Movement Optimism – Details, episodes & analysis

We talk what role Motivational Interviewing plays in working with patients.  We talk about how to do it and of course how not to do it.

Have a listen

More about Guillaume:

Graduated from Bordeaux (France) in 2005, Guillaume began his career as a physiotherapist working full-time for a professional football club in France. Since 2007, he has been practicing in private practice, specializing in the treatment of musculoskeletal conditions. He has developed a coordinated practice with general practitioners to provide patients with his expertise in musculoskeletal rehabilitation. He now focuses exclusively on shoulder pathologies.

Guillaume holds an MSc in Physiotherapy and Education from the University of Brighton (UK). During this Master's program, he explored and synthesized literature on the prescription of home therapeutic exercises, shared decision-making and reflective practice which was the subject of his final dissertation.

As a trainer, he teaches Motivational Interviewing, Reflective Clinical Practice, and his course titled "Motivating Patients to Do Their Home Exercises." He also hosts the French podcast "Evidence Based Physio Podcast." Lastly, Guillaume is the co-founder and co-manager of l'Agence EBP, a continuing education organization for healthcare professionals that offers training based on the latest scientific evidence.

Dr Stu Phillips, Tier 1 Canada Research Chair in Skeletal Muscle Health, shares his expertise on the importance of strength, power and muscle hypertrophy for healthy aging.

As is often the case Stu discusses how simple exercise programming can achieve the physical attributes that help us all age well.  

The fast recap is:

- something is better than nothing

• strength train 2x/week, 2-4 sets, 5-20 repetitions with an effort of 8/10.  
• progress this over time
• train power but moving a much lighter faster!
• eat a little bit of protein within 24 hours of your workout.
• easy peasy
  
  
  

Dr Feigenbaum is a medical doctor, strength and conditioning coach, strong dude, wicked golfer and motocross expert.  He co-runs Barbell Medicine catering to both health care professionals and clients.

We talk:

technique and injury risk (duh)

the ideas behind the "orthopaedic cost" of lifting

the role of excess body weight on health and Osteoarthritis

the need for specificity of training

when we can forego specificity and be very general in our training

and the importance of healthy debate and clinical reasoning

This is another episode where we will definitely have a Part Two!

One of the hardest discussions to have with people in pain is shifting our focus from trying to "fix" pain to living well with pain.  Because, if we are very honest there are a huge number of people who might always have pain.  Sometimes the goal for healthy rehab is to shift from eliminating pain to living well with pain.  This is a fundamental of Acceptance and Commitment Therapy (ACT).

Dr Bronnie Lennox Thompson is an expert in this area and she takes us through the importance of this approach and how you can have this difficult conversation with your patients.

Bronnie's webiste is here

Dr Pak has a PhD in minimal effective dose training in powerlifters.  So, guess what we talked about?

Dr Pak is a powerlifting coach, scientist and science communicator in the world of strength and conditioning.

His PhD specifically focused on the minimum that a power lifter could do to increase their strength.  

We talked about:

- adults >50 and their powerlifting safety and performance gains

- minimal and optimal approaches to improving strength and hypertrophy

- when, how and whether technique matters for injury and performance (as usual)

Have a look at his research here

Physios have been lambasted awhile for not understanding the basics of strength and conditioning principles.

I reject this idea.  There two areas we explore in this podcast.

1. The idea that strength and conditioning basics are relevant for rehabilitation

2. Whether physios actually know these basics.

I make an attempt at trying to understand the arguments againsts physios and try to provide a competing view.

Here is how the AI summarized it (not really accurate but I don't want to piss off the robots):

Recovery Mechanisms in Rehabilitation Programs

Greg discussed the importance of understanding what facilitates recovery in rehabilitation programs, emphasizing that it's not always about building strength. He argued against the judgment of programs based on arbitrary ideas of what needs to change, as the actual mechanism of recovery can vary. He also addressed the concept of tolerance, suggesting that improving a person's ability to tolerate loads can lead to recovery, even without necessarily building strength. Greg rejected the idea that physiotherapists don't understand the basics of strength and conditioning, stating that they do and that the judgement often comes from bias. He also highlighted the need for more research to better understand what mediates recovery.

Strength Training Program Design Debate
Greg discussed the flexibility and options in designing a strength and conditioning program. He highlighted that the basics are simple and the key is to progressively overload the muscles. Greg also addressed the debate around whether to push to failure during exercises and suggested checking in to see how close one is to their failure zone. He further stated that there's no need to obsess over specific exercises, as the principle of progressive overload applies to them all. Greg concluded by stating that he'd like the debate to shift towards understanding when specific attributes are important and how to achieve them, with a focus on patient-centered care.

Today we take a bit of a detour and talk a little bit about the business side of Physical Therapy.  We don't do justice to our speakers knowledge but I hope that if this a topic you need to know more about I've introduced you to the right person.  Karen Litzy is an excellent physical therapist out of New York City, owner of a concierge physical therapy business, host of the very popular podcast "Healthy, Wealthy and Smart" and she is the creator the Strictly Business Blueprint.

Links

Karen's Website

Antony Lo (aka The Physio Detective) is an elite physiotherapist with a special interest in the pelvic floor and the female athlete.  Antony is an amazing clinical educator and provides a lot of insight into how our profession can keep moving forward.

We discuss:

his evolution from the kinesiopathological model to movement optimism

the role of movement technique in injury risk reduction (he hates this question)

when we need to be clinically specific in our interventions (specific examples related to the pelvic floor are discussed)

his views on behaviour and opinion change.

Future Teaser! - we are going to have Antony on again to dive deep into behaviour change.

Relevant Links

More about Antony's courses here

Antony's clinic page here

Antony's popular The Female Athlete LITE course

And The Female Athlete Full course

Global Pelvic Health Course

Diastasis Done Differently course

Greg's Links (Blogs, courses, Recovery Strategies Workbook blah, blah, blah)

Website

Once again we are lucky to have another leader in our physio and rehab space.  Dr Ebonie Rio PhD, researcher (>100 peer reviewed publication), big thinker and practicing sports physiotherapist (with the Victorian Institute of Sport and The National Ballet).

Ebonie discusses her dual role as a researcher and as a practicing clinician.  She shares her insights on:

• manual therapy
• the role of heavy resistance training in tendinopathy
• the importance of a diagnosis for both rehab and in research
• when we need to be specific
• when we need to back off and sometimes listen to pain
• my pain in the butt

This podcast was excellent and there is no way we won't have her on again.  She has too much knowledge that eveyone needs to know.

Dr Stefi Cohen holds multiple (25) world records in powerlifting, is an accomplished Physical Therapist, Strength Coach,author and pro boxer.  She has done it all and shares the wisdom she has gained in all these areas.

Stefi talks about her views on:

• overcoming her own low back pain
• her book (Back in Motion) to help others with low back pain
• her powerlifting and athletic career
• her views on movement technique and injury risk
• her approach to helping others improve performance, stay healthy and get out of pain.

Some Relevant Links

The Revived Method

Minimal Effective Dose Training