Pain Catastrophizing Sabotages Joint Replacements

"Pain catastrophizing" is a relatively new term. In short, it's a negative cognitive style. Laura Frey-Law & Steve George write that pain catastrophizing "at the extreme includes feelings and beliefs that the pain experienced is beyond the control of the individual and will inevitably result in the worst possible outcome" (in Sluka, 2016). The instrument [...]

Breaking the Cycle of Fear and Disability

Spinal surgery is on the rise. The annual number of laminectomy and spinal fusion surgeries increased from 1998 to 2008 by 11% and 137% (!) respectively, even though the benefit of spinal surgery for some patients is questionable at best. Three randomized controlled trials (RCTs) found no evidence for the superiority of lumbar fusion at 11-year [...]

“Whether you believe you can do a thing or not, you are right.”

Henry Ford once said, "Whether you believe you can do a thing or not, you are right." His words are powerful. I imagine that he was talking the need for relentless confidence as an entrepreneur, even though we can apply his quote to the physical therapy profession, too. And I don't just mean for what [...]

The STarT Back Screening Tool is Changing Physical Therapy

Forecasting is tough work. Whether one is a meteorologist or a stock broker, it takes guts to make a prediction. The same applies to making predictions in the physical therapy profession. The beauty of a prediction is that it is testable. We can look at a set of data, make a reasonable guess about what [...]

The Curious Case of Psychologically-Informed Physical Therapy

I love psychology, but physical therapy has a psychology problem. I've already written about how the physical therapy profession should be more willing to embrace psychological research. There are some good explanations of why PTs are slow to adapt their practices to the biopsychosocial model. Many psychological interventions are poorly described, poorly implemented, and even poorly [...]

What are your goals?

"I'm going to walk out of here without a walker, without a crutch, without a cane -- without any of that." A patient told me this during his evaluation in inpatient rehab. It was three days after his total hip replacement. Considering that he was still struggling to walk with a walker, I remember appreciating his optimism [...]