#PTonICE Daily Show The Institute of Clinical Excellence

Dr. Joe Hanisko // #FitnessAthleteFriday // www.ptonice.com 

Dr. Ellison Melrose // #TechniqueThursday // www.ptonice.com 


In today's episode of the PT on ICE Daily Show, Dry Needling lead faculty Ellison Melrose discusses using dry needling for recovery, including e-stim parameters using the ES-160 unit.
Take a listen to the podcast episode or check out the full show notes on our blog at www.ptonice.com/blog
If you're looking to learn more about our live dry needling courses, check out our dry needling certification which consists of Upper Body Dry Needling, Lower Body Dry Needling, and Advanced Dry Needling.
EPISODE TRANSCRIPTION
ELLISON MELROSE
Welcome to the PT on Ice daily show. My name is Dr. Ellison Melrose. I am lead faculty with the dry needling division of ICE. I am here to talk to you guys today about recovery, so dry needling for recovery. We are coming off of Ice Sampler Weekend, and we had two pretty intense workouts this weekend, and we're feeling it, I think. So we are pretty sore in the quads, so what I wanted to demonstrate today was a recovery method for primarily the quads. We're gonna go over recovery mechanisms, how to choose the muscles when you're thinking about setting up a recovery circuit, and the e-stim parameters that you want for dry kneeling for recovery. So there are three main mechanisms of action when we're thinking about recovery.
The first is pumping, so hemodynamics. We're getting big muscles to pump. There are some muscles that are better pumps and better sponges, so they do a better job at the fluid dynamics. The second mechanism is washing out cellular debris from in that intracellular space. So thinking a little bit more microscopic than just vasohemodynamics or moving fluid. We're thinking cellularly. So we know that active recovery and facilitated recovery can do both of those things. What's nice about dry needling when we're thinking about recovery is that we're not putting any mechanical stress on the tissues, loading like we would with active recovery. Third, we have an autonomic nervous system response.
DRY NEEDLING FOR HEMODYNAMICS
So one thing that they saw throughout the research is that dry, or e-stim, facilitated recovery with e-stim, there is a longer base of dilation effect after we removed the e-stem from the tissue. And so what they postulated from that is that we have an autonomic nervous system response, so we have increased vasodilation, which is just going to improve our body's natural ability to pump fluid. When we're thinking about choosing muscles, again, as I mentioned earlier, there are some muscles that have better capacity to pump, but also absorb fluid and that is based off what we call O2 flux capacity. We're not going to dive super deep into that today, but pretty much what it means is that there's increased capillary density in those tissues and so they act as better sponges and better pumps. When we look at the lower quarter, there are two main muscles that are going to be pretty good or have higher O2 flux capacity. One is the medial gastroc and the other is the quadriceps.
CHOOSING THE RIGHT MUSCLES FOR RECOVERY
Another way to think about what muscles to choose are thinking about following the venous system. So again, we're trying to improve hemodynamics. So we want to follow the venous and lymphatic system to encourage that fluid to work its way back up towards the heart. And so thinking about a lot of the bigger venous structures, the lymphatic tissues run immediately. So when I'm thinking about setting up an entire lower quarter circuit. Sometimes, depending again on why I'm choosing these, we may be doing medial gastroc, medial quad, adductor magnus is a huge pump for the lower quarter. And then working into the glutes as well. And then, last but not least, is we have sport-specific muscle fatigue. So when thinking about, a great example I like to use is in CrossFit. After a really grip-heavy workout, we may be just specifically treating the forearm flexors, so the muscles that we're using t

Dr. Julie Brauer // #GeriOnICE // www.ptonice.com


In today's episode of the PT on ICE Daily Show, join Modern Management of the Older Adult lead faculty Julie Brauer translates lessons learned from training for a 50k trail run into strategies to use when working with older adult clients to help them become the person they want to be as they journey through life.
Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog.
If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.
EPISODE TRANSCRIPTION
INTRODUCTION
Hey everybody, Alan here. Currently I have the pleasure of serving as their Chief Operating Officer here at ICE. Before we jump into today's episode of the PTI Nice Daily Show, let's give a shout out to our sponsor Jane, a clinic management software and EMR. Whether you're just starting to do your research or you've been contemplating switching your software for a while now, the Jane team understands that this process can feel intimidating. That's why their goal is to provide you with the onboarding resources you need to make your switch as smooth as possible. Jane offers personalized calls to set up your account, a free date import, and a variety of online resources to get you up and running quickly once you switch. And if you need a helping hand along the way, you'll have access to unlimited phone, email, and chat support included in your Jane subscription. If you're interested in learning more, you want to book a one-on-one demo, you can head on over to jane.app slash switch. And if you decide to make the switch, don't forget to use the code IcePT1MO at signup to receive a one month free grace period on your new Jane.

