A Unified Body and Mind Approach for Trauma Recovery and Healing with Bryan Maynard

Sensorimotor Psychotherapist Bryan Maynard shares his personal journey to address his childhood trauma by listening to his body.

By the age of six, fighting had already become a way of life for.Bryan Maynard. Growing up in Appalachia, he was raised by an abusive father and surrounded by a cultural imperative to fight for honor. 

The trauma of that time became a distinct part of Bryan’s DNA. Anxiety filled his daily life and he began to repress the anger he felt toward the family life that hurt him deeply.

“When you are terrified of the people who you want to lay against their chest and should receive their comfort,” Maynard said. “There’s an energetic storm of wanting to reach for safety and shutting [that impulse] down that tornadoes inside your nervous system.” 

Maynard survived that trauma and moved away from home. But, it wasn’t until he listened to both his mind and his body that he was really able to address his past.  In this episode of Powering Health and Wellness with RPM Rehab, Maynard shares how he went from a patient of sensorimotor psychotherapy to a practitioner.

Addressing the trauma

For years, Maynard tried to adapt to his trauma by being task-oriented. He was driven to succeed as an athlete, then later in his career – but he wasn’t taking time to address all the residual anger he carried around.

The more he tried to ignore his trauma, the more the urge to be violent bubbled up in him.

“It’s just right under the surface. It’s right there,” he said. “I was anxious all the time. I was having headaches. I was having back pain…I had gastrointestinal issues. I had trouble sleeping because of the pain.”

He began going to counseling – where the mantra was ‘Change your thinking and your feelings will follow’. He tried it for more than two years including time as an in-patient. But, the symptoms of his trauma just kept coming back. 

“I got some bandaid with that counseling,” he said. “But I could not change those physiological reflexes by just changing my thinking.”

At the age of 40 – facing the possibility of divorce – he began to look for other solutions. As he was studying psychotherapy, he started to look for something that addresses the whole person.

That’s when he found what he was looking for: sensorimotor psychotherapy. He finally had answers for how the trauma affected his physical self, not just his emotional self. As he experienced sensorimotor psychotherapy himself, it validated everything he felt throughout his life.

“It was like…we had walked into some sacred room in my body that said ‘Let me tell you what it was really like’,” Maynard said. “But not with your brain – not your talking brain. Let your body talk.”

What is sensorimotor psychotherapy?

Sensorimotor psychotherapy is an approach to trauma treatment that takes the whole person into account. It takes the time to break down the physical impacts – not just emotional pain – that Post Traumatic Stress Disorder (PTSD) can have on an individual. The approach is useful for victims of traumatic accidents and injuries as well as psychological trauma.

At the center of the practice is the connection of thoughts and physiological reactions.

“The observing part of the brain goes offline,” he said. “And you’re triggered, and now your body actually knows something while the other systems are not allowed to talk.”

In this body-oriented approach, the mind isn’t pitted against the body. Instead, a therapist is attuned to the physical reactions of the patient and shares those experiences. 

“In that shared state, [the pain] reorganizes somatically,” Maynard said. “At a level where it’s like ‘Oh, I kind of think I understand what it feels like for someone to take care of me.’ Which I had never had before.”

Some trauma is just too deep to be verbalized or understood by our thinking brains. But as a patient experiences a constriction in their throat or pain in their chest, it speaks for them.

Trauma in the body

When someone experiences trauma, it buries deep in their bodies. It’s in their neurons, in their subcortical thinking, in their muscles. 

And, trauma doesn’t look the same for everyone. A spectrum of experiences fits into that small word.

“You don’t have to have a story like mine to have your sub-thinking, your brain stem, hold shame,” he said. “We don’t work just with PTSD, we work with the daily stuff that happened.”

We all carry things that can have an impact on our bodies. It doesn’t have to look like Maynard’s story to merit treatment. Negative feelings around our identities pervade our culture.

“Shame is underestimated,” he said. “It’s not just ‘at my core identity, I don’t feel like enough.’ It’s visceral.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

Spine Surgery, Patient Engagement and Collaboration with Rehabilitation Professionals with Neurosurgeon Dave Atteberry

Neurosurgeon Dr. David Atteberry discusses state-of-the-art spine surgery and shares how he engages with patients and collaborates with physical therapists to deliver compassionate care while achieving strong outcomes.

From the time he was in kindergarten, Dr. Dave Atteberry knew what he wanted to do with his life. Even as a young kid, he wanted to make a difference to correct the health disparities around him – and he thought he could do that by becoming a neurosurgeon. 

“I stuck to it,” Atteberry said. “I’ve been doing this now for 14 years, and my passion for learning new things remains as it was so many years ago.”

Dr. Atteberry’s passion for patient-centered care drives him to keep learning and diving into the many mysteries of neuroscience. In this episode of Powering Health and Wellness with RPM Rehab, Dr. Atteberry discusses how he views healthcare as a collaboration of individuals – all working toward one goal.

