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The tenth episode of the Hand to Shoulder Podcast is all about baseball. More specifically, we talk about assessing and treating pitchers. And who’s a better expert on this topic than Dr. Garrett Bullock? Not only is he a Doctor of Physical Therapy, he is also a former collegiate and professional baseball player. Dr. Bullock provides insight on ways to assess the lower extremity as a critical part of our evaluation of elbow or shoulder pain and several clinical pearls for maximizing treatment outcomes for these athletes. He encourages us to explore outside of our traditional assessment tool box, throw a curveball in our treatment plans, and strike out pain and dysfunction for good using a whole-body approach.
Dr. Garrett Bullocks Bio:
Dr. Garrett Bullock is physical therapist, quantitative epidemiologist, and former collegiate and professional baseball player. Dr Bullock is a Clarendon Scholar at the University of Oxford and holds joint appointments within the Nuffield Department of Rheumatology, Musculoskeletal Sciences and the United Kingdom Centre for Sport, Exercise, and Osteoarthritis Research Versus Arthritis. He will begin a faculty position within the Wake Forest School of Medicine beginning in July 2021, leading research in the Wake Forest Biomechanics Pitching lab. Dr Bullock is the cofounder of Aletheia, a sport analytics and data consulting company. Dr Bullock consults with the NFL, MLB, English Institute of Sport, the United States Military, and Functional Movement Systems. Dr Bullock is a recent PhD graduate in clinical epidemiology and medical statistics at the University of Oxford.
Dr Bullock’s research focus is in creating real world clinically applicable research, that has direct application to clinical decisions in sports and orthopedic medicine. His specific research entails big data epidemiology, injury risk and risk mitigation, and life span impact of exercise and sport. He has over 60 publications.
Do you have patients you just cannot seem to get out of pain or explain the reasoning behind their pain? Dr. Chad Cook returns to take a deeper dive into the complex world of pain. In addition to his clinical research, advocating for the therapy profession, and treating patients, Dr. Cook holds a Certificate in Chronic Pain Management from McGill University. In this episode, we discuss pain types – guided by the Pain and Disability Drivers Model – which Dr. Cook helped develop. We dive into each category with Dr. Cook providing clinical examples and interventions for each. You will learn how to determine if your patient is pain adaptive or pain non-adaptive and how to approach these patients in the clinic with more confidence and skill.
The Extensor Tendons. Located on the back of the hand, sometimes referred to as the extensor hood, the extensor mechanism, etc. It can get complicated with the different structures. Listen as Josh MacDonald MS, OTR-L, CHT from Hand Therapy Partners guides you through all you need to know.
Josh is a certified hand therapist (CHT) with extensive experience working directly with hand surgeons to help rehabilitate hand trauma surgery patients. Some of the more common conditions Josh has treated include:
Flexor and extensor tendon injuries Amputation revisions Compartment syndrome Soft tissue trauma and grafting Digit and forearm fractures
Josh began his career specializing in pediatrics focusing on outpatient therapy, neurorehabilitation and pediatric hand therapy. In addition to caring for patients, Josh has started and managed therapy clinics and developed pediatric therapy programs for handwriting training, aquatic therapy, inpatient neurorehabilitation evaluation and inpatient therapeutic outings.
According to Josh, some of the most challenging patients have chronically stiff hands. Josh recently helped one of these patient through her recovery process. After a car accident broke most of the bones in her hand, this patient developed a severely stiff hand and fingers. She worked hard at therapy after surgery, but her progress was slow and tedious. She became understandably frustrated when she did not soon regain full motion in her injured hand. But after months of hard work, this patient was able to return to work and independent driving and self-care tasks. Not every patient can regain 100% of his or her hand functions after a severe injury, but Josh works with each patient to help them reach their highest potential.
Josh is fluent in conversational Spanish and is constantly pursuing professional education opportunities. He regularly participates in national conferences sponsored by the American Association for Hand Surgery, American Society for Hand Therapy, American Society for Surgery of the Hand, Indiana Hand Care and the Philadelphia Hand Foundation. Josh is very active in the local Crossfit community and has multiple Crossfit certifications. He also coaches children, adults and competitors.
Josh received his Masters in Occupational Therapy from Grand Valley State University in 2001 and his Hand Therapy certification in 2015.
