Welcome to the Healing Pain Podcast with Dr. Ginger Garner!
Today we are joined by Dr. Ginger Garner, doctor of physical therapy, orthopedic physical therapist, founder of The Professional Yoga Therapy Institute, and author of Medical Therapeutic Yoga.
In this episode, Dr. Ginger Garner talks about how she has brought yoga both into her practice and into her life. We discuss all the different ways that yoga fits in to medical and therapeutic practice, restorative yoga practice versus regular practice, bio-psycho-social framework, etc. We talk about what Dr. Garner thinks about the future of yoga, which she thinks is in education as well as interdisciplinary education.
About Dr. Ginger Garner
Dr. Ginger Garner is a doctor of physical therapy (DPT) and athletic trainer (LAT/ATC) who has spent over 25 years studying and creating “best fit” yoga practices in and outside of healthcare through Professional Yoga Therapy (PYT) and her early training in yoga (ERYT 500). For patients and practitioners alike, yoga is a powerful mechanism for healing and helping you reach your highest potential physically, psychoemotionally, energetically, and spiritually. Medical Therapeutic Yoga, methodology for yoga practice in healthcare, is an accessible systems-based practice she developed and have successfully used in physical therapy and integrative wellness practice for nearly 20 years. Yoga is the missing piece that can help you achieve your goals for healthcare and/or fitness.
Medical Therapeutic Yoga, with Dr. Ginger Garner
All right, everyone. Welcome. This is Dr. Joe Tatta. You are watching the Healing Pain Podcast live on Facebook Live. I’m here with Dr. Ginger Garner. She is a doctor of physical therapy. She’s actually an orthopedic physical therapist who uses yoga in her health care clinic and her physical therapy clinic. She also treats people with orthopedic injuries as well as woman’s health. She’s the founder of The Professional Yoga Therapy Institute where she teaches both internationally and nationally new concepts of medical therapeutic yoga.
We’re going to be talking today about her new books that’s out probably later on the podcast. It’s called Medical Therapeutic Yoga. It’s really a wonderful book. She just released it. I know it’s been a labor of love for her and she worked really hard on it. It’s a wonderful combination of medical therapeutic yoga, how yoga can be used in medical setting whether you’re a physical therapist or a physician or any kind of health practitioner or any kind of wellness expert. Dr. Ginger Garner, welcome to the Healing Pain Podcast live on Facebook.
Thank you. Thank you, Joe. Thanks for having me. Glad to be here today.
Dr. Garner, you are a doctor of physical therapy, which is a wonderful thing, and you help people with all sorts of pain and health conditions. Tell me how you brought yoga both into your practice and into your life?
That’s a big exhale. First, I started out before actually going to PT school. I also have a license in Athletic Training. Yoga came before all of that. I used it with athletes in Division 1 sports, whether it was soccer, swimming, baseball and then at the high school level as an athletic trainer with wrestlers against soccer players, etc. Where it became most poignant and the most profound I think, obviously yoga helps with athletics in high level development without question as far as the sports’ medicine side goes. But as far as the profound changes of really changing people’s life is when I finished PT school and began to work in all different settings.
The first job that I took was at an underserved area and there were a lot of people who didn’t have access to POINT. As a result, you can imagine what the end result would be by the time they got to me and walked in the office was that they were in a lot of pain. In working with those people and using yoga as a big part and as a big modality and a lifestyle change for those people, that profoundly impacted me the most because they went from being in a great deal of pain to being able to overcome and managed that pain in a successful way.
I’ve told this story a lot, but it’s true. I remember the very moment where I realized that yoga had profoundly changed the way I was practicing PT. I was with a patient and I was working on that patient early in the morning because I tended to work with people and meet them where they needed to be and where they are. I was working with a patient and she was driving about three hours round trip to come and see me. I looked up and I realized that not only was yoga working but yoga, I have to say yoga evolving it for the evidence space and really interconnecting it and weaving it in physical therapy. Rather than just yoga as a standalone, but yoga woven with physical therapy was pretty much the only modality I was using in physical therapy, and it was so incredibly effective.
That’s when I first started to really realized the impact that yoga could have. It’s also when I actually sat down and literally put pen to paper and thought, after all the training that I had gone through in yoga already, there wasn’t anything that was speaking to the health care professional at their level of education and for the needs that they had, i.e. dealing with people in chronic pain or people at the acute bedside. That was in the late ‘90s that I started to do that.
