is now Compass Physical Therapy!
Posted on April 2nd, 2018

‚ÄčAutism.  What does it mean to you?  In the last decade the numbers have escalated from 1 in 300 to 1 in 150 to now 1 in 88.  That can be scary for many but for us in the trenches seeing it firsthand, everyday treating pediatric patients, the numbers are becoming an injustice to the parents and to the children themselves.  The saying goes "If you've seen one child with Autism, you've seen one child with Autism."  It is accurate, therefore, that the diagnosis is referred to as a spectrum.  The unfortunate side effect is that it seems EVERYONE is being placed somewhere on the spectrum regardless if they belong there or not.  When everyone is "special" no one is and all it does is slow the process down.  

My frustration began when I saw a news story of a little boy who clearly had Down Syndrome who the reporter labeled as "autistic."  What?!  He is not autistic!  He has Down Syndrome!  Why was he place on the spectrum?  It made no sense.  Since then, every child who is a little different, is delayed in speech, introverted, or has any other diagnosis like Cerebral Palsy or a traumatic brain injury is having the autism diagnosis tacked on.  Yes, yes, I get it that it is a behavioral diagnosis, but do we really need to give every child the label?  It is a grave injustice to the children who actually have autism!  

In my practice, I've seen a handful of "types", if you will, of truly autistic children.  One group is non-verbal, is on-the-go continually, sleeps very little and avoids eye contact with just about everyone.  They tend to be sensory seeking for firm contact and constant motion.  Another group is highly intelligent, incredibly articulate and intuitive.  They have a masterful command of the English language but have very little ability to see outside of black and white, steadfast rules.  This group tends to fixate on a concept and can't move past it.  A third group appears to be stuck where language is concerned but are otherwise cooperative, affectionate, and interactive.  They start with echolalia then one day have an explosion of speech like a dam breaking free, usually catching up to their peers in language once this happens but may retain some quirky social behaviors. 

Then there is the numerous children who come in with a diagnosis of autism that I ask the parents "what merited the diagnosis?" because in all honesty, in many cases I don't see why the label was given.  Most of these "others" have sensory issues which would more accurately be labeled "sensory processing disorder".  Some simply spend too much time in front of screens and have very little ability to socialize or communicate because of what I call early onset gaming that thwarts attention span, language development and social skills, not to mention makes them clumsy, have poor balance and body awareness because they rarely use any body part except their thumbs.  What I find most baffling is when a parent tells me that their child couldn't get services at school without the diagnosis, that other diagnoses "don't qualify".  What?!  So we are labeling kids who don't have autism as autistic just so they can get the services they need at the school level?  Something is wrong here.  No wonder the numbers are sky rocketing- it's false data.  This is muddying the waters and is truly unfair to everyone involved.  

If the powers that be really want to help the real autism community, not to mention children who should have a different diagnosis to get the help they need, subcategories need to be defined to allow parents, educators and professionals the ability to save time, money and resources and get these kids exactly what they need right away.  What frustrates me is the lack of information per child past the broad spectrum diagnosis so parents often spend a year or more, hundreds to thousands of dollars and countless hours of anguish trying to figure it out on their own until they happen upon the right mix of services for their child.  It is heartbreaking!  The diagnosis drives the path for getting help that is why getting the most accurate and detailed diagnosis from the start is so essential.  

And so I ask,  Autism- Really?  You should, too.  

Posted on February 22nd, 2018

Breathing- so natural, we all started doing it the day we were born.  Somewhere along the way into our adult life, we adopt a pattern of breathing that can affect the way we feel, how we sleep, and contribute to aches and pains all over our body.  As asymmetrical beings, we also develop patterns sitting at our desks, going through our daily motions of getting dress, eating, even riding in the car.  With enough repetition, some muscles turn off and just stop working while others stay on and work overtime to compensate for their dormant counterparts.  The result?  Shoulder pain that pinches when you raise your arm over head, migraines, back and neck aches, hip pain, knee pain, you name it.  It is not so much your age as your pattern.  

