Tips For Finding A Rehab Professional

Transcription

1 Tips For Finding A Rehab Professional

2 The Daunting Task of Finding Medical Care Seeking medical care can be a daunting task. Who is best? Are they close by? Do they have experience with my condition? Where do I start? You may be among the lucky few and you ve already found a doctor who you really trust. In this case your doctor may be able to recommend a rehabilitation professional. But we ve found this typically isn t the case. In our clinical practice we re usually NOT the first professionals our clients have seen. And through our website we ve fielded questions from numerous readers, who are likely in the same boat as you, reporting they ve either had poor prior experiences with rehab or just don t know where to get started. Our hope is that this brief Ebook will help take a bit of the guesswork out of choosing a rehabilitation professional. Now, there is no absolute method to find a miracle worker each and every time! But we can help guide you in the right direction. Not All Rehab is the Same If you ve read through any of our blog posts, you may have come across a frequent theme of ours: not all rehab is the same. There are multiple reasons for this. First, there has been very little research into the best methods to rehabilitate the body following diagnosis of spondylolysis or spondylolisthesis. There is more literature describing the effects of bracing on bony healing than there is on the rehab that should follow. So there s not a great guide out there for therapists to refer to. Second, there are multiple professions to consider. A rehab professional could be a Physical Therapist, Chiropractor, Massage Therapist, or other exercise professional. There are differences in training and philosophy between these professions. And each state creates practice laws outlining what types of treatment they can perform. 1 P a g e

3 Beyond the differences between professions, there are differences within professions. A Chiropractor trained at one school will have different treatment theories and skills from a Chiropractor trained at a different school. The same goes for Physical Therapists and Massage Therapists. And here s one more whammy to consider. Rehab is a business. It s highly influenced by insurance reimbursement. So there are business decisions being made that will affect what type of care and attention you get. In order to survive, some rehabilitation companies will play the numbers game -- the more people in the door the more money they can make. Or some professionals may avoid certain types of treatment which may be beneficial to you because your insurance doesn t reimburse well for that treatment. The Three Step Process And for sure, there are more influences why we say all rehab is not the same. So what do you do now? Well, we have a plan for you! We ll outline three simple steps you can take to narrow down the field of potential targets. It s similar to hiring a contractor to work on your kitchen. Would you dare have a contractor come into your home and get started on such a big project without knowing anything about that contractor? You re taking a big risk if you don t interview them first, right? Contractors expect this. That s one reason why free consultations are the norm with kitchen remodelers. You need to view your rehab professional as you would view a contractor. You re investing money, time, and energy into this professional s skills. It s in your best interest to find out what they re all about before you ve invested too much. Make a Commitment to Yourself You want to invest your time, energy, and finances with the right rehab professional. You re going to learn how to determine if a professional is likely to help you succeed. Well, guess what, the rehab professional is scanning you to determine how likely YOU are to succeed, too. The most knowledgeable and talented rehab professional in the world can t help someone who won t help themselves. Rehabilitation is not a passive process. Yes, you will be better off with a knowledgeable practitioner, but it is up to you to follow through with their instructions. Here s another way to think of it. There are 168 hours in a week. The rehab professional you choose is likely to have direct contact with you for maybe 3 of those hours. What you do with the remaining time will make the difference between achieving your goals and continuing a pattern of pain and limitation. 2 P a g e

4 Here s what you need to find out about your potential choice in a rehab professional: 1. Do they assess the entire body? 2. Do they restore movement before building strength? 3. Will they spend adequate time with you? The good news, is that much of this information you may find out by looking over their website! 3 P a g e

5 Step One: Find Practitioners Who Assess the Whole Body Why is it important to consider the whole body? Your diagnosis of spondylolysis or spondylolisthesis means that something happened to your back. In previous articles we ve discussed that spondylolisthesis is most commonly the result of stress to the spine. It s not the spine s fault! There are other issues at play which are creating stress on the spine. If your rehab professional never looks above or below your low back then don t expect to find what s causing the problem in the first place. Gray Cook (physical therapist) and Perry Nickelston (chiropractor) have done a lot to champion the notion to stop chasing pain. Yes, your back hurts, and initial treatment may need to focus on resolving any acute pain. But your long term success ultimately rides on being able to identify the movement issues that lead to pain in the first place. If you don t fix these issues, then you may be much more likely to experience recurrent bouts of pain. There are some options for finding someone whose evaluation principles consider influences from the whole body. Check out any of the websites below to get a start. Because of our clinical experience, we re more partial to practitioners utilizing the FMS and SMFA. Selective Functional Movement Assessment (SFMA) Link - click on the tab for Find Certified Members certified professionals include Physical Therapists, Chiropractors, and Physicians (MD or DO) more information about the SFMA can be found at 4 P a g e

