4 Burst results for "Dr Mark Sheppard"
"dr mark sheppard" Discussed on Evidence In Motion Clinical
"Do you and your family how to save and clean place to sleep and then the client can could share about that and then another question about domestic violence. Do you feel safe at home. Those are two great examples. I think safety in the home that goes across every economic status in every demographic in so I think again. Ideally everybody would get screened in being able to help those clients tap into the resources that are available are really really important. I think just a blog samples because a lot of the people who do enroll in research. Studies are Caucasian and middle class. But I've had several of them who had either domestic violence in the past or have had some sort of an adverse childhood band that if I wasn't one tuned to the need to assess for those things I would have missed it. I don't know that that necessarily be something that people would not bring up. That's not necessarily prompted to without having a relate quality orthopedic relationship that we developed. I think just being much more in tuned to the possibility of those underlying issues being there and being open to listening and being open to the possibility is really critical for therapists as an excellent excellent point there and I love the thought that he social determinants of health. Because there's so many of them it doesn't pick and choose certain people in certain areas and certain racial backgrounds and it just shows how open we need to be in looking at these things and understanding them and kind of going back to your line of research. Katie with sleep. It's interesting that your journey to discovering the importance or at least the variability of these things really stemmed from trying to make people sleep better and to optimize that really important body function and I think it's interesting a lot of journeys come this way and and I think when you look at trying to change one's behavior. You're not going to be able to do that unless we peel back. The layers of the onion. That may be surrounding our patient or client's background and so it's just. It's a point that I think the listeners really need to reflect on an I challenged listener to think about the patients. They are seeing and the type of behavior change that you're trying to get out of them whether it's trying to sleep better or eat better or move better and are you looking at these. Are you assessing for them in? Are you helping to address them or even refer out to individuals who can help address some of these other factors here and so I think Katie? That's been really helpful there so with that in mind. Are there certain people you find yourselves from an inter disciplinary standpoint Katie referring to when it comes to addressing some of these social determinants of health as it relates to sleep? I do I think with a lot of my clients that are sharing that they've had domestic bonds currently in past or some sort of an address childhood advanced. That's outside my wheelhouse and I most certainly repair those individuals decided to psychologist or to account slow. I encourage them to go meet with that person and definitely we have to recognize as physical therapist waters within our scope of practice in what is without outside of at the practice himself having that referral network built in. So that if you are talking to somebody about sleep health and something like that comes up which it's going to if you are talking to people about their sleep in their sleep health to be prepared for that sleepers for a lot of people to their private behavior very personal behavior. They're inviting you into their bedroom to talk about their sleep. And so I think honoring but that's kind of sacred place in the Saker conversation to have with people honoring that and making sure that we're doing a good job of of referring. Would we need to? I think that's really important so I think Katie the last question I have in my mind here to wrap up our discussion here. I don't know if you can even answer this question because I think it's a bit challenging but is there one specific social determinant of health. That you feel is the most important for healthy sleep. Is there one? And what would it be? Gosh that it's kind of tough. I know I can tell you about the research about underrepresented minorities and having or sleeping on Leslie. Galatian being at risk for that and access to healthy food inadequate housing because often times needs that must be met before a worrying about our sleep. We didn't even talk about light and exposure to light in the nighttimes. There's all these different factors that contribute. I would say though in my in my research that I'm doing what I most often see. Though is the issue if the safe place to sleep. I think it's just the demographic that I work with and safe meeting not often times from an unsafe neighborhood perspective but more often the relationships that these individuals have not having a safe place to sleep because bad being open to to hearing bad and developing relationships that people are willing to talk about those things