Forge | Physical Therapy, Fitness and Health @ForgeFearless

@DerekGriffin86 My question: what happens if your heart rate seems to spike past zone 2. Me & my 13 year old son appear the same. I can walk at an incline fast walk & feel challenged in zone 2, then start "jogging" at the same pace & incline & I'm almost instantly zone 4, despite feeling relaxed

@Retlouping @RaphaelDeLutzel Why not present options to the patient, empowering them to choose. Seems graded ADL or graded deadlifts aren't that far apart...but perhaps "heavy" is the crux of the argument

@MikeMakher @Retlouping ☝️1000%. Internet and social media posts struggle to exist in the gray of life. Thank you @MikeMakher

@shelbymillerpt Placebo/sham surgery & impacts on PT profession, conservative mgt of what is normally considered surgical interv [ACL, massive RTC, hip/shoulder labral tears], [exercise intervention]+osteoporosis, anything that simplifies and structures our assessment & documentation

You know what has shifted from pandemic to endemic: physical INACTIVITY! 52% of adults DON’T meet guidelines for aerobic exercise 16% meet guidelines for strengthening 33% report ZERO leisure-based physical activity 😬🤯 Courtesy of Kathryn Brewer (twitter handle?) @MedBridgeEd

@SeanHagey @RahulSRikhySPT Now we are talking! Gotta meet the needs of the people. Meet people where they are not where you want them to be. And then work together towards a common goal once defined.

@SeanHagey @sunsopeningband @jptlowy Also I think the Innovators Prescription is a worthy read on different models of care in medicine that can be applied to PT

@SeanHagey @sunsopeningband @jptlowy Ethics for sure but it’s not always group vs individual. 7 pts 1 hr billing 1 unit each is ethical billing. Also cost saving for insurance & consumer and profitable for PT while promoting adherence & behavior change. Not every hr or every pt. Also need EMR to handle.

@SeanHagey @RahulSRikhySPT I think this misses the point. Th interventions don’t define us. Futlrther if the other professions are competent then they should have access and it’s up to us to demonstrate value. Otherwise we are no different than those who oppose direct access for PT.

@SeanHagey @sunsopeningband @jptlowy I like ZDoggMDs post on moral injury. I actually think high volume isn’t the issue. I think it’s the lack of ability to adapt and adjust to patient needs. Some patients don’t need as much 1:1. Others do. An issue is managing high needs patients with high volume. They don’t mix.

@MedBridgeEd love your stuff generally...but your security / password requirements for your EMR are cumbersome, over the top and have lead to multiple patients ceasing use of the program. Great stuff is worthless if it’s not used. Please consider revising.

@PBlite29 @AdamMeakins @nwrogers08 @JOSPT The other problem is 2 sessions of advice vs 10 of advice and MT. Advice, education, learning and behavior change take time. Much more likely in 10 vs 2 creating addtl bias for manual. This alone is an easy fix that is sadly overlooked too often

@scotmorrsn @kcrehabexpert @SPTSAPTA I think we are on same page. Recovery time relative to % 1 RM can affect recovery time and thereby impact POC and HEP guidelines, correct? Important also to be able to determine capacity of patient to determine dosage, recovery, et al.

@jmeure Interesting. You bring up clinical behavior & I bring up knowledge. An important distinction. In many ways more frustrating that we may know what to do and aren’t actually doing it. Reminds me of a saying: “Culture eats strategy for breakfast” - Peter Drucker. And to your point:

@jmeure This seems to imply, or at least I inferred some form of comparison of others. As such I felt a healthy challenge was within the framework of your original post. With that in mind I offer some data (a bit old but still valid I think). (But yes, we definitely need to improve!)

@jmeure I interpreted your aversion to #GetPT1st (and comparable campaigns) as a lack of confidence in our profession as entry point providers. My assumption then was your confidence in current entry point providers and an intrinsic belief they are better (on average) than us in the role

@jmeure My bias frames how I read your piece , right or wrong. I read part of it as a lack of confidence in us as entry point providers but having confidence in other entry point providers. While that is a small part of you post it spoke to me.

@jmeure Absolutely. I love the CPGs put out by the ortho section for treatment and prevention (among other tools reducing barriers to implementing EBP). We need to work more towards implementation. But we are not alone in this need. It is not solely or predominantly a PT problem.

@jmeure Enjoy these pieces that challenge us to rethink what we’re doing and how we are doing it (px and SoMe). While attempting to contextualize let’s also recognize we are unlikely to hold other professions to the same standards we hold ourselves. This by itself can be a big blind spot