Simply PM&R

Guest: John H. Hollman, PT, Ph.D.

Host: Jeffrey S. Brault, D.O. (@JeffBrault)

As the corner stone of the rehabilitation team, physical therapy has transformed over the last 10 – 20 years. Dr. John Hollman reviews what it takes to earn a Doctorate of Physical Therapy along with current trends in residency and fellowship options. Listen in as he covers the KISS principle to patient exercise adherence and nationwide direct access.

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.

Guest: Thomas P. Pittelkow, D.O., M.P.H.

Host: Jeffrey S. Brault, D.O. (@JeffBrault)

How do you treat acute vs chronic pain? Dr. Thomas Pittlekow details how he approaches patient education around pain and treatment options for chronic pain including spinal cord and peripheral nerve stimulators and who stands to benefit most. Dr. Pittelkow outlines best practices for prescribing opioids and the reasons behind them. He shares how he’s helping patients “live better, feel better, and move better” using a multimodal approach.

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.

Deeper Dive:

• CDC Guidelines for Prescribing Opioids for Chronic Pain https://www.cdc.gov/drugoverdose/prescribing/guideline.html
• Mayo Clinic Pain Rehabilitation Center https://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/resources-for-physicians

Guest: Jonathan Finnoff, D.O. (@FinnoffJonathan)

Host: Jeffrey Brault, D.O. (@JeffBrault)

Leg and buttock pain seem synonymous in athletes. How do you narrow down the differential diagnosis? Dr. Jeff Brault presents a series of cases to Dr. Jonathan Finnoff. Do you know the diagnosis? How would you approach one of these cases? Dr. Finnoff walks through his approach from presentation to treatment, offering his expert insight on things to consider when evaluating patients with leg and buttock pain. 

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR and Department of Sports Medicine @mayoclinicsport. 

Deeper Dive: 

• Exertional Leg Pain https://doi.org/10.1016/j.pmr.2015.08.012 
• Evaluation of the Athlete with Buttock Pain doi: 10.1249/JSR.0b013e3182423d71 
• The Gluteal Triangle: A Clinical Patho-Anatomical Approach to the Diagnosis of Gluteal Pain in Athletes https://bjsm.bmj.com/content/43/6/460 
• Variability of the Ischiofemoral Space Relative to Femur Position: An Ultrasound Study https://doi.org/10.1016/j.pmrj.2015.03.010 
• Variability of Ischiofemoral Space Dimensions with Changes in Hip Flexion: an MRI Study https://doi.org/10.1007/s00256-016-2508-2 

Guest: Amy E. Rabatin, M.D. 

Host: Jeffrey S. Brault, D.O. (@JeffBrault)

Pediatric patients are not just little adults. Dr. Amy Rabatin lays out the main differences to be aware of when treating this patient population, how you can specialize in this field, and what types of conditions are typically seen. She also discusses how to manage obesity in children with disabilities and how to manage the barriers they face when being active, and how to keep these kids safe while participating in sports.

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.

Guest: Kathryn M. Alfonso, D.O. and Ike B. Hasley, M.D. 

Host: Jeffrey S. Brault, D.O. (@JeffBrault)

What questions should you ask on interview day? How do you make the final decision? Dr. Brault discusses what factors into resident perceptions and decisions with two of Mayo Clinic’s current PM&R residents, Kathryn Alfonso, D.O. and Ike Hasley, M.D. What is your programmatic culture? How do you make it through the filter to a top choice for applicants?

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.

Deeper Dive:

• The Student Doctor Network: https://www.studentdoctor.net/ 

Guest: Carmen M. Terzic, M.D., Ph.D. 

Host: Jeffrey S. Brault, D.O. (@JeffBrault)

While heart attack survival rates are increasing, these patients are often left with functional deficits that require treatment. Dr. Carmen Terzic dives into cardiovascular rehab for the post-event patient, aiming to gain control of risk factors, making lifestyle changes with the aim of prevention, and helping patients to maintain these changes long-term.

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.

Guest: David C. Weber, M.D. 

Host: Jeffrey S. Brault, D.O. (@JeffBrault)

Dr. Dave Weber discusses healthy aging, what it is, what it isn’t, and how you can help your elderly patients optimize their quality of life.

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.

Guest: Stephen J. Wisniewski, M.D. 

Host: Jeffrey S. Brault, D.O. (@JeffBrault) 

How do you counsel your patients about the risks and benefits of corticosteroid injections? How long should you expect their pain relief to last and how do you decide when and if to repeat one? Dr. Stephen Wisniewski discusses the choice between treatment with corticosteroid injections versus NSAIDS, side effects, and the benefits of using ultrasound guidance. 

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR. 

Guest: Russell Gelfman, M.D.

Host: Jeffrey S. Brault, D.O. (@JeffBrault)

How do you determine what work restrictions would be most beneficial? When is maximum medical improvement determined and how does it relate to disability ratings? Even though the job landscape has changed from the dawn of worker’s compensation and insurance, work rehabilitation has maintained the same goal: return patients back to full duty employment. Dr. Gelfman lays out the specialist’s take on the Biopsychosocial Model in application to work rehabilitation, the need for more practitioners in this field, and how to develop this skillset within your practice.

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.

Deeper Dive:

• AMA Guides® to the Evaluation of Work Ability and Return to Work https://commerce.ama-assn.org/store/ui/catalog/productDetail?product_id=prod1230017&navAction=push
• The Work Disability Functional Assessment Battery (WD-FAB) DOI: https://doi.org/10.1016/j.pmr.2019.03.004

Guest: Andrea L. Cheville, M.D. 

Host: Jeffrey S. Brault, D.O. (@JeffBrault) 

What exactly is cancer rehabilitation? How can we keep our patients working and living their best life during cancer treatment? How do these patients differ from other rehabilitation patients? Dr. Andrea Cheville shares her insights on the Mayo Clinic multidisciplinary approach to providing rehabilitative care for cancer patients. This includes those actively going through chemotherapy and/or radiation treatments, as well as patients whose treatment has concluded. 

Connect with the Mayo Clinic’s PM&R Department on Twitter @MayoClinicPMR.