but I certainly I never assume that the other issues are not an issue and so I do screen for so strict hermits of health just as a bound thing with my clients but I think the other thing to think about is maybe aren't going to admit to you on the initial intake by the domestic violent relationship. And so even though you may screen for this and people may say they don't have these issues I think just keeping it on your radar and looking for those things and then once you do have that relationship with the individual then they might be more. Welcome open to having that conversation with you. Yeah well things Kitty. That's a great way to sum up here and I really think one of the things that stuck out to me on your last point there was. This is not just assess for it on day one and be done. This is something that you have to keep your ears perked for throughout the plan of care because as we get to know patients and clients we get to have a better glimpse into their life. Obviously as you build a therapeutic alliance with the patient they start to talk and you can gain some information and assess so I think that's a pertinent factor there to reiterate so thanks again. Katie for your time and wealth of knowledge as it relates to sleep in this important topic on social determinants of health. Thank you very much for having me on your podcast. Appreciate talking when he does. Yeah Katie thanks for joining us while what a great episode with Dr Katie Sang Kasan. Just a really interesting conversation mark. I thought just really talking about sleep. Which is something that has a physical therapist we don't often discuss and probably unfortunately so given that sleep represents probably a third of our life and in particular really exploring the various social determinants of health and mark you know that patients invariably come into the clinic and instantly we can start focusing on physical impairments and Lo and behold you've got patients who come from situations where there's domestic violence and there's inability to sleep and various other founders and unless we consider those as physical therapists were GonNa miss the mark in optimizing recovery. So Katie is one of those really progressive physical therapists whose research is focused in exploring the influence of social determinants of health on sleep. And so I know this is going to be a really informative podcast for our listeners. As always thanks for joining us on the podcast you can reach out to us on at MTM is our social media certainly on the blog and can certainly reach out tomorrow night directly. We'd love your suggestions on who invite on as guests so police in those our way and we look forward to having you with us on another episode here against thanks for joining us. Thanks for listening to the clinical podcast with Dr John. Childs and Dr Mark Sheppard for more information on the podcast guests and the latest and physical therapy visit. Www DOT evidence in motion dot com slash blog. If you like this episode be sure to subscribe like rate and review on your favorite podcast directory..
"dr mark sheppard" Discussed on The Tony Kornheiser Show
"Overlap in a very tight circle. I'm pretty certain that Mr David ceiling the details of your life and the stories. You tell tells them so that we cannot see the similarity my only question for him would be who is wilpon on the show. I'm pretty sure it's not Jeffrey. Leon it's probably Richard Lewis because he will have a desire to argue with you and Larry about anything and everything so if we see a Richard Lewis hates analytics episode of Curb. You should sue. Let me also point out. He had an episode recently. That I thought of you. Because they had a friend who committed suicide and they just played golf with them and Larry's like he shot like an eighty two right. Exactly this Larry. David went to sheep's Head Bay High School. He was best friends with J Bloomfield. Who was my dear friend at Harper College? Larry David went to Camp Toga. A- I went to camp tug and met my wife at Camp Toga. I have met him a number of times. He has no particular regard for me. He ran away. Yeah he ran away from a couple of times But I it's not that I don't think it's funny. It's that everything he does. Seems reasonable seems Honda Civic next season Saturday March shepherd. Dr Mark Sheppard. Who I know in Rockville? Someone who's driven to Atlantic City? Many times it is about the same time for little out of the way to go down to exit three on the Jersey Turnpike to the Atlantic City expressway. It avoids all the lights on route. Forty and go straight into town. There is however no reason to get to the Garden State Parkway and this adventure Kudos to wow was helpful employees. I'm not I'm going east. I'm going east of Atlantic City a little southeast of Atlantic City. I'm not going all the way to Atlantic City but thank you Abraham Karzai Karzai. Dear I don't think so dear Dr Tony. Born and raised in silver spring with aspirations in entering the world of sports media frequently. Listened to your show as well as what was tuning into. Pti your expertise on not just sports but the stories of your wacky adventures in.
