Environmental Physical Therapy And The Tonic Of Wilderness With Filip Maric, PhD And Todd Davenport, PT, DPT, MPH, OCS

Welcome back to the Healing Pain Podcast with Filip Maric, PhD And Todd Davenport, PT, DPT, MPH, OCS

Physiotherapists have a role to play when it comes to saving the environment. You can tell your clients to drive less. You can try to start influencing public policies to be more environment-friendly. There are a lot of ways physios can help save the degradation of the planet. Join Dr. Joe Tatta as he talks to Filip Maric, Ph.D., and Todd Davenport, PT, DPT, MPH, OCS. They discuss the state of the environment today when it comes to carbon emissions and environmental contaminations. Find out how you, as a physiotherapist can help save the environment. If you want to learn more, check out Integrative and Lifestyle Medicine in Physical Therapy, where Filip and Todd have a whole chapter dedicated to this. Find out how physiotherapy relates to the environment today!

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Environmental Physical Therapy And The Tonic Of Wilderness With Filip Maric, PhD And Todd Davenport, PT, DPT, MPH, OCS

Thank you for joining me for this episode of the show. In this episode, we discuss how our natural world affects our lifestyle and our human health. As physical therapists and other licensed health providers, we often use integrative and lifestyle medicine approaches to reduce chronic conditions. We do that by educating people about healthy nutrition and eating patterns, ways to move your body and exercise, become more physically active, how to sleep more soundly, how to improve your social connections, and even how to mitigate and manage stress.

However, as we start to look at the amount of chronic disease that exists not only in the United States of America but globally, it becomes apparent that we need to look further upstream at the factors that influence not only our lifestyle but also influence the health of our globe, the health of our environment, and the health of our natural world.

Here to speak with us about how our natural world affects our human health are Dr. Filip Maric and Dr. Todd Davenport. Dr. Maric is a professor of physiotherapy at the Arctic University of Norway, and the Founder and Executive Chair of the Environmental Physiotherapy Association. His interests include the outer rims of healthcare and physiotherapy, specifically philosophy, ethics, environmental health, and planetary health.

Dr. Todd Davenport is a professor and Vice Chair of the Department of Physical Therapy at the University of the Pacific in Stockton, California. His scholarly interests include the design, implementation, and evaluation of population health programs to improve healthful physical activity and nutrition, with a special emphasis on improving health equity by lowering structural barriers to good health. In this episode, we discuss why we need the tonic of wilderness and how environmental influences impact our health. Without further ado, let’s begin and let’s learn how planetary health affects our collective as well as individual health.

Todd and Filip, welcome to this episode of the show. It’s great to have you here.

Thanks for the invitation. It’s good to be here.

I appreciate you having us.

This is a very new topic for our profession. I have to say that off the top of the show here. I commend you for bringing the topic of lifestyle medicine into the environment together. We are just starting to address this in significant ways in our profession. It’s something that we can’t ignore as a profession since the world can’t ignore it either because it has implications for our health. I’m curious to know as physical therapists how the two of you became interested in this important topic.

I can identify three somewhat significant points in this regard. First and foremost, it is really simple. I always like being outdoors. I like the environment and enjoy being outdoors. That’s a simple baseline. The other part is that during my PhD studies, I was looking into some questions of ethics and physiotherapy.

The thing that struck me there was that we seemed to be missing considerations about ethical responsibility for anything beyond the individual human body in our professional understanding of ethics. That lingered with me for a while. After my PhD, I went into clinical practice because I wanted to break from academia for a while. In clinical practice, I found myself in clinical and treatment spaces, that seemed divorced from anything remotely resembling the natural environment. Putting those three bits together at that point in time triggered me to pursue this path and this topic and start exploring in a bit more serious way. Those are my three. I like being outdoors, the ethics questions, and some issues that I have observed and experienced in treatment spaces.

Filip’s story is somewhat familiar to me, growing up outside. I spent a lot of time fishing and camping when I was a kid and growing up in the Pacific Northwest in the United States. There are a lot of places to be outside. I was exposed to some of the issues that came up in the ’80s and the ’90s when the spotted owl went on the endangered species list, and how the goals of conservation and commercialism clashed in a very big way. I grew up in that milieu. I have friends who after high school got into organizing with environmental groups doing mediation between various different companies that are tasked with extracting natural resources and environmental groups. I have that background from my friend group.

