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Weekly Q & A for the 16% October 27,2019 Podcast
Bill:
Bill Hartman 11:33–14:19
I would caution you against trying to say, oh, this is a sports hernia protocol. I don't think those things exist. I think we have to treat the humans. I can't pronounce this name; it looks like A F H O O G S. So however you pronounce that. This is a student question. So this is exciting. Do you have any advice on handling the current DPT education knowing that much of it is no longer best practices? So that's a really, really strong question. I like this a lot. First, let me throw this out: in physical therapy, there is no such thing as best practices. It's impossible. We're dealing with complexity. At best, what we have are what's called emergent practices. So we don't know what will be the best choice. What we have to do in a complex situation is intervene, then reassess. So you have what is presented—that's our evaluation. We provide an intervention and then we reevaluate for the outcome, and that guides our practice. So that is an emergent type of practice, and so there are no best practices. So right away that's in favor of the PT curriculum in a way, and that they're doing the best that they can. They're trying to provide you with elements of education that they think are reasonable and necessary. Most of the curriculums have to teach a certain way because there's a board's exam that they have to support, which is unfortunate. But I would also default to Max Planck's quote in regards to science progressing one funeral at a time. And so there are people in charge who are driving these curricula. I don't know; my Latin is kind of weak. So they're driving these curricula and they have to do the best they can. I get to talk to some of these academic people regularly just because I have a student every semester, and they are going to pickle too. There are things they have to teach that they don't want to, but I think it's going to be a matter of practitioners like yourselves who will eventually take power. And rather than doing it as we have always done, I would hope that you would start to try to change those things. As a consumer, as a student who is paying for an education, it is also your responsibility to ask questions. And I think that's something that unfortunately gets squelched in academia: that the instructors understand there are things that don't necessarily apply in the real world anymore, but they have to teach them. And so they encourage students not to ask the difficult questions or they're incapable of answering them, just because of the environment they're teaching in, which is unfortunate, because I think when the student is paying an absorbent sum of money, they deserve to get what they pay for. So what I would offer you as a piece of advice is to continue to educate yourself outside of your curriculum. Take continuing education courses as you're allowed to, and you get discounts, which is really nice. But I would also encourage you to try to learn as much as you can with the understanding that there will be information in conflict. And so what this does provide is a very powerful concept called an earned opinion. So when you can argue multiple sides of anything, that allows you to have an informed and earned opinion, which gives you the capacity to see things from multiple sides and allows you to problem solve much more effectively. So let's not look at this as a negative that you're stuck in this curriculum. Let's look at the curriculum as one viewpoint and then this expansive amount of information and education available to you, which will provide you with this earned opinion that eventually will again give you great power in regards to how you intervene with your patients.
physical therapy educationevidence-based practicecontinuing education
Bill Hartman's Coaching Conversation with Andy McCloy Podcast
Bill:
SPEAKER_01 0:54–0:56
Your daughter looks very young.
The Bill Hartman Podcast for The 16% - Season 15 - Number 9 Podcast
Bill:
Bill Hartman 2:07–2:16
Yeah, so everything is going to compress anterior to posterior at the, keep in mind it's a twist, right? You understand that we're turning?
biomechanicsspinal rotationcompression mechanics
The Bill Hartman Podcast for the 16% - Season 16 - Number 3 Podcast
Bill:
UNKNOWN 0:39–0:39
Uh huh.
The Bill Hartman Podcast for the 16% - Season 16 - Number 2 Podcast
Bill:
Bill Hartman 0:49–0:52
We want to go over the entire book of respiratory physiology.
respiratory physiologybreathing mechanics
The Bill Hartman Podcast for The 16% - Season 17 - Number 6 Podcast
Bill:
SPEAKER_07 0:48–0:50
I guess early, but I'm just trying to see the difference.
pelvic mechanicsinternal/external rotationinfrasternal angle
The Bill Hartman Podcast for The 16% - Season 18 - Number 2 Podcast
Bill:
SPEAKER_02 1:34–1:40
I'm not practicing anymore. OK, but what was your what was your art? What did you what did you study?
The Bill Hartman Podcast for The 16% - Season 18 - Number 1 Podcast
Bill:
SPEAKER_01 3:47–3:57
My sumo deadlift is like 30 pounds to 50 pounds heavier than the conventional. Yeah.
deadlift techniquesumo vs conventionalbiomechanics
The Bill Hartman Podcast for The 16% - Season 17 - Number 10 Podcast
Bill:
SPEAKER_03 1:29–1:31
In this particular scenario. I'm with you. OK. Now I understand. But so I assume you can end up with some excessive yielding that allows the expansion while also some scarring down that prevents the movement.
abdominal expansiontissue restrictionmovement impairment
The Bill Hartman Podcast for The 16% - Season 17 - Number 9 Podcast
Bill:
SPEAKER_05 2:50–2:50
OK.
