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Tips on selecting great therapists who can get superior outcomes

The biopsychosocial model of pain consists of the following: •  A. Biological •  B. Psychological •  C. Social •  D. All of the above

Choose 2 methods of stress reduction: •  A. Mindfulness Meditation •  B. Eating •  C. Heartmath •  D. Skydiving

When choosing a therapist to treat chronic pain, what do you need to look for? •  A. Current license •  B. Interest in treating chronic pain •  C. Manual therapy background •  D. All of the above

Physical Therapist § BS, MS or DPT

§ Licensed by State

§ Can have post graduate specialties: OCS, NCS, SCS, CHT, etc.

Occupational Therapist § BS, MS or OTD

§ Licensed by State

§ Can have post graduate specialties: CHT, MLD/CDT, BCMH, BCPR, BCG etc.

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Biopsychosocial Model A framework that accounts for the biological,

psychological, and social dimensions of illness and

disease. The biopsychosocial model provides a basis

for the understanding and treatment of disease, taking

into account the patient, his/her social context, and the

impact of illness on that individual from a societal

perspective. The model states that ill health and

disease are the result of interaction among biological,

psychological, and social factors.

Evaluate for mechanical variants that can cause or contribute to pain.

Educate on stress reduction.

Identify pain or pain perception limitations that isolate the patient or keep them from attaining their goals.

§  Muscle Energy Techniques

§  Strain-Counter Strain

§  Active Release Techniques

§  ASTYM

§  GRASTON

§  NeuroKinetic Therapy

§  Primal Reflex Release Techniques

§  Myokinetic therapy

§  Manipulation

§  Dry Needling

§  Craniosacral

§  Visceral Manipulation

§  Manual Lymphatic Drainage

§  Indirect Technique

§  Pain Neutralization Technique

§  Myofascial Referral Technique

§  Postural Respiration

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§ McKenzie

§ Ola Grimsby

§ Functional Movement Screen

§ Blood flow reduction

§ Total Motion Release

§ Neuromuscular Re-education

§ NeuroKinetic Therapy

§ Dynamic Neuromuscular Stabilization

Mindfulness meditation

Heart Math

Visualization

Yoga

Tai Chi

Guided Imagery

Biofeedback

Licensure •  Holds appropriate licensure with the State

Reputation •  No brainer!

Interest in treating patients

with chronic pain

•  NOT someone who is just looking for more referrals

If you are insurance-based •  Is the therapist in the same networks you are?

If not insurance-based •  What is the cost per visit?

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Timeliness •  How quickly can your patient get in?

Consistency •  Will your patient see the same therapist each time?

Treatment •  Find out what the therapist mix is when it comes to manual vs. exercise

Biopsychosocial Model

•  Do they offer skilled relaxation or stress reduction strategies?

Proof is in the Pudding

•  Have the therapist treat you or a member of your staff

Evaluation

Musculoskeletal exam and interview

Structure: Skeleton

Treat and correct with muscle energy

technique primarily

Structure: Cranial

Craniosacral Therapy

Support: Muscle/Fascia

Primal Reflex Release Technique

Pain Neutralization Technique

Myofascial Referral Technique

§  Those manipulative treatments in which a patient, on request, actively uses his or her muscles from a controlled position and in a specific direction against a distinct counterforce.

Leon Chaitow, DO

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CST is a gentle, hands-on method of

evaluating and enhancing the functioning

of a physiological body system called the

craniosacral system-comprised of the

membranes and cerebrospinal fluid that

surround and protect the brain and spinal

cord.

John E. Upledger, DO

PRRT is based on the premise that over-

stimulation of the body’s primal reflexes

creates pain and keeps painful patterns

occurring again and again. These reflexes -

startle, withdrawal, and the protective joint

reflexes are hardwired into the nervous system

of the body for the purpose of survival. PRRT

addresses muscle and joint receptors along

with their spinal modulation.

John Iams, MS, PT

PNT is based on the golgi tendon organ reflex, which is a defensive action

protecting our muscles from injury. PNT uses a specific stimulation, accurate

positioning and light pressure by hand to activate the GTO reflex. The stimulated

muscle relaxes and tenderness of the trigger point is relieved.

Steven Kaufman, DC, LAc

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Any one point in the body has a connection to another point when an exact patient

positioning and angle of pressure is applied. When one of these referral points is

stimulated in an effort to affect an injury or painful area on another part of the body

the results are often remarkable.

Ryan Whelton, DPT

Glide Peripheral Nerves

Nerve mobilization

Active Release Techniques

Indirect Technique

Move Movement-Based Programs

Strengthening

Stretching

Balance

Nerve Mobilization

§  Ability of the nerve to glide during movement

§  David S. Butler

Active Release Technique

§  ART is a hands-on touch and case management system that allows a practitioner to diagnose and treat soft-issue injuries.

§  P. Michael Leahy, DC

Indirect Technique

§  Work at the balance point away from the barrier of motion or away from the restriction.

§  Steve Paulus, DO, MS

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Functional exercise programs to

identify and work with muscle

imbalance.

Once a there is a balance and a

reduction in pain I refer them onto

programs they can continue such as;

yoga, tai chi, Pilates, etc.

After Care I want them to stay involved in movement so depending on their hobbies, activity level and mind set.

§  Walking, Yoga, Tai Chi, Pilates, etc.

Chill

Mindfulness

Heartmath

Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.

John Kabat-Zinn

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§  Coherence is the state when the heart, mind and emotions are in energetic alignment and cooperation. When the physiological coherence mode is driven by a positive emotional state, we call it psychophysiological coherence. This state is associated with sustained positive emotion and a high degree of mental and emotional stability.

§  Dr. Rollin McCraty, Heartmath Institiute

§  Active Release Techniques www.activerelease.com

§  Muscle Energy Techniques www.academyosteopathic.com

§  Primal Reflex Release Technique www.theprrt.com

§  Pain Neutralization Technique www.painneutralization.com

§  Whelton Myofascial Referral Technique https://wheltonmrt.com

§  Craniosacral Therapy www.upledeger.com

§  Nerve Mobilization www.noigroup.com

§  Mindfulness www.mindfulnesscds.com

§  Heartmath www. Heartmath.org

ü  Interest in treating patients with chronic pain.

ü  Has a good manual therapy background.

ü  Uses a functional exercise approach.

ü  Practices relaxation exercises.

ü  Let them treat you.

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The biopsychosocial model of pain consists of the following: •  A. Biological •  B. Psychological •  C. Social •  D. All of the above

Choose 2 methods of stress reduction: •  A. Mindfulness Meditation •  B. Eating •  C. Heartmath •  D. Skydiving

When choosing a therapist to treat chronic pain, what do you need to look for? •  A. Current license •  B. Interest in treating chronic pain •  C. Manual therapy background •  D. All of the above

Contact Information: •  Chuck Renner, OTR, CHT •  chuck@advantagetherapyonline.com •  417-889-4800