Patient collaboration

At the heart of Dr. Atteberry’s work are his interactions with patients. Around the office, he’s known for spending so much time talking and listening with his patients that he’s often late for his next meeting. That’s because he believes that healthcare should revolve around the patient and their goals. 

“You want a person to be an active participant in their healthcare,” Dr. Atteberry said.  “If it were up to me, I’d make everyone their own healthcare ambassador. You are in charge of your own healthcare.”

The most important thing is to ask the goals of the patient. From there, Dr. Atteberry listens to what treatments and approaches they’ve tried before. Understanding what has and hasn’t worked for patients in the past should guide your care plan.

For Dr. Atteberry, that often means guiding patients away from surgery – despite being a surgeon. He views surgery as the last option, after more conservative measures fail. 

“My best patients are the ones that have tried everything else first,” Atteberry said. “I have more patients that I’ve probably helped from giving them advice away from surgery than I have from operating on them.”

Dr. Atteberry understands how ironic that may sound coming from a surgeon. But, it’s because most of the people who come into his office are just looking for someone to carefully listen and give advice.  Those that can do that – he believes – are the most successful physicians.

“We only have so much time in our day. We only have so many patients that we will be able to see. Try and maximize the opportunities for the individuals you get to see and give them the best chance of getting good advice.”

Working with Physical Therapists

But patient collaboration is just one element of Dr. Atteberry’s job. As a surgeon, he also  works with Physical Therapists to help his patients after their operations.

In his more than a decade of experience, he’s found that this collaboration makes all the difference in reaching optimal patient outcomes.

“I’ve found that through working with good therapists, that they will push people. They will get them better results than I can get them by myself,” Dr. Atteberry said. “It’s a synergy that takes place when you have good surgical technique and good rehab technique.”

In a perfect world, Dr. Atteberry would like to see Physical Therapy implemented from beginning to end of the process. That would include a pre-hab session that would help doctors understand the baseline for the recovery plan.

“On the first visit, let’s see what your range of motion is. Let’s see what you can do. Let’s see how you stand and posture. Let’s see what your gait is like,’” he said. 

From there, a better rehabilitation plan can be created. And, oftentimes, Physical Therapists are able to identify the small things that could make all the difference in recovery. By being good observers, they set a better path forward for patients. 

“You have to be focused on the little details, because the little details make you the big outcomes.”

Changing lives

Many times the patients who find themselves in Dr. Atteberry’s office are frustrated. They’re in pain, struggling to function and have oftentimes hit dead end after dead end in their recovery process. 

But, those same people are the ones who are most grateful for the surgical and therapist collaboration that restores normalcy to their lives. 

“I’ve had dozens of patients tell me ‘You’ve changed my life,” Dr. Atteberry said. “That’s a wonderful feeling.”

That moment – when you see a patient go from struggling each day back to functioning how they were meant to be – is what keeps Dr. Atteberry coming back to neurosurgery. It makes him forget any of the other less exciting parts of his job. 

“It’s a very special role that you get to play in people’s lives,” he said.

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

Applying Lessons from Ultramarathons and Embracing Adaptability in Rehabilitation with Lisa Bliss MD

Ultramarathon athlete, Physiatrist and rehabilitation medicine specialist Lisa Bliss MD explains how physicians adapt individual care plans to fit their patient needs.

Nothing gives Lisa Bliss MD the same joy as seeing a patient overcome an obstacle and adapt to their situation. As a physiatrist and rehabilitation medicine specialist of twenty years, she’s always looking to how she can help her patients reach their own personal goal – no matter how big or small that goal may be.

“That’s what I love about rehabilitation medicine,” Bliss said. “It’s not just fixing the actual injury or illness. It’s getting that person back to a full restoration of function.”

She works with each individual patient to find what they define as restoration. In this episode of Powering Health and Wellness with RPM Rehab, Bliss shares how to use a diverse set of tools to maintain a patient-centered practice.

Making a personal plan

Bliss defines success as more than just helping a patient to heal from whatever ailment they entered her office with. It’s about connecting with her patients on what they want to be able to achieve.

“Listening is the most important thing,” Bliss said. “Because when somebody says their goal is to lift their grandbaby after a shoulder surgery, I want to hear that.”

Typically, she finds her patients’ goals don’t necessarily seem as big and ambitious as running a marathon, until the obstacles to be overcome are fully understood. Rather, she asks her patients to think about what physical skills they want in order to fulfill their emotional needs.

“I look at what is that person’s goal, what makes them feel healthy and how do we achieve it in a helpful way,” she said. “We really need that hands-on approach.”

In her own practice, Bliss ensures that she’s doing everything she can to engage her patients and make them feel heard. It starts with making eye contact and actively listening to their concerns, and then progresses to physically putting her hands on their body to identify functional issues.