Fast forward to a good number of years, I’m still outside, enjoying and appreciating the natural world. Doing a master’s degree in Public Health and an entire curriculum on Environmental Health, I realized that if we look at this in a very human-centric or anthropocentric way, not only is environmental degradation bad for the environment, the critters, and the plants but it’s bad for us. It makes it very difficult for us to maintain our own health as humans. This is where Filip and I found a common cause to start talking a little bit more about how the environment impacts human health, how human health impacts the environment, and how physiotherapy can be involved. That was the genesis of our work together.

HPP 293 | Environmental Physical Therapy
Environmental degradation is not only bad for plants and critters, it’s also bad for us. It makes it very difficult for us to maintain our own health as humans.

 

You both have now mentioned this paradox between we have this trend towards precision and personalized medicine, which is going to continue to trend. You guys are expanding that conversation in a much broader way. Somewhat, the topic pulls you away from personalized or precision medicine. In a lot of ways, it still keeps it squarely within that space. I want to come back to that later.

As I mentioned in the introduction, the two of you authored a chapter on environmental health and an upcoming textbook called Integrative and Lifestyle Medicine in Physical Therapy. There’s a lot of great background information on where we have come as a globe and as a society culturally with regard to public health and environmental health. Where do things start to go wrong for us as a planet and a species where we now have a focus on this topic of environmental health, which impacts our public health?

Historically, we can identify a few different points in human history when things started to go wrong. If you have a little bit of a look through human history on this planet, we have not been around for that long compared to our planet. Our planet has been around for four billion years-ish, while humans have successfully only been around for the last 11,000 years roundabout. That’s because of some particular environmental conditions that have been present during the last 11,000 years, which is the Holocene Epoch. It was also marked or characterized by a relatively stable climate that closely fits what is defined as the human niche climate-wise and a great degree of biodiversity, which means availability of food, resources, and so on.

During that time, while these environmental conditions were present or have evolved, we have also evolved some not-so-great practices, which you could place around the beginning of animal and plant husbandry. We started large-scale farming, both animals, plants, and so on, and changing how we interact with the other beings we share this planet with.

Fast forward to a few thousand years, a significant point in time, about 400 and something years ago, would be the rise and peak also of European colonialism. It went out from an increasingly industrialized Europe and increasingly mobile European countries and places, going into other countries, nations, continents, and so forth. They were extracting both human and natural resources for an acceleration in consumption and production around the world.

Fast forward from that, colonialism and the processes that came with it eventually made possible industrialization, and then eventually also the extraction of fossil fuels for global use. That is the famous marker of when things started to go wrong. The burning of fossil fuels is one of the key drivers of global warming and climate change. Some points like that, early particular ways that animal and plant husbandry has evolved, colonialism as a significant marker, the things that enabled industrialism and fossil fuel use, and the economic systems that came with all of that, and the effects that all of these practices have on the environment and human health. Those are some historical pointers.

What’s the relationship between our global health and the ecosystem as we start to look at physical therapy practice in the natural environment?

When I started thinking about this environmental physiotherapy idea, my question for myself was, “What is the relationship between the environment and health, and then specifically physiotherapy?” It’s because of the fact that we don’t have a lot of experts thinking about this relationship in our profession so far or we haven’t had anyway.

In the beginning, when I started thinking about this and started discovering a few different ways that things relate and then started talking to people, I would frequently try and justify by pointing out different ways that environment and physiotherapy relate. It has been four years-ish since I started having these conversations with people. Over the last year and a half maybe, the question has turned around for me quite a bit.

I’m sorry if this is an evasive answer, but my response to the question has increasingly become a return question in the sense of, “Which part of physiotherapy does not have something to do with the environment in one way or another?” If you start thinking about physiotherapy, anything we do, anywhere we are, or any area of research practice or education, you are going to struggle very hard to not find out relatively quickly that somehow, all of it is related to the environment in one way or another.

