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Healthy Wealthy & Smart

The Healthy Wealthy & Smart podcast with Dr. Karen Litzy features top experts in health, wellness and business with a particular focus on physical therapy. We take evidence based medicine and break it down making it easier to understand and immediately apply to your life. At Healthy Wealthy & Smart our goal is simple: to provide you with the best information to live a healthy and pain free life!
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Now displaying: August, 2016
Aug 29, 2016

On this week’s episode of the podcast, I welcome Dr. Evangelos Pappas back onto the show to discuss current research on ACL rehabilitation. Dr. Pappas is a Senior Lecturer within the Discipline of Physiotherapy with expertise in sports medicine and musculoskeletal physiotherapy at the University of Sydney. He has published extensively in journals in sports medicine, musculoskeletal physiotherapy and biomechanics and he has presented his work in more than 50 national and international conferences. Dr. Pappas research passion is to develop programs that effectively prevent lower extremity injuries and identify rehabilitation techniques that provide optimal outcomes for injured athletes.

In this episode, we discuss:

-Biomechanical deficits that predispose athletes to ACL injury

-Treatment interventions and screening assessments for return to sport that reduce the likelihood of re-injury

-Training programs on ACL injury prevention

-Wearable technology’s impact on future ACL injury statistics

-And so much more!

 

Dr. Pappas is critical of physical therapy interventions that do not address deficits that could predispose the athlete to re-injury. He stresses, “Even though it is relatively easy to rehabilitate somebody after an ACL reconstruction in terms of regaining strength, range of motion, and even some proprioception, and even getting them ready for sports, I would strongly argue we are providing a disservice to this patient if we don't take it a step further and try to identify the biomechanical deficits that would potentially predispose them to an ACL tear and try and rectify those…”

 

ACL injuries not only affect the athlete at the time of injury and throughout rehabilitation but also may lead to lasting adverse health effects. Dr. Pappas states, “You have an athlete with an ACL tear at age 16 who develops osteoarthritis because that commonly happens within the next 10-15 years… They’re supposed to be in their most productive years and there are not many good choices because they are too young for a total knee replacement and their knee related quality of life is similar to someone who is 70 or 80 years old. We are very passionate about preventing those injuries because once they happen there are things we can do to prevent it from getting worse or getting another injury but just the fact that it happens it can really be a life defining event.“

 

The FIFA 11 + is a successful injury prevention program because it is incorporates an easy-to-follow dynamic warm-up into the daily practices of athletes. “The athlete does a 10 minute warm-up, they will have to do it either way. They have a choice of doing something that is ineffective like static stretching or they have the choice of doing something that is probably a little bit more fun and also effective… The same exercises that prevent the injuries are also good at making athletes run faster or jump higher and have a competitive advantage over their opponents.”

 

New research has found that athletes who have deficits in the single hop test still present a year post ACL reconstruction have a higher likelihood of re-injury. Dr. Pappas cautions, “Almost nobody should be returning to sport before 9 months after an ACL reconstruction. The knee will feel okay, especially if they had some allograft with no other side morbidity, but it's the job of the PT to discourage and convince the athlete to not return to sport earlier than 9 months after the ACL reconstruction.”

 

For more on Dr. Pappas:

Professor Evangelos Pappas trained as a physiotherapist in Thessaloniki, Greece before pursuing a Masters in Orthopaedic Physical Therapy at Quinnipiac University and a PhD in Orthopaedic Biomechanics at New York University in the USA. Prior to coming to the University of Sydney, He taught for 11 years at Long Island University-Brooklyn Campus in kinesiology, clinical decision making and musculoskeletal pathology and physiotherapy. His excellence in teaching was recognized by his nomination for the Newton award for excellence in teaching. A/Professor Pappas joined the University of Sydney as a Senior Lecturer in 2013 where he continues to lecture in the areas of musculoskeletal physiotherapy, and particularly as it relates to the upper and lower extremities.

 

Professor Pappas is also active in musculoskeletal research. His research has been funded by the National Institutes of Health and intramural grants. He has presented his work in more than 50 national and international conferences and he has been interviewed on the radio as an expert on knee injuries. His publications appear in top journals in the fields of physiotherapy, sports medicine and biomechanics. One of his publications received the T. David Sisk award for best review paper from Sports Health; a leading multidisciplinary journal in sports medicine. In addition, A/Professor Pappas has served on the research subcommittee of the awards committee of the American Physical Therapy Association.

