How to pass the SCS exam from an SCS (Sports Certified Specialist) by Robert Dulay, PT, DPT, OCS, SCS, FAAOMPT

follow us on social media!

Check out our Jetset courses HERE!

By Robert Dulay, PT, DPT, OCS, SCS, FAAOMPT

I’ve always known that I wanted to work with the athletic patient population, and quickly learned that they can be among the most difficult patients to treat, because of the demands of needing to return to sport as soon as possible and not miss too much competition time. Further exacerbating this, every parent of a youth athlete thinks their son or daughter is the next LeBron James or Serena Williams, so they can add to the pressure to get their child back to playing. For some of these high level patients, there is even more external pressure from college recruiters or professional scouts.

 

After PT school, I realized I lacked the confidence working with these patients. The movement faults and impairments I knew to look for in the average patient were not obviously apparent in these patients, and some of their symptoms only came on with high level activities. I was fortunate to have done a 16 week clinical internship with a phenomenal therapist (shoutout to Jeff Wang at Glendale Adventist Therapy and Wellness Center!) at the end of PT school, who pushed me to improve every day of that clinical experience. After that, I knew I wouldn’t stop continuing to seek out learning opportunities to work in this field.

IMG_3164.jpg

 

"The movement faults and impairments I knew to look for in the average patient were not obviously apparent in these patients, and some of their symptoms only came on with high level activities."

 

In addition to perhaps struggling with working with athletes in the clinic, new grads are not qualified to provide sideline coverage at athletic events. The SCS is a specialty certification that designates an expert in athletic injury management, including acute care, treatment, rehabilitation, prevention, and education.  Read this article for more details on why the SCS is worth pursuing if you are interested in some day providing on field coverage.

 

Fast forward 5 years, and now I can say that I am confident in my ability to treat the athletic patient population. Here are some tips on how to pass the SCS exam:

 Sports enthusiast Jessica Mena PT, DPT

Sports enthusiast Jessica Mena PT, DPT

 

"This may not be immediately obvious, but sports patients are really at the end of the day ortho patients, they just move faster."

 

1) Consider taking an orthopedic residency. This may not be immediately obvious, but sports patients are really at the end of the day ortho patients, they just move faster. Completing an orthopedic residency involves weekly mentoring from a clinical specialist, didactic learning, and honing in on clinical reasoning. Additionally, you can also consider a sports residency or fellowship. Here is the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) website.

 

2) Familiarize yourself with the SCS application process, exam format, and test materials. Here is the American Board of Physical Therapy Specialties (ABPTS) SCS candidate guide. 

 

3) Study, study, study. Unlike the OCS exam, there is no Current Concepts (if you are preparing for the OCS, this is the definitive material to study to pass the exam.  As such, you will need to study from several different sources in order to adequately cover the material covered in the SCS exam. I used the following sources:

- American Red Cross Emergency Medical Response (EMR)

- Sports Physical Therapy Section (SPTS) SCS preparatory course

- Medbridge SCS prep program

 

Each source has material to study, with practice tests. You'll have to figure out what works best for you, but as for myself I knew I needed to set up a plan to keep myself accountable. My friend and colleague from fellowship, Shemaiah Holness, assigned ourselves 1-2 chapters each from the above study materials to go over each week, and had review sessions every Sunday in which we would go over the material and practice quizzes. This worked out well for us as we didn't want to let the other down by not preparing that week.

 

 

Of course, there are other study material sources, but these are what I used. Among the others I know of are Evidence in Motion and Praxis, however personally I chose not to pursue these opportunities simply because it was not financially feasible, as they are not cheap. Give yourself at least 3 months, preferably more to study and go over practice exams, and resist the temptation to procrastinate as the SCS exam is definitely not something that can be passed by cramming in the weeks leading up to it!

 

After taking the test, you will have to wait 3 agonizing months until learning if you've passed, but if you follow the above tips, you will have prepared adequately and set yourself up for success. The SCS is definitely a certification that is worth the effort to pursue, as less than 2% of all APTA members are recognized with the credentials. Good luck!

 

WCU-CGS Robert Dulay .jpg

Robert Dulay, PT, DPT, OCS, SCS, FAAOMPT is currently practicing in Southern California with Kaiser Permanente

--------
Robert Dulay, PT, DPT, OCS, SCS, FAAOMPT
Doctor of Physical Therapy
Board Certified Orthopaedic and Sports Clinical Specialist

Podcast: Achieving Financial Independence as a Physical Therapist (and paying off those loans)

disclaimer:  We are not financial advisors.  Correction:  I mention that our guest is in his mid 30s, but at the time of the recording he is 29, he will be financially independent in his early 30s. 