It’s been almost 16 years. I would ask you, people look into this saying, “Okay, this is a doctor, doctorate degree, great training. She’s a doctor of physical therapy so she has advanced training.” Why would someone go in the direction of yoga, which is almost looked at as a form of exercise, so to speak? How does that influence your practice now? Because people think, “She has a doctorate. She has advanced terminal training in something that would help people with pain.” Why is this missing from our education? Why is it missing from certain types of practices? Not every practice is going to grasp on to the principles of how yoga can be medical and therapeutic. Where does that fit in?
Let me get a good feel for what your question was there. You’re wondering and wanting to understand how yoga would fit into a practice that, having a terminal degree so to speak, it almost seems that if people are just looking at yoga as a form of exercise or something that looks very simple from the surface, then where does that fit it in to the practice. I think that’s a great question for multiple reasons. It brings up an important point about the use of yoga worldwide really and that is, what are different levels that you can actually use yoga and apply yoga? People look at yoga as, “Oh, you mean the classes I can go to down the street?” That’s one way that you could plug in to the use of yoga, which can be very beneficial for a large number of people. Just to drop into that general yoga class in the studio down the street from you.
To tier up from that, there’s a level of people who may not be able to walk in to that yoga class, that general studio class. There was just an article out, there was a recent study looking at yoga injuries, and yoga injuries are on the rise maybe just in part for reporting, maybe in part because teachers need more training and in part also because the population is aging, by and large, in large numbers. Older adults are the ones that tend to get injured, so that brings up where does yoga fit in to PT.
While a large number of 20 year olds or 30 years olds may be able to drop into that studio class, there’s another level of individuals that whether or not they are in chronic pain, maybe they have a hip condition, that’s one of the areas I like to focus in on, is preservation of hip, that can’t drop into those classes or maybe don’t even know that that’s not exactly appropriate for them. That’s where you can channel then into yoga that’s used by a doctor of physical therapy or someone with a similar background who can pick apart those even yoga postures. Something as simple as yoga postures, there’s so many levels to that bio-mechanically and from a pain science perspective, that we can help them from a neurophysiological perspective benefit from those postures and have them be more efficient, to be more effective overall and certainly safe. Those are two general levels.
There’s another kind of gray area between that. But between yoga teaching, yoga instruction and therapeutic yoga that’s used medicinally, prescriptively, is the general realm of a new profession, maybe the first new profession of the 21st Century, and that’s yoga therapy. Those people have had more training than yoga teachers, but certainly not the level of training that we have to undergo to university with the degrees that we have and licenses.
You have a couple of different points that I want to touch on as we continue on this interview. You mentioned how people, especially those with chronic pain, because as a physical therapist we’re seeing people with pain every day. I just had a patient who has hip arthritis, and she’s doing yoga. She’s doing just fine. I have another patient with fibromyalgia who really is quite scared to enter into a yoga class. The question is, should someone who’s had chronic pain, let’s six months or more, should they venture out and just try a regular yoga class that can be found in a gym or a yoga studio that’s in their town?
First, I wish there was a quick, a down and dirty quick answer to that, but there isn’t. I would say that if they wanted to do that and perhaps they had limited access in their area, I would say a restorative yoga class could be really beneficial for them. A restorative yoga class, a very gentle yoga class that moves in a limited range of motion would be best for them. The optimal or ideal situation would be able to go and see a physical therapist who’s using yoga and can help them appropriately diagnostically and prescriptively navigate fibromyalgia in the best way.
For those who don’t have access to that or once they have seen a physical therapist and know the cans and the cautions per se, then you could work with a yoga teacher or a yoga therapist and help channel then into maybe some of the classes that they offer. That’s when where all the levels of yoga can come together and work together to optimize health care for people.
How does Medical Therapeutic Yoga differ as far as training goes versus let’s say a yoga certification or even something like a restorative yoga practice, which oftentimes people say, “Well, if you can’t do a beginner yoga class and you’re having problems with that and that causes you pain, then just go to the restorative class.” Medical Therapeutic Yoga, where does it fit between the restorative yoga practice versus a regular practice, and what kind of training is involved in it?
