The visual impacts of manual therapy applied for voice and swallowing disorders
My job is a satisfying one. I get to indirectly work through clinicians as they apply the work I teach with others. Having clinicians who take the next step and use social media to talk about this work is a real bonus. Brooke Beilman, MS, CCC-SLP and Kate Hoerner, MA, CCC-SLP have done just that. They've made a number of short videos using the "split-screen" concept I used for my original video showing the simultaneous internal imaging of externally applied work ( this original may be viewed here). I pieced together three shorter videos they sent me into the one shown below. Questions? Please let me know.
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New articles
Feasibility of manual therapy in combination with a Dynasplint® for the treatment of trismus in head and neck cancer survivors
In this 2020 paper, the author dives deep into the use of the Dynasplint® passive stretching device combined with manual therapy for post head neck cancer-related trismus, which is a common secondary effect of radiation treatment. I've often been curious about how clinicians wall off passive devices, such as the Dynasplint® and Therabite®, as somehow distinct interventions from manual therapy. Though the intervention is delivered by a device, there is still a patient-experienced interaction/intervention going on, whether from my hands or from a device.
Nedeljak's paper demonstrates the utility of adding manual therapy to Dynasplint® when compared to the use of the Dynasplint® alone, with demonstrable improvements in mouth opening coming from the combined intervention over the Dynasplint® alone. Such devices are one way to provide home-based continuation of care. I've yet to see a similar study looking at trismus and self-applied manual therapy, but I suspect someone will undertake such a study at some point.
Meaning makes touch affective
This is another paper that shows the importance of the clinician's attention to task, much as Cerritelli (2017 Effect of Continuous Touch on Brain Functional Connectivity Is Modified by the Operator’s Tactile Attention) did.
"The pleasantness of gentle stroking (CT-targeted touch) varies highly between individuals and studies, indicating that relevant factors may not be accounted for. We propose that the affective value of a touch event is determined by how well its perceived purpose matches the goals of the touch receiver. The perceived purpose or meaning of touch is in turn informed by the sensory characteristics together with the setting, person factors, and the touchee’s expectations. Affective touch is often a sign of affection, intended to soothe or show support. Ina typical lab study however, the toucher is a stranger and its purpose is research. The purpose of laboratory touch is nevertheless compatible with the goal of participants, namely to contribute to research. To fully understand how the perception of affective touch emerges, more studies should directly manipulate participants’ beliefs about the purpose of touch."
UnPayWall
For those of you who struggle with research papers locked under paywalls and don't want to resort to pirate sites (Sci-Hub), check out the site UnPayWall. It is available as an add-on to Google Chrome and will immediately let you know if a free version of any paper is available. Once you add the extension to Google Chrome and open a paper/abstract, a small little colored lock will appear on the right side of the browser window. The color of the lock lets you know if a free version is available. Accessing it is as easy as clicking that little lock. Easy peasy. https://unpaywall.org/
Efficacy of Myofascial Release Therapy on the Cardiorespiratory Functions in Patients With COVID-19
I have huge problems with papers that correlate the perceptions of tissue-based problems with positive outcomes when a method of interaction is applied. This is a huge problem for myofascial release (MFR) based papers, as there is a huge gulf between "doing" MFR, which is a defined ritualistic manner of engaging a patient, and unsubstantiated views on what is wrong with the tissues and what is being done to those tissues.
This paper is essentially reporting that when the researchers treated Covid patients with techniques seen as MFR techniques, symptoms improved, with none of the BS often seen in MFR-based (or any other type of modality-based papers), improvements we seen.
Best in 2022,
Walt Fritz, PT
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New Seminar Locations
After a long delay due to Covid and the US/Canadian border closures, I am pleased to announce the new dates for my Voice and Swallowing Disorders class in Atlanta, Georgia on August 4-5, 2022, and Carroll, IA on November 12-13, 2022. I've also confirmed a Balancing the Body seminar in suburban Dallas, TX on July 15-16, 2022.
There are many more class locations in various stages of closure, including a Voice/Swallowing Disorders class in Los Angeles, CA, and San Antonio, TX later this year, so keep watching for more.
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This has been a busy few weeks for podcast appearances, with many more available on the website.
