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Archive for June, 2012

Physical Therapy for Autoimmune Illnesses

Ann Wendel Profile picture

Greetings from balmy Northern Virginia where it’s 80 degrees at 8:40am!

I hope everyone is enjoying the start of summer. I wanted to share an article I wrote as a guest post for Sarah Ballantyne (AKA The Paleo Mom) on the role of physical therapy as part of the comprehensive treatment plan for folks with Autoimmune Illness.

It is my hope that the 23.5 million Americans with AI will seek out the expertise of a physical therapist as they strive to regain a healthy, active life. Please share this article with anyone you know who has an AI.


Be well,



Review of It Starts With Food by Dallas and Melissa Hartwig


Review of It Starts With Food

It Starts with Food: Discover the Whole30 and Change Your Life in Unexpected Ways

You know how you look forward to Christmas morning? Even as an adult, you wake up a bit early, filled with expectation? That’s the way I felt waiting for It Starts With Food to arrive in the mail. I was fortunate enough to receive an advance copy to review, and as luck would have it, my copy arrived just before Memorial Day weekend. I spent three days sitting in the sun (soaking up Vitamin D!) while reading this book with a highlighter in one hand and a pen in the other.

I recommend that you buy a few highlighters before your copy arrives! You will most definitely want to take notes in the book and mark things to refer to later. This book is filled with good information throughout. Whether you are brand new to the idea of eating real food, or a seasoned veteran, you will open this book again and again over the years to refresh your thinking on important topics such as hormonal factors which influence our brain and body (insulin, leptin, glucagon, and cortisol), the mechanism behind leaky gut syndrome (bouncers defending Club Body), inflammation and autoimmune illnesses, balancing Omega 3 and 6 consumption, and emotional factors that drive our nutrition choices.

Along with the good science-y stuff, It Starts With Food teaches you how to plan meals, what a portion looks like, and how to create a meal focusing on delicious, healthy ingredients rather than complicated recipes. They discuss nutrition for special populations (pregnant women, kids, folks with autoimmune illnesses, active individuals and vegetarians/vegans) to help fine tune the plan for your individual needs. I have referred to this section several times in the past few weeks while consulting with my clients, as I tend to see folks who have a number of issues that they are trying to address through nutrition.

I love Dallas and Melissa’s ability to say really brilliant things in short, easy to understand one-liners. I don’t want to spoil the fun for you; but, here are a few of my favorites:

  • With regards to the myths about Paleo: “We are far more concerned with health than we are with history.”
  • With regards to research, clinical experience, and observation: “Scientific research + Clinical Experience + Self-experimentation” = win-win-win.
  • Persistent biological signals lead us to overeat sweet, fatty, salty foods while keeping us malnourished.
  • It’s all about hormones.
  • You cannot “out-exercise” poor food choices and the resulting hormonal disruption.
  • Sugar = sugar = sugar.
  • Gluten-free is not a get-out-of-jail-free card.
  • This does require effort on your part.
  • Start thinking of eating as a nourishing experience.
  • You are not that busy, you just choose to spend your time elsewhere (in regards to sitting down to eat well prepared, nutritious, delicious foods).
  • This. Is. Not. Hard. (when compared to birthing a baby, quitting heroin, or beating cancer).
  • At some point, you need to start making positive, sustainable changes in other areas of your life too, so…
  • Don’t (only) look for a nutritional solution to a lifestyle problem.


The best news is that It Starts With Food will begin shipping on June 12th, so the wait is almost over! I highly suggest that you buy this book (I recommend the hardcover so you can use your highlighter, but I tend to be old school!). You will refer to this book over and over as you continue your journey to health. I am so impressed by Whole 9’s first book, and happy to call Dallas and Melissa friends. These guys are going to change your life.


Brainwashed: Change requires starting with a clean slate.

Ann Wendel Profile picture

Brainwashed: Change requires starting with a clean slate

This one’s for all the PT’s in the house. Most of the writing I do on my blog is for patients: to provide information, encourage, and teach self-care techniques. Today I’m writing for my peer group.

I would like to preface this post by saying that I am not currently a member of the APTA. Before you leave this website or think that I have no right to have an opinion on an organization that I am not part of, let me explain to you the major reason that I am not a current APTA member: In October 2011, I left a job that was meeting all of my financial needs to pursue my dream of being a self-employed physical therapist. I took a risk, and the reward has been great. I opened my business without a single patient on my books. It was the scariest thing I have ever done; but, I believed that I had a unique service to offer and a community that would value that service enough to become my clients. In eight months, I have gone from zero patients per week to averaging twenty patients a week. Anyone who has ever run a business knows that this is no small feat. And, I did it without a small business loan, without six months of savings in the bank (I wouldn’t recommend anyone do this), without participating with any insurance providers, and without being in any way connected to a physician for referrals. I am proud of my accomplishments, grateful to my patients, forever indebted to my husband and children, and appreciative of the help of the other physical therapists I work in concert with on a daily basis. I believe that I have a unique viewpoint, and I would like to share my thoughts on a few things.

