!   Join me and other professionals for PT Day of Service this October 15th and give back to your local community!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and as always stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!      

On today’s episode, Amy Mewborn discusses how she jumpstarted her career and now designs strategies for others to do the same. Amy is a serial entrepreneur, CEO, author, and operations and strategy expert. She teaches women business owners how to use technology and systems to leverage their business growth and maximize profits through automation. In this episode, we discuss, -Amy’s health journey and how she escaped the 9-5 -Building an information highway through automation technology -What to do if your launch falls flat in the online space -Mindset challenges women need to address to kick start their business -And so much more!   Amy discusses the importance of taking action when branching out into new business opportunities. In Amy’s experience, she states, “You have to have the courage to take a risk, because if you don't, one day you will wake up and your entire life will go by and you've been going through the motions but never really got to where you want to be. Listen to your intuition, no one knows what is better for you than you do yourself and do as much research and be as well prepared as you possibly can.”   Amy describes the reciprocal relationship between passive income streams and personal independence as a result of automation.   She states, “The more time that you can free up from the things that you are doing, the more revenue streams you can potentially create, the more income you can have, the more clients you can see, and the more time you can have off and have fun…That’s when our creative energy starts to flow.“   Amy embraces taking risks because failure can offer an equally beneficial learning experience. From her experience, she states, “Had I given up after falling flat on my face the first time, I would have just thought I would never be able to make it… it's just about going back and looking at what worked and what didn't work and how you're going to adjust going forward.”   For women who are hesitant to pursue a new venture, Amy reassures us that, “As women, we always wonder if we are good enough—is what I have to offer really any different or more valuable or anything better than what is already out in the market place? We don't think about how we do business with people we know, we like, and we trust… We constantly have to break through that mindset that we are not enough because there is probably someone out there who is just like us and is waiting for us to share our gifts and secrets with the world.“   For more information about Amy:   Amy Mewborn is a serial entrepreneur, CEO, author, and operations and strategy expert. She teaches women business owners how to use technology and systems to leverage their business growth and maximize profits through automation.  She has spoken with Carlsbad Chamber of Commerce, Healthy Living Expo, Health and Wellness Expo, and Blastoff Business Breakthrough. She has been a featured teacher and continuing education provider with the American Council on Exercise. Amy has been featured on CBS, KUSI, Fox, Ivillage, San Diego Magazine, Ranch and Coast, and is a contributing editor to a number of publications.   She is a sought after speaker on business topics surrounding increasing profitability through technology, systems, and automation.   Her passion is helping women business owners achieve financial independence, and every speech or educational program that she produces is designed to teach women how to increase their business through systems and automation.   Check out all the goodies Amy has for you on her website and send her your questions, comments, and concerns via email Amy@amymewborn.com.   You can also get her book The Great Escape: The Successful Women's Guide to Escaping the 9-5 FREE this week only!(July 25, 2016 to July 30, 2016)   You can find Amy on twitter, facebook, and instagram!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and as always stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!  

On this week’s episode of the Healthy Wealthy and Smart podcast, Dr. Beth Darnall joins us to talk about the opioid epidemic and alternative treatments for patients experiencing chronic pain. Dr. Darnall is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University and treats individuals and groups at the Stanford Pain Management Center. She is an NIH-funded principal investigator for pain psychology research that is examining the mechanisms of pain catastrophizing treatment, including a novel single-session pain catastrophizing class she developed (funded by the NIH National Center for Complementary and Integrative Health). She is dedicated to empowering life beyond pain. In this episode, we discuss: -The opioid epidemic and cost effective treatment solutions that you can incorporate into your care -Tapering off opioid use, associated effects, and protocol -How opioid use and chronic pain effect brain chemistry -Pain catastrophizing defined and what patients can do if they have chronic pain -And so much more! Treatment for chronic pain with opioids alone is not sustainable and alternative treatment approaches are needed to retrain the brain. The research has shown that, “When we take opioids, it really changes brain chemistry. It actually changes the structure of the brain but so does chronic pain itself…[With alternative treatment,] you're rewiring and recovering and exercise and enjoyment and going out and getting back to doing the things you love, these are going to help facilitate your brain as it is rewiring, as you’re managing pain differently, as you’re becoming more and more active and functional.”   Evidence based healthcare providers must monitor patients who begin opioid treatment for chronic pain and how their condition evolves. “We want to ask ourselves a critical question—are people getting better? And this is where we've really fallen short, opioids will be prescribed and nobody is tracking long term to see if they are getting better or if there are new risk factors or addictive behaviors. It’s a constant process of monitoring… We need to do better at stopping what isn't working. If people aren't getting better, if their pain is only worsening, let's not add more of what isn't working. Let’s stop it and emphasize the alternatives.”   