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Muscle Cramps!

Tetanus
I have a penchant for enjoying things that are often ubiquitous, yet poorly understood.  The human body is ripe with these topics.  Among my favorites are delayed onset muscle soreness, muscle fatigue, and muscle cramps. 

Muscle cramps are often extremely painful and debilitating.  I remember struggling with quadriceps cramps more than one time while cycling.  The worst time was on the return leg of a 80 mile trek through the mountains (relative, I know, but surprisingly steep) of northwest NJ on a hot summer day.  The cramps began at mile 42.  I remember completing the rest of the ride in fear because a feature of muscle cramps poorly appreciated among non-cyclists is that when you do cramp, your foot is mechanically secured to the pedal.  Avoiding a crash and somehow gaining enough control of your tetanic leg to unclip from your pedals is a true miracle!

I enjoyed this recent article in the New York Times, which provides a nice overview of some competing theories behind the daunting muscle cramp.  Featured in the article is one of my colleagues at the Medical College of Georgia, Dr. Michael F. Bergeron, who runs the environmental physiology lab and calls the physical therapy department his home.  He discusses a specific type of cramp related to excessive sweating. 

Dr. Bergeron, incidentally, had an enviable week in the media, also making an appearance in a Times Magazine article, "Little Athletes Big Injuries."

The next time you have a muscle cramp, perhaps thoughts of the scientific wonder that they are will help ease your suffering. 

Yeah, right!

ERIC

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The Big Rip-Off

Linking to this NYT’s editorial about the lawsuit between the State of NY and Ingenix seems the thing for PT blogs to do today, so I will not disappoint.

"Mr. Cuomo and the American Medical Association, which has a
long-standing suit filed against Ingenix and various UnitedHealth
companies, claim that the data is manipulated. They claim that health
insurers and Ingenix disproportionately eliminate high charges, thus
skewing the numbers for customary charges downward."

But NPA is a Think Tank, and so linking to this editorial is simply not enough.  We need an original thought on the topic.  Here it is:

Where is the APTA on this lawsuit?  Jump on board with the AMA and, in an act of altruistic cooperation, invoke reform of the slimy health insurance nation that surrounds us.

Am I asking too much?  Maybe.  But I’m please to see this issue getting some press.
ERIC

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Physical Therapists Now Eligible for Debt Relief

Last week legislation was approved to finally include physical therapists in the list of health

providers eligible for student loan forgiveness.  

"This amendment provides valuable incentives to enter the profession of
physicalDebt_2 therapy and help meet the high demand for physical therapists
that exists across the nation," said American Physical Therapy
Association (APTA) President R Scott Ward, PT, PhD. "Physical
therapists often begin their careers with significant levels of student
loan debt. Offering forgiveness will help enhance physical therapy
availability for children, adolescents and veterans, and provide
lasting health benefits in these areas."

Indeed!  Physical therapists, does this legislation effect you?  It doesn’t help me, but I am only one.  Check in with a comment!

ERIC

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The National Wiihab Crisis

Dunce
Most news articles on physical therapists can be found in newspapers by the following categorization:

"Newspaper name / world news / national news / health news / local news / physical therapy news"

No longer, as I found this headline under the "world news" category in the  Atlanta Journal Constitution:

"Forget rehab, try Nintendo Wiihab"

Yikes!!! World news?  Forget Rehab?  Yes, Wiihab is surely helping our professional branding now, isn’t it?

Let’s put a hypothetical example forward.  I’m a random guy with a business background, perhaps a personal trainer, and a half-dozen Nintendo Wii systems.  I’m not a licensed physical therapist, but still I decide to open a Wiihab Center.  I’m not doing physical therapy, I’m not billing for physical therapy…I’m doing "Wiihab."  Wiihab is exercising with a Wii, surely not the intellectual or professional property of the physical therapy profession.  I’m now free to invite all those injured patients who have read about Wiihab in to exercise at my singlularly branded Wii-clinic.

Is this was all those clinics getting press about Wiihab are hoping for?  Obviously, not.  But as Wiihab gets a national branding and enterprising individuals realize that anyone can open a fitness center, how can they stop it?  Won’t they feel like a dunce when a Wiihab shop opens up next door and bills cash at a higher rate than physical therapy reimbursement for therapeutic exercise!

Will the APTA and state chapters spend thousands of legislative dollars trying to get Wiihab added to practice acts, to prevent chiropractors and athletic trainers from performing Wiihab?  I sure hope not.   

The Wiihab crisis…it could be just the beginning.
ERIC

p.s.  I’ve added a Wiihab category to the blog to track my posts about this next big thing in rehab!

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Who Cares About Their Physiotherapist?

Ronaldo
Ronaldo does.  Seen here trying desperately to stabilize his patella after he tore a tendon in his left knee, which has put the career of the soccer star in jeopardy. 

"That will depend not only on the surgery, but also on physical therapy
and the motivation of Ronaldo – currently 31 years old – to return to
high-level sports.” a Paris hospital reported.

