Welcome to another engaging episode of the Hands On Hands Off podcast! In this special AAOMPT Conference preview, host Jimmy McKay sits down with esteemed physical therapists David Kempfert and Amanda Grant to discuss their upcoming presentations and the latest trends in manual and manipulative therapy. Discover the groundbreaking techniques and insights that will be showcased at the conference and gain valuable knowledge to enhance your clinical practice.
Key Points Discussed:
- Overview of David Kempfert and Amanda Grant's presentations at the AAOMPT Conference.
- Key trends and advancements in manual and manipulative therapy.
- Detailed discussion on innovative techniques and their practical applications.
- Case studies and real-world examples shared by the experts.
- Predictions for the future of manual therapy and its impact on patient care.
00:00:00 --> 00:00:01 And let's do this thing.
00:00:01 --> 00:00:03 David, Amanda, welcome to the podcast.
00:00:04 --> 00:00:05 Thank you for having us.
00:00:06 --> 00:00:06 Thank you.
00:00:06 --> 00:00:07 Excited.
00:00:08 --> 00:00:09 So you will be presenting in
00:00:10 --> 00:00:11 Orlando at the AOMT conference.
00:00:11 --> 00:00:13 So this is the prequel.
00:00:13 --> 00:00:14 This is the teaser.
00:00:14 --> 00:00:16 This is the movie trailer of
00:00:16 --> 00:00:18 what will be coming up when
00:00:18 --> 00:00:19 we get together in Florida.
00:00:20 --> 00:00:22 So my first hard-hitting question is,
00:00:22 --> 00:00:25 will you be presenting in
00:00:25 --> 00:00:26 Mickey Mouse ears?
00:00:26 --> 00:00:27 Are you going to be hitting Disney?
00:00:27 --> 00:00:28 That's the question everybody asks.
00:00:28 --> 00:00:29 Are you going to be hitting
00:00:29 --> 00:00:30 Disney beforehand?
00:00:30 --> 00:00:31 Amanda's already nodding.
00:00:33 --> 00:00:33 Of course.
00:00:34 --> 00:00:34 Yes.
00:00:34 --> 00:00:35 Or at least a Disney costume,
00:00:35 --> 00:00:36 maybe of some sort.
00:00:36 --> 00:00:38 Maybe not Mickey ears, but Disney costume.
00:00:38 --> 00:00:39 A little flavor.
00:00:40 --> 00:00:40 Yeah.
00:00:40 --> 00:00:41 I'm expecting that.
00:00:41 --> 00:00:42 I do not have the ears,
00:00:42 --> 00:00:44 but I will be wearing the slippers.
00:00:45 --> 00:00:45 That's all I'm looking for.
00:00:46 --> 00:00:48 All right.
00:00:48 --> 00:00:49 Let's get down to business.
00:00:50 --> 00:00:51 What are you presenting on?
00:00:51 --> 00:00:52 What do people get to learn
00:00:52 --> 00:00:54 from you when you'll be
00:00:54 --> 00:00:56 together on stage at the AM
00:00:56 --> 00:00:58 conference this October?
00:00:59 --> 00:00:59 Yeah,
00:00:59 --> 00:01:02 so we're actually continuing off of a
00:01:02 --> 00:01:03 series of presentations
00:01:03 --> 00:01:05 that we've given at prior AM conferences.
00:01:07 --> 00:01:08 You know, we've done the shank,
00:01:09 --> 00:01:09 if you will,
00:01:09 --> 00:01:10 and the tibialis posteriors
00:01:10 --> 00:01:14 roll on the hind foot, mid foot last year,
00:01:14 --> 00:01:15 talking a little bit more
00:01:15 --> 00:01:17 specific of hind foot and
00:01:17 --> 00:01:18 transverse tarsal joint.
00:01:18 --> 00:01:19 And then based on feedback,
00:01:20 --> 00:01:21 we're continuing down the
00:01:21 --> 00:01:22 mid foot to the medial and
00:01:22 --> 00:01:23 lateral columns.
00:01:24 --> 00:01:25 So it's a sequel is what you're saying,
00:01:25 --> 00:01:26 which just fits with the
00:01:27 --> 00:01:28 Universal Studios and the
00:01:28 --> 00:01:29 whole Florida mindset.
