for all coming today and our next speaker is going to be john duffey physical therapist john is your proverbial hometown guy he literally came back to serve the community patients i'd say commonly so he's going to speak to you about why physical therapy is a viable choice for your injuries please john thank you thank you everybody for coming but about me i have a local guy township actually right behind lessons clinic and my mom still lives back there and bergland graduated from pit in one thousand nine hundred one with my p t degree and worked at allegheny general hospital for a couple of years and then i became director southall sports medicine clinic donovan adium road until two thousand and eight when i left to come for phoenix so during that period of time i was running a large region i opened up the sylvie's in bedford and read bill and altoona and hospital facilities but i got three little kids and else i'd kind of cut back to just treating patients and doing what i love so i've been up at phoenix since two thousand and eight and one of the give everybody a good talk about ten good reasons and it was hard because of probably fifty good reasons as to why somebody should choose physical therapy or for various things in their life and it's a health care so it's it's very appropriate to talk about it but the fact that it's also for suicide fund raising in it ties into that i'll give a couple examples of that as they go along so the number one it's physical therapy is actually direct access in pennsylvania it's been going on for about ten years meaning you can go to a physical therapist without having to see a physician first unless your medicare worker's comp or auto which is for me only about twenty percent of the insurances that i take so you can come to the physical therapist we can treat you for thirty days and if we don't like what we see we will send you to a physician to have things checked out my first patient that i had direct access is a girl i had treated a bunch of times and she was going through a divorce and a lot of stress she was running and running and running and is beating yourself up and she had hip pain i didn't like what i saw and i examined or so i said her next door to the orthopedist he came over about a half hour later with an x ray and said i'll show you something and he held it up and she had a crack in her hip so we operated on our last night that night and put a couple pins in her so that she didn't fall and break her hip so we're trained to pick up a lot of stuff most people don't realize that the physical therapists graduating now are actually doctors of physical therapy just as you have doctors  any one of those things and we send a person over the to the physician number two there's numerous specialties and physical therapy and i think we have an image problem because most people per tray physical therapist is you know the young guy with chino a polo shirt walking a smiling old lady with a walker and that's just constantly the image that's put out there and i don't do that in you know maybe some of the hospital petey's do but there's a lot of different aspects to it and you know there's orth medicine which is what i personally do there's women's health and they treat incontinence and pelvic pain and there's a lot of women out there especially after childbirth that suffer from incontinen and it's treatable and it's a shame because a lot of women will not exercise because of that they don't want to go to another always class because they don't want to dribble when they're jumping and bouncing around but it's a very treatable condition and the therapist the do it i'm not one of them i think that's at least for that component that's usually where they're more comfortable having a female therapist they have great luck with that and men suffer from incontinence too and men after they've had prostate surgery suffering from you know incontinence you know both ends and that is all treatable as well there's pediatrics they specialize in treating kids with muscular dystrophy cerebral palsy things like that it's an aspect of the profession i could never even step into because it's so different than what i do on the daily basis home physical therapists that goot simply to people's houses and treat them whether it's after surgery and they need to have something done at home until they're able to get out of the house and there are some people are just home bound in and i think it gets neglected because you have people who are elderly they can't get out easily and somebody can go to their house and improve their quality of life and death stuff that's covered by insurance as long as it's medically necessary and improvements can be made but they usually can so it's it's a shame that some elderly people are stuck in their house and you know the next step is the nursing home because they can't get around their house on their own but it's fixable there's no logical therapist to treat spinal cord injuries and stroke patients and cardiology and pulmonary so there's a lot of different subspecialties number three this is this is probably the most important one the reduction and or the elimination of pain and it's in the news all the time right now there is a serious opioid epidemic in this country in two thousand and twelve they said enough prescriptions were written for opioid medications to give every adult in the united states a full bottle of pills and that's bad so they realize now we got a problem on our hands and you know five six seven years ago they're just you know you read about all this in four out of five heroin addicts started on these prescription medications and what happens is you know they have cracked down doctors count the pills when these people go back to pain management you know and give them crap you know you're not so you know you're not supposed to be out at this point you're supposed to have three left and then they don't give them anymore well it's a lot easier and cheaper to go out and get heroin than it is to get some of these prescriptions filled and that's what they do because at that point they're hawked and i had a younger lady and everybody thinks that these people are junkies you know living under a bridge but you know there may be somebody in this room addicted to opioids and i'm sure you walk by somebody somewhere today that has a problem with it it happens very quickly for some people you know they say heroin is addictive the first time you take it or there are people that get their knee replaced they go on the utopia lloyd's and they're hawked some people can get off it easy some people can i got a guy right now