 

Resources discussed in this show:

Dance Research Collaborative

University of Sydney: Evangelos Pappas

FIFA 11 +

 

Kyritsis, Polyvios, et al. "Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture." British journal of sports medicine (2016): bjsports-2015. Link: http://bjsm.bmj.com/content/early/2016/05/23/bjsports-2015-095908.abstract

 

Myer, G. D., Martin, L., Ford, K. R., Paterno, M. V., Schmitt, L. C., Heidt, R. S., ... & Hewett, T. E. (2012). No association of time from surgery with functional deficits in athletes after anterior cruciate ligament reconstruction evidence for objective return-to-sport criteria. The American journal of sports medicine, 40(10), 2256-2263.  Pubmed link: http://www.ncbi.nlm.nih.gov/pubmed/22879403

 

Make sure to follow Dr. Pappas on twitter and facebook! You can reach out to him with your questions via email evangelos.pappas@sydney.edu.au! Listen to Dr. Pappas first discussion on the show here!

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and stay Healthy Wealthy and Smart!

 

Xo Karen

 

P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on The Do's and Don'ts of Social Media!

 

Aug 22, 2016

On today’s episode, I had the pleasure of welcoming Dr. Richard Severin PT, DPT, CCS back onto the show to address audience questions on pursuing a terminal degree and entering the world of academia. Dr. Severin is a physical therapist currently pursuing his PhD in Rehab Science at the University of Illinois at Chicago with a focus in cardiovascular physiology.  

In this episode, we discuss:

- What it takes to get accepted into the right PhD program for you including how to find a mentor and develop a competitive advantage

-Differences between each terminal degree and their job prospects

-Is it possible to manage DPT debt and clinical work while you pursue a PhD?

-The changing academic world and growth in the job landscape

-And so much more!

 

The ideal PhD program for you comes down to finding the right mentor. Dr. Severin’s advice is to, “Find someone who does research that you are interested in. The PhD really is mentor driven. Usually if you’re considering going down that road, you have a list of researchers or authors you follow—you kind of know who they are already. So that’s the first step, finding the person. If you have discourse with them, reach out to them. And if not, you're not going to get a negative response from cold emailing and just say, ‘Hey, these are my interests, I would consider applying here, what are your opportunities?’”

 

Dr. Severin believes that the academic world is allowing for more entrepreneurial pursuits to support your income. He states, “You’ve got to eat what you kill. You’ve got to find ways to find revenue. Historically, patents weren’t something that contributed to rank and tenure and now they are starting to count. Social media is going to be a bigger thing now... Academia is starting to wisen up—which I think is good.”

 

Before applying to a PhD program, develop research experience to show that you can bring value. Dr. Severin recommends to, “Get a little bit of a taste of what it means to work in a lab before you commit yourself to 3 to 5 years of it. And that will look good on your application. There are usually 1 or 2 spots in most places, and if it’s a good lab with good researchers those are going to be very competitive spots. Sometimes even if it’s a smaller lab, funding is a scarce resource. It gives you a little bit of a taste, gives you an expectation of what you're going to be doing, and it also shows you can do certain things. A lot of times it is what you can contribute to our lab, goes back to those scarce resources, they want to bring in people who are going to contribute.”

 

Dr. Severin is optimistic about the prospects of researchers and clinicians bridging together to validate clinical practice with evidence. “There is so much [data] out there that if we can find a way to harvest that data, process it, that’s going to be huge for us. When we talk about proving our worth, imagine if we could get all the outcomes from all of the PTs and find out what is going on here, we can really have some strong numbers that can combat different organizations or insurance companies who are trying to take away our reimbursements.”

 

For more about Dr. Severin:

Dr. Severin is a physical therapist and ABPTS certified cardiovascular and pulmonary specialist. He completed his cardiopulmonary residency at the William S Middleton VA Medical Center/University of Wisconsin-Madison which he then followed up with an orthopedic residency at the University of Illinois at Chicago (UIC). Currently he is working on a PhD in Rehab Science at UIC with a focus in cardiovascular physiology. In addition to research, teaching and clinical practice regarding patients with cardiopulmonary diseases, Dr. Severin has a strong interest in developing clinical practice tools for risk assessments for physical therapists in a variety of practice settings. He is an active member within the APTA and serves on the social media committee and Heart Failure Clinical Practice guideline development team for the cardiopulmonary section.

 

His research interests include: Assessment of cardiovascular risk in orthopedic physical therapy patients, hemodynamic responses to orthopedic rehab, Heart Failure, End Stage Lung Disease, Transplant Rehab, Exercise Physiology, Sport Performance, Peripheral muscle changes with cardiopulmonary and metabolic diseases, Tendinopathy

 

Resources discussed on this show:

List of PhD programs

UIC Integrative Physiology Laboratory Twitter

Clinical Rehabilitation and Technology Research Certificate

Rehab Review Youtube Channel

 

You can find more from Dr. Severin on twitter, facebook, and his website PT Reviewer!