6 Functional Movement Screen (FMS) Link - click on the tab for Find Certified Members certified professionals include Physical Therapists, Chiropractors, Strength Coaches, Personal Trainers, Athletic Trainers, or other professionals who can prescribe exercise The Performance Matrix Link - click on the tab for Find Movement Specialists certified professionals include Physical Therapists, Chiropractors, Strength Coaches, Personal Trainers, Athletic Trainers, or other professionals who can prescribe exercise there are few specialists listed in the United States If no practitioners in your area have additional certification in one of the methods listed above, then don t fret. There are plenty of rehab professionals out there who understand the importance of assessing movement throughout the body even though they haven t completed a certification. Move on to Step Two. 5 P a g e

7 Step Two: Find Practitioners Who Restore Movement Before Working on Strength While utilizing a whole-body approach to evaluating your status is important, it won t amount to much if the rehab professional can t implement a meaningful treatment program. One of the most common findings we see in patients and clients with failed rehabs is exercise programs that put the cart before the horse. Meaning the rehab professional is trying to get you stronger before you ve restored the necessary movement. On your road to beginning to move better, you ll likely encounter the need to free up some movement. Typically, this is the realm of manual therapists (Physical Therapists, Chiropractors, Massage Therapists), but with the rising popularity of foam rolls and selfmobilization you may find a trainer with a good base of knowledge to help you. Here are our recommendations for possible websites to check: Kinetacore Link - enter your city or zip code into the Find a Therapist feature certified professionals in functional dry needling include Physical Therapists, Chiropractors, and Physicians (MD or DO) North American Institute of Orthopaedic Manual Therapy Link - in the About Us tab, you can choose Find Certified PTs certified professionals include Physical Therapists 6 P a g e

8 American Academy of Orthopaedic Manual Physical Therapy Link- click on Find a Member tab certified professionals include Physical Therapists Anatomy Trains / Kinesis Myofascial Integration Link - click on Find a Practitioner at the top of the page certified professionals include Massage Therapists; many Physical Therapists and Chiropractors follow the principles but few complete the rigorous standards for certification University of St. Augustine Link - click on Certification Graduate Listing certified professionals include Physical Therapists the University of St. Augustine also teams with other organizations, such as Advances in Clinical Education, to offer other specialty certifications Academy of Chiropractic Orthopedists Link - certified professionals include Chiropractors Again, this is not a comprehensive list, but it will get you started. Once the available motion is improved, your body will need to know how to control the motion. We ve got to admit though, this is a tricky path to navigate. This is where movement screens and assessments like the SFMA, FMS, and Performance Matrix make progression a little more black and white. In addition to rehab professionals certified in SFMA, FMS, or the Performance Matrix, here are additional certifications that may prove helpful in restoring functional movement: NeuroKinetic Therapy Link - click on Certified Practitioners certified professionals include Physical Therapists, Chiropractors, Massage Therapists, Strength Coaches, Personal Trainers, and other professionals who can prescribe exercise Muscle Activation Technique Link - click on Find a Specialist in Your Area certified professionals include Physical Therapists, Strength Coaches, Personal Trainers, and other professionals who can prescribe exercise 7 P a g e

9 Dynamic Neuromuscular Stabilization Link - click on DNS Certified Practitioners or DNS Certified Exercise Trainers certified professionals in the Certified Practitioners section include Physical Therapists, Chiropractors, Physicians (MD or DO), Athletic Trainers certified professionals in the Exercise Trainers include Massage Therapists, Strength Coaches, Personal Trainers, and other professionals who can prescribe exercise The beauty of this is that you have options. The rehab professionals appearing on one or more of the websites we ve listed have demonstrated they are serious about improving their skills. We do not believe that any one of these certifications or treatment philosophies is better than another. We believe there are different ways of approaching the same situation. So please do not feel that a rehab professional MUST appear on any of these lists. And definitely do not expect a rehab professional to appear on all of these lists! We understand and appreciate that the methods we use are not the only methods that work. The problem is that the methods that work aren t being utilized by all rehab professionals out there. 8 P a g e

