Monday, December 31, 2018

Brain


The brain receives its arterial supply from two pairs of vessels, the vertebral arteries, and internal carotid arteries. These vessels are interconnected in the cranial cavity to form a cerebral arterial circle called a circle of Willis. The circle of Willis lies in the interpeduncular fossa at the base of the brain.

Thursday, December 27, 2018

Neck and Shoulder Pain



NECK AND SHOULDER PAIN - LEVATOR SCAPULAE MUSCLE AND MYOFASCIAL RELEASE

The levator scapulae muscle resides at that back and side of the neck. Levator means to lift in Latin, so as the name implies, its goal is to lift the scapula. It comes up by tendinous slips from the transverse processes of the atlas and axis and from the posterior tubercles of the transverse processes of the third and fourth cervical vertebrae. It is embedded into the vertebral border of the scapula, amid the medial angle and the triangle smooth surface at the root of the spine.

Where do the levator scapulae muscle cause pain?
Levator scapulae muscle trigger points can lead to referred pain on the lateral side of the neck and in the shoulders as you can see on the red marked zones in the picture. You may feel burning between your shoulder blades after sitting at your computer without elbow support.

What causes elevator scapulae muscle pain?
▪️Stress ➡️Relax those shoulders!
▪️Head forward posture ➡️Remember to sit up straight, lower your shoulders and bring your head back!
▪️Holding a phone between your ear and shoulder ➡️Get a headset!
▪️Wrong training habits ➡️❌Shrugs!
▪️Bra straps that are too tight ➡️Have your bra fit by a person trained to get a good fit!
▪️Any position where your head is turned to one side ➡️Do you turn to see your computer screen?

For an evaluation and/or treatment please call our office: 337•264-6282

Wednesday, November 21, 2018

Thanksgiving



Wishing everybody a safe and

Happy Thanksgiving ๐Ÿ 

I am so grateful for the confidence given by so many, to assist you with restoring your health and quality of life๐Ÿ™Œ

So very grateful for God, family and friends in my life๐Ÿ™

Proud and thankful for living in this amazing country we call USA ๐Ÿ‡บ๐Ÿ‡ธ 

Wednesday, August 15, 2018

Deep soft tissue mobilization and Trigger point release

Patient came in this morning with complaints of severe ‘icepick’ pain of his left upper back. Deep Soft Tissue Mobilization and Triggerpoint Release were administered to the inter-scapular muscles of the posterior aspect of the left shoulder girdle.
Patient reported a 65-70% improvement after treatment session, which made his (and my) Monday great again!!
Typically Ice/Heat treatment and Stretching Exercises are recommended for homework.
Photo credit: Gaywynn M Vuijsters

Thursday, July 12, 2018

Facebook Page = Main Page!


It has become a lot of work, trying to keep information up to date on so many different accounts....
I am focussing mostly on my Facebook account to keep you informed.
There you'll find most all information about my clinic.

Please click on the Facebook Badge listed on the right side of this page and become enlightened. 

Wednesday, April 18, 2018

Foam Rolling

FOAM ROLLING
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Great post from EMBRK Lifestyle.
・・・
๐Ÿ’ก The amount of time I've seen some people spend on a foam roller (way too long), you would think their workout split is push/pull/foam roll. Let's dive into what foam rolling does, what it does not do, how it works and how we can optimize our results.
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๐Ÿ”นFoam rolling does(based on research):
-Increase range of motion (albeit for a short time <10 minutes)
-Decrease delayed onset muscle soreness (DOMS) when foam rolling post-workout
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๐Ÿ”นFoam rolling does not (based on research):
-Break adhesions or knots in your fascia (takes over 9000N of force to influence fascia 1%, amateur boxers can punch on average roughly 2500N to give you an idea of how much force that requires)
-Increase muscle performance (it does not decrease it either)
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๐Ÿ”นMechanism of how foam rolling works (mainly theoretical, still needs more research):
-If we are not breaking knots or adhesions then how do we get new range of motion? It kind of works like a massage in the sense that we believe the foam rolling is decreasing neurological tone in the muscle. If we decrease the tone then we can have better tissue extensibility (limited).
-The 'massage' that foam roll gives may also help improve blood flow which is why it may help prevent DOMS (yet to be researched on a physiological level).
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๐Ÿ”น Optimizing our foam rolling routine (based on research):
-Used in conjunction with static/dynamic stretching and loading yielded longer results
-4x30 seconds had the same amount of ROM benefits as 2x10 seconds, so stop rolling yourself like a pasta
-You should not spend more than a couple of minutes (<5 minutes) foam rolling before and after workouts IF you want to use it as a tool
••••••••••
๐Ÿ“šCheatham SW, et al. The effects of self-myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. Int J Sports Phys Ther. 2015.