This past week a huge shift occurred. Out of the blue the APTA started interacting on Twitter using the @APTAtweets account. Instead of just posting links and information, they started interacting with several individuals in real time. The interactions were kind of like mini Tweet chats. I was involved in a few which made me realize that I had some thoughts to share that required >140 characters.
See, the fact that APTA was interacting in real time was new (and exciting); but, the problem is that they were saying the same old thing using a new form of communication. The need for change was pointed out several times in the conversations. The response (in my opinion) was something like this, “We know things need to change; but, we’re not sure how to do it, and first we’re going to become defensive, because change is really difficult.”

Now, I applaud APTA for their efforts in trying to engage with physical therapists in real time. This is no small task. Interacting in social media is risky: what you say may easily be taken out of context and upset people, the comments can be re-Tweeted, posted to Facebook and blogs, and live on for eternity. Most of all, you run the risk of people having the ability to say whatever they desire in response to you. There is no moderator on Twitter, no one to screen comments, no ability to delete the Tweets you don’t like. If you are going to engage, you need to be prepared to hear what people really think. And, this is a good thing, because all organizations should be willing to listen to what people think.

Before we go any further, I would like you to read the following article written by Seth Godin:

Seth Godin is an absolute genius, and in this article he describes how we have all been brainwashed into believing that “creating average stuff for average people, again and again, is a safe and easy way to get what you want.” He poses a very important question: “When exactly were we brainwashed into believing that the best way to earn a living is to have a job?”

I think it is vital to ask ourselves this question! Because I don’t just want a job, I want a life filled with passion where I can give my gifts and help others. That is what drew me to the field of physical therapy, and it’s what has kept me here for 14 years. I never set out to be a cog in a machine, and I’m willing to take risks to ensure I don’t end up as one.

If we are honest with ourselves, we can acknowledge that the idea of working a “steady” job to ensure a lifetime of safety and security has flown out the window. In my mind, that’s a good thing, because we have to ask ourselves (as the author did in this article): “do we want the same job, but more work, less pay? Same industry, but less growth, no challenges? Same path, fewer options?” The answer should be a resounding NO! Because right now, if we can be brave, the opportunities are endless! We can start tapping into these opportunities by reinventing the way we are perceived as a profession.

We can’t continue to play by a set of rules that aren’t true anymore. We need to be innovative to thrive. We need to be serious about transformation. As Mr. Godin states, “I’m not talking about polishing yourself, I’m talking about a reset button, a reinvention that changes the game.”

See, I think we need to stop wringing our hands, asking how we can ‘show people we have value’ and just start showing people we have value! Let’s not have committee meetings, and endless discussions about how to do this! Let’s press the reset button and get out there and start showing value!

How do we do this? A complete overhaul of the system. Mr. Godin lists 7 ways to press the reset button that I think can help our profession.

1) Connect – He says that “social media is a crack in the wall between you and the rest of the world.” It offers the “chance to make real connections and gain insights from people you would never have a chance to interact with in any other way.” How true! How easy! Use social media to connect and build relationships with APTA members, non-members, and patients (AKA our customers who will ensure that we have a profession in the years to come). The take home point I would like to make is that APTA members are already connected! The APTA needs to use social media to connect with potential members and the general public. See, just about every time I have clicked on a link put up by @APTAtweets, it takes me to a Members Only page on the APTA website! This prevents me from reading the link, and prevents me from sharing valuable information with my patients who participate in social media. How can an organization increase their influence if they only connect with those who have already ‘bought in?’ It can’t. An organization needs to connect with potential members and support systems to grow. The best way to connect? Allow people to volunteer. I tried to connect with APTA last October when I responded to a call for volunteers to work the Move Forward booth at the Marine Corps Marathon Expo. The venue was not far from my house, and I had just gone into private practice that month. I looked at it as an opportunity to educate athletes about our profession, and to make connections with other local physical therapists, as well as my professional organization. And, since I was just starting my practice, I had plenty of open time during the Expo to volunteer, since my schedule was light. I was told “Sorry, but only APTA members can volunteer.” I was actually shocked that a volunteer for anything would be turned down. It was a completely wasted opportunity to connect. How can the APTA better connect?

