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Mind Body Puzzle

A fracture/dislocation of my ankle skiing Mount Perisher last July, subsequent surgery and 8 weeks non-weight bearing, gave me great insight into the physical and psychological hurdles and time investment needed to get back to a busy and productive work and home life.
I experienced firsthand the many pieces of the puzzle that need to be assessed to achieve optimal functional outcomes and it is very much a mind and body challenge that needs to be addressed both from the bottom up as well as top down. As one of my course slides below shows, there are many factors that feed into the puzzle of minimising pain and disability with individualised weighting to rehab components depending on the individual client.

So the latter half of 2017 saw me focusing rehab goals from each piece of the above puzzle (as an old gluteal tendinopathy issue raised its head again), strength and ergonomic challenges for teaching and not to mention the psychological hurdles of 10 hour work days and returning to skiing with the family.
It’s wonderful to see the current concepts discussed in the ‘Body in Mind’ blog bringing some emphasis back to addressing the needs and requirements of the body while still addressing the mind and psychological aspects of recovery.

As I paced myself towards walking, sledding then skiing Icey /snowy sloped on our winter holiday in the northern hemisphere in January, I was channelling Lorimer Mosley (I even told my kids about his now famous brown snake and the brown twig pain experience) and facing my fears. I do know however, the required surgery, the manual therapy afterwards, the rehab strength, balance and cardio vascular conditioning and the hip tendon program were essential and pivotal to face my fears of skiing Icey 5 km long mountain slopes at 3,000 metres.
So in 2018 Bounce back is committed to provide new online resources backed with face to support clinicians in providing multifaceted and targeted functional and manual therapy strategies to optimise patient outcomes.

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Hip Case Study with Video Assessment

Want to efficiently and effectively diagnose hip dysfunction in a busy clinical setting?

Easier said than done, or is it?.

A video case study gives some new strategies and tests to make the clinical job easier.



What if I told you there is now a simplified flow chart approach to hip differential diagnosis which makes both manual treatment and specific exercise prescription clear and logical. Would it be worth your while to understand a little more? Well in this weeks Blog I provide you with the visual answers to understand the “Hip Differential Diagnosis Flow Chart” and a case study that puts it into practice with videos, as a picture tells a thousand words!

How much were we really taught about differential diagnosis and treatment of the hip in Undergraduate courses? Not very much at all, but via advances in hip imaging, arthroscopic surgery as well as muscle and tendon research, our knowledge about how the hip should be assessed and rehabilitated has exploded in the past 5 years.

During my Sports Physiotherapy Specialist preparations, it became clear that there are well in excess of 50 hip tests that are recommended for effective differential diagnosis of the hip as pathology is so widely varied. Authorities on the hip agree that differential diagnosis is the key and must be considered and addressed to optimise performance, but so often a combination of presenting signs and symptoms leaves the health professional confused and frustrated, even if you have remembered all of those 50+ tests.
The trick to understanding the hip lies in using a visual flow chart that divides presenting hip pathologies into 5 different categories and understand that more than 1 issue can be present and muddy the water. Using the flow chart approach to hip diagnosis will keep you on track to seeing the whole hip picture clearly.
Hip Differential Flowchart
The 5 categories that all assessment strategies from the beginning should aim to deferentially diagnose are:

  • 1) Inflammation/sensitisation
  • 2) Poor dynamic control/instability
  • 3) Hip Intra articular pathology
  • 4) Hip extra articular pathology
  • 5) Tendon issues

Once the presenting issues are identified and demystified, a treatment and exercise program can be designed with an evidence based rehab strategy. The case study link using Powerpoint and video shows part of an assessment protocol differentiating between anterior hip stiffness and anterior hip instability.

If the hip excites or confuses you….

join me at my upcoming 2-day Hip Course to be held at APA Sydney Rooms 5-6 August 2017 ($828) – or book via the APA portal if you are a APA member

 

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Free Hip Rehab Exercise Grid


Want to really understand  Hip rehab from the inside out? Here is a free resource with the answers.Tile_50_Hip

Why do some patients flare with exercises that should work to improve hip and dynamic function? 

We have all had those patients  that keep you awake at night thinking: why does their hip or pelvic pain keep flaring with Pilates and hip strengthening exercises that you know work with other clients? I know the term “psychological issues” is the  easy answer,  but make sure  you don’t throw the baby out with the bath water, by ignoring  local hip structures that may create a cascade of pain responses, cortical motor control inhibition and emotion.

I  spend many of my clinical hours seeing  complex  hip pain clients referred by Orthopaedic/Sports Specialists,  Physio colleagues and insurance companies asking for a multifaceted rehab strategy. Obviously psychological strategies  must always be considered and addressed  but differential diagnosis  of often  a combination of presenting
musculo-skeletal issues is also key! Once the presenting issues are identified and demystified,  a treatment and exercise program can be  designed with an evidence based  rehab strategy.

