Fearless Physical Therapy PLLC

I have worked the majority of my career in the Orthopedic setting. In that time I’ve seen thousands of post-op patients such as total knee replacements, lumbar and cervical fusions, and rotator cuff repairs. The last few years I have also worked in Home Health and have had the opportunity to see patients who are one day out of surgery.

The first question I get is almost always “Is it supposed to hurt like that?” “ How long is it going to hurt like this?” “ It’s not supposed to hurt, something is wrong.” The unfortunate thing is the answer a lot of times is it depends.  I know that is not what my clients want to hear but it’s the honest answer. Many times this person is in more pain than what they expected to be in. Their expectations were that after surgery the pain that caused them to get surgery would be gone. The thing is surgery involves movement or cutting of tissue which the body interprets as trauma. So the body will respond to that trauma causing inflammation and swelling, adaptive shortening, and other responses to protect the site of injury/trauma to allow for proper healing.

I can go into all the average healing times of muscles, ligaments, and tendons. For the most part, they generally hold up but one also has to factor in the person’s overall health, emotional state, sleep patterns, eating habits, beliefs about pain, and a host of other factors. Each person is going to respond differently. The joint/muscle can be completely healed on every scan that the doctor takes but the pain is still 10/10 because one of the other factors has taken the reins and won’t let go. There are some things that the patient can do to help out.

People who are active prior to surgery generally tend to do better movement wise. When I say active I don’t mean in the gym 3-4 times a week. It’s the people who try walking 30 minutes a day prior to surgery. It seems small but that one activity helps with overall health and if it’s a habit already it will be easier to do post surgery. With back and lower extremity surgeries one of the major activities we prescribed to our clients is to walk frequently throughout the day.  One of the things our bodies need to heal is a good blood flow to the area involved. Walking for 30-plus minutes improves overall cardiovascular activity and health, increasing the blood flow to promote healing. 

There are times when the patient has a difficult time adjusting to the life changes that have occurred due to the surgery/injury. Many times due to restrictions they cannot participate in activities around and out of the house that were a big part of who they were. Some have a hard time adjusting to finally having to ask for help. It helps to speak to someone to get these feelings out and wrap their head around it. I know in many cultures seeking counseling is taboo. The thing is if those negative emotions slow down the healing process.

Another thing that helps is surrounding yourself with the right people. The friends that keep you in good spirits, laughing, and in a more positive state of mind are important. You want the people who are going to make you be as active as possible around. There are times I find myself getting frustrated because the family is doing everything for the patient. The family believes that they are being helpful and doing the best for their family members. The thing is by doing everything for the injured party they are not allowing the patient to heal properly. Motion is lotion and the more movement one can get the better they can heal. That means letting them do as much of their normal routine as possible. Reaching into a cabinet to get a glass, and putting their plates in the sink may not seem like much but those small movements definitely add up.

Also understand that there is going to be some pain. It’s part of the normal healing process. It is important that we learn how to differentiate between bad pain and soreness/discomfort. Our muscles post surgery are going to be tight and there will be discomfort with movement. You have to ask yourself if this pain is telling you something bad or if it’s something your body isn’t used to. I generally tell my clients that if the pain only moves up 2-3 points it is okay but more than that we need to find a modification to the activity or maybe right now we need to hold off. It doesn’t mean we won’t revisit it but for right now, this very minute we may put it on pause and try to find a way to lower the irritability for that activity.

The reason for surgery on a muscle or joint is usually to reduce pain. It is understandable that one would be worried about a new pain when they get out of surgery especially if it feels like more pain than before the surgery. Most times this is all part of the normal response to the trouble that your body goes through. For many that pain starts to improve a few weeks after surgery.  The thing is that there are many factors involved in the healing process. So there is more that you have to look into with severe pain besides it hasn’t healed right. That being said, always bring up your concerns to your therapist or physician but if the answer we give is “it depends” it’s not because we don’t care but that there could be other issues coming into play.

So stop me if you heard this one you go to physical therapy for 2 to 3 months the whole time you’re not paying a copay not paying a coinsurance. About a month or so after therapy, you get a bill for $500 sometimes $2,000 plus. it also comes with a note saying that you have 90 days or 30 days to pay it. Now I know some people out there can see a $2,000 bill and not sweat it but not me. If you grew up like some of my friends and see a bill like that, you begin to fear that you’re going to have to go back to eating wish sandwiches.  

