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.

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.

Physical therapist Chuck Martin shares observations he’s made during his forty years in the field and offers a glimpse into where the industry is headed next.

Chuck Martin has spent almost half a century on the front lines of the physical therapy industry. Every new patient reinforces for him the importance of taking good care of your body — a concept he says you can trace back far into history.

“An argument could be made that physical therapy goes back 5,000 years,” he says. “Properties have been used by individuals to heal themselves and to help heal others for a long time.”

In this episode of Powering Health and Wellness with RPM Rehab, Martin shares his predictions for the likely equally long future of physical therapy: how COVID-19 has impacted treatment, the achievement of direct access and why physical therapy should be used on a more consistent basis.

Becoming the Practitioner of Choice

The future of physical therapy lies in the growing need for consistent, regular functional assessments. Martin says physical therapists should expect to see people at a much higher frequency.

“If you think about when you go to see a cardiologist, a cardiologist doesn’t usually just treat you for a little while and then let you go,” says Martin. “It’s usually we’ll look at your advancement, see where you are, then we’ll see you in another six months or a year.” 

Physical therapy is beginning to advance to this same kind of pattern. By seeing patients biannually, even after care for a specific problem or injury has finished, physical therapy professionals are able to effectively monitor changes in functionality and mobility within patients.

“That’s going to be the future,” Martin believes. “We’ll see them every six months or once a year to sort of look at how they’re moving, how they’re tweaking, trying to keep that train on the track as opposed to having the train jump off the track.”

With more consistent check-ins, Martin says patients will be able to remain active for a much longer time, and even avoid needing walkers as they advance in age.

“I’m a firm believer that if we keep people moving, and people keep their fitness and their stretching up, that there’s no reason why they can’t remain healthy and active up into their nineties.”

Growing Autonomy

An important recent development for physical therapists has been the transition to patients having direct access to care. In the past, it was necessary for patients to get a referral from a physician in order to begin sessions with a physical therapist. 

“As the desire for more autonomous practice grew, there began to be a push for physical therapists to have direct access,” Martin explains, “which means the patient could make the selection to come directly to a physical therapist.” 

Martin says before direct access, patients often had to wait extensive periods before they were able to get seen by a doctor. This was an ineffective way for treating both injuries and mobility issues.

“Often what happens when you have an injury, it may take three to six weeks to get in to see the physician and another two to three weeks to see the physical therapist,” he says. “So now you’re two, two and a half months out from the time you were injured before receiving the care you need.”

Today, to some degree or another, all 50 states have changed their laws to include direct access to physicians, allowing for earlier treatment for patients.

“By being able to come directly to a physical therapist, treatments can start earlier and interventions can be developed earlier.”

Telehealth Transformation

The past year and a half has pushed physical therapists to adapt to a virtual world. It also opened up opportunities for telehealth care to take an even bigger role in physical rehabilitation. And Martin hopes that growth continues beyond the pandemic.

According to Martin, now it’s as easy as setting up a video conference with your practitioner of choice to address the daily wear and tear we feel on our bodies.

Another advantage of telehealth services is the ability to provide some level of care from almost anywhere in the nation, thanks to the “Physical Therapy Compact.” The PT Compact is an interstate agreement between participating states intended to provide collaborative access to physical therapy services, regardless of where the patient lives.

“If I have a license in Washington state and I pay a fee and pass a small test, I can then be considered to be licensed in all these other states, which allows me then to do telehealth across state lines,” Martin explains.

For physical therapists, this means expanding their reach to new patients in desperate need of help. And for the consumer, Martin argues, a much wider access to life-altering therapy for all.

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.