Brad Simpson

Physical Therapist, Portland OR

  • posts17

Ergonomics 101. Teaching people how to assess their own workstation. πŸ…
β€’start away from your desk. Get your chair right, and find your 'ideal' sitting posture. πŸ’Ό
β€’the feet need to be flat on the floor- it's hard to be stable without a stable base. πŸ‘£
β€’cues for sitting posture: neutral pelvis, lift chest, relax shoulders, gentle chin nod (gets your eyes looking fwd). πŸ‘€
β€’mold the chair around this posture. β€’TIPS:
1. if you have a neck history, don't let the chair-back tilt backwards. The farther your chair tilts back, the farther your eyes are from your screen, meaning you push your head fwd.
2. Your armrests should only gently touch your forearms when your shoulders relax in good posture. If you are slender, you may need armrests that shift and tilt inwards. β€’after maximizing your chair and posture, scoot back in to your desk and mold that desk area around this 'ideal' posture. πŸ‘Œ
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#ergonomics #ergo #physicaltherapy #physicaltherapist #posture #lowbackpain #neckpain #chronicpain #ergonomic #workstation

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Chronic pain curve I originated years ago, published in the Practical Pain Management Journal last year. β€’
It describes posture, stretching, feel good interventions, and how people who have chronic pain differ from people who don't have chronic pain. I use this frequently, early in treatment, helping set expectations of how we will begin managing their chronic symptoms. I almost always use it if we are working on ergonomics, or working to improve something the pt does for extended time daily. β€’
The middle of the curve is 'perfect' posture. I never tell people they need to be here. The majority of the curve is 'ideal' posture, and the extreme outliers are BAD posture and FEEL GOOD positions. β€’
People with CHRONIC PAIN: their pattern is typically poor/unaware posture, then going into a feel good act (stretching, heat, ice, self-manipulation, etc (including massage, chiro, acupuncture/pressure, etc)). These interventions are not harmful, but what happens after? Pts go right back into the bad posture/lifestyle position, then back into 'feel good' position, and back/forth. What determines where they are on the curve? PAIN. Pts wait to hurt, b/c that's where their minds are trained in to focus. Now, they're in a vicious cycle where they seek relief 'extremes', and go back/forth in a REACTIVE way. β€’
People WITHOUT CHRONIC PAIN: aren't perfect (: They slouch all day long. They go from poor posture, maybe to then a stretch in the feel good extreme (reaching arms overhead, getting up and walking, etc), then posture in the 'ideal' portion of the curve, back to slouching, ideal, stretch, etc. If you asked someone w/o chronic pain how they were sitting 10 min ago, they wouldnt know. Their body naturally moves due to position-sense. Remember all the structures in our body constantly telling our brain where we are in space. Their body is atuned to POSITION, NOT PAIN. This is a PROACTIVE way to live, vs being reactive to pain and be in constant worry of the next pain cycle. β€’
To have your body 'aware' without having to think about it takes 10-15K reps. Train to recognize position, not wait for pain! #retrainthebrain #chronicpain #physicaltherapy #physicaltherapist #lowbackpain

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I need to get to teaching my daughter to keep her core tight and back straight during wheelborrow racing!! It hurts me watching her form....... then I remember she's 4, and she'd just tell me 'well I beat you, dad' anyways!! πŸ˜‚

#corestrength #educate #physicaltherapy #core #plank #oceanside #familyvacation #familyfun

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The best compliment from a patient is when they refer a friend, family member, and/or co-worker to me for my help with their musculoskeletal issues too!! Building your practice this way greatly improves job satisfaction! If you have a positive experience with somebody, you likely will enjoy that person's friends and family also. πŸ˜ŠπŸ‘πŸ€ #physicaltherapy #physicaltherapist #bethechange #directaccess #apta #jobsatisfaction #customerservice #referrals

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Happy Labor Day!!! A day to get rested, relax, and enjoy life a little more! Done, done, and done!! #funwithfriends #labordayweekend #oceanside #relax #bocce #athleticdevelopment #physicaltherapy

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Day 1 Oceanside, CA family vacay yesterday! Can't beat the oceanfront view! Looking fwd to a relaxing break with the girls, full of good eats, sandcastles, n warm ocean water for body surfing!
#familyvacation #oceansidepier #physicaltherapy #physicaltherapist #relaxing