“Why didn’t they tell me my bill was going to be that high?”

”How in the Sam Hill did they let my bill get that high. What makes them think I can afford that? “

Then you realize the new year has started over, and insurance has struck again. Most of us forget that at the beginning of a new term usually at the beginning of a new year. your insurance starts all over so all the co-pays that you have paid all the money that you have put down towards your deductible and the last year do not carry over into the next. So a service that may have been free at one time it’s no longer free because your deductible has not been met. That means you start over again with each and every office visit meaning more out of pocket. Depending on your insurance you may have a copay or coinsurance or a secondary that’s going to take over part of it so a lot of times the office doesn’t know what your amount will be so they’re just giving you a rough guesstimate.

 Also, there are times when the insurance company says that the services are covered then they send you a letter stating they aren’t. The patient is now on the hook for that amount. This happens with a couple of the insurances more often than it does with others but  I’m not one to gossip so we’re not going to name no names here.

Nothing makes a clinician or front office person feel worse than finding out that a patient they enjoyed working with is now stuck with a big bill. Most of the time a staff clinician doesn’t know how much their company is contractually billing the insurance company. This means that they don’t know how much the patient may be on the hook for beyond the copay. I remember the first time a patient showed me the remittance letter that they received from their insurance company. I saw how much was billed for that hour.  I also saw how much the billing company paid and how much the patient was on the hook for after the deductions. Let me tell you I was in shock when I realized I wasn’t even making a third of what I billed that patient.

I came to learn that the insurance companies set up contracts with medical providers where they are allowed to make reductions in the bill. The insurance company comes up with fee schedules where they will only pay a certain amount for each service if THEY deem it necessary. “So why wouldn’t the healthcare provider just bill what the fee schedule said they will pay?” Well, not all insurers have the same fee schedule. On top of that, there are times when the set amount on the fee scheduled is paid less than what is in writing. 

If this sounds confusing and stressful it is. Billing a lot of times is the worst part of a clinician’s job. you don’t want to set your prices too high and make it so that patients can’t come to you but you also have to make it so that you are covering your overhead and that you’re able to live and eat and pay your bills with what you’re taking in. 

That is why a lot of providers are starting not to take insurance now. It is just too much of a headache. Many times the patient ends up owing more than if they would have gone the cash pay route.  There have been multiple times when a patient had to pay me more than my cash pay rate. Say my cash pay rate is $75-100 for each visit no matter how long I see you that day. You know you’re paying each visit. Time and what is done in that time is a big factor in how insurance pays the bill.  One visit the patient’s out-of-pocket could be less than $50. Another visit where more was done with the patient for a longer time will cost more. Couple this with the patient who is using their insurance coming to therapy more because hey a $30 copay may not seem like such a big thing so they want to come more than the person paying $75-100 because they don’t realize that they may have to still pay more on the back end.

Something that you can do is make sure you have a clear understanding of what your insurance company is going to cover. Also, know how close you are to meeting your deductible. If you know that you have a co-insurance pay a little bit, maybe $20, every visit, so that at least part of that bill is cut down before you end up with sticker shock. Also, make sure you check in with the clinic about every 2 weeks to see what information they may have been given from the insurance company.

Lose yourself

When a loved one becomes seriously ill or injured a family member or members may decide to take it upon themselves to help provide care. They feel that it is only right to support the loved one in their time of need. This can be a good thing for the patient if said family member(s) are equipped to provide the needed assistance.  In my time in the healthcare profession, I have seen numerous situations where the family tried to do what was best for the patient but in the end, it can sometimes turn out to be a bad situation for all parties involved. Either the patient does not get adequately taken care of or the caregiver ends up losing themselves to make sure that the needs of the family member are met. The situations that turn out well usually occur because of proper planning, resources, and a support system that is willing and able to provide assistance.

One of the first things that need to be done when deciding to care for a family member, is making sure that you can adequately meet the family member’s needs.  When patients come home from the hospital they may need someone to change them, clean them, or feed them.  If your family member is 220 pounds and you’re only 150 it can be difficult to move them around.  If the family member is at least able to assist with rolling and transfers this may not be an issue. When the patient is unable to assist with rolling or transfers grooming, transfers and toileting becomes a lot harder. 