“That’s one of the big benefits of rehabilitation medicine, that we put our hands on our patients,” Bliss said. “We work with them…we watch them, and we’re really interested in always keeping in mind what their goal for recovery is.”

Embracing a diverse set of solutions

Once a patient sets a goal, there’s not just one way to meet it. In fact, Bliss encourages her patients to be adaptable and embrace a wide swath of tools for healing.

Typically, Bliss finds that people are more likely to achieve long-term functionality when they diversify their recovery tools.

“When we have all our goals in one basket, and then someone takes the basket away or something happens, we tend to get stuck,” Bliss said. “So, cross-training and looking at our options is really important.”

For a patient that enjoys running, Bliss would encourage them to feed that passion, but to also add some other activities into their routine. She reminds clients that repetitive use is a very real threat to our bodies – especially as we age.

“The older we get, the more important it is to do ‘prehab,’” she said. 

This translates into really focusing on strengthening the muscles we use on a daily basis in order to prevent injury. Strength training can oftentimes be the key to sustainable functionality.

“Sometimes physical therapy will get us back to our level of function,” Bliss explained. “But sometimes we need to add something more like strength training to prevent the loss of muscle mass which is a normal part of aging.”

Building endurance

In her personal life, Bliss is no stranger to overcoming obstacles. She’s an ultra-marathon runner and endurance sports fanatic.

But, it took support from her friends to realize that she could achieve such amazing feats. They gave her the courage to try.

“It was the people that believed in me that pushed me into the possibility that I can go beyond what I think I can do,” Bliss said.

It wasn’t easy at first. At the beginning, she often felt like an imposter or she was out of place. But, when she was finally able to cross the finish line, she looked back and felt proud of how much she grew.

At the heart of her success is the ability to adapt. She encourages her patients to put the same belief in their capacity to overcome difficult situations that she does in herself.

“It’s using that adversity and switching it around to make it your friend,” Bliss said. “Whatever your desire or whatever your goal is, if you can adapt to your environment then you can succeed.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

Mind Science, Happiness and Rehabilitation with Cindy Shaw

Speech pathologist and student of mind science Cindy Shaw reveals how mental awareness can help you improve your happiness and take control of your life.

After twenty years as a speech pathologist in neuro-rehab, Cindy Shaw saw what some others couldn’t see, the connection between emotions and cognition. She understood that the mind is an important personal health asset.

“When I looked at my own mind, I could see I had what’s called a ‘monkey mind’. Our thoughts jump around rather uncontrollably. Our emotions can be up one minute and down another,” said Shaw. “There’s so much randomness going on in the mind. I was feeling like my mind had control over me and I wanted to have a method to get control over my mind.”

This realization led Shaw to training and studying ‘mind science’ with Tibetan teachers. In this episode of Powering Health and Wellness with RPM Rehab, Shaw shares some of what  she has learned from her studies on the infinite potential of the mind.

What is mind science?

While the words ‘mind science’ may conjure up images of a new age, experimental discipline, Shaw shares that this evidence-based practice is quite the opposite. For over 3,000 years, the Tibetan people have been mastering introspection of the mind.

“What’s happened is that in pairing with neuro-scientists and physicists, they are starting to do rigorous investigation to see that these subjective ways of examining the mind are being verified through current research,” explained Shaw.

At its core, mind science is about examining our awareness or consciousness. Through various techniques, the practice takes a look at how our minds shape our daily lives.

“It’s about specifically being aware of our feelings or what we perceive through our senses: what we see, what we hear, what we taste and so on,” Shaw said.

Tibetan experts in the discipline study for 20 years after high school to get their Ph.D.. They look at science from various directions and the potential of the mind – like memorizing over 100 pages of information.

“The more that we open our mind to taking a more curious outlook on things, rather than thinking my way or the highway or having an immediate judgment about things, the more that we keep our mind open,” said Shaw. “The more we can tap into this really infinite potential of the mind.”

Training the emotional mind

What mind science teaches us is that we can control our mental states and emotions. When we investigate the source behind our negative mental states — jealousy, anger — we find we are our own enemies.

“If we really examine our minds during these negative mind states, we can see that the central actor is ‘me.’ There’s this extreme focus on self, on ‘mine’, and ‘I’” said Shaw. “Basically, we’re sitting on our pity pot.”

In order to overcome these negative emotions that narrow our mind, we need to recognize that we can change our perception. Shaw learned you can’t have two opposing states of mind at the same time. 

“If we’re angry, then we’re not feeling love. If we’re feeling love, we’re not feeling anger,” Shaw said. “This gives us an antidote for the negative mind state by changing our perception, changing the way that we’re thinking to a positive mind state. Looking at it from an aspect of love rather than looking at it from an aspect of anger.”

