Category: Denver physical therapy

Fall Prevention & Balance: Episode 19

  • Falls are a big concern especially as the weather becomes cold, snowy and icy. When you can up-train your balance system that will help reduce your fall risk.
  • We tried to review SunChips Harvest Cheddar. It did not go as planned.
  • Trivia question of the week: What holiday is currently under a United Nations investigation?
  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional information related to Fall prevention & Balance injury throughout the week.
  • Thanks for listening!!

Today we are going to be going over fall prevention and balance at the request of one of our all times favorites, Maryann. Thank you Misses Shepard. And we are going to review SunChips Harvest Cheddar. Potentially. Schuuuuuu. Aw this is going to be good. So fall prevention and balance kinda comes down to balance as a starter. Balance has 3 main components; there is the visual component, there is the proprioceptive component, which is your bodies awareness of itself, and then there is the is your vestibular system. We also tend to talk a little about muscle strength. If you don’t have the strength to hold yourself up you are going to fall over.

 

It’s maybe not as much pure muscle strength as it is dynamic stability, right. The ability for your muscles to work together in order to keep you up right. I think that is something we run into maybe with post operative patients. Lower extremity post-op patients where there is maybe some muscle imbalances that can affect your balance.

 

Big time. I mean post-op there is a huge proprioceptive loss. You no longer have the same tissues in the same places as you did before. You have to reprogram that entire situation. Especially if you are talking about joint replacements or ligamentous surgeries like Achilles and ACL. There are struggling with that.

 

I’d say that with most all our patients at some point in time we work on balance, be that either core stability, sitting balance, standing balance.

 

There is huge need for balance to be addressed because really one else talks about it. No. Your PCP, your surgeon, your physician will tell you “ work on your balance”. That right, that’s classic. Especially when you get past 60-65. That’s the first thing your primary care Doc tells you “make sure that you work on your balance”. OK how? And what kind of balance. Stand just on one leg. What am I supposed to do? Walk on a tight rope?

Rotator Cuff Injury: Episode 18

  • Rotator Cuff Injury is common and becomes more likely as we age. The good news is most are non-surgical.
  • In honor of Thanksgiving we are reviewing Trader Joe’s Turkey Stuffing and Seasoned Kettle Chips
  • Trivia question of the week: What is the only sea without any coasts?
  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional information related to Rotator Cuff injury throughout the week.
  • Thanks for listening!!

We are going over rotator cuff injury and we are also going to be reviewing Trader Joe’s Turkey Stuffing and Seasoned Kettle Chips. All the flavors of Thanksgiving in each potato chip, I gotta’ tell ya’ they tried cause it looks like a feast. It does you can smell it from here, we have the bag open already. If I had smellification I would be able to smell it.

 

Smellification, that would be a cool tool. I’ve been low on the smellification lately. Smellification that is like the Richie Rich thing, you ever see that with Macaulay Culkin, back in the day. Sure haven’t. Well the smellinator 5000 saved them, because it smelled TNT which they then threw out the window. So the parents didn’t die. Gotcha. He was the dude from Home Alone. Yes. Yeah. Anyway we digress. I was going to say the same thing, we digress. Weeeird. That is so weird, isn’t that weird.

 

So rotator cuff incidence, fairly high, 17% of the population has a full thickness tear. The good news. It’s kinda like the disks, the slipped disk. Your disks can’t slip, but that is a whole other story. You can have a rotator cuff tear, and it’s completely asymptomatic. And this grossly affects the population as it ages. So individuals over 60 years of age make up 30%. 30% of 60 year olds or older have a rotator cuff tear, under 60 only about 6%. Ok. If I said that correctly. Yeah, that sounds about right.

 

This is defiantly something that we see more in the aging population. Some of that may have to do with the fact that there could be some postural incidences. As we tend to slouch a little more and we have a type I or II acromion that creates impingement and that can dig into the rotator cuff and just gradually fray away at it. Which will eventually lead to a partial thickness tear and then full thickness tear.

That acromion type is basically a little hook or a slightly bigger hook so it almost acts to kind of carve into it. It’s almost like a nail carving into a rope. Eventually, with that kind of friction over time it’s going to tear. It will.

Shin Splint: Episode 17

    • Shin Splint also known as tibial stress reaction comes in two types, muscle; which will affect the tibialis anterior or tibialis posterior and bone; which is the pre-cursor to a stress fracture
    • This week we are reviewing 3 different chips from Ireland. The Irish trio consists of O’Donnells of Tipperary Irish Cider Vinegar and Sea Salt, KP Mega Meanies Pickled Onion and Tayto Smokey Bacon. Hand delivered by Mr. and Mrs. Schneider
    • Trivia question of the week: What is special about the 37th parallel in the USA?
    • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional information related to Shin Splints throughout the week.
    • Thanks for listening!!

