The Calamity of the 1st MTP fusion…

 

MTP = MetaTarsoPhalangeal, the joint at the ball of your foot where your toe joins…also the joint where patients develop bunions.

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I’m not even sure where to start with this blog, my heart breaks every time I see a patient with a 1st MTP fusion…usually they are fused bilaterally. It is a biomechanical disaster that should essentially never happen.

Why do patients have this debilitating procedure?

  • They have 1st MTP joint pain.
  • They have radiographic evidence of 1st MTP degeneration (osteoarthritis).
  • Failed conservative management (arch supports, physical therapy, and medications).

Surgeons motivated to help the patient with their only real tool: surgery and NOT understanding the consequences of fusing this MOST critical joint in ambulation.

What leads to 1st MTP degeneration? Unless you are a ballerina, you have earned a degenerative 1st MTP through bad biomechanics and physics. The most common cause I see for 1st MTP pain and degeneration is a collapse of the Metatarsal or Transverse Arch which is also frequently a victim of further biomechanical issues.

Treatment of 1st MTP pain?

  1. Fix the biomechanics…this usually entails an Orthotic…NOT AN ARCH SUPPORT. (See my post on the difference between a biomechanical orthotic and a “custom” arch support)
  2. Get the 1st MTP joint moving.
    1. Treat the soft tissue on the medial (inside) and plantar (bottom) of the joint.
    2. Mobilize the joint (1st MTP extension in sagittal alignment).
    3. If the 1st MTP has been dysfunction for a long time, there is likely restriction of the plantar fascia and that will need to be treated too.
    4. This is NOT a problem that can be fixed with patient stretching exercises, however use of a “Prostretch” device can be a helpful addition to manual therapy intervention.
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  3. NEVER consider surgical fusion of this joint!!! 5 degrees of motion is a whole lot better than zero. It may make the 1st MTP joint feel better to be fused, but it doesn’t fix the problem that caused it to fail in the first place and it forces further compensations up the lower extremity chain of joints where the patient will likely begin to manifest other symptoms (hip/back most common).

 

 

 

Why the Affordable Care Act can do Nothing to Improve Health Care

 

  1. The problem is not access.  For the vast majority of Americans, access to health care isn’t the issue.  The issue is quality of care.  Because the average quality of care is so poor in American medical offices, few patients are accurately diagnosed and fewer still are healed.  Typically, at best they have their symptoms managed.  Why is quality of care so poor?
    1. `Medical appointments are too short.  The insurance industry reimburses so poorly that the typical primary care appointment is less than 10 minutes long.  In my profession you are lucky to have 25-30 minutes of face-to-face time with your physical therapist.  The insurance industry documentation requirements for reimbursement leads to more and more mouse clicking and “key phrase” typing which steals more minutes from actual patient interaction.   The vast majority of documentation requirements lend little/no value to the patient interaction or even to follow-on care appointments.
    2. Medical professional skill level.  Fewer and fewer medical appointments are conducted by actual physicians.  More and more care is provided by physician extenders (Physician Assistants and Nurse Practitioners) and ancillary medical professionals (CNA’s and MA’s).  These medical assistants to physicians are doing their best, but they have less training, less time and more documentation requirements.  The deck is stacked against them.  I’m a firm believer in direct access for physical therapists for musculoskeletal pain.  We have more training and evaluation appointment time than any PCP (Primary Care Provider and if anything, insurance companies should mandate that their beneficiaries be required to see a physical therapist BEFORE seeing a PCP.  Physical Therapists are more qualified to make follow on consultations and radiographic orders (X-rays, CT scans, MRI’s, etc).   This system has already been in place and extremely successful in all branches of the U.S. military.   
    3. Quantity:  Number of trained medical professionals.  Our profession has a vast shortage of trained medical professionals and I’ve said many times that if the government wants to get involved improving healthcare it should create more scholarship opportunities for Americans to attend various medical schools (ranked based on need assessments).  I’m also a firm believer in reinstating a medical internship program.  Right now if you have all the intangibles to be the best physician in the history of the United States, but can’t pass the MCAT, you will never enter the profession.  I believe that with a 3-5 year internship interspersed with select college course work, writing assignments and a LOT of 1:1 mentorship by experienced clinicians (>10 years in field), that we would be able to field another group of highly skilled medical professionals who would improve both quality and quantity deficits.  