Moving  250 pounds at the gym is a lot easier than trying to move your 150-pound grandfather who is unable to assist. Not only are you having to move the family member but you have to maintain them in that position for however long it takes to finish the task at hand. I’ve been in situations where I’ve had to hold someone on their side for what felt like an eternity while the nurse or CNA  provided cleaning or dressing. Ok, 10 -15 minutes is not an eternity but trying to keep some from falling while making sure they are not rolling over onto soiled linen for that length of time can wear you down multiple times throughout the day. A sole caregiver, especially one without any assistance, can start to develop physical issues such as back or shoulder pain or potential injury.

It is important if possible to have a team in place. Skilled care can come into your home but there are caveats. The patient’s insurance company dictates how many visits the patient will get if any. Some no matter the situation will offer up just 3-5. A patient who just had a severe stroke and still suffering from limitations may not get better in 3-5 visits. Also, a personal care assistant or sitter may not be readily available. These are not high-paying jobs and can be very stressful so turnover and a lack of staffing in some areas can be an issue. Even if your loved one does get an aide they may only be there for a couple of hours a day. If you have to go back to work and your family member is not able to adequately take care of themself or is a fall risk, you must have someone who can assist. If not you will find yourself worrying about your loved one at all times which will start to affect you physically and emotionally.

In my experience, finances can become a huge source of dissension in the family. I’ve seen some of the strongest individuals break down crying because a sibling, uncle, or aunt said that they would help take care of momma’s supplies. Then after weeks/months of inquiring and pleading the family member gives them $20 for momma. $20 won’t cover the skin cream, Depends, wound care supplies, and Ensure.  If the family decides to keep Home Health, after the insurance company says the visit limit has been reached then per discipline cost can exceed 200 dollars per visit. I had patient family members who went without their medicine or other necessities to cover the cost of care for the patient. There are resources available but most people do not know where to look. If possible please request a meeting with a social worker to learn about and how to get access to these resources. 

Understand, I am by no means telling you to not try to take care of your sick family member at home. Studies have shown that being around loved ones in a familiar environment can help with recovery. I watched my mother for over 10 years take care of my grandmother when she was paralyzed. In that situation I saw the effects of having a strong community to help and what happens when there are gaps in said community. In my experience as a PT, I saw people try to do it on their own, a strong community trying to help mama/daddy and what happens when the family dynamics are poor. It can make you stronger but if you don’t have a strong team you can lose your entire identity.

In the Bible, we meet numerous individuals who, despite their fears and worries, decide to obey God’s commands. Gideon is one of these people. In the book of Judges, we first learn about Gideon, the weakest man from the smallest family from the smallest tribe. The story of Gideon illustrates a strong example of how a person can act in faith even when filled with fear and facing seemingly insurmountable odds. The story of Gideon is one that always inspires me especially when it feels like I’m in over my head and the proverbial dragon is breathing down my neck.

Gideon lived during a time of great trouble. The Israelites were being oppressed by the Midianites for ~ 7 long years. Coming from a humble background, Gideon was probably the last person, one would think, God would select to save his people. God did choose Gideon to deliver His people from their oppressors. He picked the runt of the litter, the tiniest of specks to do the job. When the angel of the Lord came to  Gideon, he logically expressed trepidation. Quite frankly Gideon was scared out of his mind. Gideon’s reaction of uncertainty revealed his lack of faith in God’s calling and in himself. He doubted his own abilities and saw himself as wanting, not as someone who could defeat an army.

Gideon required signs of confirmation before he was going to step out into the unknown. I know I probably would have done the same thing. I would have asked so many questions that the Angel would have been like “ God, can we just get the dude from down the street because Quis ain’t it.” Gideon eventually mustered the courage to assemble an army of over 30,000 men to face the Midianites. Apparently, Gideon had some clout or there was something about him because there is no way 30,000 men will follow someone that they didn’t think would cut it.  However, God had other plans, and that many extra soldiers were not in his plans. He instructed Gideon to decrease the size of his army. The ones that were scared were told to kick rocks. Still too many men. There were some that were exhausted and lapped up the water like dogs. He told them “Don’t let the doorknob hit you where the good Lord split you.”   The size of his army eventually dwindled down to 300 men. Sounds kind of familiar doesn’t it, like a Hollywood movie. The whole time Gideon is thinking he is possibly hearing God wrong because how is 300  hundred going to take on tens of thousands maybe more.