Physical Therapy…Paris…not Physiotherapy?  Hmm. 

Am I the only one who wishes American PT’s were called physiotherapists as the rest of the world refers to us/them?  Perhaps having a profession that was it’s own word would reconcile many of the branding and legal problems encountered by naming a profession simply by combining an adjective and a noun that are used 10 million other places in the English language.

Here’s to the American Physiotherapy Association.  (APtA)
ERIC

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"Wiihab" Hurts my Brain!

ArtwiirehabapI’m still conflicted about this whole Wii-physical therapy link.  One side of me cringes when the concept of Wiihab has become so pervasive that, indeed, a phrase has been coined.  One side of me asks, "Is it so bad?  Maybe it’s professional insecurity creeping up on me that drives my discontent related to Wii-habilitation?"

I do know that I have almost completely stopped reading my Google News "physical therapy" feed.  It seems like for any 20 articles about physical therapy, 19 of them are about this clinic or that clinic using a Nintendo Wii. 

This is not my first post about the conflict the Wii presents.

I was glad to see Science Blogger, Karen Ventii brings this up on her blog, Science to Life.  She points out the lack of science behind the use of the Wii, and even points us to a pending study on just that topic.  She has a nice video parody of Wiihab linked in as well.

The thing is, I don’t care if there is science that says a Wii produced good results in a physical therapy setting.  I really don’t!  Here is why:

Movement, coordination, muscle control, etc., all combined is not a new concept for physical therapists.  We know how these principles impact healing and outcomes, which is why function and active-based treatments are the hallmarks of physical therapist treatments.  Exercise with a Wii, my friends, will only ever be functional for helping people to play the Wii. 

If you, as a patient, suffer from such disinterest in your health and how your body works that you need a toy to provoke interest in healing, I say, "Shame on you!"

And will all those articles on Wiihab please also mention two things:  1)  The clinic in this article is looking for gimmicky, cheap press, and, 2) physical therapists (good ones, at least) do not provide painful, dreadful treatments that are so awful as to require a parlor trick to enable a patient’s endurance of said treatments!

Come on, Wiihab providers!  Are you physical therapists, medical professionals with a doctorate-level education and significant musculoskeletal expertise, or are you a sideshow performer interested in games and cheap thrills?  I guess it depends on whether you give out stuffed animals to patients who beat the video games prior to discharge!

I guess I’m less conflicted than I thought on this…

ERIC

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Not Just Clothes, Performance Enhancing Clothes

Phelpsspeedo

FanHouse checks in with this little bit about the fancy new swimsuits to be worn in the upcoming Olympics, and how Michael Phelps describes them as the best swimsuit ever made.

“It literally feels like you are a rocket coming off the wall,” said Phelps.

This makes me think of poor Oscar Pistorius.  At what point does technological clothing provide enough of a competitive advantage to warrant it an "unfair advantage" that Pistorius is proposed to have? 

I know, many countries will have access to the suits, which is different from a double amputee except for the most dedicated of competitors.  If running on prostheses was such an advantage, why doesn’t every sprinter have a surgeon and a stump wrapper in their contact list?

But just because everyone has the suit, it still  raises a question of competition.  Perhaps the swim suit could also come with flippers.  Should all the marathon runners ride motorcycles this summer?

It might not be a bad idea considering the expected air quality in China!

ERIC

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Article Chronicles Poor State of Business for PT's

I can’t believe I read this in the actual news…one not written or published by a PT, that is.

"At least 10 outpatient physical therapy clinics across Southwest
Florida have closed since midsummer as a trio of trends has sapped the
businesses’ income."

The article goes on to give an excellent summary of the state of the PT union, including some notes on big mergers, Stark laws, Medicare caps, and the works. 

"If you’re going to do things the right way, what is best for the
patients and the ethical way, you’re going to lose a lot of money,"
said Karen Fitzpatrick, account Specialist for Bay Area Physical Therapy & Wellness.

The APTA even makes a slightly weak appearance as physician self-referral is discussed.

ERIC

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Paperless!

Paper
I really like this piece in the NY Times about one person’s quest for a paperless home.  I never have liked paper, it creeps me out a bit.  Think about this quote:

“Paper is no longer the master copy; the digital version is,”

I consider this a very valid point and one to consider in my own profession.  Electronic medical records have been adopted very slowly by physicians, but perhaps even more slowly by physical therapists. 

Going digital can have many benefits for a business in terms of storage, efficiency, and increased organization.  Data can be found only when it is needed, and virtually hidden when it is not.  That’s just perfect, no?

As delightful and warming as this image is, for me it would be more pleasing with a nice, slick, minimalist laptop.  Unless it was fine linen paper, I secretly still enjoy that.

Is your physical therapy clinic digitized?  Has anyone experienced a health care provider’s office with a complete electronic medical record?  I wish I have.

ERIC