Wherever we are in practice, we are using natural resources or some other resources that have an implication or a footprint on the environment. If we are treating in a clinical space, we are treating in a particular kind of environment, which is different from other kinds of environments. In reality, if you are in a hospital, that has something to do with the environment, be it natural or not.

First and foremost, everything in physiotherapy and everything related to health has something to do with the environment. It’s where we live, move, thrive, hopefully, laugh and sometimes also struggle. The question is nearly impossible to answer. It’s easier to answer by pointing out that there’s nothing that doesn’t relate.

It’s striking because, in lifestyle medicine, one of the things that it has a great focus on is reducing chronic disease burden. When you look at the effect of the environment on health, what you come to realize is that what we have induced the environment to do to us based on how we treat the environment is bad for our health. For example, there’s an increased risk of cardiovascular disease. There’s an increased risk of asthma or cancer, just based on the pollutants that we put out into the environment.

What people induced the environment to do to them based on how they treat the environment is bad for their health. Click To Tweet

If we put ourselves out there as physios among other clinicians who are interested in this lifestyle medicine, we have to think about the environment. At the end of the day, what we do if we don’t think about the environment, the cost is we undo all of the great work that we are doing with our patients. We are basically ignoring a potentially big piece of the puzzle for people. Chiefly and arguably, it’s the people who need it the most because the folks who are most likely to come into contact with environmental pollutants are people from lower socioeconomic strata.

These are people who live in places with unfavorable zoning laws that put them nearby industrial and commercial areas, or places that are likely to have less green space, which can independently reduce one’s risk of non-communicable diseases at large. Also, these neighborhoods are hotter as we talk about global change or climate change. The built environment where people reside can have a compounding effect. There are lots of reasons lifestyle medicine practitioners like physios should be interested in this topic.

I have another thought still on this question. This question is important, that fundamental question about the relationship between environment, health, and physiotherapy. In nowadays world, we are increasingly aware of, already aware of or becoming aware of problems like global warming, biodiversity loss, ocean acidification, pollution of all sorts, and the effects that this has on health, and also the unequal distribution of these health impacts as what Todd had mentioned.

Even at a more fundamental level, it’s important that next to that somewhat worrying piece of information or bulk of information that we talked about there, there is also this fundamental piece of knowledge that we maybe need to remind ourselves of, and that we can go to by thinking about anatomy or physiology. How is the environment related to health? We breathe oxygen. How is oxygen produced and so forth?

We are related to the environment at such a fundamental physiological and even anatomical level. It goes past us because it’s such a matter of cause. We forget how fundamental that actually is. Somehow, the joints in my elbow might be made for having this range of motion from 180 degrees to whatever it is, depending on what I have available. In reality, the functional anatomy of this elbow is not that range of motion. It’s so that I can reach for my cap or whatever else in my environment, or move somewhere with my legs and so forth, and interact with my environment.

Fundamentally, we are entirely environmental creatures, critters, whatever beings we are. For me at least, it’s also important in this new field that we look at the range of that. There is this fundamental way that we are related to the environment. As humans, we have done something in the world to change how our environment now is and what it’s doing to us. That has a great impact on the environment and our health. Here we find ourselves doing an episode about that.

What you are saying is biochemistry doesn’t happen in a beaker in a lab. The biochemistry of the planet impacts an individual or a larger group’s biochemistry. We have all heard things like pollution showing up in the cord blood of a newborn baby. It means hydrocarbons show up in fetal tissues, and that’s now in a newborn child. What types of impacts does the change in human physiology at an early age have we been able to identify that those changes in human physiology at an early age lead to other conditions? What are those conditions?

We do talk about it in the chapter. The example we brought up was cardiovascular disease. How exposure to exhaust from living near a busy road can predict one’s incidents of cardiovascular disease later on. That’s something that’s known. There are certain environmental pollutants that are teratogenic that can cause birth defects.

Exposure to exhaust from living near a busy road can predict one's incidents of cardiovascular disease later on. Click To Tweet

There is some literature out there to suggest that early life exposure to pollutants can certainly cause problems. I think too what’s a little bit less known, but is an area for future research and maybe some research out there that I’m not thinking off the top of my head, is epigenetic modification related to environmental exposures. There are some potential concerns there that there may be effects of environmental contaminants that can be transmitted to future generations.