Even though Gideon was being obedient he was quaking with fear. God saw this and understood that Gideon needed some assurances. The night before the battle, Gideon by himself wandered around and came upon some Midianite soldiers. He overheard their conversation and to his surprise, his small band of soldiers were stressing the Midianite army out. He was still afraid but Gideon steeled himself to do what had to be done.

The next day, Gideon divided his army into 3 groups of 100 hundred and gave each one a jar of oil and a shofar. A shofar as I just have found out is a horn. Now why couldn’t they have just said a horn? The 3 groups surrounded the enemy. At a set time they screamed out, blew their horns, and started lighting torches. The Midianites heard the den and thought a large army had set upon them. The Midianites were so confused they began eliminating each other. The 300 were winning, take that, Gerard Butler. Gideon sent for the men of Ephraim, another tribe of Israel who was the equivalent of that friend you call when you know it’s about to go down. The leaders of the Midianites were captured and killed.  They just lost to the smallest man of the smallest family of the smallest tribe.

Gideon’s faith and obedience were rewarded as God granted him a resounding victory over the Midianites. The story of Gideon lets us know that if God has given you a calling no matter how big or scary he will be with you.  Gideon’s initial reluctance morphed into courageous action and dogged determination that won the day.

1. God equips the hesitant: God doesn’t need to use the biggest, strongest, or smartest. He knows what is in you and if he calls you to it you have the equipment to get the job done.
2. God’s ways are not our ways: this one I feel like I have heard my entire life. Look at the story of Gideon. He thought he needed the 30,000+ soldiers to beat the Midianites but God said nope. All that was needed was 300 men and faith. 
3. Overcoming fear through faith: The story of Gidon is about one man overcoming his crippling fear and self-doubt to take down an army. Gideon just had to trust in God and step in that ring and good things happened.

Gideon’s story serves as an inspiration and an example to those of us who feel called to do something that seems greater than what we are capable of. This story reminds us that faith and courage are not the absence of fear, but the willingness to trust and obey even when fear is present and the obstacles seem insurmountable.  By embracing the lessons from Gideon’s life, we can find the strength to overcome our own doubts and fears, knowing that God is with us wherever we may go.

In today’s fast-paced world, finding time to prioritize our health and fitness goals can be challenging. It can be especially difficult to perform exercises that aren’t geared toward making cosmetic changes but to regain normal function. However, the home exercise program is an important part of the healing process. Whether you’re a busy professional, a stay-at-home parent, or simply feel that the clinician should do passive modalities, implementing a home exercise program offers numerous benefits for healing and your physical and mental well-being. In this blog post, we will explore the importance of incorporating a home exercise program into your lifestyle and its importance on your road to recovery

1. Convenience and Accessibility:

One of the most significant advantages of a home exercise program is the convenience and accessibility it provides. Most HEP requires or should require little to no equipment. Their therapist should craft a program utilizing what they have available to them in their home. With a dedicated space and compliancy, you minimize the time and money spent in the clinic. 3 times a week starts to become really expensive and time-consuming if it has to be kept up for a prolonged period of time. Being compliant with the home exercise program allows you to recover faster and saves time and gas because you are not constantly going to a P.T. clinic. Just think about it you have the freedom to exercise whenever it suits your schedule, fitting it seamlessly into your daily routine. This accessibility removes barriers and excuses, ensuring consistency in your fitness journey.

2. Time and Cost Efficiency:

Even if your copay is only $20 a visit it starts to become expensive. At 3 times a week for 2-3 months for instance becomes $480-$720. Then tack on the price of gas, parking, and potential time off work you are looking at well over $1000. In contrast, a home exercise program allows you to save both time and money. Your clinician probably has a variety of ways to deliver your program including various online platforms, mobile apps, and workout videos available that cater to different injuries functional limitations, and goals. These resources offer a wide range of workouts, from high-intensity interval training (HIIT) to yoga and strength training, enabling you to choose workouts that align with your preferences and needs without breaking the bank.