Thursday, March 22, 2018

Owner's Manual for Life on Earth

When you were born, you didn't come with an owner's manual;
These guidelines make life work better.
You will receive a body. You may like it or hate it, but it's the only thing you are sure to keep for the rest of your life.
You will learn lessons. You are enrolled in a full-time informal school called "Life on Planet Earth."
Every person or incident is the Universal Teacher.
There are no mistakes, only lessons. Growth is a process of experimentation.
“Failures" are as much a part of the process as "success."
A lesson is repeated until learned. It is presented to you in various forms until you learn it -- then you can go on to the next lesson.
If you don't learn easy lessons, they get harder. External problems are a precise reflection of your internal state. When you clear inner obstructions, your outside world changes. Pain is how the universe gets your attention.
You will know you've learned a lesson when your actions change. Wisdom is practice. A little of something is better than a lot of nothing.
"There" is no better than "here." When your "there" becomes a "here" you will simply obtain another "there" that again looks better than "here."
Others are only mirrors of you. You cannot love or hate something about another unless it reflects something you love or hate in yourself.
Your life is up to you. Life provides the canvas; you do the painting. Take charge of your life --or someone else will.
You always get what you want. Your subconscious rightfully determines what energies, experiences, and people you attract -- therefore, the only foolproof way to know what you want is to see what you have. There are no victims, only students.
There is no right or wrong, but there are consequences. Moralizing doesn't help. Judgments only hold the patterns in place. Just do your best.
Your answers lie inside you. Children need guidance from others; as we mature, we trust our hearts, where the Laws of Spirit are written. You know more than you have heard or read or been told. All you need to do is to look, listen, and trust.
You will forget all this.
You can remember any time you wish.

Tuesday, March 13, 2018

Your Brain Loves The Gym


"Think about the brain like a muscle. The more you're working out, the bigger and stronger your hippo-campus and prefrontal cortex gets. ⠀

๐Ÿ”นWhy is that important? Because the prefrontal cortex and the hippocampus are the two areas that are most susceptible to neurodegenerative diseases and normal cognitive decline in aging. So with increased exercise over your lifetime,you're not going to cure dementia or Alzheimer's disease, but what you're going to do is you're going to create the strongest, biggest hippocampus and prefrontal cortex so it takes longer for these diseases to actually have an effect.⠀

๐Ÿ”นYou can think of exercise, therefore, as a supercharged 401K for your brain, and it's even better, because it's free.⠀

Working with Katie Platt

 Great working with Katie, restoring her knee\leg to full function. 
We’re closing in on max improvement soon...
Grateful for the opportunity to help and having a new found friend in our circle! 
You can learn more about Katie’s way of helping others Little Creek Yoga and The Camellia House!

Sunday, March 11, 2018

The Spenii-Rhomboid-Serratus Sling

So often I get questioned of “how come my neck hurts on the right, yet my shoulder hurts on the left (vv)...
This picture illustrates the:
“Splenii-Rhomboid-Serratus-Sling”
It shows what muscle groups can be involved in ‘compensating’ while one or the other site can be the Origin of Pain. 
Hence it is best to treat not only the original site of pain, but also the surrounding muscle groups. 