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and stay Healthy Wealthy and Smart!

 

Xo Karen

 

P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on The Do's and Don'ts of Social Media!

Aug 15, 2016

On this week’s episode of the Healthy Wealthy and Smart Podcast, I welcome Dr. Claire Hiller to the show to introduce us to dance medicine and how physiotherapists can break into the industry. Dr. Hiller is a physiotherapist specializing in dance injuries and her current research interests at the University of Sydney include further development of the Cumberland Ankle Instability Tool, prevalence and impact of chronic ankle problems, predictors of chronic ankle instability, dancers' lower limb injuries, and dance footwear.

 

In this episode, we discuss:

-Common injuries of the spine, knee, and ankle seen in dancers

-In-depth analysis of the lateral ankle sprain vs the high ankle sprain and differential diagnosis

-Pre-pointe assessments and when to give your dancer the green light

-How a medical professional can effectively collaborate with dancer, dance teacher, and parent

-And so much more!

 

Dr. Hiller encourages physical therapists to pursue their interest in dance medicine by taking continuing education courses regardless of their current background. She states, “Physical therapists and other allied healthcare professionals are trained to watch people move… Dancers are very forgiving, if you even show a glimmer of the fact that you have an understanding of just the basics that go into dance, and you know what to look for and how to look for it, and you understand the body and how it moves and how it all connects, then you can be just as good if that’s the field you want to go into.”

 

In dancers, lateral ankle sprains usually don’t occur in isolation and a full ankle assessment is necessary for a realistic prognosis back to sport. From her experience, Dr. Hiller has found, “Dancers will often do something at the base of the outer part of their foot. Dancers can also have a high ankle sprain component again because they are coming down from a [demi-pointe position] and that’s often missed. People will go back far too soon if they have that. It’s a really important injury to stay longer off than even your lateral ankle sprain.”

 

Dr. Hiller believes that parents should be tuned into their child’s complaints of pain and advocate early on for preventative care. “Some ways of training is you power on through everything. The life of a dancer is to live with pain, to be able to cope with pain. When you have pain, it is nothing unless you’re laid out on the floor and can hardly move. If your child is complaining of pain, and their consistently complaining of pain, don't wait till they are nagging you that they’re having pain. Listen to them when they start to say they have pain in my back, pain on the side of my knee, pain in my ankle, pain in my foot.”

 

Physical therapists have the training to facilitate a safe progression to pointe. Dr. Hiller illustrates this role, “A pre-pointe assessment is about whether your child is actually ready for that step of putting your pointe shoes on. It’s not just about being able to put the pointe shoes on and balance, you’ve got to be able to have the strength and the control at a certain level before you can safely get up on your pointe shoes. And not just safely, once you get up there and actually be able to do something and enjoy it.”

 

For more about Dr. Hiller:

Dr. Hiller has been awarded a Postdoctoral Fellowship at the University of Sydney to study ankle sprain and instability. Her current works aims to build on her doctoral studies which included: the development of the Cumberland Ankle Instability Tool (CAIT), an objective measure of functional ankle instability; finding bilateral changes following unilateral ankle sprain; and proposing a modified model of chronic ankle instability. Dr. Hiller is also a practicing physiotherapist with a special interest in dance injuries. She has been involved in convening specialist interest days at the International Association of Dance Medicine and Science Annual Meetings and recently co-convened the 4th International Ankle Symposium.

 

Current research interests include: further development of the CAIT, prevalence and impact of chronic ankle problems, predictors of chronic ankle instability, dancers' lower limb injuries, and dance footwear.

 

Resources discussed in this show:

International Association for Dance Medicine and Science

Harkness Center for Dance Injuries

Dance Movement Therapy Association of Australasia 

National Institute of Dance Medicine and Science (NIDMS)

Ausdance

Healthy Dancer Canada - The Dance Health Alliance of Canada

Performing Arts Medicine Association (PAMA)

 

Articles mentioned in today's podcast:

1) Liederbach MJ et al (2008) Incidence of anterior cruciate ligament injuries among elite ballet and modern dancers. American Journal of Sports Medicine 36: 1779-1788

2)Sman AD et al (2015) Diagnostic accuracy of clinical tests for ankle syndesmosis injury British Journal of Sports Medicine 49:323-329 

3) The Hazards of Ankle Sprains NYT July 25th 2016

 

Dr. Hiller invites you to reach out via email (claire.hiller@sydney.edu.au) and connect with researchers, clinicians and students interested in dance related research at Dance Research Collaborative!

