The Future of Advanced Physical Therapy

With the continuum of advancements in the field of physical therapy, rehabilitation and athletic performance, it’s truly amazing how some of the most innovative methods in the field are expediting recovery, preventing injuries and improving physical performance better than ever before.

I am proud to bring together a prestigious group of the top sports performance physical therapists from across North America to share their most innovative and effective rehab methods that are creating dynamic results for their clients and patients in record time. Here are the best physical therapy methods in the physical therapy industry today, and how to use these methods to expedite recovery and improve performance.

Functional Dry Needling

“Improving ankle mobility with dry needling – The list of sports where adequate ankle mobility is extensive.  A treatment technique that I’ve found to be effective in treating many cases of limited ankle mobility, especially due to limitations in soft tissue/neural tone, is dry needling.  I start by assessing an athletes ability to bring their knee to the wall while keeping their heel on the ground.  I then dry needle their calf muscles (gastrocnemius, soleus, and tibialis anterior) and then retest.  This normally increases the ankle flexibility by 20-30% which is then reinforced with a mobility exercise for the athlete to perform as part of their pre game/practice warmup.”

Jason Shane, MPT, CPT

Owner of Shane Physiotherapy in Vancouver, British Columbia

Preventative Strength Training For The Masters Population

“I’m a firm believer that we don’t LOAD our clients over 65 enough, she taught persons in the 60s, 70s, 80s how to squat, do burpees, work into higher intensities and saw the amazing results! Its a lot easier for your grandmother to get up from a fall if she does burpees – or maybe she just won’t have that fall in the first place! This prompted me to start my PhD in 2015 where I will be comparing different strength protocols in older adults. While in the gym, I also run a “Boomers” program that focuses on prevention and maintaining function into our “Boomer” years. I am proud to announce that I will be starting my own facility in June of this year based off this exact idea.”

Christina Nowak MScPT, CSCS, PhD(c)

Owner of STAVE Off Fitness in Kingston, Ontario

RELATED ARTICLE: “The Masters Athlete

Instrument Assisted Soft Tissue Mobilization (IASTM)

“IASTM is one of my first manual treatments of choice. Why is that? It has less contraindications than joint mobilization/manipulation. Also, many times when recovering from surgery or injury, directly treating the area is contraindicated, or too sensitive to work on directly. You can treat adjacent areas and affect the rest of the chain. In addition, you can still have direct effects to the area under most threat without causing any “danger” signals to the CNS. Finally, you effect a larger portion of the homuculus with IASTM. Skin is the largest organ in the body with many mechanoreceptors located in the underlying fascia. With only a few short days of immobilization or pain, the virtual representation of the body part in the brain, or the homuculus appears smudged or blurred under fMRIs. A major tenet of Modern Manual Therapy seminars – IASTM could have a plausible “neurosculpting” effect on the smudged area through light and novel skin stimulation. This is more likely than breaking up fascial adhesions or scar tissue, since it thousands of pounds of force to stretch only 1% – unlikely under any manual techniquesLastly, it’s effective and saves your hands. Don’t believe me? Here are some studies here, here, here and A quick review on What IASTM is, is not, and what it may beLike ALL other treatments, IASTM is an input, is transient and needs to be reinforced with education and exercise to have lasting effects. Check out EDGE Mobility System here! Coupon code strengthdoc10 gets you 10% off of everything!”

Dr. Erson Religioso, PT, DPT, FAAOMPT

Owner of The EDGE Mobility System in Buffalo, New York

The Emergence of Pelvic Floor Postural Reeducation 

“As a Sports Medicine Physical Therapist that thrives on connecting the entire kinetic chain to truly fix an injury, I treated chronic pain for over 10 years in my out-of-pocket pay practice, where most of my patients had already been to 3 or 4 other practitioners, and the traditional routes of treatment didn’t work. This gave me an outside-the-box approach to treatment. Utilizing knowledge of the body and becoming a mom myself, I turned my focus to women’s health and the pelvic floor. My approach to treating the pelvic floor through the kinetic chain is not only fun, it also produces dramatic results. Alignment and strength of the diaphragm, spine, core, hips and feet are crucial to building a strong foundation for dynamic pelvic floor strength.”

Dr. Sarah Ellis Duvall, PT, DPT, CPT, CNC

Owner of Core Exercise Solutions in Boston, Massachusetts

RELATED ARTICLE: “Peeing During Workouts Is NOT Normal!”