The quick answer there would be Medical Therapeutic Yoga is a way for health care professionals to use yoga within their practice that differs from yoga and yoga therapy. Here’s an example, restorative yoga. We were talking about fibromyalgia, for example. The first DVD I ever did, which was twelve years ago now, was based on a case study that’s actually on my website, under publications, GingerGarner.com, if you wanted to see that. It was based on an 18 month case study that I did with a woman with fibromyalgia and a long other list of comorbidities with that.
For her to be able to drop into a general class wouldn’t have worked for her. There was a lot of fear of movement and fear of pain and recurrence. The association that if I do this then I’m going to hurt. The difference between medical therapeutic yoga and the ability to just say yoga therapy or yoga instruction in general is that as a physical therapist, I take every individual movement, just the same as you do in your practice, and individualize it for that person and their specific needs. Whereas dropping into a general class they may have them, for example, doing a favor type movement, flexion abduction, abduction, the external rotation of the hip which may not be appropriate for that person with fibromyalgia. What if they have fifteen to twenty people in the class, and the yoga teacher doesn’t have the training, or frankly, the time even if they did have the training, to screen every single person that comes in the class with all of their myriad of diagnosis and complications.
The average person that comes into CS does have quite a long list of concerns that they have and medical history. We take those things very seriously in listening to our patients and listening to their story. That’s the basic difference. Someone comes in to me and I take all those things to consideration, and consider all the physical therapy diagnosis that may apply or may affect that prescriptive plan that I make for them.
As far as the training aspect of it goes, that’s something that I embarked upon almost twenty years ago now, back in 2000, to start writing a program that would train physical therapists, occupational therapists, nurses, physician assistants, and we have some physicians in the program now also. All of those health care providers to be able to use yoga in a way that is safe across the spectrum of patient and person-centered care. That training has evolved over time and now it takes people about two years to complete it. Then they have a community based project, which looks like a master’s thesis when everything shakes out at the bottom.
People are allowed to take courses, drop in at any level. There’s one on GI, there’s one on musculoskeletal, there’s neural concerns. We come from a systems based perspective where we looked at all the systems of the body and make sure that the yoga that we’re using is evidence based and evolved so that it’s suitable to be able to use in medicine and appropriate. That’s the general difference.
You mentioned a systems approached. You mentioned the digestive system, which you work a lot with woman and woman’s health. Woman oftentimes have digestive issues, irritable bowel syndrome, IBS, IBD. How have you found yoga has impacted those digestive concerns where people are taking all sorts of medications for digestive function or trying to make the digestion function normally? How does yoga impact that? Can we get a little nerdy and talk about the physiological level for a minute?
Yeah, I teach a unit on that. It’s a week-long training on the overlap between orthopedic function, which is what a lot of PTC, and gastrointestinal function and how those are intertwined. The way that I’ve seen it personally worked in seeing patients, aside from the manual that I wrote from the course has about 600 references in it. There are a lot of references that support on multiple levels why it’s important to address and actually paramount to address nutrition and digestive function along with and alongside orthopedic and a dysregulation and dysfunction in general.
Personally, there’s probably not a patient that I have seen, I’d say 90% of them that come in and have any kind of pelvic pain, which the hip is included in that and so is the low back and the SI joint and all that great stuff. About 90% of them all have some kind of digestive issue. There’s not a case that I haven’t had where the inclusion of evidence based yoga evolved with some foundations of neurophysiological principles, which are in the book, there hasn’t been anybody that hasn’t remarkably improved and been able to manage their condition, without drugs while we are working with their primary care physician to decrease those.
They are obviously getting better with maybe doing some traditional physical therapy plus you’re using the yoga with them and you’re seeing their function change, which is quite fascinating.
It’s profound for me because the other thing that goes along with that is improved self-efficacy and confidence. Their issues with body’s dissatisfaction can be tied in with irritable bowel disease and inflammatory bowel disease. Those connections between our sense of control, which traditional bio-medical medicine has tended to strip those things away from patients. When there’s this directly proportional relationship that if people don’t have a sense of control and if self-efficacy is low, that they won’t do as well and may not even follow through and come back to see you again. Yoga addresses all of those things.