But, adjusting your mindset takes time, determination and effort. Shaw has found that a good place to start is to interrogate the sources of suffering and question how to uproot those causes.

By deliberately seeking out positive mind states and challenging negative ones, we can begin to have control over our mind.

“Because humans have self awareness, it allows us to reflect and observe when something like anger or jealousy or anxiety arises. And we can oppose that” said Shaw. “We can take a look at those things and make a judgment that ‘Oh that’s not beneficial’.”

Pairing mind and body

Overall, having control of your mind and your happiness can help alleviate physical pain. When we look at pain as the fear of suffering, we see that the mind plays an integral role in our ability to heal.

“The real suffering is the fear of the pain,” said Shaw. “What really helps with that is to recognize it and start to work with it.”

Once we begin to look at our happiness as a personal health asset, it becomes more and more important to train our minds. We need to begin to take our mental health as seriously as we do our physical function.

“Our culture is geared towards the external world and looking at the causes and conditions externally,” Shaw explained. “But, how much of the time do we take a look at our mind, which is with us 24/7, and evaluate how we are doing? What are the causes of love? What are the causes of compassion? Those are the things that could help us in the long run to be happier.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

The Value of Patient-Centered Therapy with Michele Jacobs DPT

Physical Therapist Michele Jacobs DPT puts patients first when treating complex pain — resulting in transformative healing.

When Michele Jacobs was a child, she saw the importance of health care professionals by watching her mother, a nurse, attentively tend to patients. 

Now, after practicing as a Physical Therapist for over a decade, Jacobs aims to replicate this patient-centered care with her own clients. Many of the patients Michele treats face complex pain conditions, which require listening, compassion, and, most of all, patience.

“People that have these multi-layers and years of disease, it’s not going to change in just 6 to 8 visits,” said Jacobs. “It takes months or years. We need to take the time to do it, but the healthcare system is not set up to do that.”

In this episode of Powering Health and Wellness with RPM Rehab, Jacobs discusses the importance of providing out-of-the-box care for patients suffering from complex pain. She shares how centering patients’ needs with every decision can lead to recovery.

Customized care

Many times, Physical Therapists stick to the same script when delivering care. But, Jacobs says not every patient fits into a neat box for treatment. 

That’s why Jacobs makes sure her treatment plans are specifically tailored to each patient. 

“Some therapy is, for a lack of a better phrase, what I like to call a ‘people mill’, where patients go in and do a circuit of uncustomized exercises,” said Jacobs. “With every single patient that comes in to see me, it’s all customized. I make sure it’s individualized to their impairments because everyone is different.”

In order to individualize treatment options, physical therapists need to learn to listen to patients’ wants and needs. Jacobs starts each session by asking her patients what they want to achieve.

“You can read their chart, but really involve the patient. Always ask the question: what’s your goal? What would you like to be able to do easier in your everyday life,” Jacobs said. 

Once you’ve identified the goals of your patient, it’s important to stick with them. Recognizing that patients might regress in the process is vital. But, physical therapists should dedicate time and effort into seeing those goals through.

“I love spending time with my patients,” said Jacobs. “You build such a rapport with them. They know that you care about them. I think we are just able to provide so much education and training because we get to spend so much quality time together.”

The power of manual therapy

Once Jacobs has connected with her patients, the next step is providing treatment. She uses her hands to make transformative changes.

Through manual therapy, Jacobs touches patients directly in order to find and work to heal dysfunctional areas. 

“People do better when you put their hands on them. Whether a doctor puts a hand on your shoulder and says ‘I’m listening’ or if a physical therapist puts a hand on the pain,” said Jacobs. “I’ve had patients who have had pain and issues for years, and they’ll say ‘You’re the first person who has ever touched my pain.’ That seems like that’s something that needs to change.”

With over a decade of experience in Physical Therapy, Jacobs has learned to be able to sense and detect problem areas through touch. Before patients guide her, she is able to identify painful areas.

“Dysfunctional tissue sticks out like a sore thumb. Whether it’s connective tissue, whether it’s nerve, skin, joint, it will stick out like a sore thumb,” Jacobs said. 

Oftentimes, Jacobs begins treatment by looking at patients’ sacroiliac, or pelvis joint. She says, by starting near the bottom of the body, she is able to realign the body back to a normal, more supportive place — relieving chronic pain.

“When I put my hands on the patients and I feel that dysfunction and I use a lot of muscle energy technique, mobilization with movement, and I help put that rib back down. Then I care for that soft tissue that has just been brutalized for however long,” said Jacobs. “And you massage it, you work all those joints around it to where you get back to more of a normal.”

Looking at the whole body

When Jacobs begins treatment, she looks at more than just the localized area of pain. 

Physical Therapists need to consider joints, muscles, nerves, and mental health of the patient in order to get a fuller look at how function and mobility can be improved.