Every now and then something simple can change your life.  Often it is an idea and this idea aligns with something inside you that makes it stick.  It then grows into a thought process and evolves into a major change.  In my case, reading the blog The Fifth Wheel PT by Dr. Jared Casazza enacted such a change.  In particular this blog post and this guest blog post led me to begin a journey that led to early student loan repayment, increasing my index fund investing (roth ira) and tracking my finances.  It further led to credit card hacking with Andy Bahn and traveling to Hawaii and Las Vegas for free!

Now, I know, financial independence can sound impossible for some of you.  The debt can be overwhelming.  Trust me, there is a way out.  You just have to know down that FIRST DOMINO as they say.  It is simpler that you think.  It will take work, it will initially be time consuming but once you have your system in place it you don't have to think about it!

I am not in anyway a financial advisor but I see finance as one of the main downfalls of our profession.  I see people who are not happy with their place of work staying in jobs they dislike because of financial reasons.  Finance and Ethics are very closely intertwinned and can potentially lead to people doing a poor job at getting people better because they dislike their job.  I see these as potential threats to the profession of PT, further exacerbated by high student loan debt, purchases of expensive cars, buying homes, buying unneeded items at target and not putting money in a retirement fund.  All of this puts financial pressure on the PT and who knows?  Perhaps we are losing some amazing PTs out there because they see a profession that is not financially healthy and thus choose to do something else.  For this reason I have been using this blog to help people get to the resources that can change the way they handle their business.  I hope you enjoy this podcast and read a few of the resources we linked to below.

Please comment with your thoughts!  

Randal Glaser

 

books discussed:

The millionaire next door

The richest man in Babylon

blogs:

Mr. Money Mustache

Bogel heads forum

go curry cracker

Mad Fientist

Eat the Financial Elephant

Holiday Gatherings - should one treat a family member?

Let's ask the experts....  

 My dad after shoulder surgery not following his PROM only restrictions.  

My dad after shoulder surgery not following his PROM only restrictions.  

The holidays can be confusing for any Physical Therapist, Chiropractor, Masseuse, Occupational Therapist.  The reason for this is because family members ask us for advice.  Often they are the most difficult patients because they a) don't listen, b) want the quick fix, c) are intoxicated, d) they want a free massage e)  don't respect you as a medical professional, (after all they knew you when you were in diapers, who can blame them?).  Almost all practitioners have negative experiences that have led them to question the treatment of family members.  If you think about it, this is smart.  At a holiday get together we cannot chart review, there is not a treatment area, and if the word gets out, you will have a line of folks waiting to get " a freebe."  There is also a chance that they will not seek treatment after the holidays thinking that your session was enough.  This could prevent them from seeking the care they need.  I can recall the Thanks Giving party of 2011 when I was treating a family member on someones bed and after I was done there was a line of 6 people waiting for their session!  I have a big family and my day off turned into a work day.  Some would call this a rookie mistake.  As a Christmas morning blog post, I thought it would be a good idea to hear strategies from some seasoned Physical Therapists and how they navigate their holiday season requests.  I hope the decision to treat or not treat is easier after reading this.

Randal Glaser PT, DPT, OCS, co-ofunder JetsetRehabEd.com

 

Mariam P. Butler DPT,OCS,SCS,FAAOMPT

upload.jpg

 

I personally have no problem telling people "no." I've been known to say "this is my one day off, can we discuss this later?" then plan a date and time to do that. I'd rather have them see me first over someone else honestly.  It depends on my mood because our job isn't a 5 minute conversation where we can give some advice and send people on their way. If I am going to help, then I know it'll be at least 30 minutes. Sometimes, if I'm feeling up to it, then I'll just do it knowing I'll have to help that relative eventually.  It's easier at my own house where I have a table and stuff I need for treatment. If it's somewhere else, I'll say "tell me what's going on so that I know what to assess later when I have my table set up along with all the measurement tools I need to appropriately evaluate you." That's always a good way to listen to the person so they know you do care about them, but at least you don't have to "work" during a family function. I think overall, it's on us to be the ones to help our relatives because we know what we're doing. What are they going to do otherwise? Go see their MD that will likely just recommend meds? MOST PT's are PT's because they care about people, and want to genuinely help people get better. It's our responsibility to guide them the right way. If we feel they should go see an MD, a PT, or another health care professional, then we should be the ones to advise that, educate them on their body and give them realistic expectations on what to expect.