Dr. Darnall supports the biopsychosocial model for treating chronic pain because it effectively and comprehensively targets the nervous system. She states, “The nervous system leads us into this area where we’re really talking about the modulation of pain, the facilitation of pain and the exacerbation of pain… No matter where you feel pain in your body, no matter how it got started or why, the processing of it will occur in the brain and spinal cord. That's what we can target with some of these treatments and therapies, we’re able to dampen the experience of pain… The nervous system is a critically important part in helping decrease not only pain and intensity but more importantly how much a person suffers from pain. “   Dr. Darnall advocates a pain management approach that allows the patient to take more control in achieving a desirable outcome. She stresses, “The most important person on the healthcare team isn't the doctor or the psychologist or the physical therapist—it’s the patient. If you have chronic pain, you are the most important person on your healthcare team. My hope and my wish is that every person on your healthcare team will have a similar philosophy that is focused on empowering you to acquire the right information and the right skills so you can best self manage your pain and your symptoms so that you’re able to become more functional, to enjoy more of the life you have even with the health conditions you have so you’re able to live your best life possible.” For more about Dr. Darnall: Beth is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University and treats individuals and groups at the Stanford Pain Management Center. She is an NIH-funded principal investigator for pain psychology research that is examining the mechanisms of pain catastrophizing treatment, including a novel single-session pain catastrophizing class she developed (funded by the NIH National Center for Complementary and Integrative Health).   She is Co-Chair of the Pain Psychology Task Force at the American Academy of Pain Medicine (AAPM), and in 2015 received a Presidential Commendation from AAPM.   Beth is author of Less Pain, Fewer Pills ©2014 and The Opioid-Free Pain Relief Kit ©2016. Her upcoming book, The Surprising Psychology of Pain: Evidence-Based Relief from Catastrophizing and Pain is due out in 2017. As a pain psychologist, she has 15 years experience treating adults with chronic pain, and she lived through her own chronic pain experience. She enjoys helping individuals with chronic pain gain control over mind and body and live their best life possible.   Beth is a licensed clinical psychologist (CA License #25495).   Beth received her doctoral training at the University of Colorado at Boulder and her clinical residency at the Southern Arizona Veterans Affairs Health Care System (Tucson VA Hospital). She received post-doctoral training at The Johns Hopkins University School of Medicine Department of Rehabilitation Medicine and the Bloomberg School of Public Health (T32 Fellowship). Clinically, she provided psychological services to patients with catastrophic burn, spinal cord injury or amputation. She was an Associate Professor at Oregon Health and Science University (2005-2012) prior to joining the faculty at Stanford University in late 2012. Her desire to specialize in the management of chronic pain was inspired by her clinical experiences and by her own personal experience with chronic pain.   Make sure to grab copies of Dr. Darnall’s books The Opioid-Free Pain Relief Kit: 10 Simple Steps to Ease Your Pain and Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control over Chronic Pain and follow her on twitter!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and as always stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult

On today’s episode, I had the pleasure of welcoming Dr. Jason Falvey PT, DPT, GCS onto the podcast to discuss how physical therapists can better treat the geriatric population. Dr. Falvey is currently pursuing his PhD at the University of Colorado Denver in the Muscle Performance Lab and is interested in optimizing rehabilitation for medically deconditioned older adults in post-acute and home care settings. In this episode, we discuss: -The push for more medically necessary research funding for the growing baby boomer population -Are fresh PT graduates prepared to manage older adults? -Jason’s top strategies to break cemented patient routines -How to properly dose exercise for the geriatric population -And so much more! Jason explains the value of understanding optimal aging and long term health management when dealing with clients of any age and in any setting. He states, “In every practice area, knowledge of successful aging will make you a better therapist. If you’re a geriatric specialist or have good knowledge in that area, I think you would be an incredible asset to any healthcare organization.”   Some of Jason’s best treatment results come from empowering patient’s on their rehabilitation journey. “These patients we see are often homebound, their often not respected or valued or heard by medical professionals… So really getting in and promoting autonomy and putting power in their hands immediately to take charge of their care. It’s surprising how refreshing that is for patients and how much they open up after the first session.”   In order to maximize patient outcomes, clinicians need to understand the foundations of movement and address their patient’s functional deficits. To better illustrate this point, Jason proposes this example, “If I gave you a book in Spanish and I tell you to read it, you read through it and you don't understand because you don’t understand the foundation of the Spanish language and then I have you do 100 repetitions of reading that book, that 100th time you’re not going to be any better at it because I didn’t fix the foundational issue that you don’t know some of the basic vocabulary you needed to understand.”   