Friday, December 2, 2016

Functional and Integrative Medicine

I recently attended a course that spoke of "functional and integrative medicine". What exactly does that mean?  And how does that apply to physical therapy?  Functional in the sense of improving health and wellness through purposeful movements.  Integrative by way of caring not only for one's body, but mind and well being. 

In a word, it's a "holistic" way of approaching care.  In many ways, my colleagues and I already practice in this manner.  A patient/client is not a diagnosis on a prescription.  They are an individual person with individual lifestyles/personalities.  Treating a patient/client as a whole, not just a body part. 

As crude as it sounds, many clinics simply don't have the time to focus on you as a whole person, but you as a body part and only a body part.  This is why we promote patient focused one on one care.  We want you better and we'll take the time to do it.  It's not that health care practitioners don't want to spend more time with their patients, the current environment is not conducive to it for reasons I will not address in this post.  It's unfortunate, but that is the reality of health care in the US.  Sadly, many have accepted it.  Honestly, this is your health.  YOU should care.  Ok, I'm stepping down from my soapbox.

There is more to the puzzle than just a body part to fix.  Lifestyle, mindset/personality, nutrition, physical function, support all play a role in how we get injured and how we recover.  In my years of practice, I can determine the prognosis of a patient with all of these factors in mind.  In terms of modifying some of these factors to work in favor of the patient will be determined by the patient themselves.  Change is hard, I get it.  However, if change does not occur, are you willing to go on as is?  My role as a health care provider is to not only help you, but empower you to be proactive in your own physical and mental well being.  I can guide you in the right direction, but you must eventually take the reins.

Many times I have clients that ask for my advice or act as a sounding board.  I'm happy to listen.  If it helps my clients improve, then, by all means, please, I'm happy to listen and provide feedback, if wanted, on strategies that may continue to help you.  As part of my education background, I've taken many a psychology course.  While I do understand that does not make me a psychologist or a psychiatrist, I understand how the mind works.  Through sport and self education, there are many lessons I have learned on how to approach many of the annoyances and hardships that life throws your way.  The thing between your ears is very powerful.  Use with care.

On the functional side of things, purposeful movement and training of the body hone in your body and self awareness.  Athletes are known to have great awareness of their bodies. 

As a physical therapist, I look for efficiency of movement and posture.  This is not a generalized statement.  I want to know what you do in your life (work and play) and how you interact physically within these environments.  WHY?  Because these two things, if lacking, will cause a cascade breakdown of the body resulting in increased risk of injury.  These functional movements promote neuromuscular re-education of how muscles are activated and recruited to produce efficient movement patterns in line with how the body is designed.  I've always said, "It's not WHAT we do that hurts us, it's HOW we do it". 

The downside is that our bodies are primal in instinct meaning it will figure out a way to work around pain at the sacrifice of other structures, unbeknownst to itself.  Compensations can lead to other issues if not halted.  This not only pertains to movements themselves, but to changes in the physiology of muscle functioning.  If we let the problem persist, then the compensations become hardwired, rewriting the original efficient program.

Functional movements and training work to reprogram these faulty patterns to reestablish the original efficient program filed away in the inactive drawer of our brain.  In order rewire these patterns, it takes time.  Just like it took time to develop bad patterns, it will take time to dust off the old program.  Persistence and commitment to the process WILL lead to a healthier version of you in the long term.  Again change is hard.  Developing new habits is hard.  I do my best to instill this holistic approach because I want to see the best version of my clients. 

Functional and integrative medicine is a balance of all facets of well being.  The focus is on YOU not just treating your injury but also help prevent future injuries from occurring (hopefully).