 

Andre Chavez PT, DPT, OCS, Movement Science Fellow

upload.jpg

Treating your relatives over the holidays can be an interesting task but something that all clinician will face this holiday season.  Careful consideration has to take place before doing this. You know your family members better than anyone so you know who is going to listen to what you say and who thinks you don’t know anything.  You also have Aunt Mildred who just wants you to push on them because it feels good. Since this is relative, (please excuse the pun) I pick and choose who I treat based off what I know about them and the situation. For example, my dad is stoic so if he is asking me for advice or for a mini-evaluation I’ll give it to him because he wouldn’t ask if he didn’t want to get better. Then you have Aunt Susanne who has Fibromyalgia and spends half of every Thanksgiving and Christmas dinner talking about her new pains and ailment . . . I wouldn’t touch that with a ten-foot pole.  And then you have your cousin Ryan who you still must talk out of dumb decisions every now and again and who thinks you just gives massages anyways, I’ll pass on that one too. For me it easy it depends on the relative and the situation. 

Michael Curtis PT, DPT, OCS author of Why you have Bad Posture and Turn down your Pain.

founder of the blog: Michael Curtis PT

upload.jpg

 

I’ve found it helpful around the holidays to refer friends and family members to a trusted resource online – and I’d recommend the same for you… 

Here’s your script:  Memorize it, repeat it, sell it, and you’re golden.

“Wow!  it sounds like you’re going through a lot right now.  I have the perfect article with videos of exercises you can do that I think will give you some relief.  Send me an email to remind me and I’ll give you the link.”

If they follow up with you, you can link them to a good article while also informing them to follow up with their PT or doctor should their symptoms continue. 

This tactic has worked well for me because:

  1. It offers them quality information and actionable exercises

  2. It gets you off the hook for treating Aunt Marilyn on your grandparent’s couch

  3. It puts the responsibility on them to email you 

  4. It funnels them into following up with someone else in-person

Where do you get these online resources?  You can use any trusted resource you know of (if you have some, put them in the comments below for all to see).  Also feel free to use what I’ve got on MichaelCurtisPT.com – patient education articles based on body regions with exercise videos for each diagnosis.     

I hope this approach works as well for you as it has for me.

If it doesn’t work, I’d go with the “Home Alone” version:

“I’m going to give you to the count of ten to get your ugly, yella, no-good keister off my property… Merry Christmas ya filthy animal!”

 

Dr. Kristie Fong DC

upload.jpg

 

It’s funny and bad enough when the just-met stranger at the office party or happy hour finds out I’m a Chiropractor and starts telling me about their neck and back pain and asks for a real quick free adjustment right then and there; it’s worse when it happens at the family party- because I can’t just laugh it off and walk away.  These loved-ones deserve my attention and real answers. When I faced this fresh out of school, I would ask all kinds of questions and give them a ton of advice, and usually working on someone on the couch, floor, or someone’s spare bedroom. Looking back, I think I may have been eager to prove myself, or was just so happy to be able to give back to the family that I really tried to treat them as if they were in my office. The smells of a feast, screams of kids running around, and party sounds were definitely a distraction.  I know better now. Nothing beats the focus, clarity of purpose, and single-mindedness of practicing in my office.  Now I listen and happily give them some basic advice, (like, ice/heat/move/immobilize it) and then tell them they really need to get it taken care of. I don’t care if they see me or someone else.  I offer to see family in my office for free, but tell them if they cancel or are chronically late, I will start charging them something. At least half of my family has insisted on paying anyway.

 

Gabrielle PT, DPT, OCS, Woman's Health Specialist

upload.jpg

 

Surprisingly the holidays are pretty smooth sailing for me! Yes, I’ve made that rookie mistake of opening the can of worms, but for each family member I’ve treated:

1) usually they only need one treatment and if they follow my directions, they can usually prevent it from happening again, or know how to manage if symptoms return or

2) they don’t follow my directions, symptoms return , they come back to me, I ask them if they did what I told them to do, they say “no”, then I say “do what I told you to do”, then they never ask me again. I don’t know if the latter is a good thing or bad thing!