Geriatric research is now beginning to incorporate physical function into the equation and physical therapists are at the forefront for advocating its importance. Jason stresses, “Physical function is its own independent risk factor for so many adverse outcomes like hospital readmissions, all cause emergency room visits, falls, cognition and physical function often run in tandem… I think there is increased recognition that how people move and interact with their community is not just a secondary outcome but it is a primary outcome… They haven’t included physical therapists in physician trials, so there is still work to do, but we have successfully promoted the message that mobility is important, mobility is a quality of life issue, and exercise is medicine and we need to integrate those things across the spectrum. “   For more about Dr. Falvey: PhD Student Jason Falvey was awarded a Kendall Scholarship from the Foundation for Physical Therapy in 2014 and a Fellowship for Geriatric Research through the Academy of Geriatric Physical Therapy in 2015 to support his research examining the role of home physical therapy in enhancing function and reducing re-hospitalizations for medically complex older adults. He is also the primary investigator on a research grant from the American Physical Therapy Association, Section of Health Policy and Administration looking at the role of physical therapists in models of transitional care for older adults after acute hospitalization. You can find more resources on Jason’s research here and follow him on twitter! Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!  

Happy Independence Day to the American Healthy Wealthy and Smart family! On this week’s episode, Greg Lehman and I review the evidence and rethink effective treatment strategies. Greg is both a physiotherapist and chiropractor who treats musculoskeletal disorders within a biopsychosocial model and simplifies pain science for clinicians around the world. In this episode, we discuss: -Why explaining pain leads to better treatment outcomes -The case for and against repeated spinal flexion -Does glute activation or inhibition affect pain? -Functional training and the carry-over effect -And so much more!   Greg stresses that most physical therapists should rethink what is valuable to their patients. He states, “The technical mastery is less important…It probably has more to do with how your patient feels comfortable and how you respond to them rather than you being a good robot who knows lines of drive and the biomechanics. That isn’t what is valuable and isn’t supported in all the research that we have.”   Greg also questions the effectiveness of being so specific with our interventions and takes a broader approach in his treatment philosophy. “I don't think there is any treatment that ever has to occur… It’s actually a neat, big question for therapy I would like to see addressed more. Is there ever a treatment that is absolutely necessary for a specific condition or are there a number of things that can be helpful? I tend to believe there are a number of things—I have my biases—but I think most things aren't that specific.”   Greg builds patient self-awareness with education and believes it is his most effective treatment tool. “I go right into education for low back pain. I am not too worried about getting them super active right away. I want to encourage them to getting back to doing the things that are important. If they tell me they are afraid to do a number of things that they like doing and they are meaningful activities, my go to intervention is to convince them they can start doing those things again.”   Greg suggests shifting our focus as clinicians from a purely biomedical approach to treatment and instead developing our psychosocial expertise. “I really believe it is okay to be simple. We don't really need the complexity that we try to do, especially the biomechanics. The big point of that is if you simplify your biomechanics, your physical interventions, it can allow you to develop your skills in the other areas, the psychosocial stuff and start taking more classes outside our typical training—psychologists, social workers, that type of stuff. That’s where we can build our skill set. There's not a better manipulation, there’s not that special exercise technique that you need to learn. It’s fun but it’s not necessary for patients with pain.”   For more about Greg: GREG LEHMAN BKIN, MSC, DC, MSCPT He is a physiotherapist and chiropractor treating musculoskeletal disorders within a biopsychosocial model. Prior to his clinical career he was fortunate enough to receive a Natural Sciences and Engineering Research Council MSc graduate scholarship that permitted me to be one of only two yearly students to train with Professor Stuart McGill in his Occupational Biomechanics Laboratory subsequently publishing more than 20 peer reviewed papers in the manual therapy and exercise biomechanics field. Greg was an assistant professor at the Canadian Memorial Chiropractic College teaching a graduate level course in Spine Biomechanics and Instrumentation as well conducting more than 20 research experiments while supervising more than 50 students. He has lectured on a number of topics on reconciling treatment biomechanics with pain science, running injuries, golf biomechanics, occupational low back injuries and therapeutic neuroscience. His clinical musings can be seen on Medbridge Health CE and various web based podcasts. Greg is currently an instructor with therunningclinic.ca and with Reconciling Biomechanics with Pain Science.  Both are continuing education platforms that provide clinically relevant research that helps shape and refine clinical practice. While he has a strong biomechanics background he was introduced to the field of neuroscience and the importance of psychosocial risk factors in pain and injury management almost two decades ago. Greg believes successful injury management and prevention can use simple techniques that still address the multifactorial and complex nature of musculoskeletal disorders. He is active on social media and consider the discussion and dissemination of knowledge an important component of responsible practice. Further in depth bio and history of my education, works and publications. For more information on where Greg will be lecturing next, make sure to visit his website and keep up with Greg on twitter!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!  

