The holidays are here and our clients are busy hanging decorations and eating lots of holiday food. Most of this holiday food is loaded with extra calories from added sugars, fat, and processed junk. After climbing their ladders, lifting the boxes, and the stress of traveling and seeing family, they come crawling into our clinics or gyms with extra weight and a sore back.

What can we do as Doctors of Physical Therapy (DPTs)? Aside from our traditional physical therapy treatments like manual therapy and exercise, we should be using patient education for weight loss. Here are some of our top tips for PTs and weight loss.

Journal Your Foods

Holidays bring big emotions and lots of junk food. Many of this junk food is eaten without our clients' being aware they are eating hundreds, if not thousands, of extra calories. These calories add up quickly promoting weight gain, reducing glycemic control, and stimulating inflammation.

To improve your PT outcomes and shed some pounds, data...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

If you were reading the news last week then you might have seen an article that sounds something like: "Good News, Meat May Protect You from Heart Disease." While this sounds exciting and promising, many of the published media articles just don't dive into the science enough to give citizens and clinicians an educated viewpoints. Let's examine the new evidence, its science, and what impact it should have on physical therapy practice.

The Article

The main research paper the media is slinging around can be found in mSystems, an open access journal. The authors, Kivenson and Giovanni, published the paper title An Expanded Genetic Code Enables Trimethylamine Metabolism in Human Gut Bacteria, which full-text can be found here. Both Kivenson and Giovanni are researchers at Oregon State University and their primary focus is in microbiology.

mSystems is a relatively new journal. Overall it has an impact factor of 6.28...

By Dr. Sean M. Wells

Many facets of nutrition can impact older adults' function and health. The focus on this blog article will be to highlight how inflammation, which can be mediated via diet, impacts older adult function and health. 

Using the Dietary Inflammatory Index (DII), physical therapists can quantify the amount of inflammation a client's diet is provoking. Essentially the score ranges from as low as -5 to as high as 5, with a "fast food diet being reported at 4 and a macrobiotic diet being listed at -5. Probably the best diets on the DII are vegetarian Indian diets and other Asian diets rich in vegetables and spices. Another way of "scoring" or ranking the inflammation cause by a diet is to use an A-F system. An "A" score would be ideal and the most negative (e.g. close to -5, which is the least inflammatory), while "F" is the most inflammatory (e.g. most positive, 5). An average, or "C" score, would be a 0. 

 Using the DII, PTs can see how diet...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT CNPT, Cert-DN

Physical therapists (PTs) are stepping up their game and focusing on important in the clients' lives: social determinants of health (SDOH), wellness, alcohol and drug use, sleep, and nutrition. As we venture into a newer world of PT practice, clinicians need to be armed with useful tools and resources to help them along the way. Let's outline some of our team's favorite nutrition apps that have helped us help many clients.

Nutrition Guide for Clinicians

Published by the well-known Physicians' Committee for Responsible Medicine (PCRM), the Nutrition Guide for Clinicians is a simple app that all Doctors of Physical Therapy (DPT) should have installed on their phones. The app allows a clinician to easily look up a condition or diagnosis, and then scroll through easily summarized data on simple nutrition tips that can contribute or treat the disease. Authors of the app list copious studies in their references...

By: Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, CNPT, NSCA-CPT, Cert DN

Many people kickback and enjoy a cold beer or nice glass of wine with a meal or just to relax. But does alcohol consumption pose a risk to our health and physical therapy patients? The answer can be difficult to find amongst the literature, especially due to industry influence. Let's take a look at the guidelines, some upcoming revisions to alcohol intake recommendations, and what all this means to PTs and physical therapy outcomes.

Old Guidelines

Alcohol intake guidance varies depending on where you live. In the United States, the Centers for Disease Control (CDC) and the Dietary Guidelines demonstrates that females should consume no more than 1 drink per day, while males can have 2 drinks per day. Most of this guidance is rooted in the fact that males usually have larger mass, and therefore, can physiologically "handle" more booze. Obviously all drinks are not created equal, so if  a person...

It's exciting to see our team has been active in the community and online. Dr. Wells was featured in the online blog, Eat This Not That, over the past few years. Here are few excellent articles focused on nutrition, physical therapy, weight loss, and health.

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

Weight Loss and Physical Therapy

Traditional physical therapy (PT) does an amazing job at treating dysfunction, pain, and problems. Preventative care and wellness, such as weight loss, was once taboo and often ignored by many physical therapists. However, today's Doctors of Physical Therapy (DPTs) are truly embracing more holistic treatments like nutrition, mindfulness, and sleep habits. Having physical therapy patients lose weight can help reduce inflammation, prevent health issues, and may improve PT outcomes. But what about stopping the weight gain in the first place? Weight gain prevention is vitally important, as it is much more difficult to lose the weight than it is to gain it. Given such interest in these topics, our team found it relevant to consider a recent study looking at weight gain and arthritis -- let's make the case for more PTs to start talking about patients preventing weight.

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

There's always a blog or hot article on your newsfeed talking about a "miracle" nutrient or special vitamin. While many of these articles are complete clickbait or mere fluff to get you to buy their supplements, this article has some science and experience behind it. Now that we have that settled, I want to explore the one nutrient that I think has the biggest impact on clients with arthritis: fiber. 

Arthritis comes in several forms but the 2 most common types are osteoarthritis (OA) and rheumatoid arthritis (RA). We as physical therapists (PTs) often help clients with both of these diseases. From exercises, manual therapy, modalities, dry needling, and education -- our roles as PTs is to help our clients move better and reduce their pain. So, how does all this physical therapy talk for OA and RA fit in with fiber? 

Fiber is uniquely a plant-based product that is essentially indigestible to human...

Image: Obesity by Jesper Sehested using Creative Commons - (CC BY 2.0) 

Physical Therapists Should Be Promoting Weight Loss

By Dr. Sean M. Wells, DPT, PT, OCS, ATC, CSCS, CNPT, Cert-DN

Physical therapists (PTs) specialize in movement, exercise, and rehabilitation. Our role as healthcare providers extends into many facets  of life and wellness. From stress reduction to nutrition, PTs ought to consider interventions beyond the basic modalities.  Diet can have a substantial impact on weight loss and its commiserate reductions in pain and inflammation, and improvements in function. Regardless of what setting (e.g. outpatient, nursing home, acute care), PTs can educate patients on the benefits of weight loss and even provide simple steps to reducing weight. 

What are the best nutrition methods PTs can provide patients to reduce or even prevent obesity in the first place? A simple answer can be found in the literature centered on the Whole Food Plant-based Diet...

Most physical therapists (PTs) routinely measure the vital signs. Heart rate, blood pressure, pulse oxygen, respiration rate, and often pain. But what about diet? Should diet be another vital sign? In the opinion of many scientists and medical experts diet ought to be a major vital sign that is measured by not only registered dietitians (RDs) and/or medical doctors (MDs), but also healthcare providers like PTs, on a routine basis.

What evidence do we have to say that diet ought to a basic vital sign? How about the fact that diet is the single leading predictor variable of all major health outcomes? The vast majority, roughly 80% according to the literature, of our diseases in the modern world are preventable and are caused by a poor diet. From cardiac disease, cancer, diabetes, and stroke, the injuries and diseases that lead to a patient ending up in a physical therapy clinic are likely preventable, if not reversible. 

But how does a PT measure diet as a vital sign? Many PTs...