2.   Little to no focus on prevention.  There is no money to be made in the field of prevention, all the money is in pharmaceuticals and surgery once illness or injury has progressed.  I’m sure you don’t have to believe in conspiracy theories to imagine the big pharmaceutical companies might be lining the pockets of politicians and government employees to allow the status quo.  This is far from my area of expertise, but imagine the effect of pollution, pesticides, “food” additives, fertilizers, artificial food dyes, artificial sweeteners…many of the above are banned in some or all of other modern countries, but not the United States.  Don’t underestimate the effect of a stationary lifestyle where Americans sit far too much hunched over a laptop or cell phone.  What if insurance companies rewarded fitness with cash rebates to their beneficiaries?  What if our government rewarded agriculture and food industry for producing “clean” food?  What if insurance companies rewarded individual practitioners for best results and healing rates?

 

If the average American were healthier he/she would need fewer appointments and access to healthcare and cost of medical care would both improve.  

Visceral Therapy for stomach problems

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How many people do you know who take medications for their abdomen on a regular basis? Stomach medications for heart burn, reflux or indigestion, intestinal medications for ulcers, constipation, diarrhea, or general digestive problems. How many have had their gall bladders removed?? What if there were fibrotic adhesions from illness or injury that may have occurred years earlier? Adhesions that were impacting the performance of the abdominal organs and causing them to be symptomatic?

These tissue adhesions can be treated with physical therapy, specifically visceral therapy in which tissue mobility and motility can be restored and stomach or intestinal symptoms can be resolved which may eliminate the need for medications.

Come to Bare Necessities PT…There is Hope…True Healing Exists!!

Testimonial from my patient Tyler:

I had severe stomach problems from the age of 12 to 17. Severe pain, nausea, constipation, and diarrhea were all symptoms that I lived with on a daily basis. I missed so much school that I was unable to graduate on time.  I had seen several doctors and specialists and was diagnosed with IBS, possible Crones disease and even parasites.  I was prescribed several different medications and supplements, as well as changed my diet, all with little to no relief.  I was told I would have to live with this for the rest of my life. I then was introduced to Tony.  Just three visits cured my problem and I no longer suffer or have to worry about how I’m going to feel each day. It has changed my life. THANK YOU TONY!

 

The Therapeutic Value of Visceral Manipulation

Visceral Manipulation (VM) was developed by world-renowned French Osteopath and Physical Therapist Jean-Pierre Barral. Comparative studies found Visceral Manipulation beneficial for various disorders

Digestive Disorders
Bloating and Constipation
Nausea and Acid Reflux
GERD
Swallowing Dysfunctions 

Emotional Issues
Anxiety and Depression
Post-Traumatic Stress Disorder

Pain Related to
Post-operative Scar Tissue
Post-infection Scar Tissue
Autonomic MechanismsPediatric Issues
Constipation and Gastritis
Persistent Vomiting
Vesicoureteral Reflux
Infant Colic

VM assists functional and structural imbalances throughout the body including musculoskeletal, vascular, nervous, urogenital, respiratory, digestive and lymphatic dysfunction. It evaluates and treats the dynamics of motion and suspension in relation to organs, membranes, fascia and ligaments. VM increases proprioceptive communication within the body, thereby revitalizing a person and relieving symptoms of pain, dysfunction, and poor posture.

An integrative approach to evaluation and treatment of a patient requires assessment of the structural relationships between the viscera, and their fascial or ligamentous attachments to the musculoskeletal system. Strains in the connective tissue of the viscera can result from surgical scars, adhesions, illness, posture or injury. Tension patterns form through the fascial network deep within the body, creating a cascade of effects far from their sources for which the body will have to compensate. This creates fixed, abnormal points of tension that the body must move around, and this chronic irritation gives way to functional and structural problems.