"dr mark sheppard" Discussed on Evidence In Motion Clinical
"The E. M. Clinical podcast. My name is John Childs and I'm joined as always by my illustrious co host Dr Mark Sheppard and and we have the privilege today of doing something a little bit different on the podcast. We're being joined today by two physical therapists Brian. Guskey and Tim Reynolds. Both relatively in recent graduates graduated from bt school about five years ago and they reached out to me several weeks ago and are working on a project really trying to collate and curate responses from those who've may be you know had some impact on the profession sort of movers. Shakers whatever you WANNA call it leaders in the field and so are conducting a number of different interviews and written responses and so we thought wow. Why don't we use this as an opportunity to have them jump on the show and perhaps interview mark and I rather than the traditional national way that we typically do it so without further ado? Just want to introduce both Brian and Tim. And if you don't mind start off telling us a little bit about the project you're working on and then we'll dive in that great. Thanks John so Brian Gusty here as he said Jonathan Practicing for about five years now currently reside in Rochester New York working with University of Rochester Medical Center treating in outpatient orthopedics just to give a little background on China are Y and you know how he got started with this this book call years ago Kinda proposed this project to ten we kind of kicked it around. It was a pretty good idea man. You know this this year. I'm not sure what what sparked that. I think we both got put in a position where we're getting has a lot of questions. Kyle guiding students as part of the residency program program. Here at the university. Getting ask questions of you know goals and how to stay motivated and you know what are things that we like to read. How do we stay engaged with profession? So Tim and I both reflected on this idea for a book of reaching out to our own leaders and mentors and different thought leaders and innovators within our profession an SM similar questions that we were being asked so that's kind of how he got started on it and then again like I said not sure what sparked it but as of maybe three months ago the one we kinda started sending out emails and doing interviews setting up digital interviews receives awesome feedback when we first out our introductory the email kind of talking about the book see people are interested was like shot in the dark. We both know what kind of feedback we were GONNA get or if we're going to get any response so John you when you replied to to use any email you responded. We were like Oh my dad like John. I hope this is actually. We started getting a ton of good feedback in a bunch support. So it's been really rewarding so far working on this project so we're excited to be here with you today and an Esa you know some of the clashes or asking a bunch a AH leaders within our field. Tim has anything anything else to say about that or about our why we got started. Yeah definitely my name. Is Tim Reynolds. I'm located Ithaca New York Mark. I'm a physical therapist with wellness center. I'm a full time. Clinical Faculty member at Ithaca College well and sort of carry on with what Ryan said. There are so many really talented knowledgeable physical therapists and researchers within our profession that are contributing so much work to the betterment of our profession. Shen as a whole and I think you can go online. You can find out. What are these awesome exercises which we'd be trying to patients with back pain or persistent pain and I think that provides a lot of good knowledge and education for young clinician editions? Right now there's some questions that typically don't get asked I and Brian and I when we sat down and we were trying to generate lists of questions in. Who Do we want to interview? We want to know the why. And the what makes the people we really respect. And who are the leaders in this field and so what are the habits that have helped them develop to become the people that they are and what other things. Outside right of learning humanity techniques or learning different exercises could potentially contribute to making the whole cohort of this upcoming PT generation better quality people and clinicians themselves. Awesome will appreciate that background. And I guess I'M GONNA WE'RE GONNA turn it over to you guys and let you run the show. Go ahead awesome awesome so John the first question is for you. What advice would you give to a smart driven college student about to enter the quote unquote real world? And what advice. I should ignore. Yeah it's a great question and I will confess I think about this question now in a very personal way because I've got five children total but got one that's recently married eight and Now Working Graduate From College. I've got another one who's in college and then I've got a fifteen year old son. You know in some younger kids. So like I've got got kids with editor sort of wanting and perhaps benefiting from whatever kind of advice that I might have so this is like a real world full mid for me not hypothetical I think one of the biggest things I sort of encourage in. Try to advise students that when you go to college and you start thinking about entering the real world you know. There's no longer any participation Tirupati trophies. I think we do kids. This is could get on the soapbox. I think we'd do kids are a disservice when we don't really teach them about winning and losing and you know somehow wow this idea that everybody wins is just not true. I mean when you go to college in you compete for jobs. Some people get the job. Some people don't some people move up the career our ladder. Some people. Don't don't get me wrong. I don't see the world is