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I’ve posted this before, but tissue healing times are extremely important to know/understand to be able to set appropriate expectations so it’s worth sharing again!
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Repost @dr.caleb.burgess
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Healing Times
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One of the most common issues I encounter when helping people recover from an injury or from surgery is of the healing times of various tissues. Everyone wants to be better NOW, but this isn't realistic. Tissue healing takes TIME. We can't rush it. And it's important to understand that tissues heal at different rates depending on their physical makeup and blood supply, among other things. Additional contributing factors, such as diabetes, age, poor nutrition, inadequate rest, etc can further delay the healing process.
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This chart shows the AVERAGE range of healing times for various tissues in the body, including different grades of tissue injury for muscles, tendons, and ligaments. It can serve not only as a guide but also a reminder that we can't force our bodies to heal faster than physiologically possible. What we can do is OPTIMIZE the healing process by rehabbing appropriately, eating high quality food, getting adequate rest, and staying PATIENT and POSITIVE throughout the journey.
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❤️ SAVE this chart as a reference and TAG a friend recovering from injury who could use it too! Questions? Comments? I'm happy to help!
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Axe, M. J., & Shields, C. L. (2005). Potential Applications of Hyaluronans in Orthopaedics. Sports Medicine, 35(10), 853-864.
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#evidencebasedmedicine #researchbased #goodtoknow #heaingtimes #clinicalathlete
This is a statin conversion post that I posted last winter. It seemed to be helpful..so I figured I’d redo it for those of you that just started following me over the last few months.
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#pharmd #pharmacy #pharmacist #pharmacystudent #medlife #pharmacyschool #pharmacytech #medicine #medstudent #medschool #studentdoctor #familymedicine #physicianassistant #pastudent #paschool #nursepractitioner #nurse #nursingschool #nursingstudent #evidencebasedmedicine #learneveryday #garyvee #internalmedicine #continuingeducation #pharmacology #pharmacotherapy #clinicalpharmacist #medicalpodcast
Let’s talk about one of my FAVORITE labor tools: peanut balls!
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If you are not familiar with peanut balls, you have GOT to hop on the train! There was a study done in a hospital from 2009-2010 that looked at the effectiveness of peanut ball use with an epidural.
➡️ The control group: consisted of about 100 people who did NOT use a peanut ball
➡️ The study group: consisted of about 100 people who DID use a peanut ball
➡️ The results: the control group had a cesarean rate of 21%, whereas the study group had a cesarean rate of 10%! The study group also had reduced labor and pushing times!
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Peanut balls work to expand our pelvis and passively stretch our muscles, allowing for babies to move down in the pelvis. Here are some great positions that you can try:
1. Squatting: great for laboring down/letting gravity and the force of contractions push your baby down!
2. Hands and knees: a great way to stay comfortable in hands and knees. Can help with pain of labor, or for babies in an OP position!
3. Fire hydrant: place one leg up on the ball in hands and knees position and switch about every 20 minutes. Great for OP babies!
4. Side lying: opens pelvis and helps baby move down. Great for people with epidurals!
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Peanut balls are one amazing way to help progress labor and potentially prevent a cesarean birth. Want to learn more ways to promote vaginal birth and potentially prevent a cesarean? That’s what’s what my entire podcast episode this week is about! Check out my bio links!
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P.S. shout out to my amazing model, @ikaria_integrative_health
Pain is not the only way we measure your progress in rehab.
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@dr.caleb.burgess has put together a fantastic list of other ways you can measure your progress in rehab and in training.
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Progress
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Measuring progress when dealing with pain can be tricky, confusing, and frustrating. However, this is what we in the rehab field deal with EVERY DAY
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Commonly, patients and clients become frustrated with "lack of progress", as their pain remains despite working hard to improve during the rehab process
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However, many times the experience of pain makes it difficult to recognize ACTUAL progress that IS occurring!
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As illustrated, pain may stay similar in INTENSITY (e.g. 4/10 on a 0 to 10 scale), but if you now can perform MORE of an activity without having to stop, THAT is progress
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If your pain comes on less often (decreased FREQUENCY), say 3 days out of the week rather than all 7, THAT is progress
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If you can do MORE of an activity before the pain comes on (e.g. starting after running 10 miles, not 2 miles), THAT is progress
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If you can do MORE sets of an exercise, although the weight and reps are the same, THAT is progress
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✅ And so on...
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That is why I made this graphic. The list is not "All-inclusive", but the point is to illustrate the many different ways that you can measure PROGRESS during the rehab process
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Pain sucks and can make you feel like you aren’t making progress...even if you are
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Spend more time focusing on how your FUNCTION is improving, not just on what your pain levels are
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You'll see that once you start doing this consistently, your pain will have LESS power over you, putting YOU in control
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I hope you found this helpful!
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⁉️ If you have any questions, leave a comment or send me a message
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Interested in:
Online physical therapy?
Movement analysis?
Personal training?
Performance enhancement?
Send me a message ✉, email , or click the link in my bio
Our bodies are amazing and adapt to the demands placed on it.
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I’m a fan of Jefferson curls, not only for gymnasts but for everyone. As long as you progress slowly with the movement and with the load added, I don’t see any problem safely integrating these into any patients plan of care (without destroying the disc integrity).
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But like this post says, if you jump right in and try to load as much spinal Flexion as a gymnast too quickly you can obviously do more harm than good.
