FMAFS/SeizeHealth Approach:  Our approach is PCP centric.  We provide resources to PCPs, allied health, and patients to optimize communication.  It is critical to be PCP centric as these are medical conditions, which need to be viewed in the context of all other medical issues (which is distinct from athletic training).  In addition, the concept of physicians using black box referrals to PT and fitness centers needs to be eliminated.  It is ineffective.  In addition, we assure all members of the patient care chain understand the patient care plan which integrates the kinetic chain and neuromuscular dysfunction. 

these are expanded on in other pages:

-The Kinetic chain.  Joints like the knee, hip, and ankle are dependent on each other. But current therapy treats them as independent.  The knee can be considered a passive joint almost totally dependent on the function of the hip, ankle, and foot.  So most knee pain relates to hip or ankle pathology.  Almost all back pain is caused by issues with the muscles of the hip, leg, and foot/ankle.  This principles are described in detail on the kinetic chain page and video.

-neuromuscular dysfunction. Muscle and joint groups are dynamically controlled by the nervous system.  The healthy nervous system finely controls both muscle excitation and inhibition around a joint, as well as interactions between joints.  The shoulder is the best example, where stability is predominately do to fine neurologic control of muscle rather than structurally coupling of bones.

The kinetic chain and neuromuscular control are two essential components of all functional movements, such as walking and lifting an object overhead.

-co-morbid CONDITIONS.  Most patients with orthopedic disorders come with other medical and psychological conditions, so training in internal medicine or equivalent is needed.  Again, while surgeons are highly trained, this is diagnosis, prevention, and rehabilitation in the setting of co-morbid disease.  In addition non-musculoskeletal medical problems can present as musculoskeletal problems (and the reverse is true).  Groin pain can be a femoral neck fracture or an ectopic pregnancy.  Therefore education beyond the musculoskeletal system is required.

-Integration with Rehabilitation CENTERS and FITNESS CENTERS.  Physical therapists and trainers are highly educated and have skills few physicians have.  But particularly for the co-morbid conditions discussed, integration is required between them and PCPs.  Therefore, critical to success in treating these disorders is, in addition to providing PCPs with consultation/education in these areas, integration of care between PCPs rehabilitation and fitness centers is required.

-PROVIDING PCPs TRAINING AND DIAGNOSTIC RESOURCES IN FUNCTIONAL MOVEMENT, FITNESS, AND INTEGRATION  Orthopedics is a surgical specialty with no medical counterpart unlike other areas like cardiology and neurology.  We provide resources to help PCPs manage these disorders effectively without extensive additional training.

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