10 Step Three: Find Practitioners Who Have Time for You This may be the common sense part of providing rehabilitation: treat your clients the way you would want to be treated. Unfortunately, common sense is lacking in the world of rehabilitation. This relates back to the pressures of running a business. We got into our chosen fields at least in part due to wanting to make a difference in the lives of others. I fully believe the vast majority of rehab professionals would say the same. But all too often, the pressure to make money conflicts with the desire to give you the best care possible. In some sad cases, the almighty dollar completely overrides what s in your best interest. There is no website (that we know of) that lists rehab professionals who do everything possible to put your needs at the front of the line. But you can look for some subtle hints on a rehab professional s website or when you call them. One on one appointments -- This is not a guarantee of great treatment, nor is the absence of it a dagger. But in general, a rehab professional who is concerned only about you is more likely to be successful in getting to the root of your dysfunction. There is no research to back up that claim, just a hunch and a pinch of common sense. I doubt many rehab professionals can remain detail-oriented when their focus is spread between two or three or more clients. The Rehab Professional s schedule -- How often does the practitioner schedule patients? Every 15 minutes, every 30 minutes, every hour, etc? There is no right or wrong, but again think about quality of care and how much attention you will 9 P a g e

11 receive. A practitioner seeing clients every 15 minutes will likely not want to get off schedule. So the quality of your session may suffer. And don t be fooled when companies tout one hour appointments. Just because you are there for an hour doesn t mean you get the practitioner s attention for an hour. You may be pushed onto other aides or techs who don t have the same level of knowledge about your condition as you would hope. Or you may be put onto time fillers that allow the practitioner to leave you while he tends to another client. Use of electrical stimulation, heat, ice, and even a bicycle or treadmill are common time fillers that provide minimal therapeutic value. Cash for Services -- Again, this is no guarantee, but paying cash for services effectively removes the financial influences from the rehab professional. For example, a Physical Therapist s employer has likely made it abundantly clear to the practitioner that certain forms of treatment aren t reimbursed by the insurance as well as others. With many companies focusing on productivity (the amount billed in any given unit of time), the therapist may feel the pinch to provide treatment that pays the best for the amount of time he has available, rather than the treatment that is most appropriate for you. When you pay cash for services (insurance is not billed), the rehab professional is theoretically free to provide the treatment he feels is best because he won t have to worry about insurance denials and such. We put quotes around theoretically though, because we know there are likely some bad apples out there. 10 P a g e

12 You Call the Shots The important thing to remember is that this is all about YOU! YOU deserve to have the best possible outcomes. You can move and feel better! But to get that YOU will have to put in a little research to get started on the right path. Use our three step process as a guide in your search for spondy rehab. The information, links and advice provided can go a long way in helping you move and feel better. 11 P a g e

13 Note: All information provided in this informational guide is free to republish for use on websites, newsletters or informational s provided you give credit to the authors and A special thanks to for the images. PLEASE READ OUR DISCLAIMER: The information and exercise found within articles provided by spondyinfo.com and spondysolution.com is intended for adolescents or adults, whether they are athletes or nonathletes, who have been evaluated by a physician and given the clearance to engage upon an exercise program. The comprehensive exercise concepts presented are designed to benefit a broad group of individuals based on frequently observed movement impairments associated with the diagnosis of spondylolysis and spondylolisthesis. However, the information you read or that is provided by spondyinfo.com and spondysolution.com should not be viewed as an individualized program. Therefore, the exercises described on our website and free information may not be appropriate for every individual. A detailed evaluation by a licensed rehabilitation professional is necessary to create and modify an individualized program. The authors strongly suggest sharing the exercises and information described within our website with your physician or rehabilitation professional to ensure that it is appropriate for your specific level of injury. Athlete Movement Systems LLC / Justin R. Adkins / Michael T. Bitzer All rights reserved. The user of this manual should be cautioned that there is an inherent risk involved by the participant in any form of physical activity, including those suggested in this manual. Anyone participating in any such activity should be cautioned that training initiatives may be harmful or dangerous if performed incorrectly. The authors assume no liability for any injury that may be sustained while performing any physical activity whatsoever, including but not limited to those contained within this manual. Participants in any type of exercise program should consult with their physician prior to initiating the program activities. This manual is intended solely as an educational guide to participants who are already proficient with the demands of physical activity, and who have discussed such activity with a licensed physician. For more information, please contact: [email protected] You can also visit our website where you can read our terms & conditions: Website: spondyinfo.com 12 P a g e