At Compass Physical Therapy, we utilize a treatment technique called Postural Restoration.  This approach first looks at the alignment of the body and what pattern it has gotten itself into. There are a handful that you will hear us say in the clinic- AIC, PEC, BC- that all just describe which muscles we need to turn off and which we need to turn on.  Once a person has achieved balance, it is referred to as neutral alignment.  Neutral alignment is where we all want to exist because it is in this position that the bones are hitting correctly with their counterparts, the muscles are firing optimally in collaboration with each other and pain from mal alignment is relieved.  It hurts to be out of neutral- literally.  

This is where the heavy breathing comes in.  The PRI treatment involves utilizing the diaphragm and lungs to move your rib cage which in turn move your vertebrae.  Once those line up correctly, the hips and shoulders shift into place which has a ripple affect for the knees and elbows.  These exercises are like nothing you've ever done before.  At least that is what our patients tell us.  PRI also involves taking a good look at your feet and your footwear.  With a stable foundation, your alignment improves dramatically.  The PRI institute recommends certain shoes for certain patterns that have remarkable effects on the way your entire body feels, not just your feet. 

Of all the treatment approaches we use in physical therapy, I can say without a doubt that PRI is the most effective tool I have come across in my 20 years of practicing PT.  Not only do I use it with my patients, I also use it myself as a chronic neck pain sufferer.  If you have tried other forms of PT and are not getting the results you'd hoped for, give us a call.  We will get you back to neutral!  256-325-5400.  

Posted on January 28th, 2018

‚ÄčIn the pediatric wing of our clinic, we see may infants with torticollis and plagiocephaly as stated in the earlier blog, "It Won't Just Go Away!" In the last year or so, the numbers of babies with severe plagiocephaly (flattened or misshapen heads) is increasing and all share one common practice: these babies sleep in a Rock -n- Play instead of in a crib or bassinet. The pattern is so clear that it is time to speak out against this product.

When measuring plagiocephaly, we use digital calipers in our clinic to determine the cranial vault asymmetry, or difference from the right side to the left side of the skull. The "normal range" is a difference of less than 5 mm cranial differential with the protocol to monitor the head shape. Most babies who are referred to us have a cranial vault asymmetry on average of 9-10 mm asymmetry, moderate plagiocephaly, which requires intervention to correct. A conservative approach is used initially with a cranial remolding helmet a "last resort" once conservative measures have not produced the desired results by ~7 months old. The babies we are seeing who sleep in a Rock -n- play are arriving with an average of 12-13 mm cranial differential which is considered severe plagiocephaly. The report of sleeping in this device is consistent across the board with the more severe cases of head deformity seen clinically. These babies more often require cranial remolding helmets to correct the asymmetry because the initial plagiocephaly is so severe.  (See first image below.)

Most parents get angry and feel they have been duped once they learn that the Rock -n- Play is the cause of the severity of the baby's head shape because it is advertised as a "sleeper." Let me clarify by saying that not all babies who sleep in the Rock -n- Play end up with severe plagiocephaly, but the ones that we are seeing clinically with this diagnosis have a consistent pattern of sleeping in this device. By design, the Rock -n- play limits movement. The baby is strapped in a reclined position with two angled side seams where the baby rests the side of his or her head or rests the chin on the chest with the back of the head flat on the surface.  (See second image below.) A body at rest in a reclined position will seek out stability, so in the Rock -n- play, it is one of these two positions. Infants do not have the muscle strength to move out of confined positions that is why it is so important to monitor what they are sleeping on and rotate them regularly. Being strapped in a position in which the body weight is primarily on the bottom prevent the baby from moving freely. 