Three bags of chips! This is going to be a crazy episode. This is very highly specialized episode. We can’t thank Matt and his wife enough for bringing in three specific flavors. Schlepping them all the way back from Ireland. They are all in surprisingly good shape considering the state of transported chips we’ve had in the past. I’m thinking these have been in the carry on. Yeah definitely.

Today we are going to be covering shin splints, also known as tibial stress reaction and we are are going to be cover, what we are calling the Irish trio. Which is the Tayto Smokey Bacon, KP Mega Meanies, which is pickled onion flavored, and the O’Donnells of Tipperary Irish Cider Vinager and Sea Salt. Yeah, the Taytos are also known as breige pratai blaistithe, which is gaelic I am assuming for smoky bacon. That would be my guess. Maybe they are just messing with us.

Tibial stress reaction, is the more formal name for shin splint. So we kinda see a little bit of two sorta shin splints. One will be the muscle, which is tibialis anterior, which is the muscle that sits right along the front of your shin. That can get irritated, strained or bothered just like any other muscle in your body. When that is the case treatment is a little quicker then if you have a true tibial stress reaction. Which is basically the precursor to a stress fracture.

This is a very common problem with runners. It’s a very common problem with sprinters. This is something that is usually an overload or an overuse problem or a mechanical weakness is involved.

I remember a case about two years ago when Newton’s came out. Which was a running shoe in Boulder. That was more like six years ago. Yes, like I said two years ago, because I’m not that old. This was a forefoot running shoe, everybody had to go away from heal striking. So we all went to forefoot running, forefoot toe running, toe landing. The Newton shoe came out and before you knew it half of Rocky Mountain Tri Club (RMTC) came in with shin splints. So a lot of times if you have shin splints there is a mechanical component that needs to be addressed. Just fixing the inflammation, is usually not enough. We have to do a mechanical assessment a running assessment and what have you. To figure out why is my shin all of a sudden getting irritated, why is my muscle being overused so much.

Robert Castillo from Active Fit Bootcamp: Episode 16

In this episode we are welcoming Robert Castillo and his training business Active Fit Bootcamp to the Rebound Therapy & Wellness Clinic family. As a welcome gift we are reviewing Robert’s favorite chip; Chester’s Flamin Hot Fries. We also got to challenge Robert with this weeks trivia question: What is the smallest bone in the body?

  • Show time line:
  • 00;00 – Intro
  • 00;07 – Guest today is Robert Castillo – The Man at Active Fit Bootcamp
    • Reviewing Chester’s Flamin Hot Fries
  • 00;24 – Robert has moved in
  • 00;57 – Fans; the machine and the people
  • 01;20 – How did you end up at Rebound?
  • 01;35 – How to get a job from Djimmer
  • 02;05 – Ginger beard…
  • 02;39 – What is Active Fit Bootcamp?
  • 03;28 – What is your philosophy?
  • 05;00 – Robert does not like snakes
  • 05;29 – What kind of access do your clients have to you?
  • 06;10 – Why are your classes so early?
  • 07;27 – What is your diet like/how important is diet?
  • 09;48 – Marching band/growing your gluts
  • 10;39 – What is the one thing about you most people don’t know but should?
  • 11;48 – What TV sitcom family would you be a member of?
  • 16;25 – What advice did you get that was the most rewarding?
  • 17;04 – Driven to be something else
  • 17;10 – We’re planning to become F1 drivers.
  • 18;00 – Djimmers impressive arm girth
  • 18;42 – a funny story about swords
  • 19;57 – trivia time
  • 20;12 – What is the northern most point of the Britsh empire?
    • Cape Columbia in the providence of Nunavut , Canada
  • 20;30 – Trivia question of the week: What is the smallest bone in the body?
  • 21;06 – Chip time! Chester’s Flamin Hot Fries
  • 23;21 – Are chips vegetables?
  • 25;27 – The Donut Boys
  • 25;37 – Thumbs up/thumbs down?
  • 25;50 – Chips are good with a beer
  • 26;45 – Next week shin splits and the Irish trio of Chips
  • 27;37 – Follow Robert or get more information:
    • http://www.activefitbootcamp.com
    • Instagram: Rob_in_motion
    • Instagram business: active_fit_bootcamp
  • 28;44 – The safe way to transition from PT to personal training
  • 29;18 – Closing: Give us a 5 star review or subscribe if you liked the show
  • 29;27 – Thanks for listening!