00:01:29 --> 00:01:29 That's great.
00:01:29 --> 00:01:30 All right.
00:01:30 --> 00:01:31 So let's dig into some
00:01:31 --> 00:01:32 specifics now that we
00:01:32 --> 00:01:33 understand where in the
00:01:33 --> 00:01:34 body we're located.
00:01:35 --> 00:01:36 Can you explain the
00:01:36 --> 00:01:37 importance of the
00:01:37 --> 00:01:38 interdependent relationship
00:01:38 --> 00:01:40 of motion among all the
00:01:40 --> 00:01:42 segments of the foot and ankle?
00:01:43 --> 00:01:44 We'll say in functional
00:01:44 --> 00:01:44 weight bearing because
00:01:44 --> 00:01:45 that's where we hope people
00:01:46 --> 00:01:46 are a lot of the time.
00:01:47 --> 00:01:49 yeah um that's a loaded
00:01:49 --> 00:01:52 question yeah right to
00:01:52 --> 00:01:55 start off with but uh yeah so
00:01:56 --> 00:01:58 The interdependent relationship, I think,
00:01:58 --> 00:02:01 is best summarized in, you know,
00:02:01 --> 00:02:02 the concept that we as
00:02:02 --> 00:02:03 physical therapists
00:02:03 --> 00:02:04 probably all know is the
00:02:04 --> 00:02:05 windlass mechanism.
00:02:05 --> 00:02:08 You know, great toe MTP extension,
00:02:08 --> 00:02:09 raising up the arch.
00:02:09 --> 00:02:11 Yes, it's by way of plantar fascia,
00:02:11 --> 00:02:12 hindfoot supination.
00:02:12 --> 00:02:14 But I think the outcome of
00:02:14 --> 00:02:16 that is perhaps even more important.
00:02:16 --> 00:02:17 And that puts the actual
00:02:17 --> 00:02:20 gastrocnemius and soleus on
00:02:20 --> 00:02:21 its best length tension
00:02:21 --> 00:02:22 relationship to produce
00:02:22 --> 00:02:24 force to actually propel us forward.
00:02:25 --> 00:02:26 Adding to that,
00:02:26 --> 00:02:27 I think knowing that the
00:02:27 --> 00:02:28 foot is a load-sharing system,
00:02:29 --> 00:02:30 So it's considered the
00:02:30 --> 00:02:32 longitudinal arch load sharing system.
00:02:32 --> 00:02:32 You know,
00:02:32 --> 00:02:34 obviously just everything is related.
00:02:35 --> 00:02:37 And you have to have that
00:02:37 --> 00:02:38 internal rotation of the
00:02:39 --> 00:02:40 shank to have that proper
00:02:41 --> 00:02:42 supination pronation of the
00:02:42 --> 00:02:44 hind foot and the
00:02:44 --> 00:02:45 subsequent elevation and
00:02:45 --> 00:02:47 depression of the midfoot
00:02:47 --> 00:02:49 for our function and weight bearing.
00:02:49 --> 00:02:50 The biggest factor to that
00:02:50 --> 00:02:51 is really just what is the
00:02:51 --> 00:02:52 ground reaction forces
00:02:52 --> 00:02:53 doing and what can the
00:02:53 --> 00:02:54 muscles actually produce
00:02:54 --> 00:02:55 for force against that.
00:02:56 --> 00:02:56 I mean,
00:02:57 --> 00:02:58 it seemed like he handled the
00:02:58 --> 00:02:59 knuckleball pretty well
00:02:59 --> 00:02:59 right off the bat.
00:02:59 --> 00:03:00 Okay.
00:03:01 --> 00:03:03 Moving on then, next pitch would be,
00:03:03 --> 00:03:05 there's a lot of segments in the foot.
00:03:05 --> 00:03:06 It might seem simple,
00:03:06 --> 00:03:07 but there's a lot of different parts,
00:03:08 --> 00:03:08 right?
00:03:09 --> 00:03:09 How do the different
00:03:09 --> 00:03:10 segments contribute to the
00:03:11 --> 00:03:12 overall function of the foot?