2) Be Generous – social media and the internet in general have made it easier than ever to be generous. It doesn’t cost anything to share information that has already been created. Mr. Godin explains that generosity rewards people who create and participate in circles of gifts. This creates a “tribal economy of individuals supporting one another.” Then, “tribes of talented individuals who are connected, mutually trustful, and supported by one another, and in a position to create a movement, deliver items of unique value, and move ideas forward faster than any individual ever could.” How could the APTA be more generous? As an example: provide links to the APTA “White Papers” that state the organization’s position on issues in the profession (I tried to click on the link to the APTA position paper on dry needling, and it led me to a Members only page of the website. As a physical therapist who utilizes dry needling, I really wanted to read the position paper and share it with my patients on my website. I even emailed the APTA to ask if I might be able to have access to just that one position paper, even offering to pay for one time access to it. I was told no. It was a total missed opportunity to be generous, which would have increased connection by allowing me to share that generosity with my patients, which in turn would lead to increased public awareness of what physical therapists do, and why certain techniques are supported by our national organization.) Being generous supports individual therapists as well as the organization, as we all go out into the world to share our gifts by “making art.”

3) Make art – we have a unique opportunity to make a difference in people’s lives and a “platform to create something new.” This is what Mr. Godin calls art. Art is “connecting with another person at a human level. And it’s risky.” Social media is risky, doing things differently is risky, being generous and connecting is risky; but, all lead to great reward. What stops us from ‘making art?’

4) Acknowledging the lizard – As Mr. Godin so eloquently states, the lizard brain – our prehistoric brain – doesn’t like being laughed at. It creates “resistance….which encourages you to follow instructions.” He explains that over time, artists have “figured out that this resistance is the sole barrier between today and their art.” The way to handle the lizard brain? “Acknowledge it so we can ignore it.” Only by acknowledging that we may get laughed at and then ignoring it and producing art anyway, can we truly succeed. Change is often painful; but, without ignoring our fear of criticism, we remain stuck where we are. Being stuck prevents us from shipping.

5) Ship – After we ignore our fear of ridicule, we need to get out there and get things done. We need to create a product or service that meets a need. The need for our services is great (we know this). Now we need to get the message out there that physical therapists are the patient/consumer’s best resource for the treatment of musculoskeletal injuries. We get the message out there by educating the public, making connections, being generous with our time and information, and laughing at the lizard. Which leads us to the next point…?

6) Fail – we need to be willing to fail, because we will. According to Mr. Godin, the “reinvention of the marketplace demands that one have the ability to fail, often and with grace – and in public!” As we try out new ideas, and negotiate new forms of social media, we will fail. People may criticize us, laugh at us, debate us, or worst of all, ignore us. That’s ok. We need to use each failure as an opportunity to do better.

7) Learn – as we try new things, and fail, we need to learn from each experience and keep moving in the right direction. We need to apologize for mistakes, make amends to those we have hurt, pay better attention to those who feel unheard, restructure according to what people are saying they want. There is no place for defensiveness in learning. We can take something positive away from each interaction to do better in the future. The big challenge in modern life is that change happens so rapidly – even a few years ago, an organization would never have had the opportunity to reach such a staggering number of people with a message as Twitter allows today. We need to learn quickly, adapt, and move on. It is difficult for a large organization to change so rapidly; but, APTA must change in order to remain relevant.

So, in a nutshell, what are some things that our organization could do immediately?

• Provide links to articles, position papers, etc. that can be accessed by anyone (achieves the goals of connecting, being generous, ignoring the lizard, and shipping)
• Allow all licensed physical therapists to volunteer for APTA events (achieves the goal of connecting, provides the ability to bring in new members, allows those physical therapists who work part time or are self-employed (and have difficulty paying dues) to give to the organization and stay connected.
• Offer different levels of membership to meet the needs of every physical therapist, offer “temporary/trial” memberships, or offer the ability to “pay for what you want.” Full membership can still offer the full complement of perks, while less expensive memberships could offer less in return. A concierge service can be offered where therapists pay for access to specific resources (position papers, news flashes, journal articles, etc.) The work has already been done, and the extra income to the organization would be a bonus. The organization (and its members) need to keep in mind that we are not a homogenous group – some therapists work full time, some work part-time due to family obligations, some are self-employed and don’t have extra financial resources. Rather than judging each other (as has happened in recent Twitter interactions, where members judged the “priorities” of non-members), let’s work as a profession to support ALL physical therapists in reaching their personal goals WHILE meeting the overall goals of the organization.
• Have a consistent social media policy – identify who is Tweeting for the account, have a goal of excellent customer service in every interaction, keep in mind the infinite (virtual) life of Tweets and ensure that each and every one adds to the overall goal of the organization.

These are just some of the thoughts that have been formulating in my mind this week. I believe there is room for all of us in this profession, and room for all to be part of the organization. We just need to realize that the rules have changed, and we can’t keep playing the same game.

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