Cupping For Treatment of Soft Tissues

“Cupping is a different soft tissue modality that provides a mechanical sensation to the body which can have a very profound impact to help modulate pain and improve movement. When you think of most soft tissue applications such as IASTM or Active Release, both utilize variations of a compressive force. Cupping on the other hand provides distraction or decompression to the superficial layers of tissue. This helps promote blood flow and neurodynamic mobility to reduce sensitivity of movement. When you combine the mechanical decompression of the cupping tool with movement, it creates a skin rolling effect. The mechanical stimulation of movement plus tissue distraction creates a very sensory rich environment that the nervous system can respond favorably towards.”

Dr. Greg Schaible, PT, DPT, CSCS

Owner of On Track Physical Therapy and Performance in Ann Arbor, Michigan

RELATED ARTICLE: “It Plyometric Training Causing Knee Injuries?”

The Use of Digital Marketing

“We uniquely utilizing digital marketing to reach right at people, at the right time, for the right purpose; using emotional selling and customer centered language to create interesting content that engages, resonates, and connects. Our view is that content is king, marketing is queen, and consistency is key. Consistency is what brings a brand image into focus. Without consistency, brands tend to visualize themselves with a certain identity while customers perceive them with an alternate appearance. Marketing embodies the channels, promotions, placements, and pricing which ultimately leads to product. Product can be content, service, or a physical product. The digital marketing take on product development is that it must communicate a story and a reason. The focal point is “Why?” Why is a product, service, or company in existence? How is it going to do the job, make gains, and kill pains for the customer? What about it, is truly unique? UpDoc Media uniquely practices Physical Therapy by answering these questions with clinical precision, benefiting other PTs and PT businesses for mutual growth and accelerated success.”

Dr. Gene Shirokobrod and Dr. Ben Fung

Co-Owners of UpDoc Media in The Interwebz

Blood Flow Restriction Training

“Blood flow restriction training (BFR) is a specialized form of low intensity resistance training that has demonstrated superior results in muscle growth when compared to traditional methods of low intensity training. Benefits of BFR include increased muscle size, muscle strength, improved bone density, and increases in cardiovascular function. Additionally little to no recovery time is required when performing BFR making it an excellent tool to stimulate growth and rehabilitation.”

Dr. Mario Novo, PT, DPT

Owner of The Lifters Clinic in Nashville, Tennessee

Unconventional Training Methods For Rehabilitation

“Unconventional Training is a training method which utilizes multiple tools of historical origin. Tools like the Sandbag, 2X4, Indian Clubs, Kettlebells and Steel Maces, just to name a few, are challenging the industry norm when it comes to rehabilitation and training programs. These tools are nothing new; in fact, many of them have been around for thousands of years. It has just been in recent time that we have largely forgotten about their unique properties and devastating effectiveness for enhancing movement and performance. These unconventional tools provide quality load and neurological adaption for movement pattern corrections, rehabilitation and many training programs. Unconventional training allows the body to get into particular positions with safer leverage points providing an awesome tool to assist in correcting faulty movement patterns and building explosive strength. One of the greatest things about Unconventional Training is it’s diversity and myriad of exercise and movement options. Implementing these tools into your training and rehab can be quick, easy, and effective!”

Dr. James Spencer, DC, ATC, FIAMA, FMS, SFMA, ART, FDN, YBT, PRI, CFSC

Sports Performance Chiropractor at Dr. James Spencer, LLC in West Palm Beach, Florida

RELATED ARTICLE: “Unconventional Tools For Corrective Exercise and Rehab”

Rhythmic and Reactionary Dynamic Stability, Strength and Stabilization

“I work with a large population of aesthetic based sports (gymnastics, ballet, etc) that requires excessive mobility ranges. Often times the athlete has great control and strength at mid range, but significantly lacks that paralleled strength or control at end range. End range is where they typically have issues related to instability or passive tissue overload, so we need to prepare them for it. To safely return the athlete back to their sport and optimize their performance, they must work strength and dynamic stability at end range. By learning these principles from other practitioners, I adopted using manual techniques for end range strength and rhythmic stabilization drills based on the athletes sporting requirements.”