The Bill Hartman Podcast for The 16% - Season 17 - Number 8 Podcast
Bill:
Bill Hartman 1:16–1:17
A lot.
bone compressiondifferential movementearly representationlate representation
The Bill Hartman Podcast for The 16% - Season 15 - Number 7 Podcast
Bill:
SPEAKER_02 0:34–1:03
No, it was folded and clean. It just did not make it back into the drawer. All right, so I have a question. Like just trying to refine the process that got me to an outcome a little bit. So I went to this patient once with their economy for low back pain, pretty much like anything where she had to assume like a flex posture. So toe touch was the main KPI that we were using. It was painful.
low back painflex postureKPIoutcome refinement
The Bill Hartman Podcast for The 16% - Season 15 - Number 6 Podcast
Bill:
Bill Hartman 3:53–4:02
Just on the medial border of the patella, if I press there, it hurts. And it keeps that hanging right in that 60 degrees of hip flexion.
medial patellahip flexionknee pain
The Bill Hartman Podcast for The 16% - Season 15 - Number 5 Podcast
Bill:
SPEAKER_05 1:43–1:49
See if Lalo comes back on. See if it works.
The Bill Hartman Podcast for The 16% - Season 15 - Number 4 Podcast
Bill:
SPEAKER_02 2:25–2:41
Right to left. I'm with you. By pushing off the right side, reloading it and moving the center mass to the left, that allows the right side to achieve the orientation. That allows the left side to come down lower than it.
weight shiftcenter of massorientationbiomechanics
The Bill Hartman Podcast for The 16% - Season 15 - Number 3 Podcast
Bill:
SPEAKER_03 2:55–2:55
Okay.
The Bill Hartman Podcast for The 16% - Season 15 - Number 2 Podcast
Bill:
Bill Hartman 2:35–2:36
You are.
biomechanicsproprioceptionenergy storage
The Bill Hartman Podcast for The 16% - Season 15 - Number 1 Podcast
Bill:
SPEAKER_03 2:24–2:32
When I say turn, that's implying like a real turn. A better word would be like he's really oriented to the left.
spinal movementorientationlumbar mechanics
The Bill Hartman Podcast for The 16% - Season 14 - Number 10 Podcast
Bill:
SPEAKER_03 2:13–2:23
I apologize, and he has a question. I had to come to Europe to get up at a reasonable time for these calls.
The Bill Hartman Podcast for The 16% - Season 14 - Number 9 Podcast
Bill:
Bill Hartman 2:46–2:48
Okay.
The Bill Hartman Podcast for The 16% - Season 14 - Number 8 Podcast
Bill:
SPEAKER_04 3:52–3:57
She did not, but she had the knee ACL operated a few years back.
ACL injuryknee painbiomechanics
The Bill Hartman Podcast for The 16% - Season 14 - Number 7 Podcast
Bill:
UNKNOWN 3:56–3:57
Like a ramp.
The Bill Hartman Podcast for The 16% - Season 14 - Number 6 Podcast
Bill:
Bill Hartman 4:06–4:08
My sacrum is going to be left, yeah.
sacrum movementbiomechanicsweight distribution
The Bill Hartman Podcast for The 16% - Season 14 - Number 5 Podcast
Bill:
SPEAKER_00 5:51–6:11
I was just thinking because the scoliotic patients that I get to work with are all narrow. So I was just thinking maybe they're more biased because they're looking at force production, how to produce the force into the ground.
scoliosisforce productionnarrow stance
The Bill Hartman Podcast for The 16% - Season 14 - Number 4 Podcast
Bill:
SPEAKER_07 3:51–3:55
So fix the apex. Okay.
sacral mechanicsiliosacral jointpelvic rotation
The Bill Hartman Podcast for The 16% - Season 14 - Number 3 Podcast
Bill:
SPEAKER_05 3:40–3:42
Like at their belly?
respirationrib mechanicsbreath expansion
The Bill Hartman Podcast for The 16% - Season 14 - Number 2 Podcast
Bill:
SPEAKER_09 2:10–2:10
Yes.
The Bill Hartman Podcast for The 16% - Season 14 - Number 1 Podcast
Bill:
Bill Hartman 2:00–2:14
Until you hit the bottom. And you said the reduction of the muscle activity will increase the yielding potential of the connective tissue.
muscle activityconnective tissuesquat mechanicsmotor output
The Bill Hartman Podcast for The 16% - Season 13 - Number 10 Podcast
Bill:
SPEAKER_03 2:35–2:38
You said depth. I'm sorry.
squat mechanicssacrum movementilium movement
The Bill Hartman Podcast for The 16% - Season 13 - Number 9 Podcast
Bill:
SPEAKER_04 3:25–3:25
Okay.