On this week’s episode of the Healthy Wealthy and Smart Podcast, Chad Prince joins me to discuss his book Physical Therapy Career & Salary Guide: Avoid the Income Ceiling and Put Your Career in the FASTLANE and strategies to add side income to your physical therapy practice. After working as a physical therapist for ten years, Chad transitioned into full-time administration seven years ago. Today, he manages an orthopaedic surgery practice. In his writing, he combines his years of professional business experience, his understanding of the healthcare world at large, and his personal journey developing a physical therapy product, the UELadder.   In this episode, we chat about: -Chad's experiences with overcoming self-doubt and self-imposed limitations -Unique PT opportunities to generate income without trading your time for money -How to expand your audience globally and 10x the impact you can make -How to get in the fastlane of healthcare innovation -And much, much more!   As budding entrepreneurs, sometimes it is our mindset that is limiting us from achieving greatness. Chad suggests exploring these questions, “What do you want to give? What kind of impact do you want to have on the world? Who do you have to become to give that to the world? And you have to go ahead and believe that you are capable of that before you can become it.”   Chad addresses the limitations of the service model and the upside of taking an alternative view, “As long as we trade time for money we are limited by our amount of time…You might be able to work more but there is no way to 10x your work hours—it’s just not possible. But with online tools and with other types of businesses still inside physical therapy, it is possible to 10x your impact.”   As technology evolves in our profession, Chad stresses, “We’ve got to look ahead at changes that are coming and embrace those in a way that’s positive and healthy for the profession and our patients. That's ultimately going to be the sweet spot for us all.”   We wrap up the interview with some lessons from the memory of a legendary figure, Muhammad Ali, “He said I'm the greatest and said it over and over and over until he became the greatest… If we can have a full and complete understanding of our what, why, and how, we can say I’m the greatest at whatever it is we want to accomplish and we can go do it.”   You can find more from Chad on twitter and can follow his blog here! Get a copy of the book and check out Chad’s UELadder! Be sure to check out the FREE 5 page report on PT Income Tips on the homepage, thanks to Chad!   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!