Imagine an adhesion around the lungs. It would create a modified axis that demands abnormal accommodations from nearby body structures. For example, the adhesion could alter rib motion, which could then create imbalanced forces on the vertebral column and, with time, possibly develop a dysfunctional relationship with other structures. This scenario highlights just one of hundreds of possible ramifications of a small dysfunction – magnified by thousands of repetitions each day.

There are definite links between somatic structures, such as the muscles and joints, the sympathetic nervous system, the visceral organs, the spinal cord and the brain. For example, the sinuvertebral nerves innervate the intervertebral disks and have direct connections with the sympathetic nervous system, which innervates the visceral organs. The sinuvertebral nerves and sympathetic nervous system are linked to the spinal cord, which has connections with the brain. In this way someone with chronic pain can have irritations and facilitated areas not only in the musculoskeletal system (including joints, muscles, fascia, and disks) but also the visceral organs and their connective tissues (including the liver, stomach, gallbladder, intestines and adrenal glands), the peripheral nervous system, the sympathetic nervous system and even the spinal cord and brain.

Thanks to the dedicated work of Jean-Pierre Barral, a Physiotherapist (RPT) and Osteopath (DO), healthcare practitioners today can use the rhythmic motions of the visceral system as important therapeutic tools.

Barral’s clinical work with the viscera led to his development of a form of manual therapy that focuses on the internal organs, their environment and the potential influence on many structural and physiological dysfunctions. The term he coined for this therapy was Visceral Manipulation.

Visceral Manipulation relies on the palpation of normal and abnormal forces within the body. By using specific techniques, therapists can evaluate how abnormal forces interplay, overlap and affect the normal body forces at work. The goal is to help the body’s normal forces remove abnormal effects, whatever their sources. Those effects can be global, encompassing many areas of bodily function.

How Does Visceral Manipulation Help You?

Visceral Manipulation is used to locate and solve problems throughout the body. It encourages your own natural mechanisms to improve the functioning of your organs, dissipate the negative effects of stress, enhance mobility of the musculoskeletal system through the connective tissue attachments, and influence general metabolism. Today, a wide variety of healthcare professionals perform Visceral Manipulation. Practitioners include osteopathic physicians, allopathic physicians, doctors of chiropractic, doctors of Oriental medicine, naturopathic physicians, physical therapists, occupational therapists, massage therapists and other licensed body workers.

How is Visceral Manipulation Performed?

Visceral Manipulation is based on the specific placement of soft manual forces to encourage the normal mobility, tone and motion of the viscera and their connective tissues. These gentle manipulations can potentially improve the functioning of individual organs, the systems the organs function within, and the structural integrity of the entire body.

Harmony and health exist when motion is free and excursion is full – when motion is not labored, overexcited, depressed, or conflicting with neighboring structures and their mobility. Therapists using Visceral Manipulation assess the dynamic functional actions as well as the somatic structures that perform individual activities. They also evaluate the quality of the somatic structures and their functions in relation to an overall harmonious pattern, with motion serving as the gauge for determining quality.

Due to the delicate and often highly reactive nature of the visceral tissues, gentle force precisely directed reaps the greatest results. As with other methods of manipulation that affect the body deeply, Visceral Manipulation works only to assist the forces already at work. Because of that, trained therapists can be sure of benefiting the body rather than adding further injury or disorganization.

*from the Barral Institute

hip and back pain during and after pregnancy

 

Marnie – hip and back pain during and after pregnancy:

When I was four months pregnant, I started getting severe hip and back pain. I was as stiff as a board, no matter how much stretching I did, and I did a lot. I would get a pinched nerve near my tailbone so bad that I couldn’t lift my feet off the ground to walk. My hips felt like they were burning on fire. The mornings were the worse, when it felt like the wind got knocked out of me, my back and hips hurt so bad. I felt like I was 90 years old and there was nothing I could do about it.

