the SOAP of my life in DPT school

1: You’ll be wrong sometimes. You’ll be right sometimes. But usually when you’re right, you’re also wrong, so it’s all a wash - make sense? idk

2: Patients are going to say some RUDE shit. Just make sure they don’t say it in front of other patients.

3: Working for free is degrading. I don’t care what your university tells you about how the experience is “priceless”; getting to the end of a 45 hour work week unpaid is actually one of the worst experiences.

4. That being said, it’s true what they say: you learn best by doing something. over and over and over and over

5: You’re might actually miss the safety of the classroom.

6: But there really isn’t anything like walking someone through some painful, shit-ass surgery and hearing them thank YOU personally for your help. Honestly, the first time that happens changes things. 

12.31.17 Hello! I wanted to create a post of physical therapists/ physiotherapists that are awesome enough to share their knowledge through Instagram! As a student, I’m always thirsting for the ‘real thing’. Something I can’t read about in a textbook. New techniques, new approaches to old problems. These people are the real deal, check em out!

  @drjarodhallpt- dispelling myths and taking names

  @physiotutors- a little bit of everything! memes, therex, quizzes, you name it! they also have an awesome YouTube channel by the same name which helped me through musculo

  @drcourtneyconley (chiropractor) I had to make an exception for the awesome women! She focuses on gait mechanics and how foot imbalances can influences other joints ‘up the chain’ Honestly, I learn something new with every post

  @vinnierehab-the go to guy for all things therex

  @thenotoriousdpt- interested in myofascial release? this is your guy

  @ptpintcast- originally a podcast, this was created by Jimmy McKay- a radio DJ turned PT. He hosts weekly podcasts with cool people in the PT world

  @rehabscience- a healthy mix of anatomy, pathology, and therex

  @theprehabguys- couldn’t forget these guys! this account was started by 3 students from USC who saw a need for education surrounding preventative rehab

Do I!!

When I wanted to start doing yoga, I just searched ‘yoga sessions’ into youtube and stumbled upon Adriene’s channel. I really recommend that you start with her Foundations series, as the biggest thing you want to avoid when starting on your own is to learn a pose incorrectly. In this series, each video takes 5-10 minutes to break down a pose and note the places to pay attention to. She also has some great starter routines–in fact, I started out with her 30 Days of Yoga series!

Kinoyoga has some powerful sessions, as well as mind-blowing demonstrations that I just like to gawk at and be inspired by.

Celest is a yoga teacher and a physical therapy student in Australia, so she gives valuable insight into the anatomy behind a yoga pose (and explains why some are not so good for your body, oops) as well as tips on how to deepen your yoga practice.

Fightmaster Yoga has full-length sessions that range from the slow and flexibility-focused to power workouts. This was a new find, and I am liking it so far!

Today I’d love to talk a little about why walking balance pose a major issue for the elderly. Remember that risk of fall in the geriatric population is the reason for increased mortality, morbidity, increased healthcare costs and prolonged hospital stays. A myriad of problems arise from falling, hence prevention of fall is the key and the first step is to improve their balance control.

When it comes to walking balance, we’re focusing mainly on the dynamic balance control (the ability to maintain COG over the BOS when the body is IN MOTION) as opposed to static balance.

Here are some of the factors I find important to understand why the elderly fare poorer in the balance department compared to their younger counterparts:

Poorer vision and hearing

Decreased joint proprioception and kinesthesia

Decreased sensation of the foot (especially in the diabetics)

Cognitive impairment or dementia

Decreased muscle strength of the lower limbs and trunk

Poor posture when walking due to increased incidence of kyphosis (shifting the COM anteriorly)

Poor control over momentum (imagine breaking suddenly from a quick sprint)

Decreased muscle length of the lower limbs

Multiple interaction of drugs (4 or more prescriptive medications)

Orthostatic hypotension

Sarcopenia or frailty

Poorer ability to recover from a loss of balance (e.g. COM perturbated out of BOS suddenly)

Reduced reaction time, poorer reflexes

Elderly tend to walk with their feet wide apart for a greater base of support (BOS) and a slower gait speed as a form of compensation for their lack of balance. Some spends most of their time looking at the ground (which contributes to a stooped posture) to make up for their lack of joint position sense (proprioception - knowing where your body part is in relation to the space without looking) and movement sense (kinesthesia - or knowing in which way / direction your joints or limbs are moving without looking).

Empty Can Test

Forward flex 90°, thumb towards floor. Downward resistance applied.

Weakness = positive 

Supraspinatus injury

Drop Arm

Forward flex 90°, thumb towards floor. Hold against gravity.

Unable to hold = positive

Supraspinatus injury

Infraspinatus Test

Elbow bent at 90° against side. External rotation against resistance.

Weakness = positive

Infraspinatus injury

Hornblower’s Sign

Elbow at 90°, forward flex 90°. Hold against gravity. (Position looks like patient is blowing into a horn)

Unable to hold = positive 

Teres Minor injury

Belly Press

Elbow at 90°, internal rotation, hands on stomach. Posteriorly directed pressure applied to elbows. 

Weakness = positive

Subscapularis injury

Lift Off

Elbow at 90°, internal rotation, hands on low lumbar spine. Hands lifted off back.

Pain or weakness = positive

Subscapularis injury or scapular instability

:(

Do I need people in my life?