“We’re master compensators. Our body wants to try to heal itself or fix the problem. But the longer you let one problem go, you compensate, compensate and compensate until you’re out of compensators,” she said.

One thing that Jacobs always looks at is the diet of a patient. She says what you eat can play a huge role in pain control and body functions.

“I think you are doing a disservice and/or incomplete treatment to your patient if you’re not trying to address the whole body.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

Helping Athletes Overcome Injury With Keith Embray

Former NFL Defensive Lineman and current assistant athletics director at the University of Pennsylvania State Keith Embray shares his journey to the football field and the physical therapists that helped along the way.

When you’re one of over 300,000 people trying out for a job that only 3,000 people in the world get, it can be difficult to persevere. But, even after early rejection, Keith Embray kept going until he landed a spot on an NFL roster. 

Embray brings this perseverance to every situation — including the multiple times on the football field when he got injured. He persisted through ligament tears, fractures and concussions until one injury ended his football career.

“My career ended on a practice field,” Embray shared, “doing something I had done a thousand times before, on a pass-rush drill.”

Embray now oversees the student athlete welfare and development program at the Pennsylvania State University, where he encourages college athletes to not only value their bodies, but to view themselves as more than just athletes.

In this episode of Powering Health and Wellness with RPM Rehab, Embray takes us on his personal journey to becoming a professional football player and the role physical therapists and mentors played in getting him there.

The connection between athletes and physical therapists

In a sport as physical as football, NFL athletes often cross paths with physical therapists. Embray was no exception — and he was grateful for every single one he encountered during his career.

In high school and college, Embray was lucky enough to not sustain any  injuries serious enough to keep him off the field. But once he entered into the world of professional football that all changed.

“One of the things that hurt the most was when I fractured one of my fingers,” said Embray. “I’ve torn my quad, my hamstring, my pec. Stuff that just hurt but you could play with it.” 

He was able to keep playing thanks to physical therapists and trainers, like Bill Bean,who coached him through injury and led him through recovery. After countless times spent with a physical therapist, Embray understands the impact they can have on an athlete’s life.

“People would say ‘Man, how do you keep getting cut and keep coming back?’” he recalled. “I had to learn mentally how to deal with that. These folks, these athletic trainers, these physical therapists, people just don’t realize the impact they have on these young people’s lives who are athletes.”

Embray was the persevering player he was thanks, in part, to all of the physical therapists that helped him to be confident enough to step back on the field following injuries. He encourages all of his student athletes to forge tight-knit relationships with their physical therapists and trainers. 

“They don’t need anything from you, but you need everything from them,” Embray explained. “People that go into athletic training or physical therapy, it’s because they want people to feel good not only physically, but mentally about themselves. There’s so much of that confidence thing to build into athletes.”

More than an athlete

In Embray’s new role guiding young athletes, he makes one message very clear: you are more than just an athlete. 

While physical capabilities and athletic talent is important, young athletes need to value themselves beyond how much they achieve on the playing field. That way, when inevitable injuries do come their way, they realize their self-worth goes way beyond their sport.

“You can do something that many people can’t do, but you can also do something that everyone can do: be a human being,” he said. “You’re a human being first.”

As a young athlete, Embray himself was no stranger to the pressure to succeed as an athlete. He invested everything in his identity as an athlete — which only made rejection harder.

“There’s this feeling of ‘Wow. Did I wrongly invest all of my energy and efforts into something?’ Then you have this feeling that you are “less than” because you’re not this or that,” Embray remembered.

Physical Therapists helped him not only cope with the physical pain that came with football injuries, but the mental pain of being rejected. It’s the role of a physical therapist to help athletes feel their best, both physically and mentally.

“It took folks with expertise mentally and physically to help me exist in that world as long as I did,” said Embray. “If it wasn’t for so many of the professionals that enter into this fields to help people feel better about themselves, then I wouldn’t be where I am today.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

Providing Elite Physical Care with Randy Bauer

RPM physical therapist Randy Bauer guides us through his holistic approach to recovering movement that he uses on everybody from Olympic athletes to Average Joes.

When Randy Bauer was in college, his focus was on football. That is until an injury on-the-field opened his eyes to the world of physical therapy. He began to work with collegiate athletes to help them preserve their personal health assets.

“It was being involved with the athlete in the day to day. It wasn’t just seeing them at a game, it was dealing with their practices, being out on the playing field and really seeing how these different athletes practiced,” he said.

Bauer has now been working as a physical therapist for over thirty years and has provided care to a large number of elite athletes, from track star Edwin Moses to tennis player Michael Chang.

In this episode of Powering Health and Wellness with RPM Rehab, Bauer breaks down what it takes to train elite athletes, the importance of building meaningful relationships with every client and how every facet of our lives can define our ability to move.