Health care is changing rapidly, it’s changing so fast in the United States. I think it’s coming both from governmental level, which we’ll see what 2017 brings us. It’s changed in the last eight years drastically. I think there’s also an organic grassroots change happening on so many different levels in the natural health space, which I think physical therapy and medical therapeutic yoga fits perfectly into that. Talk to me about policy and, as a professional staying on top cutting edge rehab, how does medical therapeutic yoga fit into that? It’s almost like we have these two systems going on, the very traditional allopathic system, that will probably always be there in some form. We have this whole other system that’s starting to come into play, where people are looking for the natural solutions for their health. Where does medical therapeutic yoga fit into that?
Thanks for that great question, Dr. Joe. That’s something that should be on the forefront of all of our minds. If medical therapeutic yoga is about health care professionals integrating yoga into our system, then it matters very much how we can impact and influence policy. Not in just the United States but beyond. I had the good fortune to be invited to give a five minute speech in the House of Commons, in the Houses of Parliament in November 21st. Finding myself there and wondering what in the world I could cram into five minutes? Because my purpose of coming there was to talk about trends and policy in the United States regarding yoga, yoga therapy, the idea of yoga and medicine, yoga and health care, which has become its own hashtag, so to speak. I found myself speaking on a couple of different major pieces.
The first was that we need to be utilizing vital and valuable services in the system that are currently underutilized. That is in large part conservative care offered by physical therapists and other related rehabilitation professions. We are sorely underutilized, and our levels of chronic pain and other outcomes in the United States are plummeting while those chronic pain levels are rising. Our ability to manage chronic disease in this country, and in other countries, are rather poor. Diabetes, low back pain, obesity are really common conditions.
How do we manage those? Just speaking from a physical therapy perspective, what if our system valued conservative care more and placed that value, which is a cost effective service to refer to, people with low back pain, people with chronic pain in general, people with obesity, and diabetes. We are capable and have a valuable skillset in seeing all of those people. And yet we rarely do until they’ve been suffering for far too long.
With respect to where medical therapeutic yoga fits in, what if those health care professionals who are using yoga and integrating it already into the system, what if we would be able to better utilize those people and lower our overall burden and cost of care to the citizens in the US as well as in the UK, by including that skillset of yoga and utilizing it through the health care professionals who are already working in the system? I think that would be a powerful way to contribute to health care reform and in a way that we’re not really addressing yet. Who knows what’s going to happen with the next administration? That’s 14 other podcasts.
However, what we can do as physical therapists and if you’re another health care professional out there listening, this conversation applies to you also if you’re working in rehabilitation and if you’re a yoga professionals also. We can’t afford to think that we can’t make a difference in policy from where we are. I think that’s the message. If medical therapeutic yoga is going to make an impact at all, then we have to get our feet wet, we have to jump off the boat and swim in the waters of policy there and figure out how we can make some kind of impact and get started. I think part of that would be utilizing services that are already there and teaching more health care professionals how to use yoga as a low cost, low tech but very valuable service.
Let me play Devil’s Advocate, Ginger. You’ve got a lot of physical therapists and yoga instructors who support you, they love you. Let’s take the physical therapist who’s in the typical sports ortho clinic. They’ve done their McKenzie training, they’ve done a couple of ortho courses here and there. They’re doing all sorts of great stuff. They’re saying, “This sounds really cool, but I don’t really see how yoga fits in to a PT clinic because people are coming in for an evaluation or a half hour treatment. I’ve got these CPT codes. Now I’ve got three codes to bill as far as evaluation goes. I used to only have one code.” Obviously things are changing rapidly in physical therapy. Who knows as far as the coding goes, I don’t think they’re ever going in the right direction. Where does it fit in for those naysayers who say, “PT is PT and yoga is yoga. Why are we mixing vanilla and chocolate ice cream together when each one is delicious on their own?” What would you say to that?
The first thing I would say is I love all the stuff that you are doing in ortho because that’s what I am. I am a licensed athletic trainer, like I said, and also a sports ortho PT. Love manual therapy, love dry needling, love all the stuff. I still incorporate those things into the practice. I might actually be doing let’s say dry needling works in child’s pose with yoga. Manual therapy and some of the adjustments that I may do for the spine, for the SI joint, using muscle energy or whatever it may be all works within the context of yoga. The way I would explain that to the devil’s advocate argument, which I love, is that yoga when it’s used in this way is a killer time saver.