I was in PT from four months pregnant until 10 months postpartum. I would feel better sometimes but it was only temporary, sometimes only half an hour, sometimes a couple of days. But nothing ever got better. Finally, a friend referred me to Tony.

Not only was Tony a kind and gentle person, he figured out what was structurally wrong with me and “fixed” it in one visit! It turns out, that during pregnancy, the hormones that let your hips open up also caused my sacrum to sort of drop down and get wedged underneath my hips and pelvis. There was no way for it to get out, until Tony and his wife teamed up and literally pulled it back out into the right place! It didn’t even hurt. I am still in shock every day that I was able to walk out of Tony’s office and not feel any pain! I will never be able to thank Tony enough for what he did for me. My life as a “90-yr old” in chronic, 24/7 pain is no longer a reality for me. I believe he works miracles!

To all the mamas out there who think that hip and back pain are just a normal part of pregnancy and giving birth, please believe me when I say, it is not normal. You can get help. You deserve to not be in so much pain!!

 

Emily: 34 Weeks Pregnant

I first came to Tony last Spring after visiting my chiropractor numerous times for my cramped neck and not feeling any relief. He was able to give me some tips and excercises that improved my neck pain in just a few visits. Because of my experience last spring I decided to go back a few weeks ago and have Tony work on my hip/ lower back area. I was 34 weeks pregnant and would cramp up so bad that I could hardly walk after laying down for a while. Again, it took just one visit to feel relief. I was amazed and slightly disappointed that I didn’t see Tony earlier in my pregnancy!! I had a chiropractor appointment scheduled for the following day. I knew I needed to explain that my hip felt much better after Tony’s adjustment. I asked that she wouldn’t adjust my hips so that it would stay in place. Unfortunately, she went right on and popped them like usual and undid the work that Tony and Amy had done. Thankfully I knew it could be fixed, so I came back to the Bare’s with the regret of seeing my chiropractor, and they were able to work their magic again. I love how they work together as a team and really truly want you to experience a pain free life. Thank you for all that you’ve done for me! I can’t express how greatful I am for your practice!

Running Training for Women

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We are excited to offer Half Marathon training just for WOMEN!

What will training packages include?

  • weekly training email
  • 12 weeks of training with one on one attention addressing your personal needs
  • private Facebook page to connect with your coach, Amy
  • gait evaluation and shoe analysis by Dr. Tony
  • weekly coached group runs
  • nutrition and running information
  • a judgement free environment of supportive women

Cost of training package:  $100
will not include race fee

Training start date: the week of February 29th with the first group run on March 5th.

Race Information: Palmer Lake Half, May 21, 2016

Group Run Time: 8:00am
Because we live in Colorado weather will be different each week. Groups run will be held unless roads are not drivable. In the event that a group run must be canceled there will be make up opportunities. Learning to run in our environment will make us STRONGER!

Registration: please call Amy at 719.290.8429. We accept cash, check or Visa/Mastercards. Registration fees are non-refundable but may be transferred to a subsequent training program.

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About Dr. Tony:

Tony was raised in Mitchell, Nebraska and received his sports medicine training at the University of Wyoming. He then joined the Army and completed the Army-Baylor Masters of Physical Therapy program in 1994. In 2008 he went back to Baylor to earn his doctorate in physical therapy. Tony received his Certification in Athletic Training in 1994 and a certification as an Orthopedic Clinical Specialist in 2003.

Tony has worked with Olympic caliber athletes all over the world. He is recognized nationally as a subject matter expert in biomechanics of walking, running and orthotic fabrication. He is also a myofascial therapist and was recognized by the Surgeon General in 2009 as one of the best clinicians in the military. He has also completed many hours of biomechanics and running specific courses. Tony retired from the Army after 20 years as a Combat Veteran.