purely winning and losing but you've got to add value to the organization to ultimately have Success at least if you think about success in terms of advancing your career growing in your knowledge and ultimately you know adding value so I think that's one one of the things I really try to encourage people to maybe think about sooner rather than later is that the real world can be really rough and if if you know if your parents sort of overly protect you from and sort of give you this idea that you know I think one of the worst pieces of advice that I tell people to ignore ignore this idea the That you know you can just do anything you want right and I know parents are well intended when they tell their kids this but the reality is if you're five foot seven you're never we're going to play in the NBA. You're just not it doesn't matter it doesn't matter. You don't have the genetics to do it so actually think we need to crush people's dreams at some point so they don't get distracted down the rabbit holes. You've got to really think about you know where your talents are and what. You're actually good at again. This idea that. Just sort of Willy Nilly follow all your passion and it's great if you can actually really love what you're doing. Don't misunderstand me passion is wonderful but ultimately you've gotTa have passion combined with you know something that you're good at and talented at and can ultimately make a living and you know along with that is you know. Don't get into massive sorts of student debt. we all are well aware of those sorts of issues you know. Education is a great investment. But it's not such a good investment that you should spend your you know to to go into debt for the rest of your life to achieve so those those are just a few of the things at least that I think about a relative to this question. Yeah it's awesome answer. John I completely agree. I have one Kinda just brief L. Question I think he kind of answered but I think the one thing that a lot of students or younger professionals heavily but have conflict with is following their strengths and talents verses following their passion and you talked about value and adding value in terms being used a lot more throughout our profession now both both combat large in our profession but also on the individual level so for a younger therapist. Would you recommend maybe finding out new kind of self analysis on your strengths and talents. Would you recommend following their passion in terms of adding more value to their company or clinic. Or what have you. Yeah I tend to think about it more trying to really identify your strengths and what you're good at and let that be sort of the litmus test for the direction that you go if you're the effective at what you do your talented at what you do you have sort of a camaraderie and feedback of your team. That you know believes your evaluated you you know. Value added member of the team. I think that ultimately ties to you know to passion into you know really enjoying what you do you know. We're we're all well aware of the starving sorts of artists in starving musicians in those sorts of things where they pursue these like pie in the Sky Dreams for ten years and then finally in their early to mid thirties. You know realize they've got to grow up and make a living and again. It's a fine line right because you know one out of every thousand. Listen you know Aspiring country music artists. That moved to Nashville. Actually make it right. So there's there's sort of this this hope but but oftentimes it's really not a a realistic venture so at least for my own in our. At least the way I talk about it with my kids is trying to find something you really good at earn a living and then once like you've gotten atten certain amount of you know sort of income under your belt so to speak you can really then afford to take some risks in quote unquote pursue your dreams. I think people like you know all these Unicorn companies you know. Everybody thinks they're going to be the facebook twitter or the AIRBNB. And you know that is just us not. That's not realistic. That is not what happens. That ninety percent of businesses it start fail. The message is a lot more sinister than that. And it's super super hard. So I I take issue sometimes with the kind of the GIG economy where you see a lot of this in PT. Now you know where you know. Go out bill. The cash based practice you know and all those sorts of in at least everybody. I know who's in a cash based practice. They have second and third jobs. I don't understand that like that's just my bias. I think you ought to it really go into an organization add value find something. You're good at learn the ropes so to speak and then at a certain point you can afford kind of look look up a bit and maybe take some risk that you otherwise wouldn't have taken so that's a little bit of a bully pulpit but that's how I sort of see now. That's that's a great answer. I completely agree ten. You want to jump into the next question. I think. The next one's for mark. Yeah no definitely and SORTA continuing on with what John Is. Talking died octopus students frequently and I asked them what their why like. Why are you here? Why are you sitting in this class? What what's your? What's your intrinsic motivation to inspire you to come Robin show up and studying all sort of stuff because of your experience but the the spoon fed generation of I want the answers to the test? I want to know exactly exactly what's on. It has definitely made academia my end a little bit more challenging the last couple of years and so too here in reinforced. Those ideas of now you gotTa Find Your Passion and and figure out. What are you good at? So that you can pursue that till allow that to become your career choice versus me trying to talk his division. Three athletes out does going to the. NFL is always fun..