JULIE BRAUER
Morning crew. Welcome to the PT on Ice daily show. My name is Julie Brower. I am a member of the older adult division, and I am going to be talking to you all this morning about my favorite thing in the world, running. So this morning I am going to share with you some lessons that I've learned from training and running a 50k that I just ran this past weekend and I'm going to translate some of the lessons I learned and give you all some advice on how you can use those lessons with your older adult patients. So This past weekend, I ran a 50K, that's 31 miles, in New River Gorge, West Virginia. It was absolutely beautiful, absolutely brutal, and I was out there for seven hours and 14 minutes. That gives you a lot of time to reflect and learn some life lessons. So I'm gonna share some things with you all, and hopefully you can translate these to be using with your patients this week.
LESSON 1: THE TRUE FINISH LINE IS AT THE END OF YOUR LIFE
Okay, so first lesson. The true finish line is at the end of our lives. The true finish line is at the end of our lives. This is a quote by Sally McRae. If you all have not heard of her, she is my absolute idol. She is a professional ultra mountain runner. She is known for her mental fortitude and crazy accomplishments throughout her career. She just did the Grand Slam of 200 mile races, which are four 200 mile races in the span of five to six months, which is absolutely insane. So she has a, her own podcast called the Choose Strong Podcast. And I started listening to her as I was starting to train. Um, when I first started trail running like a year plus ago, a little bit over a year ago, And I remember I'm running on the trail, I'm listening to her podcast, and she said that, quote, the true finish line is at the end of our lives. All of these start lines and finish li

Dr. Cody Gingerich // #ClinicalTuesday // www.ptonice.com 


In today's episode of the PT on ICE Daily Show, Extremity Division faculty member Cody Gingerich discusses the importance of focusing on the subjective exam during the first 2-4 follow-up visits to ensure patients are making appropriate progress.
Take a listen to the episode or check out the full show notes on our blog at www.ptonice.com/blog.
If you're looking to learn more about our Extremity Management course or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.
EPISODE TRANSCRIPTION
INTRODUCTION
Hey everybody, Alan here. Currently I have the pleasure of serving as their Chief Operating Officer here at ICE. Before we jump into today's episode of the PTI Nice Daily Show, let's give a shout out to our sponsor Jane, a clinic management software and EMR. Whether you're just starting to do your research or you've been contemplating switching your software for a while now, the Jane team understands that this process can feel intimidating. That's why their goal is to provide you with the onboarding resources you need to make your switch as smooth as possible. Jane offers personalized calls to set up your account, a free date import, and a variety of online resources to get you up and running quickly once you switch. And if you need a helping hand along the way, you'll have access to unlimited phone, email, and chat support included in your Jane subscription. If you're interested in learning more, you want to book a one-on-one demo, you can head on over to jane.app.com. And if you decide to make the switch, don't forget to use the code icePT1MO at signup to receive a one-month free grace period on your new Jane account.

CODY GINGERICH
All right, good morning PT on ICE daily show. My name is Cody Gingerich. I'm one of the lead faculties with the extremity management. What I wanted to come on here today on our clinical Tuesday and talk about is when things are not going to plan. Specifically the subjective exam on visits two, three, four. Okay, so when people come in and they say, hey, you know, I don't think this thing has gotten any better. I'm feeling potentially even worse, or they had a flare up since the last time you saw them on that initial eval. And what then does that subjective exam look like when they come in on visits two, three, four? How do you dive into, do you need to make an adjustment on your plan of care? Do you need to make an adjustment on dosage? Do you need to make an adjustment on anything? Or do you stay the course and you dive into really heavily on what exactly happened? Okay, so that's what we'll talk about today. If you did a good, really good initial exam, right? And you're like, man, this thing presents like I expect. We're going after it. You choose a dosage and a diagnosis that you feel confident in what you have given that person leaving your clinic. And let's say they come back in in one week. Most of the time I'm seeing people on a once a week basis, but even if they come in later on that week and they come back in and they're like, ooh, you know what? We are not really feeling any better. They come back in, something happened, flared back up, and now you have a pretty difficult conversation, right? Because on an initial eval, if you felt confident, you probably provided that confidence to the patient of like, Hey, you know, I think we found this thing. This is definitely coming from your shoulder. Probably the more of those muscles in the back of your shoulder. And you know, if we do these two, three exercises over the course of the next couple of days, I really think things are going to get better. Right. And then they come back in and all of a su

Dr. Alexis Morgan // #ICEPelvic // www.ptonice.com 


In today's episode of the PT on ICE Daily Show, #ICEPelvic division leader Alexis Morgan discusses the concept of "fitness freedom" as it relates to helping patients & clients embrace the ability to "choose your hard" in customizing rehab & fitness exercises.
Take a listen to learn how to better serve this population of patients & athletes or check out the full show notes on our blog at www.ptonice.com/blog.
If you're looking to learn more about our live pregnancy and postpartum physical therapy courses or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.
Are you looking for more information on how to keep lifting weights while pregnant? Check out the ICE Pelvic bi-weekly newsletter!
EPISODE TRANSCRIPTION
INTRO
Hey everyone, Alan here, Chief Operating Officer here at ICE. Before we get into today's episode, I'd like to introduce our sponsor, Jane, a clinic management software and EMR with a human touch. Whether you're switching your software or going paperless for the first time ever, the Jane team knows that the onboarding process can feel a little overwhelming. That's why with Jane, you don't just get software, you get a whole team. Including in every Jane subscription is their new award-winning customer support available by phone, email, or chat whenever you need it, even on Saturdays. You can also book a free account setup consultation to review your account and ensure that you feel confident about going live with your switch. And if you'd like some extra advice along the way, you can tap into a lovely community of practitioners, clinic owners, and front desk staff through Jane's community Facebook group. If you're interested in making the switch to Jane, head on over to jane.app.switch to book a one-on-one demo with a member of Jane's support team. Don't forget to mention code IcePT1MO at the time of sign up for a one month free grace period on your new Jane account.