3. Personalized Approach:

Your home exercise programs should provide the flexibility to tailor your workouts to your specific goals and preferences. Whether you want to improve shoulder range of motion, build strength, improve hip and back flexibility, or enhance cardiovascular fitness, the exercises chosen should align with your objectives. Additionally, you can ask for modifications to the intensity, resistance, and duration of workouts based on your activity tolerance and fitness level, gradually progressing as you become more mobile, stronger, more confident, and with reduced pain. This personalized approach ensures that your exercise routine is effective and enjoyable, increasing adherence and long-term success.

4. Privacy and Comfort:

Exercising in the privacy of your home eliminates any self-consciousness or fear of judgment that may arise in public gym settings. In the Physical Therapy setting it also allows you privacy as strangers aren’t directly beside you trying to figure out what brings you into the clinic. You can focus solely on your workout without having the share your therapist with others on your dime. 

      5.   Consistency and Accountability:

Consistency is key when it comes to achieving health goals, and a home exercise program can provide the necessary structure and accountability. By incorporating regular workouts into your daily or weekly routine, you establish a habit that becomes ingrained in your lifestyle also providing the right stimulus to promote healing. Setting aside a specific time for exercise and treating it as a non-negotiable commitment increases your adherence and ensures that you prioritize your health. Additionally, many home exercise programs offer tracking features, progress monitoring, and community support to keep you motivated and accountable on your fitness journey.

6. Mental and Emotional Well-being:

Regular exercise has been shown to have a profound impact on mental and emotional well-being. Your home exercise program also counts especially as you start to see progress. Engaging in physical activity releases endorphins, the feel-good hormones, promoting a positive mood and reducing stress and anxiety. It also helps to modulate pain. By incorporating a home exercise program, you have a readily available outlet for managing daily stressors, enhancing your mental resilience, and boosting your overall sense of well-being.

Conclusion.

The home exercise program is an important cog in the physical therapy machine. It helps to facilitate healing, build upon what was achieved in the clinic, and allows you to reduce the amount of time and money spent in therapy. The more compliant you are with the HEP the better your overall progress and the more pleased you will be with the results.

If I hear one more time  “My Doctor said I have the need of a 100-year-old” or “my doctor said it’s bone-on-bone arthritis and that  I have no cartilage,” I am going to scream. I’ve heard so many people say that the joint was almost nonexistent.  My thoughts are usually, did you really look at the X-ray? Did they show it to you where instead of having a ball and socket joint there was just a stick on one side and the cave on the other side and there was no ball. Also, I want to know if the person knew that cartilage doesn’t show up on an X-ray. Cartilage and ligaments don’t show up on x-Rays, only bone.

Yes, I know there are medical conditions where the bone will wear away or some infection or bacteria did some damage to the tissue. The thing is when stuff like that happens those times generally tend to show up on the patient report or on the patient chart because it’s so significant that you definitely want to make sure you stated what in the  Sam Hill was going on. In my 17 years as a  therapist, I have worked with multiple patients that unfortunately after some type of joint surgery ended up with an infection and required some type of prophylactic spacer to replace the joint. This is usually a painful and slow process that feels like it takes forever to clear up the infection. These people sometimes end up requiring multiple surgeries. Fortunately most people don’t have that type of issue. 

For most people when they are told that they have bone on bone it’s just that they have an arthritic condition. The good news is usually it can be managed with the proper non-invasive steps including diet/nutrition, exercise, proper progressive loading, managing stress, sleeping well, and other lifestyle changes. It’s not a quick process and it’s a lifestyle change you have to keep up. If I over-indulge in shellfish or red meat I know my knee will be madder than a wet hen.

