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Language As A Metaphor For Movement And Rehabilitation

The importance of language continually arises in rehabilitation circles.  Various paradigms exist that attempt to explain why people hurt and how said people can improve their function.  In rehabilitation, there is often a false dichotomy between biomechanical and psychosocial models.  These constructs are distinguished to make information more digestible and facilitate learning in the abstract but cannot be differentiated in practice.  The bio is the psychosocial and vice versa.  Perhaps the term “biopsychosocial” is just a rhetorical response to reductionist, incomplete, and erroneous preexisting models.

In rehabilitation, the pendulum seems to be shifting more towards the psychosocial end as research continues to elucidate the unsatisfying relationship between structure, mechanics, and pain, for example.  Non-mechanical explanations about pain and physical output, however, aren’t necessarily better understood than mechanical ones.  We just do happen to know now that mechanical explanations aren’t the whole story or often even the lead actor.

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Dr. Andy Morgan on the Resilient Performance Podcast

Dr. Andy Morgan received his medical degree from Loma Linda University School of Medicine in 1986; He completed his residency training in psychiatry at Yale University in 1990. He then joined the faculty of medicine at Yale University & the National Center for PTSD where he worked for 25 years. Dr. Morgan has received grants and has published over 100 peer reviewed scientific papers on learning, stress, PTSD and performance in Special Operations forces. Dr. Morgan served on the National Academy of Science Eyewitness Identification Committee (2013-2014). For his work Dr. Morgan was awarded the US Army Award for Patriotic Service in 2008 and awarded the 2010 Sir Henry Welcome Medal and Prize for his development of interventions to buffer the negative impact of stress on human cognition, memory, learning and operational performance.

Dr. Morgan served as an intelligence officer (2003-2010) for the US Government and was a government advisor to the US Intelligence Science Board; The products developed from his research have been vetted and validated domestically as well as in a theatre of operations. In addition to his work at Yale and the National Center for PTSD, Dr. Morgan has performed Selection and Assessment and Operational psychology work for the United States Army and Navy for over 7 years. Dr. Morgan’s work in National Security with UNH is focused on intelligence analysis, national security, national security psychology and psyops.

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Why Physio Discussions Are Just Another Simpsons Episode

I recently stumbled across this video and dug the reference to Comic Book Guy from The Simpsons…

I recently stumbled across this video and dug the reference to Comic Book Guy from The Simpsons. I’ve often thought of Comic Book Guy while following online physio discussions, which is why the video really resonated with me. There is generally a moral undertone to the manner in which allegedly antiquated practices are criticized and an outrage in response to seemingly absurd things other professionals are doing.  This practice also manifests itself in reverse: those who bang on their moral drum the loudest often impose their intellectual will on those who disagree with them.  When one is morally certain, no dissenting intellectual counter is worth hearing.  This phenomenon transcends physio.

Two sides of the same coin…

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Rhetorical Language In Medicine

Words devoid of real meaning undermine the constructs to which they contribute. The consequences of poorly worded constructs in medicine are dire as they promote insufficient preparation and improper political and financial incentives.  Rhetorical language in medicine is problematic because rather than focusing on the details/boundaries that help navigate medical complexity providers devote too much time to stating the obvious.

The intent behind the “evidenced based medicine” movement, ensuring that practice is not contingent upon tradition and intuition alone, is noble.  The term itself, however, is rhetorical.  Consumers don’t want to be treated by non-evidenced based providers.  Moreover, medical providers likely all consider themselves to be “evidenced based”.  Neither the consumer nor the provider would be satisfied with the alternative to evidenced-based medicine.  Any medical intervention should be grounded in sound theoretical and/or empirical justification.  Evidence in medicine and science, however, is not as concrete as DNA or surveillance footage from a crime scene.  The question then becomes what constitutes “good” evidence.  In other words, who is the arbiter of evidence?  Some insights into this very difficult question can be found here.  The “good evidence” conversation is all about the details and often changes from case to case.  It’s not resolved by a few arbitrary Pubmed citations or a #science.  Puritanical and rhetorical pleas for better science or evidence can be emotionally satisfying but typically neglect to elucidate the degree to which controlled studies transfer to uncontrolled environments (e.g. actual patient care).

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Kelly Starrett on the Resilient Performance Podcast

Kelly Starrett is a coach, physical therapist, author, speaker, and creator of this blog, which has revolutionized how athletes think about human movement and athletic 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.

His 2013 release, Becoming a Supple Leopard has become a New York Times and Wall Street Journal bestseller. This 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 a series of movement and mobility courses 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.

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

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