A baby's soft spots are open until 12 to 18 months of age so during that time, the head is molding and changing shape. The sutures are open allowing the plates of the skull to move as the brain grows. It is vital to have equal contact on all parts of the head while the soft spots and sutures are open to ensure a round head shape. After the sutures and soft spots close, the head shape can only be changed surgically. This is the only window of opportunity you will have to shape your baby's head! If a baby sleeps through the night, that is 7-8 hours of laying in the same position on the same side of the head which will cause head flattening and deformation. My recommendation is a flat surface to allow baby to easily roll the head back and forth, wiggle the body in a natural movement. Without resistance from the sleep surface, this is much easier to do and much more natural. A body needs movement even when asleep. This movement and rotation of the head will help ensure a rounded head appearance. If you want something small and convenient to place next to your bed, look for something like this: (See image 3 and 4 below). It is the best of both worlds, portable as well as a flat firm surface with enough room to move around while asleep.

Many parents begin using a reclined sleeper (Rock -n- Play, swing, bouncer) because the baby has reflux. It is shown that a baby only needs to be inclined for 30 minutes to 1 hour after eating to reduce reflux so it is not necessary to keep the baby propped up all the time. Just as adults who experience reflux do not sleep sitting up, rather, wait for a period of time after eating before laying down. The same principle applies here for infants. If you feel the need to prop you baby up, put a wedge under the crib mattress to incline the surface so the baby is still free to move around during sleep, not confined or strapped in one spot all night long.

It is my mission to stop babies from sleeping in the Rock -n- Play as it is clinically proven to be a significant contributing factor in causing severe plagiocephaly. Please don't let your baby sleep in a Rock -n- Play. Send the manufacturers a message that this device should not be advertised as a sleeper!

Posted on January 8th, 2018

As we enter the new year, it is always a good idea to pause and take a glance at the rear view mirror.  Compass Physical Therapy will be celebrating year one under it's new name in April but the company as a whole has sustained a 12 years history of serving the Madison community.  In those twelve years, there has been much change- expansion and retraction, division and unity, new faces and familiar faces but with all of the ups and downs, our core principles and overall vision has remained unchanged.  

To recap, the company opened in 2005 under the name Eagle Rehab in a small clinic "upstairs" housing 2200 square feet.  Within 2 years, we had outgrown the space and moved to our current location downstairs in the same building into a significantly larger office, 5900 square feet, and expanded the practice to include pediatric therapy and massage therapy.  During the growth period, we had the privilege of hiring additional talented and compassionate physical therapists and physical therapy assistants.  In the name of progress over the next few years, we opened two additional clinics, one in Huntsville and one in Arab and with it additional staff to carry out our vision to more of the Tennessee Valley area.  Arab was a young and up-in-coming market so withing a few months, another company came along and offered to buy our new expansion. We seized the opportunity and returned to two locations extending pediatrics to both locations.  

During our tenure, the physical therapy market shifted with an explosion of physical therapy clinics in the Huntsville and Madison area.  Being one of the fastest growing cities in the United States, it was not surprising how rapid the expansion of our city was for all areas of industry and commerce.  For a time, we wondered if there would eventually be a PT clinic on every street corner!  By my count, eight additional physical therapy clinics have opened in the last 6-7 years in the Madison area alone.  The only service industry with as much growth as far as I can tell is urgent care clinics.  One seems to open every other day!  Despite the crowding of our market, we have stood firm in maintaining our vision and the patient-centered culture.  Things may have changed outside our doors, but our focus remains the same inside the clinic.  With the saturation of the market, we made the executive decision to consolidate our remaining two clinics to one, pool all of our efforts in one location.  

I attested success with longevity.   Sure, we have had turnover in some of our staff over the years but these days, that seems to be the norm.  With almost 90% of people staying less than 5 years at the same job, I feel fortunate that the vast majority of our employees have been with this company for 9+ years.  A patient said last week, "You always have good people here, even the new people."  Again, it is a vision, a culture, a mentality that we hold in the forefront of our minds at Compass Physical Therapy so when there is a job opening, you can be sure that we won't fill it with just anyone.  It has to be a team member cut from the same cloth, one who holds the values of patient care that is exceptional and beyond expectation.  One thing I can say with certainty, each and every one of our staff members goes the extra mile to provide a stellar customer service experience.  It is our daily routine.  