Adjusting to the world of athletes

Clients with a wide range of abilities often come into Bauer’s office at RPM Rehab. In his long career he has seen an extensive list of elite athletes, from the collegiate level all the way up to Olympic competitors.

For patients with such a skill level, he finds he has to adjust his therapeutic approach.

“They maintain their conditioning, and their training level is impeccable,” said Bauer. “You see a different level in the way people prepare themselves through a season, how  they recover for off-season and how they prepare themselves for the upcoming season.”

In his experience, Bauer has noticed that these professional athletes are models in taking their personal health assets seriously. They always come prepared and ready to maximize their sessions.

“When your livelihood is dependent on it and your longevity in the sport is dependent upon it, you’re going to put that effort in.”

One reason athletes have so much success in their therapy sessions is because they have an acute awareness of what their body needs. One of the most important things any patient can do is listen to their body.

This intense focus on personal health and wellbeing is something anyone – whether an athlete or not – can bring into their lives. 

“My emphasis is educating people inside the clinic and outside the clinic on how they can maximize their health and longevity around what they do.”

Maintaining meaningful relationships

In order to watch someone improve their overall health and well-being, you have to stick with your clients. One of the keys to success is building a meaningful relationship between therapist and patient.

“That’s something I’ve really enjoyed: the relationships that I have developed with not just the athletes that I see, but the various patients and the generations I might see in one family.”

Over the years, Bauer says he has seen the difference this kind of long-term investment in patients can make. He’s seen one patient for a little over thirty years.

“Over time, I’ve seen a few joints being replaced in that one person. And maybe a back surgery,” said Bauer. “And that develops a close tie with the individual and that extends to other clients that I have and that’s why I enjoy being in the community.”

These intimate relationships unlock whole new possibilities for therapist and patient. By getting to know a patient’s personal history, their comfort levels and their physical limitations, Bauer is able to work through these obstacles to reach new levels of growth.

But, what is most important is that this relationship allows him to bring out the best in his patients. 

“That might be feeling relaxed in the setting that they’re in. It might be motivating them to do more when they’re not in the office to help their condition. And it’s follow up communication. That’s where I would say my success is: the development of relationships.”

A holistic approach to physical therapy

When approaching a new patient, it’s important to look at more than just what they bring into a session. Physical therapists need to take a holistic look at the people who come into their office.

“You need to know how they’re using their body day in and day out,” said Bauer. “You need to know what they’re doing to provide the adequate energy supply to work. Because that’s what you’re trying to do: step up their tolerance to work.”

This means considering things like what a patient’s diet looks like, how much sleep they get each night and the amount of relaxation built into their day. All of these things will play a role in their therapy sessions.

“There has to be a look at the total patient.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

Healing the Body and Mind Through Water

Former Director of the Washington State University National Aquatics and Sports Medicine Institute Bruce Becker MD shares how aquatic therapy can unlock healing in both the body and the mind.

Bruce Becker MD doesn’t mind seeing people at their worst. He says, through his years  as a physician working with aquatic rehabilitation, he has taken the most joy from taking his patients from where they are, following illness or injury, to where they want most to be.

“It is really one of the most holistic medical fields I can possibly think of. I mean we don’t have an organ system: what we have is a human,” said Becker. “That’s an entirely different way of looking at healing and recovery.”

The former Director of the National Aquatics and Sports Medicine Institute, Becker spent his career using warm water immersion to achieve recovery that not only assisted on a physical level, but also with mental well-being. 

In this episode of Powering Health and Wellness with RPM Rehab, Dr. Becker explains the multifaceted benefits of aquatic therapy and shares his hopes for the future of the practice.

The instant ease of water

The first time patients step into the pool, they often observe the instant benefits of beginning the healing process in water. For many, Becker says it can ease the road to recovery.

“I watched how they did in the water: spinal cord injury patients and stroke patients in particular. The results were amazing.”

One of the most amazing powers of water is its immediate healing effect. When Becker brings patients with chronic pain into the pool, he often gets emotional results. The water instantly relieves some of their daily pain.

“I can remember a number of cases when I would get a patient in the pool and they would just sigh in relief or they would, at times, even cry,” said Becker. “For the first time, in water, they were pain-free. It was quite remarkable.” said Becker.

This relaxing and naturally healing quality of water is what makes aquatic rehabilitation so successful. It can often serve as the perfect first step towards recovery. 

Many times, stepping into the pool can be the difference between a patient complaining about physical therapy and a patient excited to continue their therapy. 

“There’s a big difference between the kind of early phase, post-op rehab that can happen using the water versus what happens in the gym. I go down to the gym and I see patients with grimaces on their faces. I go down to the pool and I see them smiling,” Becker said.

Psychological healing

The power of the pool doesn’t stop at its physical effects. Aquatic rehabilitation has proven to be useful as a recovery tool for the mind.