he's suffering from constipation from it he's got to go get to enemas done just from the pain medications and i treated a girl last year and her younger brother committed suicide and he was addicted to prescription pain medications but he was a football player in high school and he suffered a concussion and that's what they put him on and and it snowballed and then they started doing other drugs in the life fell apart and he killed himself twenty one or twenty two years old so physical therapy has been shown in there pushing this now the american medical association a lot of the other professions is just as effective at treating chronic pain as the opioid medications are now i know when somebody has a routine or cough repair you got to give them something because they're going to be in a lot of pain it's just this long term these people to come in to have long term chronic pain and they're just like oh here take the and that's that's not going to work because chronic pain i invited everybody if you ever get a chance going to youtube and punch in chronic point pain explained in five minutes it's one of those whiteboard drawings with a drawl real quick and they explain it and it's amazing in five minutes you'll have a really good understanding of chronic pain is and what i try to do is educate people when my favorite examples is and it's probably happened everybody in here you know you go to a movie and there's somebody sitting three or four rows behind you it's all you can hear and it starts to drive you crazy because it's almost like all you can hear that's why my wife won't go to movies with because that point i stand up and i tell people to shut up so she doesn't go to movies with me but that same person which is me can then go in sit at the swimming pool and read a book while kids are screaming splashing and all that noise around him and chronic pain can be like that you know you sprain your ankle it's a year later you're still having pain with the tissues healed you know that's all taken care of your brain is in this red alert mode now it's constantly saying there's a problem there's a problem there's a problem it becomes a muslim focus and you have to get people to learn how to tune that out and that's one of the things that we're trying very hard because you always hear the story about people phantom know they have pain in the foot that they don't even have in mr spock once said in star trek you know pain is a thing of the mind in the mind can be controlled and there's a lot of truth to that so check out that thing on you tube chronic pain in five minutes is very interesting physical therapy can save people money all right they're showing now that if if you have an m r i for a little back problem before you go to physical therapy first the costs are four thousand to over seven thousand dollars more than if you would have done p t or car practic is a conservative measure first because what happens is you have back pain you go to your doctor he sends you to a specialist they do an m r i they find things that are on there anyway that may not even be causing your pain and then they're sent to another specialist maybe for injections medications are done the next thing you know this got the cost of ballooned in with health insurance the way it is now especially for me personally i mean m r i is that's out of my pocket that's twelve hundred bucks i have to pay and i much rather good do a month of physical therapy with a twenty dollar co  that were not going get better after that period of time in the nec case and you go when you follow up with all the special stuff improving balance in reducing false and if you're a woman in your eighty's and you fall and you break your hip you have an eighty to ninety percent chance of dying from that injury just from the cascade of things that happens you know in the monia the deconditioning the heart all that and falls cost society a lot of money a lot of people lose their parents and loved ones over that so that's one of my favorite things to treat in that was when my patients and she'll tell you i've had my own mother up there are very hard i try to get somebody to bring her up three days a week because she has had some falls and how she has not broken her neck not a clue but you know when i get her there on a consistent basis and we work on things because you know as we get older there's very predictable things that happen that affect our balance you know we get weaker our neurological reflexes  slower by the time we realize rafal and we can't react as quickly we're stiff we're tight and they're all fixable things so that's the best part when you get people in there that are struggling to walk or they have to use a walker they can get up in the under steps and you can do all of these things and in a lot of instances hopefully save their life from having a problem down the road dizziness and vertigo this one is interesting i've done this before julie who i work with really loves it and i think she's brain where we are out in space at any given time and we have these little crystals in there that are really just limestone you know what you break it down chemically and they can dislodge bump in the head and illness as you get older and things just start to fall apart and one of those little stones can come out and it goes into one of the semi circular canals and now it's providing inappropriate feedback as it touches the nerve receptor is in there your eyes are seeing one thing you gyroscope saying another thing and then next thing you know you have a very interesting i mean you're basically doing is examining the person to determine which side and which canal that stone is in and it's just a matter just positions of the head if you basically get it out of that canal and back into the ut better film some exercises to do at home and they're out the door we improve function we don't always have to treat people in pain and you know fall down steps and break legs or what not or post surgery there's a lot of people that have functional problems they struggle to get out of chair they can't get up and down their steps they can't reach over head to get things out of the shelf they can't turn their head good to drive and those are all things that we can fix on people so you don't have to sit there and say well i'm just getting old you know steps are go the turnaround like this while i drive that doesn't have to be that way they're all fixable things and it doesn't mean you have to go to therapy for months or anything like that go for a couple weeks and learn what to do yourself get a family member to you know to work on you it's it's  