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GRADUAL graded exposure is the name of the game for anything to be safe!
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Repost @squat_university
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Is ALL back flexion dangerousLet’s talk about it...
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If we look deep in your spine each disc has an inner nucleus that is surrounded by layers of collagen rings held together by a ground substance, that can adapt over time to the forces place on it.✅
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Gymnasts focus a lot of their core work with exercises that move the spine through full ranges. Over time this adapts the collagen rings to become more flexible and resilient to safely handle skill work that requires forced end range of flexion.♀️
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In order for powerlifters to lift massive weights and maintain the integrity of the spine, the collagen rings adaptively stiffen making them very resilient high loads of compression and back movement. For this goal, the core with exercises to resist excessive movement.♀️
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If the powerlifter trained like the gymnast, they weaken disc structure, eventually inviting a disc bulge into the picture as the nucleus becomes pressurized under compression and works its ways through cracks in the rings.❌
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Core work must be meet the movement and load demands of an individual’s sport, allowing the body to adapt to their one or the other. This is a reason why the Jefferson curl that attempts to load the spine in flexion (a mixture of both ideologies) is usually not a good idea for most people.❌
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Big shout out to Dr. Dave Tilley @shift_movementscience for the collaboration in making today’s post, @3d4medical for the visual of the body from their complete anatomy app & the following athletes featured today: @kylie_gorgenyi, @sheepdawgst & @thevanillagorilla92
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My patients know I will do manual therapy when appropriate but this takes up an extremely small portion of a treatment session as I’m a much bigger fan of getting people moving & being active.
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Repost @dr.caleb.burgess
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Passive Treatment
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Passive treatment = things done TO you
Active treatment = things YOU DO for yourself
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In the rehab and recovery world, there is often much debate regarding whether passive forms of treatment should or should not be utilized
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Personally, I don't see anything wrong with passive treatment from time to time as long as:
It FACILITATES and promotes ACTIVE treatment approaches as the primary form of rehab, not REPLACE them
The NARRATIVE (how it's described) that is used when utilizing it is informed by the best available evidence
The patient/client feels more EMPOWERED to take an active approach, not the opposite
The patient client understands that it is being used for a TEMPORARY or SHORT-TERM benefit, not a LONG-TERM SOLUTION
It promotes INDEPENDENCE, not RELIANCE
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At the end of the day, the one thing that all treatment and rehab approaches have in common (passive and active) is that they affect our NERVOUS SYSTEM in a way that may help us on the road to recovery
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Some approaches may work better for certain individuals, while others will do better with a different approach. What determines this depends on a variety of COMPLEX FACTORS, including personality type, beliefs, biases, previous exposure, as well as many others
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In my opinion, saying that ANY sort of passive approach to treatment is a bad thing is missing the big picture. However, it should never be the primary means of treatment for LONG-TERM IMPROVEMENT
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The BEST treatment/rehab should be primarily ACTIVE and serve to achieve one's ACTIVE functional/activity-related goals, should EMPOWER the person performing it, should promote INDEPENDENCE, and should be served with a heavy dose of evidence informed EDUCATION
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♂️If a little bit of passive treatment helps FACILITATE this process along, I'm all for it!
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Shoutout to @strengthcoachtherapy for the video compilation
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⁉️What is YOUR opinion on this? I'd love to discuss! ⬇️
Metformin is considered first line treatment for type 2 diabetes by both the ADA and the AACE guidelines. It works in a few different ways. The diagram pictured shows metformin entering the hepatocyte. It disrupts mitochondrial oxidative phosphorylation by inhibiting the respiratory-chain complex I. This increases the AMP:ATP ratio. The increase in AMP blocks the activity of fructose-1,6-bisphosphatase which is a key enzyme in gluconeogenesis. This leads to the decrease in hepatic glucose production. The increase in AMP also leads to an increase in the enzyme AMP-activated protein kinase (AMPK). This decreases lipid synthesis and leads to an increase in insulin receptor sensitivity. There is also new research that showed metformin is highly concentrated in the intestine. This accumulation may increase the secretion of GLP-1 and peptide YY. These peptides would act systemically to decrease glucagon production and increase glucose-dependent insulin secretion (Diabetes Care 2016:39).
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#pharmd #pharmacy #pharmacist #pharmacystudent #medlife #pharmacyschool #pharmacytech #medicine #medstudent #medschool #studentdoctor #familymedicine #physicianassistant #pastudent #paschool #nursepractitioner #nurse #nursingschool #nursingstudent #evidencebasedmedicine #learneveryday #garyvee #internalmedicine #continuingeducation #pharmacology #pharmacotherapy #clinicalpharmacist #medicalpodcast
Today’s word(s) of the day is CPAP. If you’re new to the game, CPAP is Continuous Positive Airway Pressure. In caveman terms, forces air into the lungs to keep them open, open them up more, or shove out that pesky pulmonary edema. Useful in CHF, dyspnea, respiratory distress, or diminished tidal volumes. If your pt has never used it, ya might want to coach them through it, as it can feel claustrophobic or suffocating. You can also get an inline neb going, too. And I don’t want to hear about how BiPAP is better, because I already know. Get to know how it’s set up and it’s contraindications.
Sesame Street will return after theses messages.
#emt #paramedic #bls #als #ems #911 #evidencebasedmedicine #lightsandsirenstoeverycall #keta_m_e_m_e