00:03:12 --> 00:03:13 If someone were to ask you that,
00:03:13 --> 00:03:15 let's say a new graduate PT,
00:03:15 --> 00:03:16 now they understand the basics,
00:03:16 --> 00:03:17 now they're moving on to a
00:03:17 --> 00:03:18 little more advanced concepts.
00:03:18 --> 00:03:19 How do those segments or how
00:03:19 --> 00:03:20 would you explain those
00:03:20 --> 00:03:21 segments contributing to
00:03:21 --> 00:03:23 the overall function of that foot?
00:03:23 --> 00:03:25 Yeah, great question.
00:03:25 --> 00:03:26 First question is how many?
00:03:26 --> 00:03:26 There's 10.
00:03:28 --> 00:03:29 If you really dive into the
00:03:29 --> 00:03:30 biomechanical descriptions,
00:03:30 --> 00:03:32 there's 10 segments of the
00:03:32 --> 00:03:34 actual hind foot, mid foot, forefoot,
00:03:35 --> 00:03:36 even then the toes included to it.
00:03:36 --> 00:03:37 And yeah,
00:03:37 --> 00:03:38 they all are working interdependently.
00:03:38 --> 00:03:41 I think what's perhaps even
00:03:41 --> 00:03:42 more important than just
00:03:42 --> 00:03:44 that is understanding all
00:03:44 --> 00:03:45 of the muscles that
00:03:45 --> 00:03:46 actually contribute to it.
00:03:46 --> 00:03:48 I mean, we're talking 19 intrinsic,
00:03:48 --> 00:03:49 12 extrinsic muscles.
00:03:50 --> 00:03:50 Um,
00:03:50 --> 00:03:51 and we're trying to have a good
00:03:51 --> 00:03:53 understanding of how are
00:03:53 --> 00:03:53 each of those muscles
00:03:53 --> 00:03:54 controlling those segments.
00:03:56 --> 00:03:57 All in a very small space as well.
00:03:58 --> 00:03:58 Very much.
00:03:59 --> 00:04:00 That's a lot to it.
00:04:01 --> 00:04:02 How about this one?
00:04:02 --> 00:04:03 Who wants to answer this?
00:04:03 --> 00:04:06 What role does the extrinsic musculature,
00:04:06 --> 00:04:07 you mentioned that a second,
00:04:07 --> 00:04:08 play in controlling the
00:04:08 --> 00:04:09 combined motion of the foot?
00:04:09 --> 00:04:11 That feels like a good continuation.
00:04:11 --> 00:04:12 We'll say foot and ankle
00:04:12 --> 00:04:13 because that also comes into play.
00:04:14 --> 00:04:14 Mm-hmm.
00:04:16 --> 00:04:19 So as far as that, yeah, I'll keep going.
00:04:19 --> 00:04:20 The extrinsics, you know,
00:04:20 --> 00:04:22 that's part of my area of
00:04:22 --> 00:04:23 particular interest and
00:04:23 --> 00:04:24 what I'm trying to do a
00:04:24 --> 00:04:26 little bit of investigation
00:04:26 --> 00:04:27 on more specifically.
00:04:27 --> 00:04:28 But there is recent
00:04:28 --> 00:04:29 literature that's
00:04:29 --> 00:04:30 indicating that the
00:04:30 --> 00:04:31 extrinsic musculature
00:04:31 --> 00:04:33 actually supports the quote
00:04:33 --> 00:04:35 unquote heart arch height.
00:04:35 --> 00:04:36 I argue that it's actually
00:04:37 --> 00:04:38 arch mobility more so than
00:04:38 --> 00:04:40 the actual intrinsic musculature.
00:04:40 --> 00:04:44 So having very good, you know, activation,
00:04:44 --> 00:04:44 strength,
00:04:44 --> 00:04:47 endurance of those muscles is just vital.
00:04:47 --> 00:04:49 All right.
00:04:49 --> 00:04:51 So we mentioned key kinetic
00:04:51 --> 00:04:52 principles a second ago,
00:04:52 --> 00:04:54 and I want to continue to play off this.
00:04:55 --> 00:04:55 Help us understand some of
00:04:56 --> 00:04:56 those key kinetic
00:04:56 --> 00:04:58 principles relevant to that
00:04:58 --> 00:05:00 foot and ankle segments
00:05:00 --> 00:05:01 that we just mentioned.