not difficult but it's a lot of fun when you improve so you give somebody their neck motion back when they're seventy five years old that they had when they were forty they're happy then i'm happy improving overall health and petey's or the specialist a movement dysfunction and you know i would rather have somebody go to a good p t to learn exercise than a professional trainer they want to to weaken courses and this is what we're trained to do and a lot of petey's forget that that's something you know again you have to remind a lot of physical therapist that you don't have to see all these specific injuries i mean somebody comes in to you and i want bigger guns you know you should be able to show them how to do that i want bigger calves you know a middle aged guy like me when my son is making fun of me i'm losing my and you know it happens to guys when they get to be fifty you know that's stuff that we can teach people to do and better abs i want stronger abs any one of those things i want more trunk or core strength to help my golf swing or my tennis swing that's what we're specialized it i mean we seven years of college to do that stuff that's and it's fun to do so and you know it's kind of neat to have the variation where you might have a stroke patient in the day the little kid with a sprained ankle and somebody to just once more power on his golf swing and i enjoyed that and then lastly education  i probably should put this really up because this is very important and i find a lot of the success at least that i have as a physical therapist is simply educating people and they're coming out with numerous studies now that are showing and i'll show people this they come here's age groups by ten years ok i'm like ok so you're seven years old will ninety percent to seventy year olds you know have bulging disks you know ninety three percent have degenerated you know you go through all this stuff and it kind of puts your mind at ease th all these different conditions rotator cuff tearing label tears it's just as common as having wrinkles and grey hair sometimes they are the pain generator or the dysfunction generator for the person sometimes they're just happen to be found on there and the classic one is you know somebody comes in and they have back pain in this and that pains going down the right leg of their buttocks and they get an m r i and they get up huge disk bulge but it's on the other side so it's been there all along and it's not even causing a problem over there sometimes it is you know we treat accordingly but it's not always so they did a really neat study that and they showed that once you tell a person that they have a disc ball joint an m r i their outcomes are worse i don't know why but you've got to go through the whole education thing so i'm constantly just educating people and sometimes it's just simple stuff men are famous for this they come in their shoulder hurts and you say oh how many times a day do you do something that hurts i fifteen or twenty times to me every time i do feel the same clicking and any you know tell us what hit my head against a brick wall it hurts but if i do it every day i'm sure it's always going to hurt so you consciously have to educate people even for simple stuff just quit bugging your problem because it's the how many problems and people get better if they just quit bugging it so my neighbor in new neighbors just moved in and he's got a miniscule terry's got a brace on and he said he's probably going to come see me and i said meantime just quit doing things that bother don't twist on it don't squat don't kneel all the way those things alone are going to help most miscues tears come around and they just did a big study on this because tears that conservative treatment p t again is a lot of just education quit bothering is just as effective as the people who have the surgery on it so why have the surgery and  to do therapy after when you can just do that they would be first to get over it short of having somebody cut pieces of your body else i'm sure a doctor must admit i mean it's that that's or in the same wavelength there we like to save people from surgery surgeons cut people that's what they're trained to do we're trained to try to get people fix the natural way so as part of the education for years i used to have a the website up there was a story back in two thousand was called dot com it's for physical therapist and physicians because i got in the habit of reading a journal article every single day and i thought well you know what i'll read this critique them all abstracted help post it so i end up with this huge website with movies on treatment videos and links and everything  it was pretty cool because of people from all over the world participating with it and then as i had kids i kind of backed off it but now i use facebook as the same vehicle so we have a clinic page that if anybody uses facebook if you punch in john  ugly mug and click like and every day you'll get something on there which today was just a simple article they did a study showing that the length of time people can add to their lives if they start exercising and it's never too late to start exercising and the quality of those last years of your life that you now prolong are better because you are exercising so i try to put up evidence based material because those with physical therapy is now will become a very evidence based practice everything we're doing in the clinic we can back it up with research and  studies and you know there are some things that i do that just work for me and i might not necessarily be able to back it up with a study but i find that it does work for me we try very hard and as this information comes out i mean i've been putting up a post every day i guess maybe about five years now i've only missed a day or two if i go on vacation i stockpile and i sell them to my one girl and she posts them for me so i try to put that stuff out and there's another website at the called get p t first dot com and a lot of people it's basically like a bunch of those things like you see on facebook looks like a little billboard ad and they'll have all these things on there about you know the opioid medications just this the whole bunch of evidence based things it's on the page to go through because if you just scroll down it just keeps popping up with more of those boxes with little blurbs of information that i think everybody should know because it just improve your quality of life learning some of these things you can take away anxiety it can make you all ok well maybe i should start doing that or stop doing that stuff so that's my