I don’t want it to seem like the Medical Professionals are lying to patients on purpose. For the majority of providers, I believe that we seriously want to help but can use the wrong choice of words. In an effort not to try to trivialize the patient’s concerns, we can make things worse. I know that’s happened to me a few times.  I can think of one instance when I was trying to explain to the patient what their X-rays were saying in comparison to the results of the assessment that I just performed. I was trying to let them know that it was a good day and that their prognosis was really good that there was gonna be a short period of therapy and they should be good to go. What they got from our little discussion was that the arm was FUBAR and their life was over. All because I didn’t use the correct words or failed to explain myself properly. Effective communication is definitely important

Other times in trying to make sure we explain the gravity of the situation we can sometimes use hyperbole in giving a description of what is going on. An exaggeration can make a slight rotator cuff tear seem like something that could ruin a patient especially if they aren’t quite familiar with the metric system. So something that could just be due to normal wear and tear can sound like the bone has been completely eaten away because of a poor metaphor or analogy by the physician or medical professional. We are told not to use jargon when we’re speaking with patients but aren’t really trained in how to communicate. It’s always sad to see a patient too shook to perform a certain activity because some medical professional somewhere made the mistake of telling them that a specific activity could mess things up worse.

 I remember being told that due to my knee, I should never run again. I took that to heart so I know I didn’t run for a long time because I was afraid that I was gonna do more harm than good until I decided to be rebellious. I found out that running did not aggravate my knee more than normal and actually the weight loss from the cardio helped my symptoms.

Unfortunately, you do every once in a while get the doctors that verbalize situations to sound extremely negative,  or even catastrophic. I can’t begin to understand why they would purposely put these negative thoughts in a person’s head and I’m not I’m going to try to guess why. These are the people that perpetuate the stereotype that all surgeon wants to do is cut or all a therapist/chiropractor wants you to do is come in 3x week forever.

Next time you get told that you have the hips or knees or the back of an octogenarian. Ask more questions to get a better understanding of what is going on. Let them know what you understand from the information that they gave you. Most likely you don’t have the worst shoulder that they’ve ever seen unless they have only been in practice 2 months.

OK, so it’s no secret I love anime. When I first discovered Dragon Ball Z back in my teens I was hooked. Honestly, even before that, I watched shows like Akira, Robotec, and especially Ronin Warriors. My love for anime is something I passed on to my son K-1. Growing up in North Carolina he probably saw more cartoon violence than is healthy for a toddler. 

It wasn’t just violence that got me it was how the protagonist always had to go up against great odds. How they would get knocked down and have to find a way to rise from a bone-crushing defeat.  It was common to see the hero bloodied, arm broken if not completely severed, crawling towards the villain. The villain would take time to do some type of monologue about their plans to take over the Earth or destroy the universe would have you. During this, that broken hero sums up the last of their strength and possibly some plot armor or some sort of deux ex macchina. 

The hero within level up, somehow find that extra gear and commence to beating the brakes off the villain. I swear for like five whole episodes Goku just screamed to summon up the power to become a super Saiyan. My and my friends and I were hooked to the TV to see what happened next. The music was switched to a beat that just told you that the villain was going to pause look at the camera and say “Welp, I bet you are wondering how I ended up buried in the face of a mountain.  My sinew is plastered all over the place like a toddler was left alone for  too long.” 

In the end, the hero stands triumphant. Well, the majority of the time the protagonist is left on the ground with a weak smile and a month’s worth of hospital bills around the corner coupled with extensive Physical Therapy. Still, they defeated their mortal enemy. Not because they were the most gifted physically or mentally, but because they had the will to push forward no matter how hard it got.

To me, Therapy can be like a good anime. The hero, the patient versus the villain which is the functional limitation or the injury or the pain. The villain is stopping them from doing what they love to do or from what they need to do in order to live a normal happy healthy life. The villain must be defeated.

I know right now you’re probably shaking your head thinking this boy has lost his rabid mind. Hear me out though, I’ve been in clinics look people screaming in pain crying barely able to move. Sometimes they had to be carried in by their loved ones. A lot of times they say I just wanna go and they’re not talking about going to Disneyland. Whatever’s going on has affected them so much that is starting to beat them down mentally and emotionally. I’ve had people scream out in pain that rivaled Goku’s. Some people had the pain taken over so bad that they were not their normal selves. The family would say that the person is not bad just miserable. In anime, there are always characters who appear to be side villains. When you learn their back story it turns out they are not the villain they are just in need of help.

