Leor Giladi

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Break your problem solving down to 5 steps. 1. Identify meaningful or important information. 2. Interpret that information. 3. Intervene based on your understanding. 4. Monitor the outcome of your intervention. 5. Repeat until the problem is resolved.

Avoid thinking and reasoning. Follow the cookbook. Regurgitate the information presented yesterday. Come baby bird and be fed. OR reject the meal offered, fend for yourself, ask questions, do the work, and earn something. Yes, it’s time consuming and uncomfortable. So what?

When adults lose ability to step up and down with variation they limit their options to function. Stay Athletic!

Simple rules: Invest in yourself before investing in others Create before you consume Schedule YOUR time Value the outcome of your work before you start There is not A way. Find YOUR way. #TheIntensive #billhartmanpt #The16percent #thinkdifferently #motivation

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Greater complexity demands simpler explanations. This is never easy. Teaching is effortful and difficult. Jargon to appear erudite misleads. Learners fault themselves for a lack of understanding. This is the teacher’s failure. The wise offer profound simplicity.

@greenfeetPT Interesting point. I'm not sure I'm in any camp deeply enough that I don't ask questions. I typically have people attempt to change a movement habit and see what happens. I think it's all exploration and experimentation to find what produces optimal results.

@giladiDPT Just worked with a sprinter who folded at the hips while accelerating out of the blocks. Showed him video and asked him to reflect. Said a previous coach told him to "stay low". Had I not asked I would have assumed he was just "self organizing".

The "self organization is best" camp supposes that people/athletes do things in an informational vacuum. Coaches and the internet opine about how people should sit, stand, run, lift, etc. Seldom do athletes just do what comes "naturally". Can't assume SO is always a "choice".

For a medication, the "minimum effective dose" is generally that which eliminates the disease or the symptoms- it's binary. Sport preparation is not binary, it's a matter of degree hence we'll never really know what the MED actually is. Avoid extremes- the rest is tinkering.

@zachrstearns "I'm really glad you're here so we can figure this out and guide you towards feeling better" followed by sx behavior questions and pain sensitivity/reactivity questions. My goal is to develop a plan fwd while providing clarity and understanding. Side note: I rarely ask 0-10 pain

@giladiDPT Thanks for clarifying. My question is intended for the scenario of meeting someone for the first time and they report 10/10 pain, whether written on an intake form or in response to a question about their pain.

Clinicians and students, I'm preparing a presentation about pain and could use your help. 🙏 What went through mind during a time when a patient reported 10/10 pain? Then what did you (or the clinician) actually say or do?

@AdamMeakins Wouldn't say I worship neuromodulation, but I definitely use it in my practice. I love empowering people through both education and options. Exercise is the medicine but there are many ways to guide them on their journey. I want them to be able to choose their path.

Do therapists ‘worship’ neuro modulation and symptom modification treatments so much because they lack the skills and confidence to reassure patients and help them continue on despite pain and disability?

Some things you should never feel guilty about: being selfish when it comes to your time, your health and your family. If those go, so does everything else. Basic principle, but often neglected.

Time under tension is one of the most poorly-defined concepts in the hypertrophy literature, largely because there is a tendency to ignore the fact that both the size principle and the force-velocity relationship are involved in muscle force production.

Great discussion on this paper: ncbi.nlm.nih.gov/m/pubmed/30130… Wanted to note lifestyle behaviors from full text: "Evidence of joint space narrowing, difficulty sleeping, & frequency of certain foods, including dairy and meat, were predictive of worsening pain over time." @TheAPHPT

We lose these patients to other professions because we spend our time on Twitter asking to see RCTs and systematic reviews on every single topic idea instead of rolling our sleeves up and getting to work. True "doctoring" involves being willing to operate in the grey sometimes.