For example, certain compounds may have obesogenic impacts on human physiology.

It’s strengthening the argument here that thinking about the environmental milieu or lifestyle should be a consideration for the lifestyle of medical practitioners.

It starts me thinking about our clinics, hospitals or medical systems that are “providing health.” Are they set up in an environmentally friendly way that they may be treating the individual, but once the individual goes out into the community around the environment, are they contributing or subtracting necessarily from public health in some way? Do we know that yet?

We know that hospitals participate in environmental contamination. Some of them are related to the lack of recyclable or reusable packaging. Some of them are related to carbon emissions. Hospitals are a large source of carbon emissions and environmental contaminants based on the waste of different types. Even as hospitals are managing disease, they may be creating some of the diseases that they manage, which is the great paradox of our medical system.

HPP 293 | Environmental Physical Therapy
Hospitals participate in environmental contamination and actually contribute to carbon emissions. So while they manage diseases, they are also creating the diseases they manage.

 

The interesting thing there is at the moment, there is a growing movement internationally to look at the environmental footprint of healthcare systems and healthcare services in general, and try and reduce that. As Todd mentioned, hospitals are one of the bigger issues of medication production. Both production and consumption are other big issues.

If you look at the National Healthcare Service in the UK, they released reports about their measures of the healthcare system’s environmental footprint, especially its carbon footprint. They found that the big ones were hospitals and then medication. There were a bunch of smaller ones. As a physiotherapist, the interesting thing was that what they found to be the total carbon footprint of the healthcare professions or allied health professions as they are called there was around 2% of the total calculation.

That suggests something fairly significant to us physiotherapists, which we might be able to talk about a bit more. To be fair to those kinds of reports and measures, they haven’t factored in fully or calculated the healthcare profession’s footprint in a lot of detail yet. That work has still to be done, but we are in a time where awareness is increasing about the fact that healthcare systems are trying to do something good for our health, but have also some negative implications or impacts on the environment, which is not good for health, and so people are increasingly looking at that and trying to address that.

Where do we sit as professionals? People are coming to us for a particular service. Are we contributing to the global decline and poor environmental health? Are we, in some way, impacting in a positive way?

As much as any other health service and sector of society, we are sitting in this ambiguity between a bit of both as physical therapists. We have a good chance and good reason to believe that they are having a low impact on the environment. We use methods like communication, touch, exercise, and so forth that don’t need a whole lot of resources.

It doesn’t mean that we are somehow ethereal either. We still use stuff. We are having a conversation over the internet now. We are using video and that has an impact. There are some things to be found out, but the potential to be a low-carbon or low-resource type of service is certainly there. Comparatively speaking, it’s likely that we are sitting at a lower scale, but there might be room to reduce further still.

Maybe it’s my inclination to see things as half-full, especially if it’s coffee. Hopefully, that coffee cup is full. My inclination is to think about the opportunity. The opportunity that we have, as Filip mentioned, is that we are fairly low-carbon and low-footprint profession as physiotherapists. We often still drive to work. Our patients still drive to see us.

Can we mitigate that through telehealth and utilize our communication through different needs where at least we are using the resources that we have extracted from the environment in a more judicious and efficient way? Can we get our patients to utilize active transportation? By that walking, wheeling, and biking more frequently to get more cars off the road. That’s good for them. It’s good for their health. It’s good for the natural world in terms of getting cars off the road.

Can we get people to eat food that’s locally sourced to try and reduce the carbon footprint associated with the supply lines ethically sourced and organic? Those are good for human health. They are better for environmental health. Many of the choices that we encourage our patients to make in lifestyle medicine do have the potential for an improved carbon footprint for our patients.

At the individual level, that’s important and that’s only one level. You’ve got that individual level and then the meso level, which is supporting efforts to monitor the environment, and making sure that environmental regulations are enforced. Keeping an eye on programs that help us spot emerging pathogens has been important over the last few years. Those are all part of the human-environment interaction that is important to the human lifestyle. If we are all in a socially distanced environment, lifestyle medicine looks different than if we are not.

