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Re: flexion contracture 6 weeks post TKR

 
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Re: flexion contracture 6 weeks post TKR - November 5, 2006 5:56:00 PM   
rv36116

 

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Only heard of G.Gray because he had an advertisement in JOSPT...

Other than that, not really, ooops I guess.

(in reply to ragempt)
Post #: 21
Re: flexion contracture 6 weeks post TKR - November 5, 2006 6:16:00 PM   
ragempt

 

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well im sure there are other PTs, trainers or scholars who have good ideas on functional training. Carlos Santana and Paul Check are two others who have some great ideas about rehab when the patients are ready to perform on their feet. I just feel that Gary Gray is the man. Rob JOSPT is obviously a great source for performance training.

(in reply to ragempt)
Post #: 22
Re: flexion contracture 6 weeks post TKR - November 7, 2006 3:05:00 PM   
treybien

 

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Has Carlos Santana gotten away from his genious on the guitar to pursue genius in PT??

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Post #: 23
Re: flexion contracture 6 weeks post TKR - November 8, 2006 6:41:00 PM   
ragempt

 

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Ryan, nice come back. look up Mr. Santana (performbetter.com) and go to one of his courses. I promise you will know his name well after. He will change your views on theraputic exercise.

(in reply to ragempt)
Post #: 24
Re: flexion contracture 6 weeks post TKR - November 8, 2006 7:50:00 PM   
PTupdate.com


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Hmmmm. I have my OCS, have read thousands of articles, and cannot say I remember hearing his name (Gary Gray)besides or twice. Not sure if I would yet categorize him as "da man". And, I still use a Cybex machine (go ahead and puke)

John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]

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www.PTupdate.com

(in reply to ragempt)
Post #: 25
Re: flexion contracture 6 weeks post TKR - November 9, 2006 12:24:00 AM   
jlharris


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There are people in my area that will tell you Ron Hruska is "The Man" and express disbelief that you don't practice "his" way or know who he is. LOL

I would love to go to a Gary Gray course, but to say (or imply) a PT is a poor clinician because they haven't is, in my opinion, egotistical and very biased.


*edited to add the "in my opinion" Didn't want anyone to think that was a factual statement :D

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My PT Blog

(in reply to ragempt)
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Re: flexion contracture 6 weeks post TKR - November 9, 2006 6:52:00 AM   
Sebastian Asselbergs

 

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Evjenth anybody? Bookhout? Tony Little? Jake? If you haven't taken courses from them -well, you have missed the boat! Names - gurus - make no difference to the function of a human brain when a person is motivated to learn.

However, falling at the feet of an "authority" in abject admiration REQUIRES the brain to be shut down. And the "believe-the-guru" glands cranked waaaaayyyy up.

It is NOT the messenger - just the stuff they bring that is important.

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Post #: 27
Re: flexion contracture 6 weeks post TKR - November 9, 2006 7:29:00 AM   
PTupdate.com


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Very true Sebastian. It is usually the younger, eager and thirsty PT that starts attending the courses that preach some dogma, often valid, but becomes almost brainwashed. The people that teach these courses are salesmen, and they make some good cash doing this. Therefore, it is in their best interests to say certain things, and then they sent out a bunch of robots that think its the "only way"

For years, this is something I have seen with McKenzie. Two of the best clinicians I have ever worked with were McKenzie instructors, and NovaCare is proud to employ one of the founding members of that institute. However, these guys practice with a myriad of routines, and their outcomes are naturally fantastic. Those that come out with a "McKenzie only" mentality usually fail, and I end up getting their patients (by that time they are usually worse)

John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]

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www.PTupdate.com

(in reply to ragempt)
Post #: 28
Re: flexion contracture 6 weeks post TKR - November 9, 2006 9:34:00 AM   
rv36116

 

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Hmmm, I've seen some of the McK faculty members who teach the courses and use McKenzie only...quite successful and they would probably be quite pissed to see other faculty (even "founding" members) using a box full of different approaches.


Funny thing is, they get all the "failures" from around town too. I have a "McKenzie only" mentality and honestly, it doesn't "fail" because it's major use is as an assessment, not JUST a treatment.


If a PT takes part A, they don't really encompass what McKenzie is about because that's a basic level to just introduce PT's to the concept and basics...

That's what people are missing when they are down on people who use McKenzie and group all of them into the same category. Just because you go to a batting cage and take some practice swings doesn't mean you're ready for the big leagues, know what I mean?

(in reply to ragempt)
Post #: 29
Re: flexion contracture 6 weeks post TKR - November 9, 2006 4:48:00 PM   
Sebastian Asselbergs

 

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Oooh. Now I get it. We are NOT in the big leagues...Oh, wait, didn't I take B and C as well? Yes, and decided not to go on.....

Rob, you must have the best sensors in the world, that you can KNOW what courses people have taken, just by reading their rehabedge posts.....

And is "McKenzie" as an approach so restrictive/cult-like that the teachers would be p***ed off if their colleagues use other PT aspects? My goodness - I think I stopped going further with McK just in time!

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Post #: 30
Re: flexion contracture 6 weeks post TKR - November 9, 2006 10:06:00 PM   
ragempt

 

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Ok i will take your points Sebastian and PTupdate. so if your not really intelligent like me how do you expect one to have fairly decent clinical skills? so your saying if i go to these cources I will be a zombie and just follow in their foot steps? im lost, why is that so bad?