Looking ahead to the coming year, no matter what lies in the future, I know that the ideals of our company will remain unchanged regardless of the ups and possible downs that will inevitably come.  One thing that is for certain, we will remain your PT Compass to better health and wellness.  I invite you to experience who we are in 2018 for all of your physical therapy needs.  Experience the tradition of excellence that is Compass Physical Therapy. 

Posted on December 13th, 2017

While out meeting with a new doctor recently, she asked me "How is your clinic different than all the others?"  I gave my stock answer "We treat both pediatric and adult patients, and we are the only clinic in Madison to utilize the Postural Restoration treatment approach for pain and injury."  Yet, I feel compelled to add to my response.  After hearing ubiquitous responses from patients who have left other PT clinics in favor of ours, it turns out the services we offer are only one aspect of what makes us different.  

The term High Volume Clinic appeared in an article I was reading the other day.  A High Volume Clinic is one in which the PT sees anywhere from 3-4 patients an hour and spends about 15 minutes with each one.  From there, a non-licensed technician or another clinician takes over to finish the treatment, typically counting exercises and applying hot or cold packs.  We have earned a multitude of patients over the years who have "fired" their previous PT for basically the same reasons after being referred to such a clinic:

"I felt rushed to get in and get out every time I went.  It was very nerve racking and not a good experience."

"I saw one person for a few minutes, then was handed off to someone else for a few more minutes, then someone else would come by and do something else.  I never knew who my therapist was and never saw the original PT who did my evaluation.  I kept having to explain myself over and over again and felt like none of them were even listening because they were treating so many other people at the same time."

"A young girl had me pull on a band a few times, would leave me there pulling on the band for 15 minutes then come back and ask me if I'd done my 15 reps. She'd give me another exercise then leave again.  I just thought that was how PT worked.  She didn't check if I was doing it right or change anything when I told her it hurt when I did it.  Just told me to keep going then leave again.  I seemed pointless so I didn't go back."  

It is equally frustrating and embarrassing as a PT to hear those types of stories but trust me, I have heard them too many times to count in the last 12 years of working here at Compass PT.  It honestly gives our profession a bad name to learn that someone views PT as "pointless" because they were left to their own accord with no direction, and equally to hear that they felt "rushed" or like "one of a number" instead of a person with real concerns.  Nothing is more infuriating then having to re-explain your pain or injury every time you walk into an appointment to someone who appears to neither have time for you or show concern for your situation. 

What honestly makes us different is our philosophy.  At Compass Physical Therapy, we are patient-centered.  We work alongside each and every patient who enters our clinic through the entire physical therapy process.  We know who you are.  We know why you are here.  We work together as a team to give you an exceptional experience from the moment you are greeted by our office staff to the moment you leave your PT session.  It is not just talk when we say that it is our mission to provide exceptional customer service and physical therapy that is beyond expectation.  That is our culture, to be patient-centered.   Our PT's and LPTA's see one to two patients an hour depending on the level of care required.  The vast majority of the time, you are with the same therapist each visit as we make every effort to have continuity of care with each patient.  You will not feel rushed or ignored while you are here nor will you have to explain yourself or your condition multiple times because we listen and communicate with each other.  We do not employ technicians, therefore you will not be treated by an unlicensed professional rather by a licensed therapist for every visit.  With this practice, each of us can make real time changes to your plan of care as you progress through the healing process.  This ensures you will get well at the pace you should be.  Better therapy=less visits=less expense to you and quicker return to your life.

Is it time for you to fire your PT?  If you are not getting a patient-centered experience, perhaps it is.  You deserve to be healed in an environment that is focused on you, not packing in as many people as possible to pad the bottom line.  It is your choice where you attend physical therapy so call us today and experience what physical therapy should be.