Please call our office 337.264-6282 for any more info, or to schedule an evaluation\treatment. 

Thursday, March 8, 2018

Tuesday, March 6, 2018

Reduce risk of Arthritis

CARTILAGE HEALTH
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Of our major synovial (freely movable) joints, the knee and hip are most affected by osteoarthritis (OA). Although the exact cause of OA is unknown and probably varies somewhat from person to person, factors such as advanced age and mechanical ⚙️injury to a joint are associated with the development of OA.
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As the condition progresses, articular cartilage begins to soften and demonstrate fibrillations (shown here). At the same time, the underlying bone may hypertrophy due to having to accommodate extra stress as the cartilage matrix becomes disrupted.
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So, what can you do to help maintain cartilage health ๐Ÿคท๐Ÿผ‍♂️? There are a few things and they revolve around loading the cartilage appropriately in order to help optimize nutrient delivery to this tissue.
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✅First and foremost, excessive stress (increased weight/height ratio, excessive exercise without sufficient rest ๐Ÿ›Œ, etc) have been associated with early cartilage breakdown.
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✅On the flip side, inadequate loading of cartilage (sedentary lifestyle) and not using a joint through it's full range of motion may impair nutrient ๐Ÿ—delivery.
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Cartilage, unlike many other tissues, does not have a pump to deliver nutrients, so it relies on a special type of diffusion called imbibition.  You can think of your articular cartilage like a sponge and in order for water, synovial fluid and nutrients to move in and out, the sponge must be squished (loaded) and then unloaded so that absorption can occur. This is why loading a joint appropriately throughout the day (this might mean losing a little weight or modifying your exercise ๐Ÿ‹๐Ÿผprogram) and using our joints through a full range of motion are so important for maintaining cartilage health long-term.
••••••••••
๐Ÿ“šRoos EM, et al. Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis Rheum. 2005.

๐Ÿ“šBricca A, et al. Impact of a daily exercise dose on knee joint cartilage - a systematic review and meta-analysis of randomized controlled trials in healthy animals. Osteoarthritis Cartilage. 2017.

Friday, March 2, 2018

Quadratus Lumborum, The Deep Pain in LBP



QUADRATUS LUMBORUM MUSCLE (QL) 

The QL is a ๐Ÿ—muscle that the average back pain sufferer needs to get checked out! It will bring you to your knees crawling on all 4 when acting up!

ANATOMY
▪️Origin: iliac crest, Insertion: 12th rib and transv. processes of the 1st to 4th lumbar vertebrae.
▪️Innervation: subcostal nerve and branches of the lumbar plexus.
▪️Close proximity to colon, kidneys, diaphragm, iliohypogastric and ilioinguinal nerve.
▪️3 sets of fibers: Iliocostal (Ilium to 12th rib), Iliolumbar (Ilium to Lumbar TVPS), Lumbocostal (Lumbar TVPS to 12th rib)

FUNCTION
▪️Essentially, the quadratus lumborum contributes to the stabilization and movement of the spine and the pelvis.
▪️A bilateral contraction leads to an extension of the lumbar spine.
▪️A unilateral contraction leads to the trunk is bent towards that direction (lateral flexion) and it can also hike up the same sided hip.
▪️A contralateral contraction rotates the spine.
▪️It can also cause functional scoliosis if the upper fibers bends one way and the opposite lower fibers bends the other way.
▪️In addition, the muscle fixes the 12th rib during movements of the thoracic cage and this way supports expiration (accessory muscle of expiration).

HOW DO I KNOW IF MY QL IS TIGHT?
▪️Your lower back pain over time develops into what seems like a sciatica.
▪️When acting up coughing or sneezing it will bring sharp agonising pain.
▪️People constantly attempting to brace and stabilize their upper body with their hands while they stand or sit.
▪️Being in an upright or sitting posture makes the pain worse but most individuals will experience pain with any movement.
▪️Rolling from side to side after laying face up for some time is extremely painful.
▪️If you’re aware of one leg being genetically shorter than the other and you’re suffering from back pain.