Also like anime the treatment process can sometimes seem to go on forever. Depending on the severity of the injury the patient could be with you for several months I’ve seen some therapists working with some patients for years. During the intake process when I find out the patient’s history there have been more than a few times where the patient has told me that the initial injury occurred before my momma met my daddy. One Piece and its 20-odd years run don’t have anything on having pain since bell bottoms were in style.

Like the wise (haha) mentor my job is to help my patient progress to the next level. True they are firing off energy blasts or manifesting ridiculously long swords, but let someone wipe their behind or wash their armpit for the first time in months. That person feels like they just mastered a new hidden technique. Oh and don’t let someone walk for the first time in a year. The look of pure joy and satisfaction on their face trumps any smile of any character that has learned to fly for the first time.

So if you happen to catch me working with someone and I’m whispering“Dragon Dragon find the Dragon” or “I want to be the very best” just know we put in work. 

 Growing up my cousin Keith joined the military and was stationed close by. Keith was tall well over 6 ft two athletic and the ladies in the neighborhood loved him. Keith also appeared to be pretty smart to me. Well, I wasn’t even in elementary school at the time so everybody was probably pretty smart to me. I wanted to be just like Keith when I grew up. One thing my mother jokes about to this day is that anytime you came over to the house the first thing he would tell me is Marquis go back inside and put on some lotion. You know light skin people can be ashy too. Well needless to say I never got to be six foot two and I didn’t gain any athleticism until High School. I wasn’t the guy that the ladies fawned over but  I remembered to put on lotion.

To heal our bodies need motion and stress due to joints. One of the little sayings and PT school that I believed was Universal, motion is lotion. Our bodies, especially anything that has collagen in them, require some sort of movement to continue to grow, reproduce and heal. If motion and stress are not applied that area either dies, doesn’t remodel or becomes stagnant. In order for bones to grow there needs to be biomechanical stress applied to them ie you need to move around and wait there. Muscles need some type of movement friction time under tension to grow and get stronger. You’ve never seen a bodybuilder that doesn’t put their muscles on some type of load. 

Keith knew that lotion was required to help the skin stay healthy. Healthy skin gives you the look of being healthy. As the old saying goes, if you look good you feel good. Back during the lockdown, I went through a couple phases of depression, one was so bad that I would go weeks close to months without putting on lotion. My skin was so dry it began to flake and it just hurt. Have you ever had your elbows hurt for no apparent reason not because you hit it or not because you moved it the wrong way but because it was so dry there were cracks and pores in it. Yeah, things got that bad for me. Our bodies are like that, also long periods of immobilization and are sedentary lifestyle causes the muscles and other connective tissue to basically lose their gift, their ability to bounce back, and the ability to move. I’ve counted so many patients who had knee pain or back pain and the only thing that felt good to them was staying still in one spot. Unfortunately, them not moving those joints are those muscles reduce the mobility in that area so when they did try to move it hurt more so they would not move it and it would become stiffer and when they turned they tried to move it again it hurt worse and so they were on this basic tragic cycle because their joints on muscles were crying out to be moved and weren’t. It seems to go against all common sense to move areas that hurt but once again motion is lotion and motion also allows for improved blood flow or vascularity which helps with the healing process and helps with pain relief. As a therapist, we always try to encourage our patients to move even when it hurts. Not because we’re sadistic monsters but because we know that in the long run, it’s going to be more beneficial. A lot of times we’ll try to have you moving in directions that aren’t painful that are close to the involved area to get the initial blood flow to that area and then slowly progress towards moving in the direction of pain.

Have you ever had cracked toes? If you have, you know it’s not a fun situation. They feel like they’re bleeding without the presence of actual blood. You see little streets of red in between the cracks but there’s nothing flowing. With that pain you’re feeling it should at least be something flowing to let you know that you’re living but no it’s just some redness and what feels like death by a million paper cuts. My wife is always getting our kids to lotion up, especially during the winter time when you know the air is dry and your skin gets cracked and once again if not taken care of death by a million paper cuts. I remember being up in Utah in the mountains during winter before the girls were born. I had lotion in my travel bag, and little packets of lotion in my notebook because the dry air in that high altitude sucked all the moisture out of my skin. I wasn’t about to be the one black dude in a sea of medical professionals and be ashy. They weren’t going to have me looking like I was the leftovers from a campfire. My roommate for those two weeks laughed at the first couple days then he realized brown people get ashy too and he started to see some of those broken lines in his skin and felt the death of a thousand paper cuts and started baptizing himself in lotion.