Throughout his career, Becker has used warm water immersion therapy with injured veterans suffering from traumatic brain injury and PTSD in close collaboration with the Wounded Warrior Project.

“It made a big difference in their recovery outcomes,” said Becker. “I saw warm water immersion as incredibly useful in the management of PTSD.”

There’s a complex science behind why warm water immersion can aid in recovery of these mental conditions. The therapy helps to change the central nervous system in an important way: it regulates the fight-or-flight response within a patient.

“What happens in PTSD is that the nervous system component has been called up so often during a series of traumatic events that it never really relaxes back to baseline. Warm water immersion allows that automatically to down-regulate.”

This neurophysiological process benefits the patient in many ways. It reduces blood pressure, heart rate, respiratory rate and, most vitally for PTSD patients, improves brain function.

“It allows your brain to more widely range, it improves memory, it improves a whole bunch of things from the standpoint of actual cerebral activity function.”

The future of aquatics

Despite all these clear benefits, these forms of aquatic therapy aren’t that common in the physical therapy field.

Becker hopes in the future that aquatic rehabilitation’s lasting impact both physically and mentally will be more recognized in the mainstream.

“The fact that it isn’t more widely used has been a major frustration for me. It isn’t very commonly used and the existence of therapeutic pools is not really widespread across the world and the United States. It really ought to be a mainline opportunity.”

He has published a number of studies detailing the benefits of this type of rehabilitation therapy. However, Becker believes there needs to be a shift in the attitude of funding disease prevention initiatives. 

“I wish that the recognition of wellness promotion were more actively pursued at a federal level and there were more grant opportunities.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

The Advantages of Aquatic Therapy with Julianne Alford

RPM – Spokane Clinical Director Julianne Alford imparts knowledge she’s learned from worldwide training on how to use the water environment to facilitate  functional improvements and improve mobility.

Twenty years into Julianne Alford’s physical therapy career, an injury to her shoulder stopped her in her tracks. No longer would she be able to treat like she used to unless she adapted to a whole new medium: water. 

“The first time I got into the water as a clinician, I had my arm back,” Alford shared. “I realized I could marry all the skills that I had on land with that of water and treat a whole new source of clientele in the water.”

Alford went on to train in world-renowned centers in key thought centers across Europe until she mastered aquatic rehabilitation practices. In this episode of Powering Health and Wellness with RPM Rehab, Alford shares her passion for aquatic therapy and explains all the ways in which water-based rehabilitation can increase support, strength and stamina in the pool.

The power of water

When you move your therapy practice into the pool, it opens up a new world with a whole new range of possibilities for improving physical health. 

Whereas on land patients have to fight gravity, the pool offers them freedom from this sometimes limiting force. In water, people benefit from the effects of buoyancy which helps lift and support them while they work through their exercises.

“Everything you do, it’s unweighting those painful joints. It’s unweighting those painful spinal structures. It’s supporting your body. It’s alleviating that stress of that gravity. And it allows that person to be upright,” said Alford.

Water is also more viscous than air, meaning you face far more resistance to your movements when submerged, which Alford says can be used in numerous ways to build better mobility.

“I can take an individual and say, ‘I can use the viscosity to support you or I can use the viscosity to strengthen you.” 

Another property that makes water such an invaluable resource is the hydrostatic pressure. When you stand in the pool, the pressure is greater on your feet than on your chest level – increasing the workload of your heart by 40%.

In this way, Alford says water is like a third partner, alongside you and your patient, assisting with the physical therapy.

“I’ll tell a patient when they first come in the water, you’re benefiting from being in the water and I haven’t even touched you,” Alford said. “And that’s the greatest gift water gives is hydrostatic pressure.”

Pool parameters

The pools for physical therapy aren’t your average pool. Alford believes it’s important that pools be adjusted to assist rehabilitation efforts as much as possible.

That includes temperature. For aquatic physical therapy, you want water that is warmer than the average pool – at about 92 to 94 degrees Fahrenheit.

“The purpose of using that is to make sure when you get in, if you’re not moving, we don’t want you to shiver, but we also don’t want you to be too warm and relaxed,” she explained. “It’s to be comfortable enough to move around and exercise, but not to overheat your body.”

In Spokane, Alford runs a clinic with a pool designed specifically to meet the needs of her practice and her patients. The depth of the pool varies from 3 feet up to 7 feet in order to allow for a wide range of movement, both shallow and deep water.

“It’s a 20 by 30 foot pool, so it’s a very large area to treat,” said Alford. “You want to make sure that a person is exercising at the appropriate level for them. So I don’t want to take a 5”2’ lady and put her in 6” water.”

Lastly, the chemical makeup of the pool can determine a lot about who you can treat. Alford uses bromine, rather than chlorine, to treat her pool because she says it’s the least harsh option for her patients’ skin. She also recommends a strict routine on how much time they should spend in and out of the water.