00:05:02 --> 00:05:04 Yeah, kinetic as far as the motion goes,
00:05:04 --> 00:05:05 you know,
00:05:05 --> 00:05:06 you can't have the proper
00:05:06 --> 00:05:08 pronation supination of
00:05:08 --> 00:05:09 anywhere within the foot
00:05:09 --> 00:05:10 without having the
00:05:10 --> 00:05:13 appropriate motion at the shank, right,
00:05:13 --> 00:05:14 internal, external.
00:05:14 --> 00:05:17 I think a good summary of the kinetics,
00:05:17 --> 00:05:18 the motion is, you know,
00:05:18 --> 00:05:20 for the students that are listening in.
00:05:20 --> 00:05:22 When we do our basic
00:05:22 --> 00:05:23 odiometry of plantar flexion,
00:05:24 --> 00:05:25 dorsiflexion of the ankle,
00:05:25 --> 00:05:26 we know that there's a
00:05:26 --> 00:05:28 total range of approximately 70 degrees.
00:05:29 --> 00:05:30 However, in fact,
00:05:30 --> 00:05:31 there's really only about
00:05:31 --> 00:05:35 45 to 47 degrees of that 70
00:05:35 --> 00:05:36 that is really happening at
00:05:36 --> 00:05:37 the talocrule.
00:05:38 --> 00:05:39 The rest of it is actually
00:05:39 --> 00:05:42 occurring minimally at subtalar joint,
00:05:42 --> 00:05:44 but the majority is
00:05:44 --> 00:05:45 actually talonavicular and
00:05:45 --> 00:05:48 some also at calcaneocuboid as well.
00:05:48 --> 00:05:49 You could include the
00:05:49 --> 00:05:50 forefoot transverse
00:05:51 --> 00:05:52 metatarsal joint in there as well.
00:05:52 --> 00:05:53 Point being,
00:05:54 --> 00:05:56 there's approximately 35% to
00:05:56 --> 00:05:59 37% of our plantar flexion, dorsiflexion,
00:05:59 --> 00:06:02 that is not at the talocruel that we,
00:06:02 --> 00:06:03 as entry level,
00:06:03 --> 00:06:04 are taking our measurements at.
00:06:05 --> 00:06:06 Understood.
00:06:06 --> 00:06:07 And I'm glad that was not on
00:06:07 --> 00:06:08 the MPTE because that would be right.
00:06:09 --> 00:06:10 All right,
00:06:10 --> 00:06:12 let's get down to what I like
00:06:12 --> 00:06:13 about conferences when they
00:06:13 --> 00:06:15 go into in terms of labs
00:06:15 --> 00:06:16 and techniques and hands on
00:06:16 --> 00:06:17 and observations.
00:06:18 --> 00:06:18 Talk about some of those
00:06:18 --> 00:06:19 specific techniques or
00:06:19 --> 00:06:20 approaches that will be
00:06:20 --> 00:06:21 covered in the lab
00:06:21 --> 00:06:22 presentations to help
00:06:22 --> 00:06:24 enhance that clinical practice.
00:06:27 --> 00:06:28 But I think just as what David described,
00:06:28 --> 00:06:30 we really go into taking
00:06:30 --> 00:06:31 that detail we talk about
00:06:31 --> 00:06:34 in how joints move and why
00:06:34 --> 00:06:35 it's important to look at
00:06:35 --> 00:06:37 multiple areas and break
00:06:37 --> 00:06:38 that down into the lab
00:06:38 --> 00:06:39 technique and look at very
00:06:39 --> 00:06:41 specific techniques that
00:06:42 --> 00:06:43 feel both quantity and
00:06:43 --> 00:06:45 quality of movement.