This week’s episode of the Healthy Wealthy and Smart podcast is a must listen if you are interested in learning more about CrossFit. Tune in, with Dr. Rick Daigle and me, to find out what CrossFit is all about and tips for choosing a box that’s right for you. Dr. Daigle is a physical therapist who is passionate about treating athletes and the Founder and President of Medical Minds In Motion which develops high quality continuing education courses for the allied health field. In this episode, we discuss: -Do you have to be in great shape to start CrossFit and is CrossFit a great way to get injured? -Does CrossFit translate into daily movement? -Must ask questions when shopping around for the perfect box for you -What you can do to decrease your chance of injury -And so much more! If you’re interested in checking out CrossFit, it is important to find a box that challenges you but also modifies the workout of the day when your body is giving you red flags. Dr. Daigle suggests, “Doing things at the level that you are capable of doing it at and understanding regression and progression. And it goes that having a coach that understands regression and progression and understands that everybody is going to move a little bit differently.” When first starting CrossFit, your box needs to understand your ability level to prevent injury. Dr. Daigle stresses, “You’ve got to earn the right to add load to a movement. You’ve got to kill the movement first, you’ve got to know it, you’ve got to own it without any load. So it’s the good box that will take that philosophy. And the not so good where they just put load on people, that's where injury happens.” It can be challenging for the CrossFit athlete but always have the humility to accept the feedback from your body. “Listen to your body. If you're body doesn't want you to do something, oh well, then modify it and figure out how you can do a quality movement in a little bit of a different manner. The biggest things for injury prevention is having a good consistent mobility program and listening to your body. Your body will tell you when it's not ready to do something.” CrossFit can be a great exercise program that incorporates variability and camaraderie. Dr. Daigle is a proponent for CrossFit and states, “It's about getting people moving. We live in a society that doesn't move enough. We live in a society that stays very, very stationary. I think CrossFit is a great avenue to get people moving and get people off their duff doing something different, doing something exciting, and improving quality of life.” About Rick: Rick Daigle, PT, DPT, FMT-C, is the Founder and President of Medical Minds In Motion, LLC™.  Dr. Daigle is a graduate of Simmons College in Boston and had the opportunity to do an extended externship at Cincinnati Sports Medicine. Dr. Daigle is an active member of the APTA and is a Credentialed APTA Clinical Instructor. His clinical expertise/philosophy is focused around a manual and movement based model. He utilizes assessment tools and techniques such as the SFMA, Trigger Point Dry Needling, Kinesiology Taping and many more.  Dr. Daigle has worked with a variety of types of patients and has consulted with numerous collegiate and professional athletes. He has a special interest in Baseball Players and has studied the mechanics of pitching and how dysfunctional movement causes breakdown, leading to severe injuries.  Dr. Daigle is the creator of “Kinesiology Taping: Movement Assessments & Corrective Exercise Strategies”, seminar series which is meant to expose clinicians to various taping techniques, movement assessments and corrective exercise strategies used to determine what taping techniques are appropriate. He created MMIM with the sole purpose of developing high quality continuing education courses for the allied health field.   If you would like to hear more from Rick, you can follow him on twitter and facebook and be a part of the facebook group Physical Therapy: Practice, Education and Networking for everything rehab related.   Check out Medical Minds In Motion’s continuing education courses and follow the blog and twitter.   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Also, check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!      

On this week’s episode of the Healthy Wealthy and Smart podcast, I had the pleasure of welcoming Dr. Emma Stokes onto the show to discuss leadership and advocacy in physical therapy! Emma Stokes BSc (Physio), MSc (research), MSc Mgmt, Phd is an associate professor and a Fellow of Trinity College Dublin. She is the deputy head of the physiotherapy programme and teaches on the entry to practice programmes in Dublin and Singapore. The focus of her research and teaching is professional practice issues that builds on her work with professional, regulatory and charitable organisations. She is the Minister for Health's nominee for physiotherapy to the Health & Social Care Professions Council & Physiotherapists Registration Board in Ireland. She is currently the President of WCPT.   In this episode, we discuss: -Practical steps that create leadership opportunities -Why self-awareness and the Power of No are integral to leadership -Thoughts on what may impact women on their path to higher goals -Dr. Stoke’s experiences with failure and building resilience -A framework for advocacy in physical therapy -How to get the most from a conference experience -And so much more!   Dr. Stokes shares great advice for those who want to get involved in higher roles that before you can lead others, you first need to be able to lead yourself. To develop that self awareness you must, “Be clear about what your values are. So learn about your values—where they’ve come from, how they serve you, how you use them in the service of others, what they bring to you as a person. And if you understand them very explicitly then you will understand when they are challenged and whether you're prepared to have them challenged or whether you need to put your hand up and walk away from a situation.”   