"dr mark sheppard" Discussed on Evidence In Motion Clinical
"Welcome to another edition of the I.. M. Clinical podcast. My name is John Childs and and joined by my co host. Dr Mark Sheppard as always days and we are privileged to have on the show of physical therapist who works actually with us at Texas physical. Therapy specialist Dr Neil. Sheth Neil completed completed the sports residency back in two thousand seventeen or so and really brings a unique perspective to all things certainly physical. Oh therapy but particularly related to strength training and so. We're really looking forward to having Neil on the show neil welcome to the clinical podcast. Thank you guys for having having them really excited so neil to get US kicked off if you would just give us a brief bit about your background maybe where you went to. PT School and sort of how you got into sort of the path that you're on now. Okay so I went to school in Philadelphia at the University of the sciences. It was a direct program so I actually didn't have to do the. Gre Three in reapply. I was just sixers don which is exciting. After that I was really well by my second year I really wanted to do. A sports. Resin team started looking looking around what I could apply to. and Luckily I am sports residency in Georgetown which XP was open and they took me on and finish that in twenty seventeen after the exam in March twenty eighteen. And now I'm down in San Antonio with one of our sports clinics where I get to mentor. The incoming residents now do a lot of teaching with that. Neil thanks for that background if you would talk a little bit about your perspective on strength with training and sort of where you think strength training sort of fits if you will and where the sort of the state of strength training I asked the question because you know oh manual therapy was sort of the decade of the two thousands and maybe overemphasize perhaps relative to strength training and it seems like the pendulum maybe swinging the other direction. Now where like all everyone talks about is like cross fit and those sorts of things. And it's like it's gone the other way so I'm just curious is like what's your perspective on strength training and what's the state of it within the profession. He adds though this really excited about. If I get to fired up just calm me down if you guys need need but again on tirades in the clinic all the time but as ours when I think I actually think that this is the biggest area that we need to improve on as a profession. Kind of like what you send John Worth starting to swing in the other way. I definitely sealed up but I think a lot of issues are that Patients are under loaded and under dosed as far as strength training principles and a lot of people. Just don't implement proper. Strengthening like thera bands are good to start with his initial seen in acute injuries. But after that initial phase there needs to be a shift to load it and having some awaits actually being put on these patients in. I could see that this so boxes. Something Neil that many people probably will resonate with and you. You know it's interesting because when you're in clinic you see you know thera bands everywhere at you know different types awaits that are usually hand weights right. If you go I went to the everyday. Outpatient clinic are even one within the hospital. It's kind of like those are the staples but you don't really see anything that can actually load people. You the heavyweights and it always kind of bugged me in two different ways one is like why is that the case too is I wasn't really comfortable understanding ending how to load people with squat racks or different types of bar. Waiting things landmine stuff like that. That took some time after I graduate sweet so when you talk about you know where the state of strength training or are really the prescription of exercises like where do you feel like. We miss the mark doc when it comes to these types of things so definitely go with the Swat rack being so at when during residency in Georgetown and even at us or as lane location. I I actually bought thought squat racks for both of those the Knicks in order to low deebo in a when I was little headed that about it but he got the point of it uh but then he was really from the beginning where in school and highly had maybe an hour a week for half a semester of going over any any strength and conditioning related things and that. Just trustees us into the clinic three graduate and we're still doing those eysenck three he by ten therapy and everything similar movements everything. Everyone gets the same cookie cutter approach and there needs to be a shift to that loading being an challenging the patient with actual weights and Neva bodyweight movements is fine but there are just not enough to have any tissue up tation Shen prevent long-term injury in. I think that also comes back to us practising what we preach. I liked to Charles Myself personally in the gym and with other colleagues of mine as far as Hauer thinking about exercise dosage. How a training myself in it leaks into how I treat? Patients Asia's Neil. Could you expand on this a little bit like you give in clinical example of like how you are implementing proper dosage. This is general as it relates to. Let's say strengthening someone's quadriceps muscle if they're coming in for let's say anterior knee pain like how does that look from your perspective when you're dosing dosing. Is it okay that provide a case about actually have a really good one for nepean young So with this. He's like a thirty three year. Old Male in the navy is all him a year after he fell on his knee and has had an tierney pain. Ever since and through the medical carousel paracel he was just prescribed