Hip Pain: Episode 15

Hip pain has many causes that change throughout the life span. Hip pain in a teenager often has a totally different cause then hip pain in middle age or as a senior citizen.

  • In honor of Halloween we are reviewing: Zapp’s Voodoo potato Chips
  • Trivia question of the week: What is the northern most point of the British Empire?
  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to get additional information related to hip pain throughout the week.

Today we are discussing hip pain, fairly broadly. Talking about some of the common diagnosis we see there. And we are going to do a nice review of Zapp’s Voodoo potato chips. Sounds Yummy. I’m pretty excited. Who brought these in? You did? Yeah I did. Yeah Yeah, I got these. I’ve had them before they are delicious and tasty.

 

Most hip pain that we see is going to fall under two categories. Does it cause groin pain? Or does it cause outside of the hip pain? So those two areas have pretty different causes. Yes. Outside of the hip is going to be much more common with bursitis, muscle strain, perhaps physical trauma some kind of bruising. We tend to see it a lot when people have a limp and they start counter balancing or changing the way they walk. It’s called Trendelenburg (https://www.physio-pedia.com/Trendelenburg_Gait). Nice, you get this overuse irritation on the outside of the hip and that could be tendonitis or bursitis or a variety of tendons.

 

A lot of that is treated similarly in terms of physical, manual therapy to the outside of the hip. Modalities to the outside of the hip. Working on, above all things again, glut med strength and external rotator group strength and that is going to cover most of your hip pain that you feel on the outside of your hip. IT band is another big one.

 

We also have groin pain. Groin pain is much more indicative of joint wear and tear. So that is going to be osteoarthritis changes in there. Or we are going to see something of the soft tissue pathology in there. So FAI, which is femoral acetabular impingement. That is a topic that is going to need it’s own show to fully cover. But to kind of briefly cover.

 

It’s one of those diagnoses that has kind of become very popular lately since they have been able to treat it with a scope now. So it is actually a surgical problem. 20 years ago if somebody had a hip impingement problem, you just kind of rode it out until you could get a hip replacement. Now it is something that is treatable. FAI femoral acetabular impingement syndrome is something we see a lot in single limb athletes. Athletes who tend to land or jump off of one leg; dancers, cheerleaders, volleyball players. Like Christiaan said it’s a topic that will require a session of its own because there are so many different ways to diagnose and treat conservatively.

Low Back Pain: Episode 14

• Low back pain is the most common orthopedic complaint that people seek physical therapy treatment for.
• Taste off: Dill Pickle Old Dutch verses Kettle Brand
• Trivia question of the week: Who has more cervical vertebra, a Giraffe a Camel or a Human?
• Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to get additional information related to low back pain throughout the week.

Today we are discussing Low back pain and doing the special taste off. We are doing the Kettle vs Old Dutch, Dill Pickle flavored. Low back pain, very exciting, very common, extremely common. I think something like 50% of cases for physical therapy have to do with low back pain. I think that’s probably low. You think that’s a low estimate? Yeah, I think most patients that come in, even those that come in with shoulder problems, or knee problems, or toe problems will have back pain. Will also complain of some sort of low back pain, that is true.

We will definitely see a little bit of both, that’s for sure. It goes back to the earlier situation that we discussed where “sitting is the new smoking”. We don’t like sitting or running. Running is not good. We also don’t like flip-flops but that has nothing to do with back pain. No, that has less to do with back pain. More to do with, well it could have to do with back pain, the kinetic chain. Yeah. Foot is connected to the knee bone. Knee bone is connected to the butt bone. Butt bone is connected to the backbone. We may want to take this out. Ahh we’ll probably, ahhh we’ll leave it in.

Low back pain. Most of the time we see two big issues with this. 1 Abdominal wall weakness, 2 glut weakness. Yes and those two aren’t mutually exclusive they can happen at the same time. They can, they will happen together very frequently. They also happen separately, but not as frequently.

Taking care of it is, hopefully it is just back pain and you don’t have radicular symptoms. That is usually an indication of a more neurological issue. Which can also stem from the same kind of things causing your low back pain. Yeah so, I think are going to differentiate here between just low back pain and any kind of neurologic issues that might be a different episode all together. Different episode, it will be more complex yes; more serious typically, takes longer to recover from.

