The other day my boss and I were discussing the usage of aerobic machines (total gym, bike, UBE) in our treatment sessions. Prior to attending the Harris Health Residency and my manual therapy fellowship, I viewed these machines as “fillers” in patient care. The machines were an easy place to stick a patient when I was busy. Ironically, after going through these advanced training courses, I use these machines more than ever BUT for different reasons.
Collagen is the principle component of most connective tissue (ligaments, tendons, fascia, joint capsules). After an injury, the normal collagen matrix is disrupted. Evidence shows that this collagen is remodeled by continuous motion, blood supply and oxygen, vitamin C, and protein intake. For example, the inner 2/3’s of the meniscus has poor blood supply. To heal a meniscal lesion, those collagen fibers need 1000’s of repetitions. The leg bike or total gym (on a low level) are the best ways to target those fibers. The same principle applies to the glenoid labrum and the upper extremity ergometer. These tissues needed to be trained at ~15% of 1 RM to allow for proper fluid exchange and healing to occur.
Sometimes the warm-up seems meaningless for our patients, but with the proper education and instruction, we can teach them the importance of these long duration interventions.
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James Heafner PT, DPT, OCS:
Owner and lead physical therapist at Heafner Health, cash-based physical therapy in Boulder, CO. Areas of expertise include orthopedic and manual therapy, functional movement, pain science, and movement science.
In May 2013, I earned my Doctorate in Physical Therapy from Saint Louis University. After graduating from the Harris Health Systems Orthopedic Residency in October 2014, I moved to Boulder, CO. Since living in Boulder, I have started my own cash-based PT practice, earned my OCS certification, and teach for the OPTIM Fellowship and COMT program in Houston TX and Scottsdale, AZ.
Chris Fox PT, DPT, OCS: Physical therapist at Foothills Sports Medicine & Physical Therapy in Scottsdale, AZ and regularly lectures at the Phoenix Campus for NAU's DPT program and for Optim Manual Therapy's COMT program. Completed multiple advanced manual therapy courses implementing aspects of biomechanical analysis. He received his DPT from Saint Louis University in 2013. Completed Scottsdale Healthcare's Orthopaedic Residency (now Honor Health) in July 2014. He became a Board Certified Orthopaedic Specialist in 2015. Level I Expert in FMS and SFMA , Kinetacore FDN Level 1 certification, and IASTM Technique course completion. He would like to pursue further education in McKenzie Technique, Dry Needling, Strength & Conditioning, Orthopaedic and Manual Therapy.
Brian Schwabe PT, DPT, SCS, CSCS:
- Board Certified Sports Physical Therapist (SCS) at Elite OrthoSport in Santa Monica, CA which specializes in treating collegiate/professional athletes and clientele from the Beverly Hills, Hollywood, and Santa Monica areas.
- USC Sports Residency Trained Physical Therapist (<1% of all PT's residency trained)
- DPT from Saint Louis University
- Future plans/interest include:
1. USAW, SFMA & Catapult Systems technology for NBA teams
2. Pursuing a position as a sports physical therapist &/or Strength coach for a Division 1 athletic medicine department or professional sport team.
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