Musculoskeletal Monday: From Technicians to MSK Specialists

Well, it is time again for MSK Monday, and I have the pleasure of writing this blog from the “espressohotel” in Milan. I am teaching a Lumbar Spine I class for a group of physiotherapists in northern Italy, and teaching in Rome the next weekend. I appreciate the Italian hospitality and their eagerness to learn. According to my translator, Italy still views PTs as mostly massage specialists and not musculoskeletal therapists (aka experts!) Physiovit (the sponsor of the courses) is working hard to change the trajectory of physiotherapy in Italy. This is much like our profession was almost 30 years ago, and being here helps me appreciate how far we have come. This post is dedicated to several therapists who have greatly contributed to physical therapy and have elevated the profession from “technicians” to musculoskeletal specialists.

Anatomy Doesn’t Lie

I use this quote a lot, and I dedicate it to my mentor Erl Pettman, who made this statement frequently in the courses I took from him. He has dedicated his life to advancing PT, from developing the quadrant system of assessment to innovating creative techniques for safe cervical spine manipulation. I am grateful for all he has offered to the profession.

He wrote an article in JMMT about the history of manual therapy it is a great read, and here is a link of Erl discussing cervical locking. In order to move forward we have to learn from the past.

Take the time to look over this article!

The Body Heals in a Predictable Manner

Jill Cook has produced important research in the area of tendonopathy. It is so important to understand the recent changes in addressing this common condition, including not using the term “tendonitis” incorrectly and avoid resting the tendon. Tendons have to be loaded to heal. Here is a link to a podcast here she explains the importance of loading tendons and healing.

Pain is in the Brain

David Butler and Lorimer Moseley have been the trendsetters in this area. Here are a couple of links to my favorite contributions which they have made.

David has prolifically written about PT. He is funny, creative and practical. Here is my favorite contribution of his, the “Roller Coaster of Professional Life.”

Dr. Mosley presented at IFOMPT 2 years ago and it is important to recognize what behaviors we have in the clinic which may increase a patient’s pain (iatrogenic creation of pain). Here is a link to Lorimer discussing ”The Pain Revolution.”

We are prone to make errors in the clinic.

This area is dedicated to Dr. Stanly Paris, who can be credited for countless accomplishments. While studying Gray’s Anatomy, he recognized that the interspinous ligament was drawn incorrectly, having the angle of the ligament reversed. This mistake was copied to several other texts. Instead of accepting the diction of the fibers when viewing them, he challenged it. He was not afraid to question what he was looking at.  His curiosity and confidence was needed in our profession in the early days.

He founded University of St. Augustine, and was the driving force behind the U.S. formation of both AAOMPT and the APTA. He has recently donated 1 million (yes $1,000,000) dollars to the APTA foundation to promote the growth of PT through research!

Here is a link to his McMillian lecture where he outlines the history of physical therapy, it is well worth the time to watch.

Treat the Patient and you win every time

I have always enjoyed taking classes from Diane Lee. I remember taking a class in 2001 and she had a several pictures of a mime, showing different emotions, and linking them to posture. She was adamant that we had to find a “purposeful meaningful task” for the patient and focus on that during our assessment and see if we can change it.

Here is a link to her palpation video of the thoracic spine.

#PTBeyone 140 is dedicated to Jenny McConnell, she not only was the forerunner to several taping techniques, but created a system which was neuromuscular in its foundation. Here is a link to Jenny discussing knee pain!

Physical Therapy in the USA is growing stronger each day. We have a vision to be the primary care providers and leading experts in MSK therapy. Let’s take the time today to remember the practitioners who laid the foundation for our growth and success in healthcare!




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