00:06:45 --> 00:06:46 And the way we've organized
00:06:46 --> 00:06:47 the lab sessions is there's
00:06:47 --> 00:06:50 time for active feedback from myself,
00:06:51 --> 00:06:53 David, Catherine Patla,
00:06:53 --> 00:06:54 who's our other colleague
00:06:54 --> 00:06:55 who's presenting with us,
00:06:56 --> 00:06:57 Because I think a lot of
00:06:57 --> 00:06:59 individuals move too fast
00:06:59 --> 00:07:00 and too quick through end
00:07:00 --> 00:07:02 range and actually feel
00:07:02 --> 00:07:03 things are stiff when in
00:07:03 --> 00:07:04 actuality they're not
00:07:05 --> 00:07:06 because they've blown
00:07:06 --> 00:07:06 through the end range and
00:07:06 --> 00:07:08 don't get to appreciate how
00:07:08 --> 00:07:09 the motion actually is.
00:07:09 --> 00:07:10 So we take that time to go
00:07:11 --> 00:07:12 back and forth and actually
00:07:12 --> 00:07:13 feel the motion together
00:07:13 --> 00:07:15 and provide feedback.
00:07:15 --> 00:07:16 And last time we were
00:07:16 --> 00:07:17 fortunate to have someone
00:07:17 --> 00:07:18 who had a problem in our
00:07:18 --> 00:07:20 session and we could do an assessment,
00:07:20 --> 00:07:20 treat,
00:07:20 --> 00:07:22 reassess and see tremendous
00:07:22 --> 00:07:23 improvements
00:07:23 --> 00:07:24 instantaneously with what we were doing.
00:07:25 --> 00:07:26 So we're hoping we can be
00:07:26 --> 00:07:27 lucky again this time too.
00:07:27 --> 00:07:28 How was that?
00:07:28 --> 00:07:30 Treating in front of your colleagues,
00:07:30 --> 00:07:31 like no pressure there, right?
00:07:32 --> 00:07:32 Yeah.
00:07:32 --> 00:07:33 Easy peasy.
00:07:33 --> 00:07:34 Yeah.
00:07:34 --> 00:07:36 So that's actually what
00:07:36 --> 00:07:37 inspired this year's
00:07:37 --> 00:07:38 discussion is that there
00:07:38 --> 00:07:40 was so much feedback
00:07:40 --> 00:07:41 requests that we could
00:07:41 --> 00:07:42 actually dive in further
00:07:42 --> 00:07:43 into our treatment
00:07:43 --> 00:07:44 approaches due to the
00:07:44 --> 00:07:47 success that we had seen in our session.
00:07:47 --> 00:07:48 That's great.
00:07:48 --> 00:07:48 And how, I mean,
00:07:49 --> 00:07:50 how is it presenting with Dr. Patla?
00:07:50 --> 00:07:51 I mean, no pressure there as well.
00:07:51 --> 00:07:53 We're talking about pressure situations.
00:07:53 --> 00:07:53 That can be kind of fun if
00:07:53 --> 00:07:54 you're on your team, right?
00:07:55 --> 00:07:55 Yeah, no, it's awesome.
00:07:56 --> 00:07:57 I think because we've both
00:07:57 --> 00:07:58 gone through the fellowship
00:07:58 --> 00:07:59 with Catherine for so many
00:07:59 --> 00:08:00 years and our colleagues,
00:08:01 --> 00:08:04 it's awesome to be on the stage with her.
00:08:04 --> 00:08:05 It's got to be great.
00:08:05 --> 00:08:06 All right.
00:08:06 --> 00:08:07 So let's talk about biases.
00:08:07 --> 00:08:09 I feel like that's a word
00:08:09 --> 00:08:10 that I don't know that I
00:08:10 --> 00:08:12 used it a ton before the last three,
00:08:12 --> 00:08:13 five years.
00:08:14 --> 00:08:15 What are some of the common
00:08:15 --> 00:08:16 biases clinicians might
00:08:16 --> 00:08:18 have in assessing foot and
00:08:18 --> 00:08:19 ankle function?
00:08:19 --> 00:08:21 We sort of alluded to one a second ago.
00:08:21 --> 00:08:23 And how can self-appraisal
00:08:23 --> 00:08:24 help identify these?
00:08:24 --> 00:08:26 Because we got to identify
00:08:26 --> 00:08:28 it before we can fix it or solve it.
00:08:28 --> 00:08:29 You got to know it's there.
00:08:29 --> 00:08:30 Yeah.
00:08:30 --> 00:08:31 And you first have to admit
00:08:31 --> 00:08:33 that there even is a potential bias.
