Bendy Bodies with the Hypermobility MD, Dr. Linda Bluestein

In this episode, Dr. Chelsea Pierotti discusses coping with dance injuries and transitions, both from a physical and psychological perspective. She explains that the way dancers appraise their injuries and their emotional response to them can greatly impact their coping mechanisms. Dr. Pierotti emphasizes the importance of shifting the mindset from seeing an injury as a disaster to viewing it as a challenge that can be overcome. She also highlights the role of social support in the recovery process and the need for dancers to define success in ways that are within their control. Additionally, Dr. Pierotti addresses the challenges dancers face when transitioning between different forms of dance or when they have to give up dancing altogether. When transitioning out of dance, it is important to consider your values and what truly matters to you in life. This will help guide your future goals and decisions. It is also helpful to reflect on who you admire and what you admire about them, as this can highlight your own values. Grief and loss are common when leaving a dance career, and it is important to acknowledge and process these emotions. The dance world can be more supportive by adopting a positive coaching approach and focusing on the whole athlete, not just their performance. Developing mental skills and self-awareness is crucial for dancers and can be beneficial for everyone.

Takeaways

• The way dancers appraise their injuries and their emotional response to them can greatly impact their coping mechanisms.
• Shifting the mindset from seeing an injury as a disaster to viewing it as a challenge can help dancers overcome the emotional and psychological challenges of injury.
• Social support plays a crucial role in the recovery process for dancers.
• Dancers should define success in ways that are within their control, rather than relying solely on external validation.
• Transitions between different forms of dance or giving up dancing altogether can be challenging, and it's important for dancers to have a strong sense of identity beyond being a dancer. Consider your values and what truly matters to you in life when transitioning out of dance.
• Reflect on who you admire and what you admire about them to identify your own values.
• Acknowledge and process the grief and loss that comes with leaving a dance career.
• The dance world can be more supportive by adopting a positive coaching approach and focusing on the whole athlete.
• Developing mental skills and self-awareness is crucial for dancers and beneficial for everyone.

Chapters ➡

00:00 Introduction

00:54 Introducing Dr. Chelsea Pierotti

01:13 Coping with Injuries

03:38 Coping Mechanisms

06:34 The Influence of Childhood Experiences

08:29 Developing Resilience

09:48 Transitioning from Dance

12:11 The Role of Pain

13:09 Challenges Faced by Hypermobile Dancers

13:23 Supporting Dancers through Challenges

17:49 The Importance of Social Support

18:43 Grief and Loss of a Dance Career

20:34 Developing Resilience and Coping Strategies

24:57 The Importance of Values

27:52 Shifting the Dance Culture

29:25 Coping with Career Shifts

33:22 Positive Coaching Approach

35:55 Developing Mental Skills

36:51 Applying Mental Skills to Life

37:24 The Importance of Self-Awareness in Dance

38:25 Mindset: Controlling the Controllables

Dr. Heather Tick, a renowned pain expert, discusses non-drug therapies for pain relief; applying the principles of integrative medicine for comprehensive pain care. She emphasizes the need for education and understanding of pain neuroscience to empower patients. Dr. Tick also highlights the significance of nutrition in reducing chronic pain and inflammation. Additionally, she explores various modalities, such as acupuncture and manual therapies, as effective strategies for pain relief. Dr. Heather Tick discusses the impact of habits on movement and the importance of developing healthy movement practices. She also explores various modalities for pain relief, including heat, cold, Epsom salt baths, and movement therapies like yoga and Tai Chi. Dr. Tick emphasizes the role of mast cells in the stress response and the importance of managing diet to reduce mast cell activation. She discusses the effectiveness of laser therapy, ozone injections, and shockwave therapy for pain management. Dr. Tick also addresses the overprescription of medications and the potential benefits of supplements. She provides insights into the appropriate use of interventional pain management and the risks associated with steroid injections. Finally, she discusses the challenges of determining the expertise of medical professionals and the need for caution when considering regenerative medicine.