INTRODUCTION
Good morning, PT on Ice Daily Show. My name is Dr. Alexis Morgan and I am thrilled to be here with you all this morning. I am here in my Airbnb in Carson City, just coming off of the ice sampler and Wow, what a weekend we've had. We have had so much fun learning from all the different divisions here at ICE and learning from all the different instructors. And let's be honest, having a blast, having a blast with each other. It has just been an incredible weekend that we are still running high from. Today's topic is fitness freedom. And it really is fitting for today in reflection of this weekend, just because the 150 people that have been all together this weekend, of course, we're all different fitness abilities, right? We all have our different fitness goals.
WHAT IS FITNESS FREEDOM?
And as I was thinking about this topic that is fitness freedom, which comes from our street parking friends, Miranda and Julian Alcraz. As I was thinking about this concept of fitness freedom, to discuss with you all this morning. It was beautiful how really the last two days here at ICE, it was just laid out perfectly. And so I wanna talk with you all a little bit about what fitness freedom is, what it means, and where it came from, and how we can implement it in our lives, as well as our practices, ultimately for our communities all across the nation. So, as I mentioned, we just got off of Sampler, and over the past two days, we've had various divisions talking. We went through different labs, and when our pelvic division did the lab on bracing, Rachel said, choose your heart. We did pushups, and we worked on bracing within pushups. But for every single person, a variation of push-ups is going to be appropriate. For som

Dr. Guillermo Contreras // #FitnessAthleteFriday // www.ptonice.com 


In today's episode of the PT on ICE Daily Show, Fitness Athlete faculty member Guillermo Contreras discusses the why behind the footwear recommendations they make and why minimalist footwear may not be the best choice for many fitness athletes to start with as well as how proper footwear can have an added benefit of improved strength, hypertrophy and fitness
Take a listen to the episode or check out the full show notes on our blog at www.ptonice.com/blog
If you're looking to learn from our Endurance Athlete division, check out our live physical therapy courses or our online physical therapy courses. Check out our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.
EPISODE TRANSCRIPTION
INTRODUCTION
Hey everyone, Alan here, Chief Operating Officer here at ICE. Before we get into today's episode, I'd like to introduce our sponsor, Jane, a clinic management software and EMR with a human touch. Whether you're switching your software or going paperless for the first time ever, the Jane team knows that the onboarding process can feel a little overwhelming. That's why with Jane, you don't just get software, you get a whole team. Including in every Jane subscription is their new award-winning customer support available by phone, email, or chat whenever you need it, even on Saturdays. You can also book a free account setup consultation to review your account and ensure that you feel confident about going live with your switch. And if you'd like some extra advice along the way, you can tap into a lovely community of practitioners, clinic owners, and front desk staff through Jane's community Facebook group. If you're interested in making the switch to Jane, head on over to jane.app.switch to book a one-on-one demo with a member of Jane's support team. Don't forget to mention code IcePT1MO at the time of sign up for a one month free grace period on your new Jane account.
GUILLERMO CONTRERAS
Here we go. Good morning, fitness athlete crew. Good morning, PT on Ice Daily Show. Welcome to the PT on Ice Daily Show and the best day of the Fitness Athlete Division of the Institute of Clinical Excellence. Super happy to be with you here this Friday morning. fitness athlete footwear. And that's a little teaser there. Hopefully you get excited for that. Before I start jumping though, I want to say anybody headed to Reno, Nevada, in Reno, Nevada for the ice sampler, have an awesome time. Have an epic time. A little bit of FOMO not being able to be there, but hope you all have a wonderful time. Take so much out of that weekend. It's such a great weekend. So much to learn. So many to learn from. And I've done this topic in the past. I've talked about my shoe recommendations for fitness athletes, whether it be the Rad One Trainer, the Strike Movement Trainer, the Nano, the Metcon. I've gone deep dive almost too long into episodes with that in the past. And today's actually a more of a, let's call it a response, a response PT on this episode, discussing why we don't, or why I don't personally recommend barefoot in the fitness athlete, whether it's the level one or the live course, we get asked, hey, what are your thoughts on barefoot shoes? Or why aren't you recommending minimalist shoes to allow the foot and the ankle to naturally do what the foot and ankle should be able to do? And this is where we're going to dive into, right? This is the topic I'm discussing because we know there's different shoes out there, right? I have somewhere in front of me right here. This would be a minimalist shoe, right? This is a zero drop shoe. it allows the foot display so a really nice wide toe box. It allows the foot to move naturally, allows the ankle to