“There’s a whole hygiene on how you get in the water, how you get out of the water and what you do with your bathing suits. And we explain that to all of our clients.”

Increasing endurance

Another amazing aspect of aquatic therapy is that it can be used not only for severely debilitated patients, but also for elite athletic training. 

In fact, studies have shown that participation in aquatic therapy significantly strengthened athletes. Alford explains that sometimes patients can “out-endurance those athletes that were on land because their cardio-pulmonary function was so much stronger in the water.”

Alford has found this cross-training method very successful for athletes of all backgrounds, from high school athletes all the way to Gonzaga University basketball players. 

“In a lot of ways, not only did we keep them on the field through their injury and protect them,” said Alford, “but then after they were done they continued because they liked the performance enhancement. They were stronger.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.

Orthopedic Surgery, Bone Health and Physical Therapy

Orthopedic Surgeon Alan Greenwald explores the training, skill, discipline and technology it takes to preserve health through procedures – and the important steps that come after.

After 40 years of being an orthopedic surgeon, Alan Greenwald MD has yet to grow old in the profession. Performing surgery has changed over time and with technological evolution, but Dr. Greenwald’s purpose has remained the same: to help people move.

“It’s a medical specialty where you can literally fix people, get them up and get them walking. You can take people out of a wheelchair and let them walk again. Or fix a broken bone and help it mend. It’s a very gratifying speciality that provides us with really rapid results and improvements.”

In this episode of Powering Health and Wellness with RPM Rehab, Dr. Greenwald takes us through the intricacies of orthopedic surgery, the importance of the Physical Therapy that follows and the ways he believes the industry can grow.

Transformative technology

One of the most engaging parts of orthopedic surgery is the almost incomprehensible technology that’s advanced along with the practice. 

“We can take materials that have been synthesized and make the body reprogram itself in a fashion to make bone where there is no bone. Or, heal tissues where it’s not possible normally to heal tissue,” said Greenwald. “So we are able to jumpstart the biology.”

These developments in technology have allowed for professionals like Dr. Greenwald to perform less-invasive and more efficient surgeries on those in need. With the technological gains and improvements, the industry has been able to continue to grow and change.

“It has revolutionized fixing people from making big incisions and big cuts to small incisions, and working through little tiny tubes with fiberoptic scopes and using technologies that I never dreamed of as a resident,” Dr. Greenwald shared.

Now, surgeries – like shoulder operations – are shorter, less complicated and offer a quicker recovery time for patients. 

And, the technology doesn’t seem to be stopping anytime soon. Even after decades in the profession, Dr. Greenwald is always continuing to learn new things and utilize state-of-the-art innovations.

“It’s been a nice and interesting ride, and it keeps changing. I don’t think it’s going to stop during the time I’m practicing.”

The need for post-procedure therapy

Even with the amazing technology available today, it takes more than just surgery to regain movement and strength after an injury. After a procedure, patients still may not feel equipped to continue their lifestyle and fully resume their usual activity level.

“It’s possible to recreate the anatomy that was damaged by an injury or an accident,” said Dr. Greenwald. “However, it takes more than just putting these tissues back in place to get the patient back to a functional lifestyle.”

That’s where therapy comes into play. Orthopedic surgeons rely on Physical Therapists to work patients through their pain and fears and to restore them to their pre-surgical, or pre-injury, functional levels.

“It takes an awful lot of effort to get from the operating room to, for example, throwing a ball,” said Dr. Greenwald. “It requires a very concerted and time-driven mechanism that is orderly.”

This process takes not only time, but a willingness to encourage patients and inspire confidence in their progress. Dr. Greenwald says the best way to restore physical health is to establish this trust then work toward movement, strength and coordination.

The impressive technologies found in the operating room aren’t enough. It takes collaboration between surgeon and Physical Therapist for complete patient healing.

“Patients aren’t able to generally do this on their own. Most people don’t have the skill or the sense of security or the confidence to do it by themselves.They often require a lot of help.”

Preserving bone health

Twenty years ago, the American Academy of Orthopedic Association mandated orthopedic providers take on the role of monitoring bone health.

But, Dr. Greenwald says that this personal health asset is currently being ignored. In fact, 90% of patients with fragility fractures go unacknowledged.

“It’s a silent disease. And I’ve been working hard in the last years to encourage physicians – especially orthopedic surgeons – to acknowledge that these patients that they’re seeing and treating need additional help.”

In addition, there are steps patients can do to avoid bone health issues in the future. By taking calcium supplements, stopping smoking and limiting alcohol consumption, you can take a step to have stronger bones later in life.

“It’s often very preventable. So the recognition of that kind of disease in the process is paramount for bone doctors.”

To learn more about this show, follow this podcast wherever you listen to your audio content. And join in the conversation by visiting us online at rpmrehab.com/podcast.