00:08:33 --> 00:08:33 Right.
00:08:33 --> 00:08:34 And then you kind of walk
00:08:34 --> 00:08:35 through those steps.
00:08:35 --> 00:08:36 And so I think part of it is
00:08:36 --> 00:08:37 going back to one of our
00:08:37 --> 00:08:39 principles in that you must
00:08:39 --> 00:08:40 have normal joint function
00:08:40 --> 00:08:42 to have effective muscle
00:08:43 --> 00:08:43 function as well.
00:08:44 --> 00:08:45 And so we really take.
00:08:45 --> 00:08:46 Say that again.
00:08:46 --> 00:08:46 One more time.
00:08:47 --> 00:08:50 You must have effective joint mobility,
00:08:50 --> 00:08:51 quantity,
00:08:51 --> 00:08:53 quality in order to have proper
00:08:53 --> 00:08:54 muscle function.
00:08:54 --> 00:08:55 Okay, good.
00:08:55 --> 00:08:55 Okay.
00:08:56 --> 00:08:57 And so going, starting at that principle,
00:08:57 --> 00:08:59 we recognize the importance
00:08:59 --> 00:09:01 of looking at individual
00:09:01 --> 00:09:03 joint motion at the foot
00:09:04 --> 00:09:06 and ankle versus just gross
00:09:07 --> 00:09:09 osteokinematic assessment.
00:09:09 --> 00:09:10 I think that's the first
00:09:10 --> 00:09:13 bias that when people look at a foot,
00:09:14 --> 00:09:14 they,
00:09:15 --> 00:09:16 it's this nebulous and it's too
00:09:16 --> 00:09:17 complicated.
00:09:17 --> 00:09:18 There are too many joints
00:09:19 --> 00:09:20 and it becomes sloppy in
00:09:20 --> 00:09:22 the assessment and the treatment.
00:09:22 --> 00:09:23 And then they get frustrated
00:09:23 --> 00:09:24 that no one's getting better.
00:09:26 --> 00:09:28 And so you have to break it down and go,
00:09:28 --> 00:09:28 okay,
00:09:28 --> 00:09:30 what do I know and what don't I know
00:09:30 --> 00:09:32 and how can I get better at that?
00:09:32 --> 00:09:33 And the foot is one of those
00:09:33 --> 00:09:35 areas that I think can be
00:09:35 --> 00:09:36 particularly tricky if you
00:09:36 --> 00:09:38 don't understand the
00:09:38 --> 00:09:39 biomechanics well enough.
00:09:40 --> 00:09:41 All right,
00:09:41 --> 00:09:43 so you'll be providing an opportunity,
00:09:44 --> 00:09:45 and that's sort of what an
00:09:45 --> 00:09:46 AOPT conference has,
00:09:46 --> 00:09:47 which is there's a lot of hands-on.
00:09:47 --> 00:09:48 If there wasn't,
00:09:48 --> 00:09:49 it would feel a little weird.
00:09:49 --> 00:09:51 But what's the best way you
00:09:51 --> 00:09:52 might suggest for
00:09:52 --> 00:09:53 clinicians to apply the
00:09:53 --> 00:09:56 hands-on practice from your presentation,
00:09:56 --> 00:09:59 from a conference, when they get home,
00:10:00 --> 00:10:00 the neck, you know,
00:10:00 --> 00:10:02 we call it Monday morning applicable.
00:10:02 --> 00:10:03 Is there a suggestion like, hey,
00:10:03 --> 00:10:04 we want some carryover.
00:10:04 --> 00:10:06 We want to have the magic in the room,
00:10:06 --> 00:10:06 but then we want to be able
00:10:06 --> 00:10:07 to apply these things.
00:10:07 --> 00:10:08 We want to make them applicable.
00:10:08 --> 00:10:09 What would you suggest?
00:10:11 --> 00:10:14 Yeah, I think ideally in the session,
00:10:14 --> 00:10:15 being able to go back and
00:10:15 --> 00:10:17 forth with one of us, like I feel,
00:10:17 --> 00:10:18 you feel, I feel, you feel.