Have you ever wondered where and when hand therapy was born? Well Terri Skirven, OTR/L, CHT walks us through the seeds of when, where and how hand therapy blossomed. She outlines the foundation of the ASHT Board and Conference, Philadelphia Hand Conference and how the iconic CHT (Certified Hand Therapy Exam) was instituted, as well as how to become a speaker for continuing education conferences. Terri is well known for her commitment as a co-author of Editions 5, 6 and 7 (newest) of Rehab of Hand, and how these hand therapy bibles have evolved over time. Join us as we interview Terri as she discusses the milestones of her career and walks us through the history of hand therapy.
The flexor tendon system of the hand is what we use to interact with our environment. Dr. Rebecca Neiduski, PhD,OTR/L, CHT, from Elon University, dissects tendon zones, strand repairs and progression of therapy after a flexor tendon repair. Rebecca received a Bachelor of Arts in Kinesiology and Leisure Studies from Purdue University; a Master of Science in Occupational Therapy from Washington University in St. Louis, and a PhD in Educational Foundations from Saint Louis University. Rebecca practiced as a hand therapist prior to her to move Academia. She is currently the Dean of School of Health Sciences at Elon University in North Carolina. Please join us as we learn the recovery of a flexor tendon post trauma through words and research of Dr. Neiduski.
Have you ever considered economics, education, neighborhood, and lifestyle choices of each of your patient’s when treating them and how this may impact their treatment? Today we are joined by Dr. Zachary D. Rethorn to educate us on this topic. Dr. Zachary D. Rethorn is a board-certified orthopedic physical therapist and certified health coach with clinical and research expertise in musculoskeletal pain conditions, physical activity, and health promotion. He earned his undergraduate degree in Exercise Science from Belmont University followed by his DPT degree from the University of Tennessee at Chattanooga. Dr. Rethorn has completed a residency in orthopedic physical therapy through Benchmark Rehab Institute and is a PhD candidate in health promotion and wellness at Rocky Mountain University of Health Professions where his research focuses on how health professionals promote physical activity with their patients. He completed a faculty development resident at Duke University in the Doctor of Physical Therapy Division and is the owner of Rethorn Physical Therapy and Wellness, a digital physical therapy practice. He has presented at national and international conferences on topics related to orthopedic physical therapy, social determinants of health, and health promotion.
Below are links Dr. Rethorn referred to in the podcast:
Here is what Dr. Rethorn uses as his intake when treating his patients: https://healthleadsusa.org/resources/the-health-leads-screening-toolkit/
Comparisons on Social Screening tools: https://sirenetwork.ucsf.edu/SocialNeedsScreeningToolComparisonTable
Some Data sources to get to know your community better:
The Triangular Fibrocartilage Complex (TFCC) can be a complicated and intimidating structure. Theresa Parry OTR, CHT, COMT joins us to break it down with an insightful discussion of the structures, the role, rehabilitation, and orthotic selection when treating someone with TFCC involvement. If you are interested in learning from Theresa she teaches continuing education courses for the International Academy of Orthopedic Medicine and has a course on medbridgeeducation.com “Treatment of Ulnar Wrist Sided Pain” that will be released soon!
003: Navigating Rotator Cuff Repairs with Paul Gagliano, PT, DPT and Daniel Miriovsky, PT, DPT, OCS, FAFS, ATC, FGC
In this episode we are joined By Dan Miriovsky, PT, DPT, OCS, FAFS, ATC, FGC and Paul Gagliano, PT, DPT for a discussion about rotator cuff protocols. They add deep educational insights about how to manage patients with very different protocols, early ROM vs immobilization, and how to look beyond the glenohumeral joint in all phases of recovery.
Dr. Chad Cook is a clinical researcher out of Duke University, a physical therapist, and a profession advocate with a history of clinical care excellence and service. His passions include refining and improving the patient examination process and validating tools used in day-to-day physical therapist practice. As you will hear, he has over 300 publications and is a wealth of knowledge in the areas of manual therapy, pain modulation, and clinical research. In this episode, we talk about the role of both the clinician and patient in manual therapy services, pain management in relation to therapy outcomes, intervention selection, and patient buy-in, use of modalities for pain management, the current landscape of the student experience in a COVID-19 world, and some insight to his current studies, which we find fascinating and can’t wait to get our hands on when the results are published.
Welcome to the first ever episode of the Hand to Shoulder Podcast! We are excited to kick things off with an interview that will leave you motivated to change your clinical approach with your very next patient and likely even try new things with patients who come to mind as you listen. Our guest, Andrew Walquist, is a PT with an impressive resume and a perspective on rehab that is fresh and effective.