This is where physios worldwide have a role in environmental advocacy at the governmental level. To advocate for that healthy milieu for movement, you need a healthy environment in which to move. The environment needs us to move. That’s our potential. That’s our value proposition back to the natural world so that we can start giving more than we take.

I don’t think we have fully embraced our political power, at least in the US, because we are a pretty significant number of people. If we did come together on certain topics, maybe this being one of them, we probably could in some ways influence what’s happening in public policy, especially in certain jurisdictions. As you mentioned, this could be a key part of public policy. Do you see future generations of physical therapists playing a role in things like the design of communities, laws and policies? Where can we start to fit in these conversations that are happening already in government and community places?

I hope so. One of the focuses of my own career has been to help physiotherapists become literate in the issues and the processes. Those are the two places to start. If you don’t understand policy-making, it’s hard to get engaged in it. If you don’t understand the policies, they are hard to engage. If you don’t understand your own value and your value proposition and find mutual wins among humans, that win for the environment, then it’s hard to tell that story to a policymaker in a way that they will understand.

Physiotherapists have a role with individual patients and clients in helping to build healthier patients and clients in that process of bringing and fostering health instead of just managing the disease. We are also hopefully fostering the health of the natural world in the ways that I mentioned earlier. Getting involved at the local level is probably the most impactful for most physical therapists or physios.

I know of physios who’ve been on planning commissions and parks commissions. That’s a role that can be valued and underleveraged at this point in our profession here in the United States. I would surmise elsewhere. Getting folks into these more country-level and global-level decision-making roles is a far-off dream for me, but something that I don’t think is unreasonable given the value that we have and that we potentially could bring as physios.

Physiotherapists should start getting into more country-level, global-level decision-making roles. Click To Tweet

I can agree with that, and briefly by way of anecdote, I supervised two bachelor students here at our university that did their bachelor’s project on looking at different parts of our city here North of Norway. What they did was there is a cycling strategy here for the city, and how the city is looking to develop its cycle pathways and those aspects. What they did was to go out and take an urban design research approach to look at some places of the city that were proposed to be worked on by the cycle strategy, and analyze them from a perspective of how they enable or disable physical activity at active transport.

They did an interesting, fun, and engaging different type of study as future professionals. They are now fully graduated professionals. We put that together and did a good analysis of the places they looked at. We are now going to look at how we can deliver that to people here locally in our city. They get this feedback and they get these inputs from physical therapists on how well the city is doing and what might be done to improve and so on.

That’s one example. I know of another example that we also have on one of our blog posts on the Environmental Physiotherapy Association website. Two students at a university in Australia looked at something quite similar to the active transport opportunities at the university or on campus, but also for travel to and from campus.

They created this amazing video and guide for students and faculty to be able to easily move around to and from campus. That has been taken up by the university and is now being spread across campus and so forth. This is not just future stuff. It’s already happening. People are doing it. People are getting involved in more and more creative ways that also go beyond what we normally think about as physical therapists. It goes way beyond active transport or increasing movement. There are a lot more possibilities. A great part of this is a somewhat urgent and sometimes worrying field, but also exciting because it’s diverse and full of possibilities of things to explore and contribute to.

Do you see any downside to therapists starting to counsel and advise on lifestyle-related recommendations? For example, if all of us were to start to educate on a more plant-based diet, which as physios, we should be doing. People would say, “That’ll have an adverse impact on the environment because then we’ll have to remove more forest so we can plant more fruits and vegetables, which would use more water,” and so forth.

People are like, “All these ideas sound good, but we don’t have the necessary means to make this happen in an environmentally friendly way yet.” There’s always someone on the opposite side of the conversation who’s maybe a naysayer and feels like this is not a fully formed conversation yet for professionals like us to be engaging in.

I love naysayers and there are always going to be. My sense if you have naysayers, you are probably on the right track because you are starting to ask the right questions. It’s reasonable to listen to naysayers. I have heard people say, “Maybe we don’t have it all together to have these conversations yet.” We have this mental habit as physios of thinking we have to solve every problem based on what we learned in physio school.