00:10:19 --> 00:10:20 And we compare right then
00:10:20 --> 00:10:22 and there and then doing it
00:10:22 --> 00:10:23 a couple of times.
00:10:23 --> 00:10:23 Right.
00:10:23 --> 00:10:25 This is a skill that you
00:10:25 --> 00:10:26 need to be using right away.
00:10:27 --> 00:10:28 But also what I like to do
00:10:28 --> 00:10:29 clinically is I do a
00:10:29 --> 00:10:30 functional assessment.
00:10:31 --> 00:10:32 Then I look at my osteokinematic,
00:10:33 --> 00:10:35 look at my joint mobility, treat,
00:10:35 --> 00:10:36 and go back and look at my
00:10:36 --> 00:10:36 function right away.
00:10:36 --> 00:10:38 So you know right then and
00:10:38 --> 00:10:40 there if something is working or not.
00:10:40 --> 00:10:41 And so I think that's a
00:10:41 --> 00:10:42 piece that people could take away.
00:10:42 --> 00:10:44 Day one is using that
00:10:44 --> 00:10:45 functional assessment,
00:10:46 --> 00:10:47 going and looking at the joint mobility,
00:10:48 --> 00:10:49 treat if there's a restriction,
00:10:49 --> 00:10:50 and go back and reassess.
00:10:50 --> 00:10:52 And if not, go back again and look again.
00:10:52 --> 00:10:55 So doing that continual assess, treat,
00:10:55 --> 00:10:57 reassess is a piece that I
00:10:57 --> 00:10:58 think is so critical.
00:10:59 --> 00:11:00 Do you want to add something, David?
00:11:00 --> 00:11:00 Yeah.
00:11:00 --> 00:11:02 And speaking clinically, I would say,
00:11:02 --> 00:11:02 you know,
00:11:02 --> 00:11:04 they have to just jump in to
00:11:04 --> 00:11:05 learn how to swim.
00:11:05 --> 00:11:05 Right.
00:11:05 --> 00:11:06 If you don't get into the water,
00:11:06 --> 00:11:08 you're never going to learn.
00:11:08 --> 00:11:11 So when it comes to the clinical approach,
00:11:11 --> 00:11:13 they have to just start investigating.
00:11:13 --> 00:11:13 They have to start putting
00:11:13 --> 00:11:14 their hands on and they
00:11:15 --> 00:11:16 have to feel many different emotions.
00:11:16 --> 00:11:18 feet types.
00:11:18 --> 00:11:19 Going back to the bias,
00:11:19 --> 00:11:20 I think one bias is
00:11:20 --> 00:11:22 presuming that arch height
00:11:22 --> 00:11:23 is related to risk of injury,
00:11:24 --> 00:11:26 but that's inconclusive in
00:11:26 --> 00:11:26 the literature.
00:11:28 --> 00:11:29 Mobility is arguably more
00:11:29 --> 00:11:31 important and they have to
00:11:31 --> 00:11:32 get their hands on
00:11:32 --> 00:11:32 different feets because
00:11:33 --> 00:11:33 there's different types of
00:11:33 --> 00:11:35 mobility for different
00:11:35 --> 00:11:36 sizes of feet related to
00:11:37 --> 00:11:38 different amounts of ground
00:11:38 --> 00:11:39 reaction force for specific
00:11:40 --> 00:11:41 demands of functional activity in sport.
00:11:43 --> 00:11:44 So you just got to start touching,
00:11:44 --> 00:11:45 touching, touching in my opinion.
00:11:46 --> 00:11:47 I now know what the promo
00:11:47 --> 00:11:48 will be for the episode.
00:11:48 --> 00:11:49 It'll be touch as many feet
00:11:49 --> 00:11:50 as possible from day one.
00:11:50 --> 00:11:51 Yes, yes, yes.
00:11:52 --> 00:11:53 And shoes off immediately
00:11:53 --> 00:11:54 when you first come in the room.
00:11:54 --> 00:11:57 That'll air the puppies out a little bit.
00:11:57 --> 00:11:59 But also, too, when we think about,
00:11:59 --> 00:12:03 I think especially at an AOMT level,
00:12:04 --> 00:12:05 we feel confident in our
00:12:05 --> 00:12:07 manual therapy skills,
00:12:07 --> 00:12:08 in our hands-on skills,
00:12:08 --> 00:12:09 our manipulation skills.