We also discuss the importance of looking to a mentor to help cultivate leadership characteristics within ourselves. Dr. Stokes suggests that you, “Identify something that someone does that you admire and have this conversation with them. Find out how they got to where they are. Sometimes it is just looking at a behavior and saying that is a behavior that is a positive behavior that I would like to adopt. It is mimicking.”   Dr. Stokes reminds us that to have an effective therapeutic relationship with the best outcome for our patients, we need to guide them on their journey and that, “The solution is owned by the client. You unpack that solution with them and it is something they own rather than us giving them a fix.”   Being an advocate for physical therapy comes down to, “Understanding what it is you want to achieve and really drill down into that. Once you understand what the outcome is, then you need to look at context. What is the environment in which you want this change to happen, who are the key people that may be the decision makers, understand who the people will be in terms of allies, who are the people who won't be so positive about this change... Understanding the context then allows you to think about what you want to do, the strategy… find the [evidence] you need in order to [support] this.” More about Dr. Stokes: Education and work experience: Emma Stokes qualified as a physiotherapist in 1990 [BSc Physiotherapy, Trinity College Dublin]. While working as a clinical physiotherapist at St. James’s Hospital, Dublin (1990-1996), she completed a post-graduate Diploma in Statistics in 1993 and MSc (Research) in 1995 both at Trinity College Dublin. She took up an academic position at Trinity College in 1996, completed a PhD in 2005 and a Master’s degree (MSc Mgmt, Business Administration) in the School of Business in 2008. She is an associate professor at the Department of Physiotherapy, Trinity College Dublin [1996 to date]. She was elected as a Fellow of the College in 2012. She commenced a Diploma in Leadership & Professional Coaching in September 2014. Since May 2015 she has been the President of WCPT.   Leadership: Emma Stokes has played a number of leadership roles over the course of her career. Since the early 1990’s, she has been an active member of the Irish Society of Chartered Physiotherapists (ISCP). As well as acting as a professional adviser, she has chaired the Society’s Standing Committees for International Affairs and for Finance. In 2012, she was appointed as the Director of Professional Development and has led the establishment of the ISCP’s first professional development unit, in preparation for the required organisational transformation of the ISCP when the physiotherapy regulatory board opens. Drawing on key stakeholder and member engagement as well as her international experience, she led the project that has culminated in the establishment of a unit of 3 staff and more than 40 volunteers whose chief function is to position the ISCP as a key provider of continuing professional development in the coming years. In 2010 she completed a 5-year term as a College Dean at Trinity College Dublin [15,000 students] with responsibility for student discipline. She was the first woman to be appointed to this senior academic management position.   Board membership: Her experience of eight board directorships covers the health, education, regulation and charity sectors. She recently completed a term as the chair of the board of a charity for people with Parkinson’s Disease – www.moveforparkinsons.com.   Regulation: She is currently the Minister for Health’s nominee to represent the physiotherapy profession on Ireland’s regulatory authority – the Health & Social Care Professions Council. She has been an invited speaker at the Federation of State Boards of Physical Therapy Regulators (USA) leadership workshop and annual conference and the International Network of Physical Therapy Regulators. She is a member of the recently established (2014) Physiotherapists Registration Board that will regulate physiotherapy in Ireland.   Research, scholarship and teaching: Dr. Stokes has had two main research interests. The first has been in the area of rehabilitation with a focus on novel ways to mediate exercise intervention and participation post stroke and in people with neurological disabilities. Her current research focus is on national and international professional issues in physiotherapy. She has published widely in these areas in international peer-reviewed journals. She co-leads the teaching modules on professional issues for the entry-level physiotherapy students at Trinity College Dublin and at the TCD Singapore programme. She spent time on sabbatical at the University of Toronto (2010). She was privileged to deliver the 2013 Chartered Society of Physiotherapy Founders’ Lecture in October 2013 - http://www.csp.org.uk/news/2013/10/11/physio13-founders-lecture-calls-physios-think-creatively In 2014, she was in receipt of a government scholarship from Taiwan as a visiting scholar and was invited to the University of Rhode Island as a Distinguished International Visiting Scholar - http://web.uri.edu/physical-therapy/2014/02/14/international-scholar-dr-emma-stokes-to-visit-uri/ She was appointed as an adjunct associate professor at the University of South Australia in August 2014.   International professional adviser: She has acted as an adviser to physiotherapy organisations advising on organisational development and capacity as well as professional issues. She was recently a member in a task force of the American Physical Therapy Association on scope of practice. She was the chair of a WCPT Working Group tasked with an organisational review of WCPT.   If you would like to hear more from Dr. Stokes, you can follow her on twitter! For more information on the IFOMPT Conference in Glasgow on July 4-8th, 2016, click here and if you’re interested in sharing your research in Cape Town in July 2017, head over to the World Confederation for Physical Therapy Congress 2017!   Make sure to connect with me on twitter to stay updated on all of the latest! If you would like to support the show, be sure to leave a rating and/or a review on iTunes!   Have a great week and as always stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page!