If you have naysayers, you're probably on the right track because you're starting to ask the right questions. Click To Tweet

We have friends that do this stuff who are in public planning or who are in ag that can help us engage these questions. We talk about this a little bit in the book chapter. Forming cross-functional or cross-sectoral partnerships becomes important because we know what we know, but to say we don’t have it together to be involved in a conversation is not headed in the right direction. We can totally have the conversation. We can totally participate. We may not have all the answers, but I don’t think we should be expected to either. There are people who know what they know. We need to come to some common ground and make new friends outside of our profession.

In this manner, we think about ourselves differently instead of thinking about ourselves as this all-encompassing and we must have all the answers. It is the mark of immaturity as a profession if we need to think about ourselves as these independent practitioners who have all the answers. It’s a healthy thing to figure out what we know and figure out what we don’t know, and then go ask somebody who knows.

HPP 293 | Environmental Physical Therapy
Figure out what you know and don’t know, then ask somebody who knows. Don’t think of that as a sign of weakness. Think of that as a marker of professional maturity and strength.

 

Don’t think about that as a sign of weakness, but think about that as a marker of professional maturity and strength. We may not have it all together to know about intensive farming techniques, where to put the roads and stoplights, how to make the bike crossings work, and the structural engineering behind the infrastructure necessary to get a pedestrian over a street without the bridge collapsing, but I don’t think that should stop us. The thing that stops us is ourselves.

Filip, tell us about your organization, the Environmental Physiotherapy group and some of the work you are doing there and where you would like to see that expand.

As I told you, those three markers in my personal life got me to this topic. After that last one, bumping into this topic strongly in clinical practice and treatment spaces that I found myself in, I sat down together with my colleague Professor David Nicholls from New Zealand, and we talked about this. We started writing something and that eventually morphed into this editorial that we published in mid-2019 calling for more explicit thinking about the relationship between environment and physio in our profession worldwide. We use that occasion to then launch the Environmental Physiotherapy Association as an international network of people who would be interested in taking this as an explicit topic, and diving into its different implications, potentials, and so forth.

Environmental Physiotherapy Association has now grown to 800 members worldwide from every continent around the world. We have anything from physiotherapy students, clinicians, academics of all levels, and professional representatives on board. We keep growing. We have a document in our little executive committee where, for a while, I managed to track all our different activities and make rubrics. We published this and that, and then we spoke here and there, and here’s another podcast we did, and this happened and so forth.

I lost track of everything that was happening about three-quarters of the year ago because there’s so much all the time that I couldn’t deal with trying to enter another 50 things into that document of what we’d be doing. To put it simply, we have been very active or we have tried to be active across research, practice and education, and try to understand how this topic and field feeds into all of those and can inform all of those and so on.

We have done academic publications and blog posts in different languages. We have gone heavily into education right away because we felt that that’s an important area to engage in. We have a project at the EPT Agenda 2023 where, at the moment, we have 57 physiotherapy universities from around the world that are participating in getting these topics into education. Fifty-seven universities are not little by any means in such an effort. There are research projects that are going on. There is so much happening all the time. I invite people to have a look at the website. There are loads of materials there already. It’s a colorful palette of anything you can think of in physiotherapy, and then related to the environment in some way.

Tell people what that URL is, Filip.

It’s EnvironmentalPhysio.com.

Everyone can check that out. Both of you work in education. How would you encourage your colleagues in academic settings to start to include this in the curriculum in either some small or big way?

I would say it the way Todd suggested it before. Don’t think that you have to know everything in advance or know everything before you even get started. It’s more about getting started in some simple or small way. Somewhere where you are feeling relatively comfortable, and then building on that. Also, engaging with others, connecting to other people, finding out what they have done, what they have struggled with, how they solve the problem and so forth. In our education project, it’s that process that we are trying to facilitate from that experience exchange, and identifying these little pinpoints of where we can get started.

You don't have to know everything before you get started on saving the environment. It's more important that you just get started. Click To Tweet

For example, if you are teaching something about chronic obstructive pulmonary disease, you might as well be teaching about air pollution as its main global driver now. If you make that link, you made a start and then you can decide, “This is very easy. I can build on that by looking at where is air pollution the worst? Where is it the least and so forth,” and suddenly you are expanding already. Don’t expect to know everything in advance. We don’t have to be perfect. Make a little start somewhere and then slowly build on it. That’s good to know because God knows how many thousands of physiotherapy universities or schools around the world. If everyone makes a pretty small start, that amounts to something. I hope so.

