An Old Guy, Mall Walking and a Cup of Coffee

February 29, 2012

I recently had a grey haired patient, ‘Sam’, who was having a problem with walking. It seemed that the longer winter progressed, the more trouble Sam was having. I wanted to get this ‘Old Guy’ on a home walking program, but as it was still winter, walking outside was not an option. Instead, I told Sam that I wanted him to walk 3-4 days a week at the local mall. He replied, “Four days a week? That’s a lot.” In reality I wanted him ‘Mall Walking’ seven days a week, but I did not think that would happen, so I asked for 3-4 days. Read the rest of this entry »


Injury Care and Recovery – a follow up

November 30, 2011

Today’s post will be a little dry. It will focus on the business end of PT, but the post should offer insights to physical therapists and their patients.

Last week I talked about working with a hand patient who I saw 12 times over a 2 month period. One of the questions I was asked more than once was, “How do I document such slow progress in light of Medicare standards that require regular progress for treatment to continue?” The answer that has worked best for me over the 20 year period that I owned and operated an outpatient PT clinic is that I documented not only what I saw, but what I thought I saw. Read the rest of this entry »


Injury Care and Recovery in Physical Therapy

November 23, 2011

How long does it take for Injury Care and Recovery in Physical Therapy?

This is a question I have discussed before. It is a complicated question and relates to the degree of injury, the health of the patient, and a myriad of other details like patient lifestyle, compliance with home exercise, etc. Some patients show rapid gains and are done with PT in just a few visits. Others, post surgery patients, for instance, attend PT for 2-3 months. The patient I am going to discuss today is one of those fun patients who surprised me with their results.

I am treating a patient with a painful 45 degree flexor contractor of her little finger. I typically do not see hand patients. If the hand injury is minor enough, I will consent to see the patient, but only if they refuse seeing a ‘Hand Therapist’. This patient is coming to me having failed at another therapy center, and earlier having responded well to me for treatment of low back pain. (I should note that this patient had minor flexor contractures of all of her fingers, but only the little finger was extremely painful. Still, if her little finger continued to get worse, likely all of her fingers would have gotten worse as well.) Read the rest of this entry »


Mark and Martha – A Home Care PT story

October 31, 2011

My home care PT patients have often left me in wonder. They can so easily absorb the difficulties life has to offer, and then just keep going. Today let me tell you about Mark, and especially Martha.

‘Mark’ was a 75 Year old farmer who was trying to recover from a CVA (stroke). He was quite physically disabled and I did not think he would ever be able to return to farming. He needed his wife’s assist for almost all mobility, except for the simplest of transfer activities. He could transfer from his wheelchair to a bed or to a commode without assist. He could manipulate his wheelchair about his home without assist (though he scraped against or banged against almost everything). He could also feed himself and he could deal with most simple hygiene issues (shaving, brushing his teeth, etc.). All in all, Mark was a typical home care patient who would probably function well, as long as there was someone there to help him with complex activities such as bathing, dressing and cooking. Read the rest of this entry »


A PT, a Farmer and his Dog, Rex – a home PT story

October 24, 2011

Last week I wrote about Farmer Bob, a home PT patient who pushed himself much harder than most and was able to quickly return to farming, even before his home PT sessions had been completed. I ended that story by mentioning that Farmer Bob had a dog.

Most of my home PT patients who lived in the country had dogs. Their dogs were usually friendly, often to the point of obnoxious. They would run up to you, barking, wagging their tail, wanting to play. Or, they would  rub against you wanting to be petted. Or they would jump on you, as if to give you a big hug. None of these dogs presented a problem. Read the rest of this entry »