Tony enjoys helping patients to become pain-free and loves the challenge of helping patients who have been in pain for years or have given up hope. He has an amazing success rate with these patients! Tony also works with patients suffering from heartburn and a variety of gastrointestinal symptoms.

Tony enjoys spending time with his family which includes his wife Amy, 2 elementary kids, 3 teenagers and 3 dogs, biking, cooking, landscaping and enjoying his 190 gallon reef aquarium.

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About Coach Amy:

I left the professional world to prepare to be a stay at home mom in 2007. During that time I trained as a birth doula and child birth educator and worked with military families in Korea. I also gained a lot of weight in my back to back pregnancies and after my daughter was born via home birth VBAC in 2010, I felt empowered to lose the 80+ extra pounds that I found myself carrying. After the weight loss I needed a new goal and began distance running, I was hooked!

I have completed multiple full marathons and have ran 1000’s of miles in the last 5 years. I am also a fitness professional holding a national group fitness certification as well as several other specialty certifications including running training/coaching. I have worked with women for the last 7 years as both a doula/childbirth (DONA, LCCE) educator and in the fitness industry.

View More: http://halchakphotography.pass.us/untitled-export-7

The Courses I’ve Taken and Taught on Biomechanics and Running

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I recently returned for a Continuing Education Course on biomechanics of gait, running and rehabilitation titled: Running Rehabilitation and after this weekend my total hours of continuing education on gait stands at 120!!

  • 1996 Locomotor Biomechanics (8 hrs)
  • 1997 Orthotic Reaction (22 hrs)
  • 1998 Grinders & Glue (16 hrs)
  • 1998 Landing on Your Feet (8 hrs)
  • 1998 Current Concepts in Biomechanics (22 hrs)
  • 2000 When the Foot Hits the Ground (Lv2) (15 hrs)
  • 2001 The Running Course (15 hrs)
  • 2015 Running Rehabilitation (14 hrs)
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I certainly learned a couple things from my most recent course.  First, the science of running has certainly evolved in the last 14 years but the course also validated that all the work I invested to become a Subject Matter Expert in Biomechanics has certainly paid off.  To summarize that work I thought I’d list my teaching experience…
  • 1999-2000 I re-wrote 32 hours of gait and biomechanics for the Army-Baylor Physical Therapy Program.
  • 1999 University of Texas Health Science Center, Normal Gait (4 hours)
  • 1999 Balboa Naval Medical Center (Tricare Region IX), Lower Extremity Treatment Options (15 hours)
  • 2000 Etiology of Foot Pain, Health Care Providers in Bosnia (8 hours)
  • 2000  Army Orthopedic Physical Therapy Residency, Normal Gait and Malalignments (15 hours).
  • 2002 Army Orthopedic Physical Therapy Residency, Normal Gait and Malalignments (15 hours).
  • 2002 Colorado Springs Air force and Army Cont. Ed.  Normal Gait, Malalignments and Orthotic Prescription (15 hours)
  • 2003 Hawaii APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hrs)
  • 2003 Army Sports Medicine Physical Therapy Residency, Normal Gait, Malalignments and Orthotic Prescriptions (15 hours).
  • 2005 Hawaii APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hrs)
  • 2007 Operation Iraqi Freedom Deployment Cont Ed. Foot Pain Management in a Deployed Setting. (8 hours).
  • 2009 Kentucky APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hours).
  • 2010 Texas APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hours).
  • 2011 Washington APTA, Normal Gait, Malalignments and Orthotic Fabrication (15 hours).
That is a total of just over 200 hours of teaching to hundreds Physical Therapy students, graduates and and post graduate specialists.  I don’t proclaim this accomplishment to brag about what I’ve done, but to give God glory for the opportunities He’s afforded me.  I’m also realizing I haven’t taught a course in 4 years…I need to get off my butt and put on another conference!! 🙂
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Gait Analysis for FIT4MOM Front Range Half Marathon Trainees

Amy here!