All the knowledge I have gathered and developed regarding hip-related issues as part of my Sports Physio Specialisation qualifications, I have put together in a comprehensive  but  easy-to-follow format in the Hip Rehab Exercise Grid which I offer to you totally free Click here to access. This is a must-have resource that you can start using today, with my compliments. My passion has always been to impart knowledge for the maximum good and if this knowledge helps you and your clients, then the years that have gone into understanding the hips have been worthwhile.

Want to know more and see the Hip Rehab Exercise Grid theory and exercises demonstrated and explained? Then choose from our 8 part “Optimising the Hip” online series Click to view our special offer including 2 for the price of 1  or join me for a Hip knowledge and food feast on my course Hip Differential Diagnosis and Prescriptive Exercises on March 19/20th, Holiday Inn Mascot Sydney. Believe me, the food and venue is second to none.

As a “great to see you face to face gift” I have decided to give all participants who attend the face to face course, the entire 8 online series “Optimising the Hip” completely free, so the understanding and learning can keep happening months after our time together on the course.

So whatever level of knowledge  you are looking for to  fill in your own clinical gaps in hip rehab, I  hope  reading this post and the free resources have made the time you have invested worthwhile. Sincerely Trish Wisbey-Roth, Specialist Sports Physiotherapist ( FACP)

Hip_Rehab_Exercise_Grid

These issues are identified and individual exercises are demonstrated in the new 8-part online Optimising the Hip video series.  This series consists of 8 Modules of approx 30 – 40 minutes each, ideally paced as a practical tutorial for  physiotherapists.Hip_Series

Click to view our special offers including 2 for the price of 1.

 

 

 

For practical applications of the exercises included in this guide, you may be interested in attending my upcoming 2-day Hip course to be held in at Sydney Airport (Holiday Inn) from 19-20 March 2016. Hurry, strictly limited to 25 participants.

If the hip excites or confuses you….

join me at my upcoming 2-day Hip Course to be held at APA Sydney Rooms 5-6 August 2017 ($828) – or book via the APA portal if you are a APA member


 

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Interested in working with elite athletes to help them to achieve their best?

This post gives you a behind-the-scenes look at world record and Olympian aerial skier, Lydia Lassila’s journey from debilitating back pain which made her contemplate retirement to a world-record at the last winter Olympics.

Lydia Lassila Olympics

It’s hard to comprehend the commitment need for an athlete to perform ski landings sustaining up to 9x body weight when they are experiencing pain just turning over in bed. This was the stark reality that Lydia was faced with when returning to her sport after the birth of her first child. I was asked by the winter Olympic team to assess the possibility of Lydia getting back to her best. After a detailed examination, it became apparent Lydia needed 3 phases to her rehabilitation program:

Phase 1) Minimise aggravating lifestyle and sporting activities combined with manual therapy and specific muscle activation strategies. Pacing and flare-up strategies were a must.

Phase 2) Retrain Lydia’s movement patterns for aerial-skiing by breaking the movement sequence down into small pieces that could be practised on water in Switzerland, to minimise impact.

Phase 3) Building elite muscle strength, finely-tuned with concentric and eccentric muscle programming in specific joint angles needed by Lydia to form the complex movement patterns required for aerial skiing and the high-impact landing.

For your benefit, attached is a link to a case study covering the behind-the-scenes rehabilitation program which I designed for Lydia. This program was undertaken by Lydia and led her back to full recovery, an Olympic medal at Socchi and becoming the first woman to ever perform a quadruple somersault in aerial skiing.

Lydia Lasilla case study file

Recently Lydia interviewed me on the strategies required to overcome long-standing back pain and some of the new and innovative strategies we are using at Bounce back.  In her own words Lydia talks about her own rehabilitation experience.

Lydia’s rehab experience and her interview of Trish Wisbey-Roth

 

 

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Thanks for attending…

SMART pic

Thanks to those that attended the Bounce back Digital info session on Saturday. We hope that the afternoon was full of valuable knowledge about the exciting new developments for the Bounce back program, particularly our move to a digital platform. Below are links to both Trish and Phil’s presentations from the first part of the afternoon.

Trish’s presentation Part A

Trish’s presentation Part B

Phils Presentation (Nov-9)

Additionally, below is a copy of a presentation Trish gave recently to the SMA on the Bounce back digital platform, which is similar to her presentation on Saturday. Feel free to review yourself or share with your staff as a way to let them know the key points of what we discussed on Saturday.

SMA presentation on Bounce back Digital

Questionnaire for attendees

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New Bounce back Overview Video

We have just received the final videos for our BOUNCE b•a•c•k Instructor Online training that Trish filmed in London earlier this year.
This 2 minute Intro gives you a short overview and taste of the 4 part Instructor training series.