straight leg. Raises and Claude sets for a whole year a whole year. That Yup and he's never done anything else using unlike multiple providers that have changed anything else. So let me stop you there. So you're telling me. Has He seen the physical therapist before this time he saw one. Yeah Yeah Oh man for a short time that kills me to know that the two exercises were still kind of on his radar but anyway. That's crazy yeah so he had no audio to do and he is in the navy he was off duty getting ready to go back to think Iraq Many leaves at the end of this month so he can squat lower than maybe like fifty degrees of neath luncheon. He tries running he kinda Gallup's because he doesn't want to bend that knee so I'm getting some of this very avoid. We didn't an week in doing things that he needs to do with him. I we do something called the Quad Index and we have a makeshift shift version with a hand held item. OMETER cheap way to do it but it works that so there's research out there especially for post. The minimum criteria needed to running is actually eight weeks and eighty percent index. So we use that. Eighty percent is our measurement to start any metrics or impact work. He we started at a at thirty percent. Thirty eight or twenty seven something like that and yeah really really low. So where I started with him outside of the cloud. Odd Settings settings. Good right especially on your continuum it's good for activation in the new progressive straight leg raises for your control and then after that you again to strength endurance endurance. He'd Kinda like that stair stepping progression over him we used. We started off a lot because of his pain with movement. We start a lot with Jafar Ayar flourished and just loading him with bodyweight movement squats split lunges straight leg raise and then eventually eventually shifts to adding weight to all those movements and making sure on his scale on what I do. A lot of patients is and use the rate of preserved exertion. So if it's something I really want them and the challenge you had told me I want it eight plus nine hundred ten anywhere in that range and if it's not there for them we just keep increasing until it's a heavy enough weight where they're actually pushing themselves not just going through the movement. That's interesting meal like so you're telling me that you're using the R.. P. To actually actually understand the reps and potentially sets for which you does your patients is that kind of how you're using yes so with the RPG round like eighty plus. It's usually definitely more my strength side or even power so I the schemes typically x amount of sets for anywhere between two to five Canadian. Six wraps her up and then if I want to get a little bit later on there are definitely increased volume for movement pattern. That were working. Oh that's cool so you know to me it would make sense. That may not be the same number going back to your statement about the three sets at ten Dan. You know that you kinda see everybody's flow chart you know potentially So yours look a bit messy. If this was documented. They're not clean. Three by ten three by tens is something I get so upset about in the clinics and we even have a table that we all work on an I wrote are actually one of my residents wrote. Think before you buy I ten has to me if everything on your flow sheet is three by ten to me. It's lazy programming. Your there's no intent behind find what you're prescribing and my floggings are definitely messy every day. There's I don't write all the way on the left side. I don't know how your flu she'd looks on the left column elements of Big Open Blank. Were most people just write back through size and then it just carries on through that entire life of that flashy for me. I leave that that left side blanket. I write in each for specific day. What I'm working on with my plan is which exercise are going to help achieve that goal and definitely the numbers are very off kilter? There's some people who do like a four by seven five three or five. I even play a lot with strength and conditioning in the clinic to every minute on the minute at a certain load of do Amr APPs so definitely. The flu sheets varied day all over the place. There's intent behind the entire goal. Now is a great discussion and you know as you talk about like this case for example you know number one. I hope you consider perhaps publishing it if you're able to do that. So the researcher in me can't not suggest that so it's thing you can share and on that note what sort of of resources the you lean on whether it be journal articles are the particular authors that you follow when it comes to all things you know how to train patients and athletes in evidence informed sorts of ways. What are the resources that are your go to? I'm definitely big on social media. I follow a lot of physical therapists percent. Strength and conditioning coaches. Some of the big ones as far as in the P. T. Rome that put out a lot of content. Is Dan Laurenz or Eric. Mira or even Mike Reimann on those people I follow. That always have a good tweeter instagram post about it. Even John Rawson has really good things breath. I also have my strength and conditioning Certification so I do rely on the NFC as website as far as articles that are coming out and Alikhan challenge different athletic populations in the clinic. So those are my big ones even J. O. S. P. T. R. J. P. T. are a good example if those that are APD members and then on that note that same train of thought you know. I know you provide a lot of mentorship to residents. So what sort of structure do you have them reading articles on a regular basis. Are You doing journal clubs or you know what's the contemporary way that you really help mentor mentor..