Tony and I are getting married THREE weeks from today! Here’s an engagement photo since I love it so much View More: http://halchakphotography.pass.us/untitled-export-7

Tony and I had the honor of seeing about 35 of the FIT4MOM Front Range half marathon trainees this last month. I own the FIT4MOM Front Range franchise. We offer fitness for all stages of motherhood from Parker to Fort Collins. We have nearly 30 instructors and several hundred moms attending our classes, making up an amazing community of support, fitness and the village it takes to raise kids AND moms. Tony and I are able to combine our professions in order to serve these moms even better.

We have been offering 5K, 10K and half marathon training for the last several years with great success. In 2015 we had over 200 moms go through our running training programs. I’m a marathoner myself so this is definitely a passion of mine and since Tony is a biomechanics expert and one of only a few people in the country fabricating orthotics the way he does I wanted to make sure our moms were given the opportunity for an evaluation with him. I’m always looking for ways to improve our programs and add value so it only made sense to incorporate Tony into the program.
As part of the fall half marathon training we offered a free gait and shoe evaluation with Tony for each registered participant. Each mom that signed up got 15-20 minutes one on one (well, two on one since I was there too) with Tony. He evaluated feet, marked them, watched them walk, checked out shoes and gave recommendations. Some were as simple as ‘keep doing what you are doing’ while others needed shoes changes and some were offered a custom orthotic. We really tried to educate each mom on her mechanics, her body, her shoes and to answer any and all questions. The main goal was to reduce injury and provide them with the resources to run a successful and easy half marathon.

We spent two days in Loveland  and saw 17 Fort Collins and Greeley group moms and a day in Denver seeing another 18. It was pretty awesome to meet all these moms face to face and to hear their stories, their struggles, their progress and their goals. We are looking forward to incorporating the evaluations into each running training that we have moving forward. Tony and I really enjoyed being able to work together on something that we both are very passionate about but it was a really fun time seeing all the moms.

Thank you to all the moms that came to see us!

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Examining and marking the foot

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The two of us  watching mom walk to analyze gait

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Tracing for measurements and prescription

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BONUS! Mama Cameron was injured so she came to see us!

If you want to know more about Tony’s experience and background with orthotic fabrication go HERE

Read more about orthotics and the Fallacy of Arch Supports

My Orthotic History and Experience

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In 1996 I had been a physical therapist for 2 years and I left my assignment at Ft. Campbell, KY to attend a 2 week continuing education course at Ft Sam Houston, TX. During the course a man named Michael Cane taught 8 hours on gait, biomechanics and orthotics. It was completely over my head. I was so angry that Physical Therapy school had completely failed to teach anything useful on the subject, that I was on a mission to remedy the situation. I took a Michael Cane’s 3 day course, another 3 day course taught by a Podiatrist and another by an Orthotist. I took another 3 courses and dove into the research…in 1998 I re-wrote the curriculum of lower extremity biomechanics, gait and orthotic treatment for Baylor University. By 2001 I had become the Military’s gait and biomechanics expert (across all services) and was a guest instructor in 2 different Graduate PT programs and 2 different clinical residencies. I developed my own 3 day continuing education course and I have taught it all over the country.

IMG_2426Orthotic magic

                                               Bosnia, Camp Eagle, 2000

God provided a perfect environment for me to become the expert described above… I grew up working for my dad as a machinist, so I had a comfort level with building and machine work. The Army provided me with an endless supply of Soldiers not biomechanically designed to run or march. I had access to some of the best orthotic labs in the nation, mentoring by orthotists with decades of experience and plenty of supplies. My skills were honed and I still learn from every patient I evaluate and treat. Every patient is so very unique. I’ve made over 5000 pair of orthotics. I’ve made orthotics for patients as young as 6 and as old as 96, patients who are Olympic track and field athletes, recreational and high school athletes and patients just struggling to walk without a cane or crutches.