00:12:10 --> 00:12:10 But taking...
00:12:14 --> 00:12:15 time in the clinic to work
00:12:15 --> 00:12:18 with your to get feedback
00:12:18 --> 00:12:20 on your techniques and
00:12:20 --> 00:12:21 maybe spending a lunchtime
00:12:21 --> 00:12:22 on a friday hey let's run
00:12:22 --> 00:12:23 through some techniques and
00:12:23 --> 00:12:24 let's see if it feel the
00:12:24 --> 00:12:25 same as that I did at the
00:12:25 --> 00:12:26 conference that we had or
00:12:26 --> 00:12:27 let me show you some cool
00:12:27 --> 00:12:28 techniques let's talk
00:12:28 --> 00:12:29 through what we're doing
00:12:29 --> 00:12:30 but taking time to hone
00:12:30 --> 00:12:32 your craft outside of the
00:12:32 --> 00:12:33 time with the patient
00:12:34 --> 00:12:35 that's smart all right so
00:12:35 --> 00:12:35 I'm gonna I'm gonna make
00:12:35 --> 00:12:37 you pick only one
00:12:37 --> 00:12:40 What is each of your one key
00:12:40 --> 00:12:41 takeaway for clinicians
00:12:42 --> 00:12:42 that they'll be able to
00:12:43 --> 00:12:45 walk away from after your presentation?
00:12:45 --> 00:12:46 So this is, again,
00:12:46 --> 00:12:47 the teaser before the
00:12:47 --> 00:12:49 teaser regarding your topic.
00:12:49 --> 00:12:50 What do you got, Amanda?
00:12:50 --> 00:12:51 What do you think people
00:12:51 --> 00:12:52 will be able to walk away
00:12:52 --> 00:12:53 with and be armed with?
00:12:55 --> 00:12:56 Is that pun intended?
00:12:56 --> 00:12:57 I'm literally trying to
00:12:57 --> 00:12:58 think of a foot pun and I
00:12:58 --> 00:12:59 couldn't before it came out of my mouth.
00:13:00 --> 00:13:00 Yeah, you got it.
00:13:02 --> 00:13:04 I think being more confident
00:13:04 --> 00:13:07 in their ability to assess
00:13:07 --> 00:13:08 specific joint motion.
00:13:09 --> 00:13:10 I think that's one thing we
00:13:10 --> 00:13:11 started last time,
00:13:11 --> 00:13:12 and we're going to be able
00:13:12 --> 00:13:13 to capitalize more on that this time.
00:13:14 --> 00:13:15 All right, David, same question.
00:13:15 --> 00:13:16 Yeah, I would say two things.
00:13:16 --> 00:13:18 I would say try to remain as
00:13:18 --> 00:13:19 objective as possible.
00:13:20 --> 00:13:23 And then number two is to ask for help,
00:13:23 --> 00:13:23 right?
00:13:24 --> 00:13:25 Seek, you know,
00:13:25 --> 00:13:26 reaffirmation from your
00:13:26 --> 00:13:29 colleagues like Amanda had highlighted.
00:13:29 --> 00:13:30 And I think that also speaks
00:13:30 --> 00:13:32 to the self-appraisal component too.
00:13:33 --> 00:13:33 Perfect.
00:13:34 --> 00:13:36 Looking forward to,
00:13:36 --> 00:13:37 I think October is a good
00:13:37 --> 00:13:38 time to head south.
00:13:38 --> 00:13:40 It's not too shabby to go to Orlando.
00:13:40 --> 00:13:42 So this is the prelude to
00:13:43 --> 00:13:44 one of many presentations
00:13:44 --> 00:13:45 going on at the AOMT
00:13:45 --> 00:13:46 conference this October.
00:13:46 --> 00:13:48 For more information about the event,
00:13:48 --> 00:13:50 check out aomt.org.
00:13:50 --> 00:13:51 David, Amanda, looking forward to it.
00:13:51 --> 00:13:52 Thanks for the time sharing
00:13:53 --> 00:13:54 what you'll be presenting on this year.
00:13:55 --> 00:13:55 Thank you, Jimmy.