When someone comes in and they’ve got an Achilles tendon problem or let’s just say they’ve got a patellofemoral syndrome. I had a runner last year come in and she went to an orthopedic surgeon because that’s what people think they’re supposed to do, is go straight to the surgeon for a musculoskeletal issue that we can probably take care of in a couple of visits. They get injected, etc. and then it takes a year. She finally shows up to me. We started out with a lot of the things that would look like straight up physical therapy that we’re doing.
What happened was, in incorporating the yoga piece, because it has a systems based approach, I was able to see her in a couple of visits after she hadn’t been able to run for 18 months. I think that just from the before or after for me in practicing, I know that now I am able to see people with the same ortho and sports issues that I saw before or the same type of chronic pain before, I actually see them in less visits and less often.
For me, I’m in a cash based setting. It’s incredibly important that I give a patient and a person as much as they can digest in that single visit. I want them to go away with immediate tools for immediate pain reduction and management so they can see those results as soon as possible. In a way, that puts you on the wire in the cash based practice. You don’t have time to do the three times a week for the whatever numbers of week that their insurance is covering. They want results.
In using yoga, it’s been able to be, like I said, a killer time saver and be so much more effective while still incorporating those ortho skills and things that we have carried with us and learned along the way. They’re all very valuable. It’s just the package is a little bit different and makes it more efficient.
Do you foresee that yoga would be a covered procedure, CPT code, cover under insurance, however you want to look at it? Is that actually a positive thing at this point?
I think the easy answer is it already is. I’ve been using yoga under therapeutic exercise, neuromuscular reeducation. All of those codes that are standard under the KISS principle of Keep It Simple, all of those straightforward codes, even manual therapy, I can do yoga in the context of doing manual therapy, like I mentioned, whether it’s a joint mobilization or something like that. They just may be embodying either a meditation or a restorative pose or something like that while I’m doing it.
I’ve never had any problems actually being reimbursed base on that. It comes down to the importance of clear documentation of using the evidence based and what we have available to us, which continues to evolve about every two seconds it feels like, and keeping up with that. It does come down to clear, accurate documentation and stating clearly what I’m using those movements or principles for in the case of following under that CPT code.
How does medical therapeutic yoga fit into the bio-psycho-social framework we’re trying to push through with people who have chronic pain?
That’s why there’s a sub-header on the book, the sub-header title is Bio-Psycho-Social Rehabilitation And Wellness Care. That took some time to reach that point, to know how we would accurately describe the title. What does that title mean? What does Medical Therapeutic Yoga mean? A combination of evolved yoga and evidence based rehabilitation coming together. That’s essentially Medical Therapeutic Yoga, which is different than yoga therapy, and different from yoga. When we shook everything out, the end analysis was the take home message is that everyone is looking at the spectrum of the individual, not just in a systems based way. Gastrointestinal, neuro organic, logical etc. Not neuroendocrine, not just that, although that encompasses Chapter Three of the book, it’s just talking about those principles.
It’s looking at their sense of social support, personal variables that need to be incorporated and considered into the prescriptive care that we would give. When it all comes down to it, the ultimate description of medical therapeutic yoga is a bio-psycho-social approach to not just fixing it when it’s broken, but trying to prevent it. Not just curative care but preventive care. I was pretty adamant that that make it to the cover of the book because what we do is so often pegged as just fixing the broken. That’s only at most half of what a physical therapist is capable of. The other half, we could be employed and involve from a policy standpoint, from a public health standpoint, and prevention.
This work is great for physical therapists and other licensed health care practitioners. Is your program approachable and easy for just the average yoga instructor to go into? Do I need to have any experience in yoga at all to get trained in your system?
There’s a couple of different ways to look at it actually. I founded Professional Yoga Therapy Institute in 2000. For this sixteen years, it’s been targeting the licensed health care professional, registered or chartered, whatever country you’re in, because we’re growing so fast and branching out into multiple countries in 2017. Whatever the designation is for you, which can be a wide range of disciplines, the program is accessible in that 25 hours of it is online. That’s on demand, self-paced, however you decide you want to work through that. Then there’s three separate weeks that you come and study directly with myself and with other people who’ve been trained in the methodology as well. That’s the nucleus of that certification program.
