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Physical Therapy Continuing Education: Rehabilitation Post ACL Reconstruction (Hamstring Graft)

ACL reconstruction surgery that use the hamstring graft are more commonly found these days than they use to be. One of the reasons is that their Physical Therapy rehabilitation is often easier than it is with a patella tendon graft.

We recently interviewed a orthopedic surgeon about this topic. Here are some of the questions & answers:

Interviewer: Well, let’s switch gears a little bit and talk a little bit more about rehabilitation following the surgery. Are there any special considerations that one should be aware of with rehabbing a hamstring graft ACL?

ACL Surgeon: Earlier on we actually went a little bit slower with the hamstring. That’s not the case anymore with better fixation. The consideration with any rehabilitation is you want an excellent physical therapist. Very important and very key and we found that to be true with the rehabilitation after an ACL, that people get started early. They start their motion early, and get going with the graft.

One of the considerations with the hamstring is that they have to just lay back a little bit off any of the heavy strengthening of the hamstrings, allowing the tissues of the hamstrings to still heal after taking the hamstring graft. So, we try to avoid some of the heavier loads on the hamstring.

Other than that a lot of the focus is on the quadriceps and on the gluteus muscles, and so we get to going with that early. I’m a big believer in getting on the indoor stationary bicycle and then progressing outside, as that is a great strengthening type of activity and has minimal stress on the graft.

So, the considerations with the hamstring are just a bit different than the patellar tendon but not much, and rehabilitation really is not slowed down any by using the hamstring.

Interviewer: Gotcha. Are then any issues with the potential for prolonged hamstring weakness following this type of procedure?

ACL Surgeon: That’s an excellent point, and that is one of the proposed drawbacks of using the hamstring, is that there are studies that show that there may be some weakness. They did strength testing after six months. And it may even out after a year or two years. But, even then there may be some, but clinically most people don’t notice it, even if there is when you do test that in the lab.

So, that is something that people work on and people do tend to get back. If there is one drawback of the hamstring, that may be the one thing. That there may be some residual hamstring strength deficit even though it is small and most people are not going to notice it.

Interviewer: Very good. So, I got another question just out of my own curiosity. Now as a therapist, I know that the patient regularly follows up with you typically 10 days to two weeks, roundabout the six week mark, and the three month mark. What do you look for in those visits?

ACL Surgeon: Critical early on is getting the full extension after the surgery. We make sure that they can gain their full extension. If the patients don’t gain that early on then it’s very difficult to gain it later, so early on I want to emphasize that.

We want to emphasize getting the quad activated and emphasize the swelling be decreased. With time, at the six week mark we want to see good motion both in extension and flexion, and I want to see the quadriceps again coming along, gaining strength, and really building up muscles.

And then at the three month even more so, that all these factors are critically important, and the motion should have already been there by three months. Then at that point we’re really looking at how their strength is.

Then it’s going to be, over the months after that, is gaining that strength and endurance and then the neuromuscular ability to go back to a sport and more functional type activities, and that’s where the rehabilitation specialist, specifically the physical therapist, along with maybe the athletic trainer, works on returning the person to sport.…

8 Tips For New Workforce Realities

Worker dissatisfaction is at an all time high among the U.S. workforce. With the national unemployment rates close to 10 percent, workers who have jobs are staying put – temporarily. Estimates of up to 65 percent will consider changing jobs when the economy picks up. Here are 8 tips for staying grounded and navigating the new workforce landscape.

1. Expect multiple jobs

The full-time job is becoming less common. Expect to have many jobs throughout the course of your career. The average person entering the work force today can anticipate 4 – 5 different careers by the time they are 38. That is different careers, not jobs. In addition to the more frequent turn over, positions are increasingly more volatile. People can expect more part-time work, more freelancing or consulting work to supplement their full-time employment.

2. Always be prepared for change

Whether you currently have a job or not, be prepared to make a change at all times. Last year we saw a tidal wave of layoffs. Workers were expected to do more with less, job responsibilities shifted, there were mergers and acquisitions, and pay cuts. Make sure you know your marketable skills.

3. Have a personal risk management plan in place

Know what you will do in the event of an unexpected lay off. It is a good idea to venture into freelance or some consulting work while you are employed. Do not allow the unexpected to catch you totally off guard.

4. Manage your network effectively

If you are not a member of a professional association, you should consider joining one. You will keep your skills sharp through the continuing education opportunities as well as meet new people in your industry or field. Associations also offer opportunities to volunteer for positions that can further enhance your resume.

5. Know your personal brand

Do you know how you are perceived as a professional? What makes you stand out from the crowd as a high-performing employee? You need to be able to articulate your value-proposition. Don’t rely on potential employers being able to intuit what you bring to the party. Leave no room for doubt through focusing on benefits, not features..

6. Have a killer resume

Your resume is your most important marketing material about you. It should be contemporary, fresh, kept up to date, and showcase your most desirable attributes to potential employers. Make sure it presents you in such a way that you look appropriate for your target. Control what the reader notices. Remember, most resumes receive only a 10 – 20 second glance to determine if they are worth further consideration.