Thursday, March 1, 2018

Ty Foreman Racing at Ruud Vuijsters PT Practice of Pain Management

Always a pleasure working with you Ty, glad to be of help๐Ÿ™ 
Godspeed on your upcoming Beaumont 40K ITT ๐Ÿšด‍♂️๐ŸŒฌ

Wednesday, February 28, 2018

"Failed Back"

We see so many "failed spine surgery" patients in pain management. Insurance companies are willing to pay for surgeries but they will not pay for pain management to prevent or precisely identify the actual pain generator. 
If you have chest pain, unless you are having an acute MI, you do not see the cardiac surgeon. 
Instead, you see the cardiologist, who makes the diagnosis, prescribes the appropriate meds, does the minimally invasive diagnostic procedures (like a catheterization), and does the minimally invasive stent. 
You only see the surgeon if you have a documented surgical lesion and you have failed medical management. 
Pain management should act like primary care....

Discs

This should answer most questions in reference to discs...
Please call our office to schedule an Evaluation/Treatment
337.264-6282

Tuesday, February 27, 2018

Exercise vs Surgery

EXERCISE VS SURGERY
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In the Western world, as many as 300 in 100,000 people undergo arthroscopic partial meniscectomy annually. In these patients, most meniscal tears are degenerative and might be regarded as the first sign of osteoarthritis. In a recent meta-analysis, the authors concluded that a small but inconsequential benefit is seen from treatment interventions that involve arthroscopy. This small effect is of short duration and absent one year after surgery. Only one in five randomised controlled trials found greater pain relief one year after partial meniscectomy compared with non-surgical treatment.

Short term and long term follow-up studies have shown that exercise therapy improves function and activity level in patients with degenerative meniscal tears, regardless of whether they have surgery. Only one small pilot study (n=17) compared the effect of surgery alone with exercise alone. Therefore, the aim of this study was to ascertain if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle-aged patients with degenerative meniscal tears.

The observed difference in treatment effect was minute after two years of follow-up. No clinically relevant differences were observed in pain, other symptoms, function in sport and recreation, and knee related quality of life.

These results should encourage clinicians and middle-aged patients with degenerative meniscal tears and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option.
••••••••••
๐Ÿ“šKise N, et al. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. Br J Sports Med. 2016.

Monday, February 26, 2018

Hamstring Tendopathy

HAMSTRING TENDINOPATHY
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Proximal hamstring tendinopathy (PHT) is a relatively new diagnosis in the research that describes pain at the hamstring origin on the pelvis (ischial tuberosity) - a literal pain in the butt.

This issue occurs when the hamstring tendon cannot meet external demand and is usually associated with situations where the tissue is repeatedly compressed against the pelvis and often begins after running hills, sprinting or sitting for prolonged periods. Running uphill and sprinting both place the hip in a position of increased flexion (increased tendon compression) and place increased demand on the hamstrings.

Symptoms associated with this diagnosis will be very local to the ischial tuberosity and provoked with isometric contraction of the hamstrings while the hip is in flexion, stretching the hamstrings or by palpation.

If you have this pain, a progressive tendon strengthening program, that is designed to increase tendon capacity, is best supported in the research. Massage and stretching may be helpful temporarily, but will not most likely not lead to permanent symptom resolution. Behavior modification is also important and should include rest from running (returning gradually with level running first), avoiding prolonged sitting and temporarily avoiding other activities such as deadlifting, lunges and deep squatting.
••••••••••
๐Ÿ“šGoom TS, et al. Proximal Hamstring Tendinopathy: Clinical Aspects of Assessment and Management. J Orthop Sports Phys Ther. 2016.
...............
Via: @Rehabscience

Please call our Clinic for further information, or to schedule an evaluation and\or treatment. 
337.264-6282

Types of Fractures

If it ain't broke, don't fix it......