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Do you have pain in your back, hips, knees, shins, ankles or feet? Have you a bag full of orthotics that didn’t help your pain in the past? If I evaluate you, you will see my evaluation will be comprehensive, I will explain to you what is working and not working throughout your stride and if an orthotic can help you. I will provide a comfortable and affordable device and you will have the chance to finally turn that page in the chapter of your life.

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Want more information?
See my Fallacy of Arch Supports article

LTC Tony Bare (ret) DPT, ATC, OCS
Physical Therapist
Colorado Springs, CO

6 Week Follow Up After Cranial Treatment for Non-Sleeping Toddler

Cranial Therapy Success!

Jill and Mike had their daughter Brooklyn treated 6 weeks ago because she was sleeping so poorly and they were all sleep deprived as a family. You can read their first post HERE

So it has been almost 6 weeks since we had the cranial sacral therapy done by Tony on our daughter Brooklyn (she will be 3 in October), and I have to say life is amazing!  I will admit that for the first week I thought every night was a fluke.  I kept expecting that this treatment would not last and we would be back to the screaming, thrashing wake ups.  That was the life that we had become accustomed to.  But here we are 6 weeks later, with a sleeping toddler.  We have the occasional night where she wakes up because of a storm or a loud noise, but it no longer is the end of our night.  It only takes about 5 minutes to get her back to sleep and she is not inconsolable.  She is also napping at least an hour a day, but more like 2-3 on a regular basis.
Besides the sleep I have to say that we have our daughter back.  Since the sleep deprivation had become such the norm, we did not realize the changes that had occurred in Brooklyn.  Looking back now it is easy to see.  She had terrible tantrums that lasted up to an hour, she became a poor eater and she her personality had disappeared.
Once her sleep improved the rest of the problems seemed to vanish.  Her tantrums still occur, she is almost 3, but they only last a few minutes and we are able to calmly discuss the issue afterwards.  She began eating much better, and has put on healthy weight and above all her personality returned.  The first day we heard her laugh again, we realized that it had been at least 6 months since we heard that infectious laughter.  She is back to her silly, dancing, singing, laughing self.  Brooklyn has also grown leaps and bounds with her confidence.  She will now go and explore on playgrounds without holding our hands and she is not afraid to introduce herself to other kids and initiate play.

6 weeks ago if you had told me that cranial therapy could improve all of these aspects of Brooklyn’s life I would have doubted that was possible.  But now I know and as a family we feel so blessed to have had this session with Tony!
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Mike, Jill and their (sleeping at night!) daughter Brooklyn
Jill is the FIT4MOM Front Range Membership and Special Programs Coordinator as well as the Littleton Stroller Strides and Body Back instructor and running coach. They are expecting baby #2 in September!

Custom Orthotics By Providing Video Gait Analysis

I’ve had a lot of interest in my Bare Necessities  Custom Orthotics (arch supports or shoe inserts) from people across the country and I’ve had good success making them based off the information below. If you’ve read my post on the Fallacy of Arch Supports, you know that one of the components of my exam that makes the orthotic successful is the dynamic gait analysis, so if I’m provided the video footage I’ll have great insight into your biomechanics and if they need any help or correction.

The good news is that I’ll assess your videos FREE!! All I need is 10 second clips of you walking barefoot on the treadmill from behind and from each side.   Just do your best to walk on the treadmill at your comfortable walking pace.  Take video footage of the following angle/level  (including both sides/foot):

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I’ll need a tracing of your foot next to a ruler. See picture below (it doesn’t have a ruler but you’ll need a ruler next to your tracing).  The tracing will let me know what size of orthotic to make and I’ll have an idea what adaptations your biomechanics have forced your foot to make and that will be even more information helping to guide my orthotic prescription.

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IMG_2431The orthotics themselves are only an average cost of $85 plus $10 shipping and handling, so send me your videos and get on the road to pain free walking or running.

Now that we are relocating to Laramie, WY please refer your Colorado Springs friends to this post.

Please email me your video and foot tracing to tony@barept.com

LTC Tony Bare (ret), DPT, ATC, OCS
Physical Therapist
Laramie, WY