7. Build your testimonials

Every time you get a complimentary note, acknowledgment, or thank you, for a job well done, be sure to keep track. You want to be able to share the great things your colleagues, managers, and subordinates say about you.

8. Pay it forward

Take opportunities to help others. You will find that pouring into the lives and successes of other people will return to you. Where you find yourself right now, is usually the result of actions you have taken over the course of the last two years.

Make a habit of being a good example in the workplace and demonstrating a positive attitude. Make the most of your current work situation, but don’t assume it will last forever. You will be much better off if you be the best employee you can be, but be ready for the unexpected.…

Acting Jobs – What You Should Know

Before one decides to search for some acting jobs, you first have to choose what type of acting career you will be having. This will be dependent on how much skill you have, your looks as well as your talent. Each actor has his or her own definite path that they take and you can’t just go for various talents all at the same time. If you want to star in action flicks, then you should have the body to match and most importantly, you should also be able to do stunts. You could just be used as someone in the background at first but there are a number of famous actors and actresses who started out that way and it took time before they starred in their first major roles.

Actors just don’t get signed on to do flicks in an instant. They go through various auditions and trainings, just to name a few. You get hired not because you have the looks, not even if you’re already famous but for the job. You should always stay grounded. Never be late for tapings. Try your best to not complain and just do what you’re supposed to do. However, the most important thing that you should do is to be nice.

In wanting to have acting jobs that you deserve, it will be to your advantage to have a lot of connections. Try to meet and talk to people who have been in the industry for quite some time, such as talent managers and/or producers, as they could help you land an acting job by referring you to people they know. It takes a lot of effort before you can achieve success with your acting career.

As an actor, you should stick to what you know you are capable of. You could change your acting directions once you’ve had enough success and would want to try something different. However, keep in mind that you should be yourself.

As an actor, you should definitely practice both your skills as well as your talents. Although you’re already excellent at something does not mean that you need not practice anymore. There is no such thing as being too good with what you do. You should train in order to keep both your skills and your talents in as sharp a way as possible. When it comes to the art of acting, as with anything else, practice indeed makes perfect.

Keep these things in mind and you will be sure to have acting jobs in the near future.…

10 Hot Tips for Passing the BLS and CPR Exam

Here is a guide to help you improve your chances of passing the certification exam for BCLS, BLS, and CPR. If you take the advice given here seriously, you will do very well on the exam. But you must allow yourself plenty of time to learn all of this material – especially if you are new to this.

1. Study and memorize study guides There are many study guides available for BCLS that can helps you study the need to knows and it is easy to take with you to study in your spare time. The study guide is not a replacement for the hands on practice and testing sessions that CPR class is known for. You need to find a study guide that helps you memorize the important things that help you perform better. There are guidelines for all age groups with the most up to date information based on evidenced based practice and research. Infants, children – large and small and adults are included with the how to do – one and two rescuer CPR, choking – conscious and unconscious, AED and pads application, and airway management.

2. Read and study the BCLS Certification Manual

3. Dress comfortably and be prepared to work on your knees (explain to your instructor if this is not possible)

4. Watch online videos on BCLS, AED and other topics

5. Take practice tests over and over until you get them all correct There are questions on many topics, including age specific questions. Topics on the exam include AED use, safety at the scene of the victim, conscious and unconscious choking victims, ventricular fibrillation and early defibrillation, one and two rescuer CPR scenarios, initial assessments, infant techniques for two-rescuer CPR, depth and rate of compressions for all age groups, and airway and ventilations.

6. Practice doing fast and hard compressions (5 cycles of 30 compressions to 2 breaths) on a doll or cushion for 2 minutes, so you can perform high-quality-CPR at the class, know the landmarks for chest compressions, depth and recoil of compression, 2-thumb technique;

7. Review the differences between the age groups and the BCLS requirements for CPR Review choking, AED pads, quick assessment for responsiveness, heart rates in infants that require initiation of chest compressions, breathing rates, a 10 second pulse check, positioning of the airway, and recovery positions, etc.

8. Understand the non-trained “hands only” CPR concept versus healthcare 30:2 CPR ratio Consider purchasing your own face shield or pocket mask with a one-way valve.

9. Read about the Bag-Mask-Valve (AMBU bag) Also, the pocket masks, positioning the victim’s airway with or without suspected neck injury other airway adjuncts; first aid. Diagnosis that are life threatening and important to learn about and recognize the symptoms; examples are myocardial infarction (heart attack) and stroke.

10. Participate in class, and ask and answer lots of questions Speaking up and asking many questions helps you understand and will facilitate your classrooms ask more detailed questions as well.…

The Secret to Abundance in Health, Wealth, and Happiness is You

Occasionally people ask me, “what’s your secret?” Sometimes they’re referring to my relationship success or career success, or my ability to acquire money easily or stay in good shape.

Although it would probably be great if I had a magic pill or a magic formula. But the truth is, the secret is you. It’s your determination, ambition, persistence in thinking positive thoughts and directing positive energy toward the achievement of your goals and desires.