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and stay Healthy Wealthy and Smart!

 

Xo Karen

 

P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!

 

Aug 8, 2016

Thanks for tuning in to the Healthy Wealthy and Smart Podcast! Coming to you from Chicago, Drs. Sarah Haag, Sandy Hilton, and Jason Falvey join me for Part 2 on our discussion all about sex! You can check out Part 1 from CSM in Anaheim, California here in case you missed out!

 

In this episode, we discuss:

-Broaching the subject of sex with your patients

-Recalibrating sex after surgery and childbirth

-Rising rates of sexually transmitted diseases in the older adult population

-How a bladder diary can help those with persistent UTI

-And much, much more!

 

Sex has multiple health benefits outside what is commonly perceived and can be utilized as exercise. “There is so much that sex is good for cardiovascularly, musculoskeletally. It’s just awesome for so many reasons mentally. When we talk about population health and things that keep people moving and happy—that’s a good one.”

 

Sex is an important activity of daily living and can be a tool for clinicians to implement into their home exercise program. “Pleasurable movement is one of the things that help you get back to normal movement. So if you can make this make sense and feel good, it’s probably going to be one of the first and well motivated things you’re going to do in an exercise program.”

 

After patients have undergone surgery, surgical restrictions are not you’re only guiding tool for sex. “Always let pain be your guide, if it hurts, don’t do it. Sex is never supposed to hurt—it’s supposed to be amazing.”

 

We tend to forget about the vital functions our pelvic organs perform every day. “Peeing and pooping and sex, they are all very basic bodily functions and we can start to forget about it. If I ask any of you how often you peed today, you would have to think really hard and I betcha 10 bucks you’d be wrong with whatever you guessed. You can go pee mindlessly.”

Today's guests:

Sandy Hilton PT, DPT, MS: Sandy graduated from Pacific University (Oregon) in 1988 with a Master of Science in Physical Therapy and a Doctor of Physical Therapy degree from Des Moines University in December 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995. Sandy has teaches Health Professionals and Community Education classes on returning to function following back and pelvic pain, assisted with Myofascial Release education, and co-teaches Advanced Level Male Pelvic Floor Evaluation and Treatment. Sandy’s clinical interest is chronic pain with a particular interest in complex pelvic pain disorders for men and women. Sandy is also pursuing opportunities for collaboration in research into the clinical treatment of pelvic pain conditions. Sandy brings science and common sense together beautifully to help people learn to help themselves.

 

Sarah Haag PT, DPT, MS, WCS Cert. MDT, RYT: Sarah graduated from Marquette University in 2002 with a Master’s of Physical Therapy. Sarah has pursued an interest in treating the spine, pelvis with a specialization in women’s and men’s health. Over the past 8 years, Sarah has seized every opportunity available to her in order to further her understanding of the human body, and the various ways it can seem to fall apart in order to sympathetically and efficiently facilitate a return to optimal function. Sarah was awarded the Certificate of Achievement in Pelvic Physical Therapy (CAPP) from the Section on Women’s Health. She went on to get her Doctorate of Physical Therapy and Masters of Science in Women’s Health from Rosalind Franklin University in 2008. In 2009 she was awarded a Board Certification as a specialist in women’s health (WCS). Sarah also completed a Certification in Mechanical Diagnosis Therapy from the Mckenzie Institute in 2010. Most recently, Sarah completed a 200 hour Yoga Instructor Training Program, and is now a Registered Yoga Instructor. Sarah plans to integrate yoga into her rehabilitation programs, as well as teach small, personalized classes. Sarah looks at education, and a better understanding of the latest evidence in the field of physical therapy, as the best way to help people learn about their conditions, and to help people learn to take care of themselves throughout the life span.

 

Jason Falvey PT, DPT, GCS: PhD Student Jason Falvey was awarded a Kendall Scholarship from the Foundation for Physical Therapy in 2014 and a Fellowship for Geriatric Research through the Academy of Geriatric Physical Therapy in 2015 to support his research examining the role of home physical therapy in enhancing function and reducing re-hospitalizations for medically complex older adults. He is also the primary investigator on a research grant from the American Physical Therapy Association, Section of Health Policy and Administration looking at the role of physical therapists in models of transitional care for older adults after acute hospitalization.

 

Resources discussed in this show:

Oswestry Disability Index

Finding a pelvic health PT

Holly Herman  

 

Make sure to give Jason Falvey , Sarah Haag , and Sandy Hilton a follow on twitter!

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and as always stay Healthy Wealthy and Smart!

 

Xo Karen

 

P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!