Tuesday, February 20, 2018

Blue Line in Therapy..

One has to feel safe and thankful when having an Officer ๐Ÿ‘ฎ‍♀️ of Law Enforcement in treatment.... #bluelivesmatter #blueline #gratefulfortheirservice

Monday, February 19, 2018

Ziva, Motorcycle Antitheft System!

 Check out my alarm system for my Triumph Bonneville T100 Black! 
So glad it came in matching colors..... 
Ziva, our 5 year old German Shepherd will keep us all safe!!

Friday, February 16, 2018

T.G.I.F.

Happy Happy TGIF folks‼️
We know how to do this, so let’s geaux and crush some dreams

Thursday, February 15, 2018

Saturday, February 10, 2018

Elbow Fracture


Follow up post on this horrendous elbow fracture, (after a nasty bicycle crash), and the progress made since the November 19th surgery. “T-girl” has completed 4 weeks of physical\manual therapy. At start the mobility of the right elbow was limited to about 130* extension, 120* flexion, also limited for external\internal rotation. Significant pain was experienced with start of mobilization. On her last visit to my office the mobility has improved to about 95* flexion, 160* extension and near full mobility for external\internal rotation. The mobilization now is paired with moderate to light pain, ( please keep in mind that T-girl is one tough cookie ). I am so proud of her, her motivation\determination and all the hard work she puts in!! Looking forward to speedy, ongoing progress and hopefully back on the bike soon...

Happy Birthday Moma!

Happy Happy 106th Birthday 
in heaven Moma! It’s been almost 17 years since she got her wings ๐Ÿ‘ผ 
Grateful for all you taught me, still missing and loving you❤️

Friday, February 9, 2018

Mardi Gras

Wishing everybody a Safe and Happy Mardi Gras Weekend!!
Clinic will be open on Monday 02-12-2018,
from 06:00 AM-05:00 PM
Closed on Tuesday 02-13-2018, Mardi Gras.

Thursday, February 8, 2018

Disc Herniations Can Heal Without Surgery

๐Ÿ’ฅDISC HEALING๐Ÿ’ฅ
————
One of the issues I get the most questions on is low back pain, especially disc herniations. While there is a lot that goes into this question, two things I usually mention are that disc herniations are common in much of the asymptomatic population and that they can heal with time and conservative treatment.
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The following is a case report from the New England Journal of Medicine that documents the resolution of a lumbar herniation without surgery.
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๐Ÿ“•A 29-year-old woman presented to the spine clinic with new-onset pain in her right leg, accompanied by paresthesia. MRI of the lumbar spine revealed a lumbar disc herniation resulting in substantial spinal stenosis and nerve-root compression (left image).
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๐Ÿ“•She elected conservative treatment with physical therapy and an epidural injection of glucocorticoids. A second MRI obtained at follow-up 5 months after presentation showed resolution of the herniation (right image). Her clinical symptoms resolved, and she was discharged from the clinic, with follow-up recommended as needed.
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๐Ÿ“•Data from clinical trials suggest that patients who have herniated lumbar discs have similar long-term outcomes whether they undergo surgery or elect conservative management. In addition, the risk of subsequent catastrophic worsening without surgery is minimal.
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๐Ÿ“šHong J and Ball PA. Resolution of Lumbar Disk Herniation without Surgery. N Engl J Med. 2016.

Tuesday, January 30, 2018

Elbow Fracture



Had a great therapy session with a 47 y/o female cyclist this morning. Patient had a nasty crash in November 2017. At first the Orthopaedic Surgeon thought a Total Joint Replacement was necessary, however with the assistance of a Trauma Surgeon the elbow was “put back together” as seen in the Xray....
She is now about 8 weeks post-op and in her 3rd week of therapy. The patient is blessed with a great outlook on life and awesome motivation! Hopefully soon, (yet not soon enough), most mobility will be regained!!