I can grab coffee with a colleague from another department. Cold call somebody in public policy or public planning. Cold call somebody in the engineering department who’s a civil engineer. That’s how this stuff happens. Wander into a meeting that you don’t normally go to and ask them what they are doing. I can’t tell you how many times I have done that over the course of my career, and I have made a new friend outside of my discipline. Sometimes that goes someplace and sometimes it doesn’t, but at least you know.

Also, for practicing clinicians, if you find yourself on a midweek night with a little extra time, show up to a hearing you wouldn’t normally go to. Go see what a zoning hearing looks like. Show up to the city council. Lots of people are doing it now for lots of different reasons. This is a valid reason as the next one. Showing up to those meetings becomes a little habit-forming.

There are going to be people who it’s not their cup of tea. They want to be clinical physios or practitioners, and that’s okay. Help people restore health. If you help people restore their health, it will have a reciprocal benefit on the environment in the ways that we have been talking about. If you strive to lower your individual footprint, small steps can still matter.

HPP 293 | Environmental Physical Therapy
Integrative and Lifestyle Medicine In Physical Therapy: A Guide For Primary Care, Health Promotion, And Disease

Everyone can check out the great chapter you wrote in the book. It’s a good place to start if you are a physiotherapist or a physical therapist. The book is called Integrative and Lifestyle Medicine in Physical Therapy which both Filip and Todd wrote. I want to thank Filip and Todd for being here in this episode of the show. Make sure to share this episode with your friends, family and colleagues who are interested in this topic. As we close, if you guys can tell everyone how they can learn more about you. Why don’t we start with you, Todd? If people want to reach out to you or learn more about your work.

The best way to reach me is on Twitter. I am @SunsOpeningBand, which is an obscure Pearl Jam reference that probably could be a podcast episode in itself. That’s where I will leave it.

For me, Twitter is good as well. It’s @FilipMaricPT. It’s my first and last name, PT. Nice and simple. Although I also like Pearl Jam, but Twitter is good. LinkedIn, Facebook or whatever you like. Any email through the Environmental Physiotherapy Association is great as well. I’m usually quick to reply. That’s another thing to point out. I try my best to get in touch as quickly as possible if people have questions, thoughts and ideas.

You can find that over at the Integrated Pain Science Institute. Once again, I ask you to share this episode with your friends and family on social media. Thanks for joining me, and we’ll see you next episode.

 

Important Links

 

About Todd Davenport

HPP 293 | Environmental Physical TherapyTodd Davenport is Professor and Vice Chair with the Department of Physical Therapy at University of the Pacific in Stockton, California. Dr. Davenport earned his Doctor of Physical Therapy degree and completed the Orthopedic Physical Therapy Residency at the University of Southern California, and subsequently earned his Master’s degree in Public Health from the University of California at Berkeley. Dr. Davenport’s scholarly and service interests include design, implementation, and evaluation of population health programs to improve healthful physical activity and nutrition, with a special emphasis on improving health equity by lowering structural barriers to good health.

 

About Filip Maric

HPP 293 | Environmental Physical TherapyFilip Maric is Associate professor in physiotherapy at UiT The Arctic University of Norway, founding member of the Critical Physiotherapy Network, and the founder and executive chair of the Environmental Physiotherapy Association. He is interested in the outer rims of healthcare and physiotherapy, philosophy, ethics, environmental post/humanities, #EnviroPT, planetary health and sea kayaking.

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Effective Date: May, 2018

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The following Privacy Policy governs the online information collection practices of Joe Tatta, LLC d/b/a joetatta.co and www.backpainbreakthrough.com ( collectively the “Sites”). Specifically, it outlines the types of information that we gather about you while you are using theSites, and the ways in which we use this information. This Privacy Policy, including our children’s privacy statement, does not apply to any information you may provide to us or that we may collect offline and/or through other means (for example, at a live event, via telephone, or through the mail).

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