Aug 1, 2016

Today’s show is with Dr. Kelly Starrett where he answers audience questions concerning how he optimizes human performance. Kelly is a coach, physical therapist, author, speaker, and creator of the blog Mobility WOD. Kelly’s work across these mediums has reached large audiences and revolutionized how athletes think about human movement and athletic performance.

 

In this episode, we discuss:

-Allied relationships between physical therapists and strength and conditioning coaches

-Do anatomical variations impact ideal posture and movement?

-Why we should be taking a 30,000 foot view in our culture

-How Kelly reconciles pain science and biomechanics in his physical therapy practice

-How to build a large platform with the use of social media

-And so much more!

 

Kelly advocates that every human should be incorporating a mobility regime into their day to day lives. He states, “What does it mean foundationally to be a human being, what are the things we should be able to do? We remain agnostic about the way you want to train, but you better have a movement practice or at least express full range of motion if you plan on moving fast, lifting heavy, going up and down stairs, or picking up your kid.”

 

Kelly stresses that enhancing movement is a continual process and every day is a movement screen. “We don't expect movement competence to happen overnight. This is a process but eventually we should all be moving better and better and better because that is what it means to acquire skills as a human. It takes 10,000 repetitions as a baby to integrate a movement pattern. That means we have some tolerance in the system to buffer some less than ideal biomechanics. Overtime we should be refining that.”

 

Kelly challenges the physical therapy profession to focus more attention on educating the public on preventative care. He stresses, “When you have a fever, you take some Tylenol. If you have a cold, you don’t go see your doctor. If you have a cut, we teach people basic first aid. [Physical therapists] are not doing a good job teaching basic first aid around the body to everyone.”

 

We also discuss Kelly’s widely successful online fitness platform and the best ways to target and gain influence in your own local community. He states, “People are looking for advocates, they are looking for help… if you set out to influence a bunch of people, you influence no one. It’s not authentic, it’s not real. Solve a set of problems and be of use to your community and people will find you.”

 

For more about Kelly:

Kelly Starrett is a coach, physical therapist, author, speaker, and creator of [mobilitywod.com], which has revolutionized how athletes think about human movement and athletic performance.

 

His 2013 release, Becoming a Supple Leopard has become a New York Times and Wall Street Journal bestseller. [His] blog was voted #4 in Outside Magazine’s Top 10 Fitness Blogs of 2011, Breaking Muscle’s Top 10 Fitness Blogs of 2011, and Health Line’s Top 100 Health Blogs of 2011. Kelly and his work have been featured in Tim Ferris’ Four Hour Body, Competitor Magazine, Inside Triathlon, Outside Magazine, Details Magazine, Power Magazine, and the Crossfit Journal.

 

He teaches the wildly popular Crossfit Movement & Mobility Trainer course and has been a guest lecturer at the American Physical Therapy Association annual convention, Google, the Perform Better Summit, the Special Operations Medical Association annual conference, police departments, and elite military groups nationwide.

 

Coach Kelly Starrett received his Doctor of Physical Therapy in 2007 from Samuel Merritt College in Oakland, California.

 

Before starting his own physical therapy practice at San Francisco CrossFit, one of the first 30 CrossFit affiliates, he practiced performance-based physical therapy at the world-renowned Stone Clinic. In his current practice, Kelly continues to focus on performance-based Orthopedic Sports Medicine with an emphasis on returning athletes to elite level sport and performance.

 

Kelly’s clients have included Olympic gold-medalists, Tour de France cyclists, world and national record holding Olympic Lifting and Power athletes, Crossfit Games medalists, ballet dancers, military personnel, and competitive age-division athletes.

 

Kelly’s background as an athlete and coach includes paddling whitewater slalom canoe on the US Canoe and Kayak Teams, and leading the Men’s Whitewater Rafting Team to two national titles and competition in two World Championships. In his free time Kelly enjoys spending time with his wife Juliet and two daughters, Georgia and Caroline, surfing, paddling, Olympic lifting, hot-tubbing, and so-you-think-you-can-dancing.

 

Resources discussed on this show:

Stand Up Kids

Chris Powers

Dan Pfaff

Functional Movement Screen

Lorimer Moseley

David Butler

Greg Lehman

International Spine and Pain Institute

PTPintcast

 

Kelly welcomes you to stop by his clinic in San Francisco, California and see what he’s all about. You can find more from him at Mobility WOD and follow him on twitter!

 

Join me and other professionals for PT Day of Service this October 15th and give back to your local community!

 

Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

 

Have a great week and as always stay Healthy Wealthy and Smart!

 

Xo Karen

 

P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!

 

 

 

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