Thursday, January 25, 2018

Friday-Eve

Happy Friday-Eve folks!!!
Let's kill it today;)))

Wednesday, January 24, 2018

Directional Preference in Low Back Pain

DIRECTIONAL PREFERENCE
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In cases of low back pain (LBP) where pain also radiates into the leg (radicular pain), one of the goals in rehabilitation is to determine if the patient's symptoms can be reduced by placing the spine in a particular position (flexion or extension). If a position is found that reduces pain, this is referred to as the patient's directional preference and is used as a guideline when prescribing exercise/movement.
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When radiating pain is present, it is important to understand that if pain leaves the leg and moves closer to the spine (centralization phenomenon), this is a sign of neural desensitization and recovery. On the other hand, if pain spreads farther away from the spine (peripheralization), this is a sign that the condition is worsening.
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If you are experiencing LBP that radiates into the leg, it can be very helpful to see if you can find your own directional preference and, at the same time, identify any positions that worsen symptoms. In the picture shown here, this patient may have reported increased symptoms when in spinal flexion (sitting, bending to the ground, etc) and reduced pain with extension (laying on their stomach, standing, etc). In this case (which is actually quite common), extension would be this individual's directional preference and they would be advised to avoid positions of prolonged flexion and use extension positions or repeated movements (i.e. standing and arching the low back 10-15 times) to create centralization and speed recovery.
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If you have any questions about radicular pain, directional preference or centralization/peripheralization, please ask as these topics can sometimes be a bit confusing.
Call: 337.264-6282

Friday, January 19, 2018

Lower Back Pain

Here are some of the symptoms when suffering with lower back pain:
Pain across the lower part of the back that sometimes radiates into the buttocks, the back of the thigh or to the groin.
Limitation in movement of the spine especially bending forward and leaning back.
Spasms of the muscles surrounding the spine and causing a stiff back with severe pain; The spine may tilt to one side causing a change in posture and/or a limp.
The pain is sometimes accompanied by a tingling sensation or numbness in the back or buttocks or leg, which may pass right down into the foot. This is called sciatica, and it indicates irritation of the sciatic nerve, which passes down from each side of the spine to the feet.
If you have any of these problems, call for info or schedule an appointment: 337.264-6282

Direct Access to your Physical Therapist without Doctor Referral!


On June 6, 2016 Senate Bill No. 291, amending the Louisiana Physical Therapy Practice Act found at La. R.S. 37:2418 et seq., became law allowing patients direct access to physical therapy.  This law is effective as of June 6, 2016.  A summary of the changes in the law are as follows: 
  1. A physical therapist possessing a doctorate degree or five years of licensed clinical practice experience may implement physical therapy treatment without a prescription or referral;
  1. A physical therapist treating a patient without a prescription or referral must refer the patient to an appropriate healthcare provider if, after thirty days of physical therapy treatment, the patient has not made measureable or functional improvement;
  1. The new direct access provisions do not change the law as it related to Workers’ Compensation as specified in La. R.S. 23:1142, monetary limits of health care provider approval; La. R.S. 23:1122, Worker’s Compensation Medical Examinations; and La. R.S. 23:1203.1, Worker’s Compensation Benefits;
  1. No physical therapist shall render a medical diagnosis of disease. 

While patient access to physical therapy has changed, the scope and practice of physical therapy remains the same.[1]  Physical therapists conduct an initial physical therapy examination and render a physical therapy diagnosis treating only those conditions within the physical therapy scope of practice.  In addition, a physical therapist remains responsible for managing all aspects of the physical therapy care of each patient.[2]  A physical therapist must continue to practice within his/her individual scope of practice by exercising sound professional judgment based on his/her individual knowledge, skill set, education, training and experience, and only perform those procedures in which he/she is competent.[3]  If in practicing within his/her individual scope of practice the physical therapist finds that the treatment needed is outside his/her scope of knowledge, experience, or expertise, the physical therapist must notify the patient and appropriately refer to another healthcare provider.