Also Sebastian why so defensive man?

Rodger Evans MPT, OCS, Cert. MDT, COMT

(in reply to ragempt)
Post #: 31
Re: flexion contracture 6 weeks post TKR - November 9, 2006 10:12:00 PM   
ragempt

 

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oh, PTupdate i guess your right i am a younger PT, if that means anything. I mean i have only been practicing for 6 years. just trying to support your comment even though i dont understand why going to cources makes you a non thinker

(in reply to ragempt)
Post #: 32
Re: flexion contracture 6 weeks post TKR - November 10, 2006 1:04:00 AM   
rv36116

 

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Ah well, since it's the internet, you can't hear my inflection and took it the wrong way, bad analogy on my part...

I'm trying to stress that just because some one can take Part A, B, C, D, E, Certified, Dip. MDT, etc... Doesn't mean they're the master at that type of assessment...

Lumping in anyone who tries to use Mck, with success or not, automatically gets everyone who uses Mck into the same category.

Those who teach is and yet use other approaches and teach those other approaches at a Mck course are doing those folks a dis-service. I've heard of course instructors teaching lumbar stabilization at a McKenzie course...??? It's like you take a course to learn english and the guy starts speaking chinese and says "oh, well this is useful to know also, so let's focus on chinese language for a bit..." while you sit there slapping yourself because you want to learn english and learning chinese doesn't help that in any way, shape or fashion...

There are people who use strictly Mck and can fully function as a therapist, but there are also those who do the same thing, and are horrible at it.

McKenzie is an approach where it's all or none, it's not something that you just can toss something in here or there, but to be truly successful with MDT, you have to use it 100%, that is what I'm trying to say and also my personal opinion.

(in reply to ragempt)
Post #: 33
Re: flexion contracture 6 weeks post TKR - November 10, 2006 5:38:00 AM   
SJBird55

 

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Hmm, the only thing that I'm aware of that is "all or none" is an action potential. LOL There are subgroups of patients that have been identified to respond positively and successfully with manipulation... there are subgroups of patients that have been identified to respond positively to lumbar stabilization... there are subgroups of patients that have been identified to respond positively to directional preference. It appears to me that literature seems to dictate that for us to be successful we need to identify the patient and the patient's characteristics and align our treatments with the patient - in other words, following one particular "camp" of philosophy is probably not always going to be the most optimal approach to take when treating patients.

(in reply to ragempt)
Post #: 34
Re: flexion contracture 6 weeks post TKR - November 10, 2006 5:38:00 AM   
Sebastian Asselbergs

 

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O)K Rob, I understand your point better. I can't say I agree with it - but thanks for clarifying.

Ragempt - defensive? Me? Nah, that would take a lot more than what seem like potshots aimed at those "unenlightened" who may have taken McKenzie and found the material lacking....
There is simply NO way that only a mechanical approach is the answer to all patients....

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Post #: 35
Re: flexion contracture 6 weeks post TKR - November 10, 2006 5:41:00 AM   
Sebastian Asselbergs

 

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and remember - if all you have is a hammer - all problems tend to look like nails...

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Post #: 36
Re: flexion contracture 6 weeks post TKR - November 10, 2006 6:01:00 AM   
Sebastian Asselbergs

 

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" so your saying if i go to these cources I will be a zombie and just follow in their foot steps? im lost, why is that so bad?"

Ragempt - because "just following in their footsteps" implies that you don't use your own brain to sift and discern between "beliefs" and "science", that you are unable to read research (see SJbird's post about the subgroups) and that you indeed blindly follow. Your thinking brain is the most important tool you have - why turn it off?

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Post #: 37
Re: flexion contracture 6 weeks post TKR - November 10, 2006 7:43:00 AM   
ragempt

 

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Sebastian every succesful person out there has followed at one time. just because you take a class does not mean you dont think. Your welcome to watch me evaluate a patient if you question my outcomes.

(in reply to ragempt)
Post #: 38
Re: flexion contracture 6 weeks post TKR - November 10, 2006 7:51:00 AM   
SJBird55

 

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Watching an evaluation does not equate to successful outcomes. Rage, the only way to really have any idea of your outcomes is to actually classify patients, collect data, use standardized outcome measures pre-evaluation and then at discharge and then statistically analyze the numbers. I'm sure that there are many therapists out there that believe they have good outcomes - the problem is that one has no idea of actual outcomes without truly looking at the statistical results. Even then, we are slightly biased because the assumption is that the patient made the gains secondary to intervention but without a control there isn't proof which led to the final outcome - the natural course of the process or the intervention.

(in reply to ragempt)
Post #: 39
Re: flexion contracture 6 weeks post TKR - November 10, 2006 8:27:00 AM   
rv36116

 

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Sebas/SJ,

Honestly, do you guys know about the different subcategories of McKenzie? "Inconclusive" which means, it won't be helped by this approach, means get them to someone who can help them or get them ready for a general exercise program.

Derangements are a large part, but there are other categories (dysfunction (contractile/ articular/ adherent nerve root), entrapment/ non-mechanical...)

I won't convince you of anything that's stuck in your mind as the outline of what MDT is. Question for you Sebas, what made you experiment with MDT and go to 3 courses?

(in reply to ragempt)
Post #: 40
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