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Theresa Richard, SLP's Swallow Your Pride Podcast. Theresa and I spoke at length about manual therapy from the shared decision-making (SDM) model I use throughout my seminars. We spoke of how SDM has become an essential factor in her life, and we talked about its inclusion into interventions. We also hit on some recent research papers. You can listen here.
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Carly Hudson, DC, was kind enough to invite me to talk on her Healing Ground Movement Podcast about my work and how SDM can be included in all models of manual therapy. We covered its use with voice/swallowing disorders, nocebo, and a range of related topics. You can watch and listen here.
- Finally, I joined Tania Velásquez as a guest on Matt Phillips on his UK-based Sports Therapy Association Podcast. Though part of Fascia Month, we spoke of moving on from fascia-only narratives and why such things matter. You can watch here.
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Recognizing your biases
Having spent many years in a specific manual therapy modality (myofascial release), it got easy to see one tool being appropriate for every problem. I did nothing but myofascial release (MFR) and anyone who walked in the door of my practice got MFR. Many improved and for those who didn't I made excuses to myself as to the failure. I parrotted what was said in that MFR training, brushing off patients who did not respond to my specific MFR approach as "not being ready" to look at their issues, etc. I helped a lot of people and, as time progressed, I began to question all that I was taught in those MFR seminars as well as to begin questioning the larger issues of how I see myself in relationship to others.
While my physical therapy practice continues to be dominated by manual therapy interventions, I see my role in a different light. Instead of seeing my role as one of finding and releasing fascial restrictions, I now see myself as a therapeutic partner, using movement, manual therapy, and education to help my patients return to the life they are missing. No matter how good your tool (modality), they should never be seen in a one-size-fits-all light.
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Retake a Seminar? Why?
Or Serve As a Teaching Assistant?
You've spent a considerable amount of time and money learning a new style of working. Why would you consider retaking that course? To some, there is no need. You learned what you needed to learn and it is time to put the material into action. But for others, new to manual therapy or an approach that requires so much interaction from the patient, retaking a class might make sense. Though my seminars are only 2-days in length, the content is not easy for many.
Retakes may make sense for you. For every class, there is a reduced fee ($275) that allows you to hear everything another time, but from the context of experience. You've had some time to digest the coursework and apply it with your patients. You have probably seen both successes and failures, as well as faced some questions. Retaking a class can make sense, as those clinicians who have done so report learning so much more the 2nd time around.
Questions? Let me know.
There is also another way to learn even more. If you have an interest in assisting at an upcoming class as a teaching assistant, I'd love to talk. Pushing your boundaries by helping others to learn this work can expand and deepen your skill and confidence. Without exception, the feedback I get from clinicians who fill this role is that they learned so much more when they assisted. For details, send an email.
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Upcoming Seminars
Foundations in Manual Therapy: Voice and Swallowing Disorders
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Honolulu, HI: January 20-21, 2022 Seats remain!
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Phoenix, AZ: February 11-12, 2022 (Discount expiring)
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London, UK: March 7-8, 2022
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London, UK: March 9, 2022: One-day small group MasterClass
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San Diego, CA: April 23-24, 2022
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St. Louis, MO: May 3-4, 2022
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Chicago, IL: May 17-18, 2022
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Montreal, QC, Canada: June 4-5, 2022
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Memphis, TN: June 10-11, 2022
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New York City, NY: June 25-26, 2022
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Syracuse, NY: July 7-8, 2022
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Atlanta, GA: August 4-5, 2022
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Miami, FL: October 7-8, 2022
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Kalispell, MT: October 28-29, 2022
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Carroll, IA: November 12-13, 2022
- Watch for a Los Angeles, CA and San Antonio, TX class in mid-2022.
Foundations in Manual Therapy: ADVANCED Voice and Swallowing Disorders
Space will be limited, with prerequisites in place
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Raleigh, NC: March 26-27, 2022
- Watch for a California class in late 2022
Foundations in Manual Therapy: Balancing the Body
ASHA CEUs and NCBTMB CEs approved, as well as many state PT/OT CEUs
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Paia (Maui), HI: January 27-28, 2022
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Paia (Maui), HI: April 15-16, 2022 (2nd 2022 offering)
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Chicago, IL: May 19-20, 2022
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Asheville, NC: August 20-21, 2022
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Dallas, TX (Flower Mound): July 15-16, 2022
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Watch for a Rochester, NY class in 2022
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Host a Workshop or Private Training
If you are interested in partnering with me to bring one of my Foundations Seminars to your facility, please send me an email. Public and private seminars are an option.
