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Feel Better, Be Better, Get to Yes!
Our Treatment Philosophy
Good health depends on all body systems working well, and on appropriate communication between all body systems. In the same way, good healthcare depends on all health professionals working well and working together for the benefit of the patient.
The best health professionals acknowledge their own limitations, and seek to collaborate with other providers outside their own area of specialization to provide optimal patient care.
Here at Yes! PT, our main interest is your good health. We are happy to refer you to another provider in order to facilitate your care.
Our treatment philosophy grows out of three major evidence-based ideas:
1. All body tissues and systems are dynamic
This means that everything is connected to everything else, and everything influences everything else.
As an example, the traditional understanding of bones as immutable anchors for muscles, tendons and joints, is slowly changing as mounting evidence points to the crucial role of adaptability in bone function. Bones move on each other, and on surrounding tissues, and bones have been shown to change shape or deform under stress (Lazennec et al., 1997). Bones have also been shown to possess the property of piezoelectricity (Salzstein & Pollack, 1987). That is to say, if an electric current is applied to a bone, the bone will change shape (Wieland et al., 2015). Conversely, every time a bone changes shape, stresses on surrounding tissues change. In addition, the changed bone also generates a small electric charge, which influences the tissues in the surrounding micro-environment (Hastings, Mahmud, & Martini, 1989). This is just a small example of the myriad interactions between tissues and systems. All this inter-connectedness can make the diagnostic process frustrating, but it also provides multiple ways of influencing the problem (see GLOSSARY below). We are just beginning to understand some of the implications. This will be a fertile field for future research.
2. The body is organized to establish the most efficient steady state possible
This means that our body will attempt to adapt to all conditions, whether those conditions promote optimal performance or make optimal performance difficult to achieve.
Everyone has experienced the aches and pains that come from activity. These aches and pains are evidence of the body’s attempt to deal with imposed conditions. Sometimes these changes are purely physiologic, and sometimes they entail an observable change in the arrangement of the body’s tissues. The changes observed by manual therapists include changes in skin, muscle and bone, as well as changes in the central nervous system (Pickar, 2002). When these changes do not resolve for whatever reason, they present a new challenge to the body. If the challenges are positive or small, you may not even notice them. But your body will recognize and adapt to them. Eventually, if enough negative changes accumulate, adaptation in one system or another may be exhausted and you will begin to experience symptoms (Liem, 2016). Regular Physical Therapy Checkups can reduce the burden of negative changes, and thus may reduce or eliminate symptoms, by optimizing the interactions among systems to promote good health.
3. The mind-body connection is an important component of any holistic treatment approach
This means that your attitude plays a significant part in your health and disease.
We are all familiar with the power of the mind, as demonstrated by yogis and followers of other eastern traditions. Recently, two very interesting studies have been published. One was conducted in Portugal (Carvalho et al. 2016). Patients with chronic low back pain were divided into two groups: One group received usual care. The other group received usual care, but were also instructed to take two sugar pills a day from a bottle labeled “Placebo”. At the end of the trial, those in the usual care only group were also offered the opportunity to take the Placebo pills. Ready ? Not only did the group taking sugar pills do better on all measures, including improved pain and function, but the people who switched to placebo after the trial, also showed significant improvement compared to usual care. The second study, done in the US, (Dunn et al. 2016) looked at predictors of failure of non-operative treatment for rotator cuff tears. Among all the factors they looked at, including gender, age, race, education, duration of symptoms, strength, and tear severity, the strongest predictor of failure was the patient's own belief that the treatment would not be helpful.
So, if you have a healthcare provider who provides support and encouragement, keep working with that person. On the other hand, if your healthcare provider is consistently negative and never offers encouragement, you should find a new healthcare provider.
Bibliography
Carvalho C, et al. (2016). Open-label placebo treatment in chronic low back pain: a randomized conrolled trial. Pain, Dec; 157(12): 2766–2772.
Dunn W. et al., (2016). 2013 NEER Award: predictors of failure of non-operative treatment of chronic, symptomatic, full-thickness rotator cuff tears. J Shldr Elb Srg, 25, 1303-1311.
Hastings G, Mahmud F, & Martini M. (1989). Non-contacting electrode system for the measurement of strain generated potentials in bone. J Biomed Eng, 403-408.
Lazennec J. et al., (1997). Dynamic anatomy of the acetabulum: an experimental approach and surgical implications. Surg Radiol Anat 19:1, 23-30.
Liem T. (2016). A.T. Still's osteopathic lesion theory and evidence-based models supporting the emerged concept of somatic dysfunction. J Am Osteopath Assoc, 654-661.
Pickar J. (2002). Neurophysiological effects of spinal manipulation. Spine J, 357-371.
Salzstein R., & Pollack S. (1987). Electromechanical potentials in cortical bone--II. Experimenmtal analysis. J Biomech, 271-80.
Wieland D, et al. (2015). Investigation of the inverse piezoelectric effect of trabecular bone on a micrometer length scale using synchrotron radiation. Acta Biomater, 339-46.
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