Takeaways

• Integrative medicine takes a holistic approach to health, focusing on achieving overall well-being rather than just managing symptoms.
• Pain management should involve a comprehensive care plan that includes movement, education, nutrition, sleep, psychosocial support, modalities, medications, and supplements.
• Understanding pain neuroscience can help patients reframe their perception of pain and explore non-pharmacological strategies for pain relief.
• Nutrition plays a crucial role in reducing chronic pain and inflammation, and a whole-food, plant-based diet is recommended.
• Modalities such as acupuncture and manual therapies can provide effective pain relief and should be considered as part of a comprehensive pain management plan. Developing healthy movement habits is crucial for optimal movement.
• Heat, cold, Epsom salt baths, and movement therapies like yoga and Tai Chi can provide pain relief.
• Managing diet and reducing mast cell activation can help alleviate stress response.
• Laser therapy, ozone injections, and shockwave therapy may be effective for pain management.
• Caution is needed when considering the use of medications and supplements.
• Interventional pain management should be approached with strict criteria and careful consideration.
• Regenerative medicine shows promise but requires further research and careful selection of providers.

Chapters ➡

00:00 Introduction to Dr. Heather Tick

02:05 Understanding Integrative Medicine

07:41 Redefining Pain Management

10:31 The Importance of Education in Pain Care

12:58 The Role of Nutrition in Pain Relief

21:53 Exploring Different Modalities for Pain Relief

53:56 Impact of Habits on Movement

55:11 Benefits of Tai Chi

56:34 Connective Tissue and Movement

57:37 Role of Mast Cells in Stress Response

58:10 Effectiveness of Laser Therapy

01:00:35 Usefulness of Ozone Injections

01:02:03 Effectiveness of Shockwave Therapy

01:03:13 Overprescribed and Underutilized Medications

01:03:44 Importance of Stopping Medications

01:04:32 Impact of Proton Pump Inhibitors

01:05:37 Role of Gut in Producing Neurotransmitters

01:06:34 Importance of B Vitamins and Coenzyme Q10

01:17:26 Evaluation of Interventional Pain Management

01:19:16 Risks of Steroid Injections

01:21:26 Appropriate Use of Regenerative Medicine

01:25:30 Determining the Expertise of Medical Professionals

01:31:28 Differentiating Flares from New Problems

01:33:48 Challenges of IV Infusions and Regenerative Medicine

In this Bendy Bodies with the Hypermobility MD podcast, Susan Chalela, MPT discusses support and bracing for hypermobile joints.  She shares how her personal and professional experience with joint hypermobility led her to develop the Finding Functional Foundations approach which is being taught as part of The Ehlers-Danlos Society EDS ECHO program. She emphasizes the importance of proper alignment and biomechanics in everyday activities and explains why traditional physical therapy approaches may not be effective for hypermobile patients. Susan also discusses the role of bracing and supports in providing stability and controlling motion. She explains the benefits of using different types of braces for the feet, ankles, pelvis, and neck, and emphasizes the need for proper sizing and education for both patients and physical therapists. Susan also shares her experience with durable medical equipment (DME) and provides recommendations for clinicians interested in offering bracing services. She concludes by highlighting the resources available for further education and support in the field of hypermobility.  Watching this episode on YouTube is recommended since there are some graphics used.  

Takeaways

• Proper alignment and biomechanics are crucial for protecting joints and managing symptoms in hypermobile individuals.
• Traditional physical therapy approaches may not be effective for hypermobile patients and can even worsen symptoms.
• The Finding Functional Foundations approach focuses on teaching patients proper alignment and functional movement patterns.
• Bracing and supports can provide stability and control motion in hypermobile joints. Proper support and bracing can help manage symptoms and improve function in patients with hypermobility.
• Different types of braces are available for the feet, ankles, pelvis, and neck, and proper sizing is crucial for optimal support.
• Education and guidance are essential for both patients and physical therapists to ensure the correct use of braces and maximize their benefits.
• Clinicians interested in offering bracing services should consider the specific needs of their patients, stock commonly used sizes, and collaborate with DME suppliers.