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Many chronic patients come to me frustrated when they have a 'setback' in their rehab, wondering if they will ever get better!
I tell them that sometimes a regression IS a progression! That they are getting more active! They are becoming less fearful or anxious to try new things! I focus on what they can do, and reassure them of the path we are taking to get them back to their goals!
Most progressions will have regressions, or we aren't pushing the envelope enough. We need to sometimes find our 'wall', to know how to get to the point of breaking that wall down to get to the next one!
#chronicillness #chronicpain #rehabilitation #physicaltherapy #physicaltherapist #positivevibes

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As little as a 2-3 degrees of knee extension deficit in the affected knee, compared to your 'good' leg, has been shown to result in lower long-term (approx 80%) functional outcomes. >90% the population has knee hyperextension, most between 5-6 deg hyperextension. Assessing for these subtle differences is vital to determining your initial care planning for these patients.

Donald Shelbourne describes assessing knee extension by grabbing the big toe vs the distal tibia. This gives you a better endfeel sense, letting you feel when the beginning resistance happens.
TIP: I prefer also palpating the knee joint line with my proximal hand, allowing me to feel the screw-home mechanism occurring at end-range knee extension, when assessing passive knee extension.
The subtle loss of knee extension causes compensated standing patterns, and a 'deconditioned' knee, affecting patellofemoral stress, and jeopardizing areas above/below the knee region.
Mobilizations to the tibiofemoral joint to regain knee extension prior to implementing a full strength program allows normal patterning when standing and walking, and begins 'normalizing' patterns through the leg. Then the strengthening can help maintain long-term change.
#KneeExtension #RegionalInterdependence #DeconditionedKnee #PhysicalTherapy #PhysicalTherapist #Physical_Therapy #ChronicPain #PatientCentered #acl #kneereplacement #knee

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Grunting! Increases Power, Increases Performance!
http://journals.lww.com/nsca-jscr/Abstract/2014/07000/Grunting_in_Tennis_Increases_Ball_Velocity_but_Not.16.aspx
#grunts #physicaltherapy #physical_therapy #performancetraining #physicaltherapist

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#tbt Looking back at Olivia's 1st demo of bench press, rotator cuff work, and lat work, all in one set of 20'ish reps! #growinguptoofast #workouttime #physicaltherapy #physical_therapy

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Ergonomics- an art of building your work environment around your postural 'ideal', rather than molding yourself to your environment. It's not about being perfect with posture, but rather having an environment that allows you to posture in your 'ideal' as much as your body requires. Give your body a chance to win!
#ergonomics #retrainthebrain #neckpain #chronicpain #physicaltherapy #patientcentered #physicaltherapist #manualtherapy

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Every day we pick Olivia up from school, we're told she's getting a bandaid on her hands. She's relentless to 'learn how to skip bars on the monkey bars!' Gotta love the determination! #determination #monkeybars #physicaltherapist #whatdoesntkillyoumakesyoustronger

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Olivia enjoying the simple things in life. These moments help remind me how amazing simple events felt when I was little (and still do), such as self-cleaning the pizza spatula and pounding otter pops!
#otterpops #pizzasauce #lickingthespatuladry

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Every story has a tipping point. Most acute pain is due to cumulative microtrauma, with a final tipping point which results in pain. Acute pain is like an iceberg, most of its contents are hiding and unseen unless you seek to find it! 'Treat the pain, find the dysfunction, treat the entire person!' #Tippingpoint #Regionalinterdependence #ChronicPain #PhysicalTherapy #PatientCentered #PhysicalTherapist #ManualTherapy

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Chronic pain is a fight or flight state of being, which includes chronically poor breathing and large-muscle guarding. The journey towards success begins by learning to relax, and understanding that you're going to be OK. "Learn to manage well!" #Relax #ChronicPain #PhysicalTherapy #PatientCentered #PhysicalTherapist #ManualTherapy

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Self-Empowerment- adj. "An individual's ability to take control of their circumstances, achieve their own goals, and help themselves achieve the highest quality of life."
#physicaltherapy #patientcentered #physicaltherapist #manualtherapy

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