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Hands-On Online Course
Now Available with
ASHA CEUs and NCBTMB CEs approved
The time has come, and the new Foundations in Manual Therapy: Voice and Swallowing Disorders Hands-On Online Course is now available. There are now three products available:
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Foundations in Manual Therapy: Voice and Swallowing Disorders Hands-On Online Course. This complete 8-hour course includes the Introduction to the Evidence and Approach and the Hands-On Course. This course completely mirrors the in-person seminar in content.
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Foundations in Manual Therapy: Introduction to the Evidence and Approach. This 2-hour course takes the learner through the logic behind this patient-centered model of care, including a dive into the evidence and concepts related to sharing decision-making with your patient. This course is included in #1.
- If you've already purchased the Introductory Module (#2) and wish to continue learning, the Hands-on Course (1) is also available. Please note: this option is only available for those who have already completed the 2-hour Introductory Course. To access this course, please email for the registration link.
I'm really of this project, as the course includes footage filmed at a live course as well as "studio" filmed footage. It contains the entire curriculum covered in the in-person seminar, with lectures, interviews, demonstrations, and lab experiences. There are lots of close-ups of the hands-on work, as well as ample opportunity to see the style of a patient-centered interview I utilize and how I incorporate shared decision-making into every interaction. While lacking in the tutelage that occurs in the in-person course, this is the next best thing to being there. Given the live seminar postponements due to Covid-19, this course allows those with a keen interest in this work to get started. As I still recommend the live course to maximize the personalized instruction and hands-on interactions, there is a discount included at the end of the Online course applicable to any live course in the future.
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Awards Program for the SLP Grad Student and Clinical Fellows (Free Seats!)
Since 2013 it has been my honor to present manual therapy continuing education to the Speech-Language Pathologist and Voice communities. Through my Foundations in Myofascial Release Seminars (soon to be rebranded as Foundations in Manual Therapy Seminars) and workshops presented at the annual Voice Foundations Symposiums, I’ve come to know many of you. As a way of thanking the SLP world, I am instituting a new program that will award one free seat at every Introductory seminar that I teach to an SLP Graduate Student of Clinical Fellow.
This program is for interested Graduate Students and Clinical Fellows who plan to specialize in voice and swallowing and who have an interest in the role manual therapy may play in those fields. Each applicant will:
1. Write a short paper that speaks to their interest in manual therapy and how it would benefit them in their career.
2. Each applicant will obtain a brief letter of recommendation from a supervisor or fellow SLP at their place of employment.
Entries will be reviewed, with one person chosen for every location of the Introductory Foundations in Manual Therapy: Voice and Swallowing Disorders Seminar. The applicant may submit their information as an email through the website, www.WaltFritz.com. The winner is responsible for their own travel-related expenses. The deadline for submissions is one month before the date of each seminar.
Cheers,
Walt Fritz PT
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Podcasts and Article Master List
Over the past few years, I've been invited to a number of podcasts. These are always quite fun and have given me a platform to spread my version of manual therapy to clinicians in specific domains around the world. I've compiled all of them on one page of the website. Here you can so find a wide range of articles written/published by various magazines and websites. You can find the list at this link.
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Massage & Fitness Magazine is the only magazine serving the industry committed to plausible and evidence-based narratives. As such is has my support. Click here for details. Watch for my article in the upcoming Summer 2019 issue.
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- Seminars for SLPs/Voice Professionals, MTs, PTs, and OTs.
- Manual therapy from an evidence and science-informed perspective.
- Lots of individualized hands-on instruction
- Walt Fritz, PT
- A content expert in the manual therapy field
- Personally teaches all Foundations Seminars
- Moving manual therapy into plausible and accepted scientific narratives
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Foundations in Manual Therapy Seminars| Walt Fritz, PT |
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