 

ACL Recovery: Episode 13

  • Anterior Cruciate Ligament (ACL) recovery is a long and unique process. No two individuals will have the same experience.
  • Review: Food Should Taste Good Brand Sweet Potato Tortilla – Huge thank you to Peggy for the chips
  • Trivia question of the week: What two countries border each other and 13 other countries? For extra credit name all 14 countries for both.
  • We always post additional pertinent information throughout the week on our: Instagram 2pts_n_a_bagofchips and Twitter @2PTsNaBagOChips. So subscribe to keep up with all the latest information.

A very special substitute edition here. We went all off the grid. We went totally off the grid. We where totally planning to do the taste test for dill pickle potato chips. But instead we have sweet potato tortilla chips. And we have a very special guest, Ian Bosman. Hi… Thank you. That’s classy. He has flown all the way in from Hope to tell us all about his ACL recovery and how it’s going. … yeah pretty much… Thanks. Wow! You really suck at this. He is on it today. You are probably the worst guest we have had to date. No no, no no, you are by far the worst guest we have had to date and you are only the second. So. That’s not really good competition though, if he has to compete with Dr. Mike. That’s true. I’m not a doctor, that’s unfair. Dr. Mike is crushing you.

Anyway, we are doing the Food Should Taste Good Brand Sweet Potato Tortilla chip and we are going to discuss ACL recovery. Ian is now 16 months post surgery? Probably closer to 13 months, August 1st . It is now October. So that would make it 14 months. Djimmer is something like 3 years post ACL surgery. And I am still struggling. And I am ACL deficient. Which means I don’t have an ACL. Well not a complete ACL anymore. Which proves that you really don’t need one. Yeah, my knee does hurt a lot today. I will come out and say that. If all you do is cycle and struggle with pain. Yeah, cause I am not allowed to do anything exciting. So anyway, that’s fine.

Let’s talk about ACL. ACL injuries happen incredible frequently now. There is something called the ACL project, which is pretty interesting. They track the number of ACL injuries. This year alone in the NFL they are up to 37 ACL tears. Which is classic. Which is pretty impressive. They have narrowed it down and found that there is one more ACL tear per year on artificial surfaces vs grass surfaces. Which is a pretty interesting statistic I think. Generally we are seeing them way way way more often now then we use to see them.

Dr. Mike Pascoe Interview: Episode 12

Today, we are incredibly honored to have as out first ever guest Dr. Mike Pascoe. Dr. Pascoe has a PHD in neurophysiology in human movement and is the anatomy instructor at the University of Colorado Anschutz Medical campus. Show time line:

  • 00:00 – Intro
  • 00:22- Describe yourself in 3 words.
  • 00:45 – 1 Word to describe your job.
  • 01:10 – Dr Pascoe is not a Physical Therapist
    • Kinesiology, PHD neurophysiology in human movement
    • 1st in family to graduate college
  • 02:36 – What are you teaching right now?
  • 04:10 – Anatomy education is specific to the field
  • 04:50 – PTs have more anatomy on the musculoskeletal system then an MD
  • 05:50 – What is your area of research?
    • Scholarship of teaching and Learning
  • 06:20 – How is research conducted for scholarship of teaching and learning?
  • 08:35 – Light field photography, Student wiki’s, live blogging, snapchat, E-books, Chat Bot (AI system)
  • 09:35 – How does your research translate into real world applications?
    • Safe clinical practice and durable learning
  • 10:30 – Has your research resulted in improved student outcomes?
  • 11:35 – Study strategies: effective verse ineffective
  • 12:30 – Cadaver based continuing education, what are you doing to make this more accessible?
  • 15:30 – Piggybacking cadaver based anatomy onto functional dry needling education
  • 17:20 – What is your biggest technology addiction?
  • 18:10 – Reaching more individuals to promote physical therapy
  • 19:00 – Most enjoyable, recent social media experience
    • Meet the student where they are – Snapchat
  • 20:38 – What are you learning now?
  • 23:05 – Best piece of advise for current PT’s, PT students or those wanting to be PT students?
    • Book recommendation: Making it stick
    • The learning scientists – 6 strategies to improve your learning
  • 24:55 – Dr. Mike Pascoe proposed with the help of Pringles?
  • 26:42 – CHIP TIME!! Ruffles Mozzarella and Marinara
  • 28:15 – Trivia answer from last week:
  • 29:10 – New Trivia provided by Dr. Mike Pascoe: What animal was dissected prior to human dissection becoming common to determine human anatomy?
  • Follow Dr. Mike Pascoe at
    • Twitter: @Mpascoe
    • SnapChat: @Anatomysnap
    • Or search him on Google to find all his social media handles
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