Chapters ➡

00:00 Introduction

01:22 Background and Interest in Hypermobility

11:56 Neurological Interest and Stroke Recovery

16:23 Traditional Physical Therapy Approaches

25:24 Importance of Bracing and Supports

39:18 Feet and Ankle Support

40:28 Pelvis Support

43:32 Neck Braces

51:46 Dispensing DME and Bracing

56:56 Carrying Products in the Clinic

01:02:59 Final Thoughts and Resources

This episode centers around unveiling 'Taming the Zebra', a book co-authored by physical therapists, Dr. Patty Stott and Heather Purdin.  The book aims to fill a void in understanding and provide therapists with the knowledge to effectively work with patients with hypermobility spectrum disorders (HSD) and Ehlers-Danlos Syndromes (EDS). It covers the impact of connective tissue disorders on various body systems and provides practical tips for modifying physical therapy approaches. The book emphasizes the importance of addressing primary issues and understanding the complexity of each individual's presentation. The chapters cover topics such as modifying movement for gentle exercise, addressing deconditioning and weakness, building confidence and safe strengthening programs, finding physical therapists open to working with EDS patients, expanding the toolkit for physical therapy, and more. 

Takeaways

• The book 'Taming the Zebra' fills a void in understanding and provides physical therapists with the knowledge to effectively work with patients with HSD and EDS.
• The book emphasizes the importance of addressing primary issues and understanding the individualized nature of each patient's presentation.
• A collaborative approach between therapists and patients is essential in managing overlapping problems and setbacks. Modifying movement can allow individuals with HSD and EDS to engage in gentle exercise and maintain movement despite physical limitations.
• Deconditioning and weakness are common issues for individuals with HSD and EDS, and addressing these problems requires a comprehensive approach that considers the underlying causes and individual goals.
• Physical therapists should approach treatment with intention, focusing on building confidence and creating safe strengthening programs tailored to the individual's needs.
• Expanding the toolkit of physical therapy techniques, such as neural rehabilitation and manual therapies, can improve outcomes for individuals with HSD and EDS.

Chapters ➡

00:00 Introduction and Background

01:58 Motivation for Writing the Book

03:28 Challenges in Managing EDS and HSD

06:08 Different Types of Hypermobility and Connective Tissue Disorders

07:35 Approaching Physical Therapy for EDS and HSD

09:21 Primary Treatment Approach and Identifying Key Issues

21:04 Approaching Physical Therapy with Overlapping Problems

22:48 Non-Linear Path of Physical Therapy

31:01 Modifying Movement for Gentle Exercise

31:21 Addressing Deconditioning and Weakness

35:13 Neural Rehabilitation and Muscle Firing

36:09 Steps to Successful Strengthening

40:18 Expanding the Toolkit for Physical Therapy

43:13 Approaching Stabilization and Alignment

56:32 Hypermobility Hacks

In this Bendy Bodies podcast episode, Dr. Lillian Holm discusses effective physical therapy for EDS and HSD and the importance of correcting function to achieve pain relief and tolerance for exercise. She explains why physical therapy may not always lead to the expected outcome, emphasizing the need for specialized therapists and individualized treatment. She addresses common misconceptions about physical therapy and highlights the importance of communication and realistic expectations. Dr. Linda Bluestein and Dr. Holm cover topics such as progress and setbacks, balancing stretching with strengthening, starting to walk again after severe limitations, physical therapy for scoliosis, and helpful resources and information. Dr. Holm also shares her favorite hypermobility hacks to help individuals stay motivated and achieve their goals.

Takeaways

• Physical therapy can be highly beneficial for symptomatic joint hypermobility, providing pain relief and improving function.
• Finding a specialized physical therapist with expertise in hypermobility conditions is crucial for successful treatment.
• Misconceptions about physical therapy, such as the belief that it should be painful, can hinder progress.
• Individualized treatment plans and gradual progression are key to achieving the best outcomes in physical therapy.
• Open communication with the physical therapist and realistic expectations are essential for success.

Chapters ➡

00:00 Introduction to Dr. Lillian Holm

01:15 What can physical therapy do for people with symptomatic joint hypermobility?

04:19 Reasons why physical therapy may not lead to expected outcomes

09:09 How to find the best possible physical therapist for EDS and HSD

11:58 Misconceptions about physical therapy for joint hypermobility

21:25 Approach for people who don't like to exercise

25:41 Resetting the boom and bust cycle

35:23 Metrics for measuring success in physical therapy

50:18 Progress and Setbacks

52:47 Balancing Stretching with Strengthening

56:22 Starting to Walk Again

58:12 Physical Therapy for Scoliosis

01:01:04 Resources and Information

01:02:23 Hypermobility Hacks