If you would like to find out more about our Special Offer to becoming incorporating BOUNCE b•a•c•k in your clinic, click this link

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On your bike…Sydney Cycling course in June!

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Sydney Cycling course conducted by Trish Wisbey-Roth (FACP) (AIS/UC) (FSMA): Providing valuable knowledge in the complex area of body and machine. Includes: bike setup, measurements & cycle-specific musculoskeletal screening.

Enrolments are now open:

Click for more info or to enrol

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Back Pain – BUY THE E-BOOK AND PLAN YOUR RECOVERY

A plan for sufferers and a tool for physiotherapists

A plan for sufferers and a tool for physiotherapists

The Back Pain Personal Health Plan – Bounce Back Edition is the only back care book you will ever need showing you how to take control of your back pain. A comprehensive self-help manual which will dispel the myths and confusion about back pain and help you to finally understand the real causes to everyday neck and back pain.

A valuable new publication  based on current research and available clinical evidence to optimise recovery and independence in all those who have suffered the effects of back and neck pain/

Learn easy to follow safe and effective neck and back exercises that increase flexibility and strength of the spine and teach efficient posture.

 

You’ll also learn:

  • How to break the fear and anxiety cycle that keeps you in a vulnerable and painful state
  • A new understanding of how our spine and body works
  • How to increase your confidence levels through exercise
  • How to identify muscular tightness and imbalances
  • Ways to improve your posture
  • Ways to use stretching to ease the build-up of tense muscles
  • How to gradually strengthen your back muscles as you continue to gain confisence and regain your full range of activity

The exercises in The Back Pain Personal Health Plan contain carefully selected examples from the Bounce Back Active Rehabilitation System and are based on the experiences of over 5000 participants.

Click here to buy or contact us with enquiries at admin@bbclasses.com.au.

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Enrol for 2-part 3D Lumbo Pelvic-Assessment & Motor Control course

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Trish Wisbey-Roth 2015 courses

 

 

3D LUMBO-PELVIC COURSE – ASSESSMENT & MOTOR CONTROL

14 – 17 May 2015 in Sydney

 

Assessment & Treatment of the Pelvic Complex and Lumbar Spine (Part 1)

  • 3D anatomy, Biomechanics and assessment of the lumbar spine and pelvic complex.
  • A clear differential diagnostic algorithm for SIJ dysfunction outlined in practical sessions.
  • Comprehensive assessment of lumbar spine structural and neural issues.
  • Effective treatment for SIJ and lumbar spine problems specific for dysfunction.

Thursday, 14th May – Friday, 15th May

Cost:  $685.00

Optimising Motor Control of the Lumbar, Pelvic and Hip Region (Part 2)

  • A detailed outline of the dynamic slings of the lumbar pelvic and hip regions and how they relate to individual patient presentation.
  • A specific and graded assessment protocol for lumbo pelvic and hip dysfunction.
  • Detailing practical strategies that can be incorporated into rehabilitation and maintenance training programs to optimise dynamic lumbo/pelvic/hip control and proprioception.
  • Detailed exercise handouts included in the training manual that can be applied in the clinic immediately.

Saturday, 16th May – Sunday, 17th May

Cost:  $685.00

** Special Offer:  Enrol into the 4 day multi-course option to attend Part 1 and Part 2 over 4 days and save 15% on enrolment cost.  Enrolment fee:  $1164.50 (15% saving)

Go to: http://www.bbclasses.com.au/view_course.php?pg=intro&course=3096

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New online Physiotherapy video resource – just a click away

video pic clicky

Introducing a new collection of Bounce Back Education online training videos. Research-based, practical and specific information that can be put into immediate use in your practice.

This first is an  8-part Hip Optimising Series priced at the special discounted price of $99.50.
This series consists of 8 Modules of approx 30 – 40 minutes each, ideally paced as a practical tutorial for physiotherapists.  1 – Dysfunction Specific Exercise Therapy to Optimise Hip Function 2 – Dysfunctional Patterns of Abdominals and Adductors 3 – Retraining of Deep Stabilisers of the Hip: Illiacus, quad fem, glut med 4 – Exercises to Decrease Hip Muscle Spasm (Part A & B) 5 – Gluteal Tendinopathies for Optimal Hip Function 6 – Optimise Gluteal Function for Performance 7 – Adductor (+/- tendinopathy) and VMO 8 – Hip Flexor (+/- tendinopathy)
There are also a number of resources and handouts that can be downloaded which are a valuable resource for you and your patients. You’ll have access to these intensely practical modules no matter where you are, what time it is, at your own pace and as often as you’d like.

To purchase go to: http://www.findbounceback.com/bb-education

 

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