If we set that aside for a minute, what makes it accessible to yoga therapists and yoga teachers? There’s an important piece that we haven’t yet worked out in saying if there are two sides of the fence of yoga and yoga therapy is over here and then there’s the whole bio-medical system, with all of us sitting together. MD, PA, RN, PT, OT, whatever you are. Yoga teachers may teach alongside the aerobic instructors and all that, even though it’s not the same. They get lumped with the personal trainer, aerobic instructor type of a profession. But it’s not that black and white. There’s a gray area, there’s a gap that needs to be filled and a dialogue that needs to be started.
If we talk about where it fits in with yoga, yoga teachers and yoga therapists, I believe that we need to establish better routes for communication and dialogue. Let’s just say you’re finished seeing a patient and you’ve given them some yoga principles to work on, maybe it’s a piece for meditation or the breath work or positive affirmations and mantras that you want them to practice for confidence and body satisfaction and just life satisfaction. It would be wonderful to be able to say that we have established such a strong dialogue with yoga teachers, yoga therapists that we know we can refer onto them, to the yoga studio down the street, because we have done that inner disciplinary education.
That’s probably one of the biggest focal points for the program that I run, is to make sure that we can establish that positive dialogue. Right now, I’m working with Yoga University Online to teach prenatal, postpartum stuff and we’re looking at other topics too. There are other health care professionals that are teaching on Yoga University. Neil Pearson and others are doing that. Teaching different aspects of trying to bridge that gap between the two communities so that patients have a better continuity of care. Once they’re no longer patients and they’ve been discharged from the system, that’s where oftentimes people either relapse or get dropped or they don’t know what to do after that. While PT can take care of some of that, we need a better conversation overall.
I’ve been working on ways to do that and will continue through 2017 and the future. That’s one of my primary passions I think, is to continue to bridge that gap and to create a better dialogue between those professions. Because ultimately it comes down to getting that person, not just patients, but the person, the best care that we can possibly give them. Because if we do our job well, they shouldn’t have to come back and see us.
We want to work well enough to put ourselves out of that job and they come back for that re-check. Now that’s another policy aspect that I think that we could stand to work on our own profession. That’s how I see the program being accessible to people on multiple levels.
Tell me how many people you have trained in medical therapeutic yoga so far and where can people learn more about your book and your trainings?
To focus in on training, if you want to work on the professional yoga therapist training, that’s available at ProYogaTherapy.org. If you just click on the for clinician button, you’ll get the whole outline of what the program looks like. Just be aware that there’s two levels of certification. There’s a level one and a level two. Level one can be accomplished in a shorter amount of time obviously that gives you a different entry points in which to start and it can be taken pretty much in any order.
To learn more about the book, you can go to MedicalTherapeuticYoga.com. There’s a free registration to the site which just lets us know that you’re real human being and you are interested in learning more. You’re not going to be spammed ever or anything like that. Once you registered, just a simple name and email address, you have access to dozens of videos for free. Those are all based on the book, Medical Therapeutic Yoga. If you do buy the book, you will find handy little codes, QR codes that are scannable for you. With the code, you scan the code and it brings up additional educational pieces, which leads you to the website again, MedicalTherapeuticYoga.com.
You can also find out more about Dr. Ginger Garner by going to www.GingerGarner.com. I’m going to put some links in the box when we’re done on the live stream here on Facebook. Ginger, just start wrapping up. Tell us where you see the future going for medical therapeutic yoga. I think it’s awesome because you are really at the forefront and the pinnacle of it.
First, it seems like it’s been an overnight success for the past, that was sixteen years in coming, so in other words it’s been really slow. Starting with an idea of writing about and to health care professionals who really want to reach their patients in a systems based way. I know twenty years ago and going to PT school, we weren’t thought a systems based approach. It was very neuromuscular and musculoskeletal and that was the extent of it.
Right now, I teach in several different doctoral programs. That’s still a big gap, so I think part of the future is addressing education and what our new physical therapists and other health care professionals are getting. I would like to see yoga integrated into that landscape of professional medical education, both graduate level and post professional. I’ve been watching that happen and being involved in that with sixteen years. That’s a wonderful thing to see evolving. A lot of graduates of the program are now teaching. University of Mississippi, Missouri-Harding University, Texas, I taught at UNC Chapel Hill this past fall. There’s just a lot of different universities that are coming along with the inclusion of yoga. I think that’s part of the future.
