Michael Smith, PT

Physical therapist (Ortho, SCI). Interested in pain and promoting better treatment of it throughout the healthcare system

[Michael Smith, PT @MSmith_DPT]

@Retlouping Wow. That’s gross

[Michael Smith, PT @MSmith_DPT]

@sweatscience @MSSEonline The getting outside, meeting others and sense of accomplishment IS brain chemistry. BioPsychoSocial can not be separated! Its all one!

[Michael Smith, PT @MSmith_DPT]

@MBourne5 @StephLaz_ But they can preferentially provoke sensitivity in the proximal hamstring

[Michael Smith, PT @MSmith_DPT]

@UltraRunner26 So frustrating. Find a PT who works with runners

[Michael Smith, PT @MSmith_DPT]

@RoyFilmDPT @aaos @APTA_official @AAOMPT @aaspt_apta @UMmedschool @UMSOMPTRS You mean atraumatic?

[Michael Smith, PT @MSmith_DPT]

@cremieuxrecueil @Intermarket_Dyn @tobyhardtospell Would you consider the current health insurance state a free market? Like people get to choose their health insurance and switch when they don’t like theirs?

[Michael Smith, PT @MSmith_DPT]

@GregLehman @BillingMartin I recently sat through a PT group discussion on everyone’s techniques to fix alignment issues. It’s not worth arguing. Most people don’t have motivation to change things they’ve been doing for a while. You can’t compare success rates of tx so I have no ground to stand on anyways

[Michael Smith, PT @MSmith_DPT]

@novicephysio @GregLehman @brettfischerDPT There are certainly instances where that’s the case

[Michael Smith, PT @MSmith_DPT]

@GregLehman @brettfischerDPT Agreed. Lots factoring in to the cause of the disability to do the movement/activity. I guess I just call it weakness to simplify but will get into deeper meanings when needed

[Michael Smith, PT @MSmith_DPT]

@GregLehman @brettfischerDPT When you say building them up, do you mean building them up from a weakness? Maybe I just call decreased ability from pain, a weakness since the capacity to do the movement is lessened

[Michael Smith, PT @MSmith_DPT]

@GregLehman @brettfischerDPT I think finding and then improving a painful weakness is the way to go. I just don’t need an objective number on the weakness

[Michael Smith, PT @MSmith_DPT]

@GregLehman @brettfischerDPT I don’t! The subjective feeling of weakness/fatigue compared to the non-symptomatic side is all I use for strength testing

[Michael Smith, PT @MSmith_DPT]

@GregLehman @brettfischerDPT It’s an approach that fits the narrative I use and I tend to think that’s more relevant. I think the embedded education that comes with the exercise prescription is more of the benefit. But that’s just my assumption

[Michael Smith, PT @MSmith_DPT]

@GregLehman @brettfischerDPT It's a non pathoanatomical impairment that can give them direction and self-efficacy, and when it’s the painful motion it’s also education on the safety of working into it. I’ve just found a correlation between addressing the weakness and improving the pain, why that happens… 🤷🏻‍♂️

[Michael Smith, PT @MSmith_DPT]

@GregLehman @brettfischerDPT You don’t have to tell someone they’re weak, they can show themselves how quickly they get to fatigue on the symptomatic side compared to the other

[Michael Smith, PT @MSmith_DPT]

@BStulberg Unless your goals are health driven and you’re exercising a few days a week. Then the murky middle is just fine

[Michael Smith, PT @MSmith_DPT]

@DrSeanMackey @DrKenWeber Causation or result of chronic movement patterns/muscle activation in people with pain?

[Michael Smith, PT @MSmith_DPT]

@hjluks And to think I’m still paying my higher premium while it’s cheaper without it!

[Michael Smith, PT @MSmith_DPT]

@arothschildpt hopefully their explanations for the treatment wasnt too pathoanatomical. A more active approach wouldve been better if it wasnt already included, but otherwise its tough to outperform natural history with those.

[Michael Smith, PT @MSmith_DPT]

@JOSPT ok, im really starting to wonder if we can have any effect at changing outcomes