Healthy skin is moisturized skin and a healthy body is a body that’s in motion. At the cellular level, we’re always in a state of motion. If not, the cell dies. If it’s at all possible even if it hurts we should attempt some movement. I’m not saying that if it feels like you’re being stabbed by a thousand knives to keep doing that movement now there has to be some kind of common sense to it but if it’s just a little bit of a nuisance or discomfort you need to move it. Truthfully, there are times when we all just want to feel lazy. Nobody wants to get up early on a Saturday morning. But if you have kids you know you got to because they want that cereal or my kids’ case bacon and eggs to go with their Saturday morning cartoons. Just like you wouldn’t ignore them to stay in bed, you shouldn’t ignore your body’s cries to be fed by movement. We also say motion is lotion because we know that the more you move are the more you perform a movement the easier it becomes so you’re basically reason up to joints to allow that movement to kind of light on through to make it smooth like my cousin Keith

Who am I ? what am I here for? These are questions everyone asks themselves. Identity is defined as the fact of being or what a person or thing is.  We all at one time or another look to search for identity. What is my purpose in the world? Why was I put here? One of the biggest accomplishments in your life is the moment you determine who you are and what your purpose is.

Unfortunately far too often we find our identity and things we have no reason to find our identity in. You could be that star college athlete who thinks about themselves in terms of the sport being the best at that sport. What happens then when you get injured and can no longer participate in said sport. The feeling of being lost can kick in, depression, and suddenly and unfortunately suicidal thoughts or tendencies can begin to take over. Others, unfortunately, don’t grow past the thought of one time being a star and find themselves living perpetually in their glory days. For me, wrestling helped me to find that sense of who I am. Going through the heartache of a loss, the euphoria of a win, and just the unnatural hurt of practice helped me to learn a lot about myself.  The fact that I kept coming back after every tough loss or disappointment helped me to learn a lot about myself. On a more primal level standing face to face against someone else and trying to enforce my will gave me the first real sense of I AM.

Most men find their identities in their job. We become so wrapped up in a job it becomes who we are. There’s something happening such as a layoff, or budget cuts and we no longer can bring home the same amount of money or no longer use said job to determine who we are in this world. Any challenge to say position can cause us distress and to question our place in the world. When we moved back home after being gone for over a decade I left a great-paying job for another job making less. It was still a great paying job but for years I was just able to do almost whatever I wanted because hey I had the extra money. Coming home and finding out the cost of living was so much more and then not making as much as playing with my head a little bit. Instead of not worrying about things I had to now count my pockets and having to sometimes tell my wife or kids no was emasculating. I felt like I was less than others. It didn’t feel like I was Dr. Jordan but back to being Quis.

Some people even find their identity and political affiliation or religious beliefs. They become so enthralled and what their religious leaders are the political leaders say that anything to the contrary he said to them to the core. Any challenge to those views is deemed a personal attack and they must come out with all guns blazing. Oh, it’s a bad day if that leader is found out to be less than infallible. For me, the only comfortable thing I found is that the Bible says that I am a child of God and that he loves me. That’s not a lot of information to go on but the fact of knowing that you are loved by somebody, especially in bad situations or trials is very comforting. There have been times in my adult life when just knowing that someone loves me unconditionally for just being me got me through some bad times.

I know I struggle with identity. I’ve tried to reinvent myself many times to fit others’ ideas or views of me. If I wanted to impress a girl I would exaggerate some aspects of myself and hide other parts. Same with some of my friends in order to fit in I would conform when I was really out of place. I guess we all do those types of things to fit in with the group. The thing is you were not being true to yourself and that is the main person to whom you owe the truth. 

I found myself at times struggling in running a business to also find an identity. Trying to determine what Fearless Physical Therapy would be has caused me to change course a few times. At times there are pivots, twists, and turns. Just trying to find the voice, and the heart has at times been a trial.

I guess I don’t have the answer to how you find out who you are. People find their identity and different things I stated earlier they can find identity in what they do, and what others think of them. Others in what brings some joy in their lives.