The second part of what we need to address in the future of yoga and health care would be interdisciplinary education. That’s a huge buzzword already. All these things that I’m saying are also in my book. I discussed them because they are important concepts. The World Health Organization and a lot of other experts in instructional design who’ve also been doing projection of the future of where things should go for culture and society in general, have been for a long time saying, “We need interdisciplinary education.” Nurses don’t know what PTs do and PTs aren’t exactly sure what social workers do, etc.
My program has been bringing all those people together in one room to study yoga for sixteen years. Literally, it may sound a little sappy, but at the end of every week of training it really brings me to tears to see what these people are capable of. To include this yoga piece and then have them do case studies. We have live patient models and trainings. To see what they’re able to do to create on systems is incredible. But I find that in a lot of university system still, the buzzword of interdisciplinary education is king but it’s actually isn’t being used. I don’t know if you’ve experience that.
It’s a catch word, especially in the pain community. We’re saying, “Things have to be interdisciplinary.” I think it’s a challenge, one, to set that up actually in the clinic just as far as the staffing goes. Two, I think it’s also a challenge to the patient to now say, “You need all these types of different services to heal whatever chronic condition you have.” Oftentimes chronic pain is the big one. Now let’s figure out how is this patient, who has a chronic decease as well as working, and a family, kids and all these things, going to do PT and nutrition and psychotherapy, and, and, and.
We know all these things work well together. I think the challenge really starts to become, “Can’t practitioners just do this on their own and in one setting with one practitioner, versus having all these different sub specialties?” Now of course, if I have a patient who has fibromyalgia who’s also schizophrenic, I don’t deal with schizophrenia as a doctor of physical therapy. But if we’re talking about pain avoidance behaviors or feelings that are negatively related to the pain experience, then that’s something that I can deal with.
Conversely, I think there are times where there are professionals that, let’s say a psychologist who has additional training in something like a medical therapeutic yoga, can bring that in and they can handle the movement aspects of it maybe without being sent to a physical therapist. What fascinates me is I think all these professionals are trying to start to overlap and all our licenses and all our silos that we all function are starting to become less and less important. Really, it’s just how do we get the best care to the patient in the shortest amount of time, in the most effective way to reverse our chronic pain. That’s the thing I talk about, but it’s chronic deceases on a bigger scale.
That’s very true. It’s manifesting. Instead of just saying, “Interdisciplinary education is important.” The how’s and the where’s. We know the why’s already, but manifesting it and actually making it happen. The one thing that you brought up that was really important is one of the reasons I think physical therapy is so ideally suited, and this goes for some other rehab professions too, is because we’re able to deferentially diagnose. We know what the red flags are. We are able to refer and to see those pieces that may validly need an outside referral.
When you’re looking at a systems based approach, like medical therapeutic yoga offers, we are often able to affect gastrointestinal function. The majority of what a gastroenterologist sees is just functional gastrointestinal disorders, which we’re completely capable of addressing through the context of physical therapy. Particularly if you have the yoga piece, that will affect genetic expression and transcription and also neuroendocrine function.
The potential is huge. I think that refers back to what I was saying earlier, in that yoga is just a really huge timesaver for what we do in the clinic. Instead of making things more complicated, my goal is always to make things more streamlined, more simple. In that way, using a yoga, not template necessarily, but the infrastructure of yoga applied into physical therapy makes for a beautiful, efficient way to streamline clinical decision making and lower compassion fatigue and burn out and all the stressed that comes along with being a caregiver
I am Dr. Joe Tatta. I’ve been speaking with Dr. Ginger Garner today on the Healing Pain Podcast live on Facebook. Typically, I broadcast the Healing Pain Podcast on my website at DrJoeTatta.com. I’m in the process of trying to maybe take this live each week. Thanks for all of you who have stuck with us through that one little technical blip. I want to point you back to Dr. Ginger Garner and her new book called Medical Therapeutic Yoga. You can find that at MedicalTherapeuticYoga.com. Tune in and sign up for the Healing Pain Podcast on my e-mail list at DrJoeTatta.com. We’ll see you next time on the Healing Pain Podcast. Have a good day.
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