Dr. David Tilley, PT, DPT

Owner of SHIFT Movement Science in Boston, Massachusetts

The Emergence of Strength Training For Injury Prevention

“While corrective exercises may have their place in physical therapy, we must not downplay the importance of heavy strength training. In order to effectively bridge the gap from rehab to performance, we MUST strive to incorporate more barbell lifts into clinical practice. The problem is, it may not always be feasible to initiate the traditional variations early on. Take the military press for example. In order to perform this exercise, one must possess both adequate shoulder/scapular ROM and thoracic extension. While it may be a great option for those in the later stages of rehabilitation, it could exacerbate issues in the early stages. Implementing an exercise such as the single-arm landmine press can effectively train upward rotation while avoiding potentially painful end-range shoulder flexion. Incorporate barbells in a safe and intelligent manner to effectively bridge the gap from rehab to performance! “

Michael Mash, SPT, CSCS, FMSC

Owner of Barbell Rehab and Performance in Pittsburg, Pennsylvania

RELATED ARTICLE: “The Role of Low-Bar Squat in Post Operative ACL Rehab”

The Improvement of Gross Foundational Movement Patterns

“So that might be an over-exaggeration but the rehab world is moving away from the stretch, smash, and crush mentality when it comes to improving mobility. Instead, we utilize loading to improve mobility. Eccentric focused exercises can profoundly impact performance and isometric holds focusing on maintaining proper alignment can help athletes “own” those difficult positions. The rehab world is also moving towards a more in-depth analysis of WHY certain muscles are tight! Previously we diagnosed tightness in the hamstrings, psoas, and piriformis muscles and simply told people to stretch those muscles. Now we realize that the tension in these muscles can be the result of the body not having proper stability in a region and that muscle tightening as a means of controlling motion. So instead of rolling and stretching these muscles, we are improving their strength and stability.”

Dr. Zachary Long, PT, DPT, CertDN, NASM-PES, BFR

Owner of The Barbell Physio in Charlotte, North Carolina

RELATED ARTICLE: “The Truth About Squat Depth, Injury Rates and The Knees Out Cue”

Prioritizing Strength Training For Rehabilitation and Prevention

“A really important trend with physical therapists recently is a shift in focus from very specific strength training to more general strength training for the purposes of optimal rehabilitation and prevention. We have traditionally focused our exercise selection and loading parameters around either basic therapeutic principles dating back to the early-mid 1900’s (ie. 3×10) or around a very advanced sport-specific model of skill or sport mimicry (I’m avoiding the ‘f’ word here). We are now recognizing that the former is insufficient loading beyond the early phases of rehabilitation and that the latter is just too specific for transfer to anything beyond the specific exercise itself. While each of these types of training still have a place at various phases of the rehabilitation process (and for different purposes), I’m extremely happy to see that therapists are embracing whole body strength training as a method of improving clients’ function over the long term.”

Scotty Butcher, PhD, BScPT, ACSM-RCEP

Associate Professor in the School of Physical Therapy at University of Saskatchewan

Systemized Pre-Training Dynamic Warm Up Protocols

“In the field of sports performance and physical therapy, we have made some huge advancements in the way we diagnose and remediate both movement dysfunction and pain. But methods like self-myofascial release techniques, dynamic based stretching, activation drills, corrective exercise and gross movement pattern development are only as strong as their execution and weakest link when programed individually. The future of gold standard physical therapy practice will have a huge amount of overlap with physical preparation in sports performance through the dynamic warm up sequence. Having a systemized plan that allows synergy between all the best methods that are used to address soft tissue, mobility and motor pattern remediation will allow physical therapists, strength coaches and personal trainers the ability to expedite their “corrective” time in training and therapeutic exercise, allowing a greater amount of time and energy to be devoted to intelligently designed strength and movement based training. Though every pre-training sequence will be specific to the individual client, the way in which we build these programs under the systems umbrella will minimize ineffective movement programming, and maximize the effects of all movements working together as a unit to prepare a client for performance and injury prevention. I have been working on perfecting this system for close to two years, and it will continue to be on the forefront of my focus until the system is released for the public! In the meantime, I will continue to speak on this topic throughout North America in 2016 on this exact topic.”

Dr. John Rusin, PT, DPT, CSCS, ART, FMS1-2, YBT, SFMA, FDN1

Owner of Dr. John Rusin Physical Therapy in Madison, Wisconsin

RELATED ARTICLE: “Why Foam Rolling Doesn’t Do What You Think It Does”

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