There are no shortcuts or quick fixes. Every thought builds on your actions. Every action builds on your results. Day by day, step by step, you can create miracles in all areas of your life. Here are some steps you can take to reach your goals:

~ Take the most prominent areas of life: relationships, health, wealth, career, etc. and determine what you want and desire in each area. Be very specific

~ Next determine the steps you can take starting today, with exactly what you have and who you are right now.

~ No matter how small the steps may seem, start moving in the direction of your desires. Small deeds every day add up.

You see, your actions should be supporting your deepest desires– directing energy to them little by little. Until, one day, your life looks like a miracle. Eventually people will start to ask you how did you accomplish so much?? How did you create such a beautiful life? And you will know that you defined your desires and took action towards them everyday.

There’s no secret to life. Succeeding is pretty simple, although not always easy. Stay focus and continually move in the direction of what you want, and eventually you’ll arrive. The cool thing is that the journey will be so fun and enjoyable, you won’t even notice when you get there.…

Successful Entrepreneurship: 5 Secrets From Employee to Business Owner

There are 5 key secrets that have served as a guide for me in many entrepreneurial endeavors over the years. They are particularly important if you have decided to transition from a regular job and a paycheck to a business of your own. This requires a particular mindset and practice very different from going from job to job. Your clear intention, consistent attention, and integrity of actions will determine your outcome. If you have arrived at the conclusion that the freedom and responsibility of owning your own business is path you wish to take, then these keys may offer helpful guidance.

Mindset. This alone will determine your success or failure. It is said that your mindset is 95% of the game; more important than your marketing budget, business plan, or any other resource. It is your responsibility to manage it. Immerse yourself in an environment that empowers you, surround yourself with people who inspire you, and always seek to expand your horizons. This will keep your mindset at a level to succeed. Do this and your very energy will attract and draw to you the expertise, the clients, the relationships and the resources necessary to build your dream.

Intention. A clear vision of your intention is critical. What is the purpose behind your vision? And it’s not the money; it’s the choices and options it affords you. What are those for you? Be specific, and infuse your vision with the feelings of excitement. Make it tangible. It will manifest. This is also where your code of ethics comes into play. Your intention must be in harmony with your personal and professional standards, beliefs and integrity.

Consistency. I used to joke that I was consistently inconsistent until I realized that was the downfall of my unsuccessful entrepreneurial endeavors. Consistence, persistence, and regularity of your daily habits of success, is vital in realizing your goals. Whether they are exercise, meditation or prayer, eating well, task lists, marketing, client contact or study, do them without fail. “A schedule defends against chaos and whim,” Annie Dillard, Pulitzer Prize winner in non-fiction, 1975.

Focus. It is a universal law that what you focus on will grow. Keep your attention on your vision. Do NOT focus on what you lack, your struggles and what you fear. That is not to suggest you stuff your feelings. Fears and anxieties will come up and they are there to protect you from harm, or the other caveman who is about to steal the antelope you just speared. Acknowledge them for what they are and move on; dwelling on your fears will create harm. Continually return your attention to your endeavor and the joy and excitement it brings you.

Action. It is not enough to visualize, to meditate upon, or to ask for the realization of your dream. I don’t care what anyone says. Without action, nothing happens. It doesn’t have to be aggressive, hard-driving relentless action, but it does have to be clear, consistent, and in line with your code of ethics. Listen to your gut, your intuition, and don’t ignore synchronicities.

As Goethe said,”Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it.” This has always been an inspiration to me. He goes on to say that when you take bold action, help will appear from unexpected places. Look for it.…

How to Prepare for an Online Class

As popular as online classes are, there are still millions of individuals that have not taken one. Some adult learners are even scared to try one. They are so used to sitting in a classroom they don’t want to try and balance a new way to learn with their already busy schedule. Online courses were not even available for many individuals going back to school for a graduate degree. But, there are some daring students out there. They are willing to try anything once. Or, because of their travel/work schedule they have to attend online classes to continue their education. They always want to know the same information; how can I prepare for an online class?

The content in online classes is typically not anymore difficult than taking a class on campus. There is definitely a learning curve for new online students though. Depending on the type of program you are entering in, there are certainly some things you can do to better prepare. For instance, if you about to start an MBA program you may want to brush up on your finance and accounting skills. Or if you are starting a Master’s in Education make sure to brush up on your APA style writing. In most programs with quantitative classes excel will probably be used. If you do not use excel on a daily basis you may want to take a tutorial on it. Also, it would be a huge help if you can get the textbook list for classes prior to them starting.

Besides the type of classes you will be taking, time management is a large component in online classes. There is no one telling you when to be online, so you have to be motivated to log in and complete your assignments. At the undergraduate level 10-15 hours per week is recommended to dedicate to school. At the graduate level, 15-20 hours a week is typically recommended to complete your assignments. This will give you ample time to do your research, read your textbooks, and take your exams. If your schedule will not allow you to dedicate this much time for school, a graduate degree may not be in your best interest. You may need to ask for some time off from your boss or ask a family member to help with chores around the house. Either way, without proper time management skills you will not be successful in your first online class. Once you take a couple and get the hang of it things will get easier.…