My husband is also a PT, so there is double the chance that one of us will get summoned BUT I can say that my family and my in-laws are very respectful of my personal time at family functions (thank goodness). Their respectfulness of our time makes me more inclined to help out if the situation does arise!

My advice is, just like life, find a healthy balance, and don’t end up opening Family Room PT, Inc during holiday dinner (unless you want to and you’re charging co-pays!)

 

Happy Holidays,

Gabrielle

 

------------------------------------------------

 

Happy Holidays from the Jetset Rehab Team

Please check out our 2018 courses, hope to see you next year!!!!!

 

 

Podcast - Melanie Carlone and Paul Tucker, Alignment: Finding relief in every step.

Alignment: Finding relief in every step

Melanie Carlone, DPT, RYT of http://customorthoticsolutions.com/is a longtime friend of Jetset Rehab Education.  When she attended our class in Portland last year we recorded this during our networking hour.  She is a Physical Therapist with over 30 years of experience.  She is a fantastic Physical Therapist and I treasure the time I worked side by side with her in Atlanta, Georgia quite a few years ago.

Read More

Clinical Neurodynamics Review by Dr. Michael Braccio DC, DACRB

The Clinical Neurodynamics course taught by Michael Shacklock explores the relationship between abnormal mechanics of the nervous system and pain syndromes. The course covered the theory of neurodynamics, assessment of the nervous system through neurodynamic testing, and treatment strategies to reduce the sensitivity of the nervous system. 
What is neurodynamics? 
Clinical neurodynamics is the application of nervous system mechanics and physiology and how they interact with the musculoskeletal system. As the musculoskeletal system creates movement, the nervous system accommodates these movements through a variety of movements, such as elongating, sliding, or compressing. When the movement of the nervous system is restricted, the production of symptoms can occur. 
Course review
The lower quarter course begins with learning how to palpate and evaluate the sciatic, tibial, peroneal, and surreal nerves. Palpating the nerves allows the practitioner to determine where a neurodynamic problem is and how sensitive the nervous system is. 
After palpating the nerves of the lower extremity, assessment of the nervous system continues through the use of neurodynamic testing. While many of us are familiar with the standard neurotension tests such as the straight leg raise or the slump test, these neurodynamic tests can be further broken down to determine where a neurodynamic problem is. An important aspect of using neurodynamic testing is the use of structural differentiation to determine whether the symptoms are produced by the nervous system or the musculoskeletal system. If structural differentiation indicates neural involvement, then a neurodynamic approach to treatment can benefit the patient. 
Neurodynamic dysfunctions can originate from three different causes. One possible cause of neurodyanmic dysfunction is an issue at the mechanical interface (intervertebral foramen). There can either be a closing dysfunction which is caused by an increase of pressure on the nerve in the mechanical interface (disc herniation, inflammation, etc…) or an opening dysfunction caused by hypomobility and stiffness. 
Another possible cause of neurodynamic dysfunction is a neural tension dysfunction in either the peripheral nerve or nerve root. These occur due to a lack of movement (sliding) in the nervous system. The third cause is a pathology in the nervous system such as a tumor or diabetic/alcoholic neuropathy. 
The treatment approach when treating a neurodynamic dysfunction depends on the sensitivity of the patient’s nervous system. The sensitivity of the nervous system is divided into three different levels. 
A level 1 (limited) sensitivity would be a patient whose symptoms are easily provoked and takes a long time for the pain to subside. A patient in this category of sensitivity would perform either static openers or off-loaders (for an interface or peripheral nerve dysfunction, respectively) to decrease the sensitivity of the nervous system. An example of an off-loading movement for the sciatic nerve would be for the patient to be supine with the ipsilateral leg slightly bent in external rotation. 
The level 2 (standard) sensitivity would be a patient with an abnormal neurodynamic test (ie. straight leg raise or slump test) and symptoms that do not last long after provocation. Treatment for patient’s with a level 2 sensitivity would include dynamic openers/closers and sliders/tensioners for interface and peripheral nerve dysfunctions, respectively. The treatment for the patient above with sciatica would involve progressing the straight leg raise or slump test with the patient side-lying while moving the ipsilateral leg more and more. 
The level 3 (advanced) sensitivity is for patients with symptoms that are difficult to provoke or for patients that require a high level of physical performance. The treatment for a patient with a level 3 sensitivity would involve placing the nerve under more tension. An example of treatment for this patient could include laterally flexing the torso away from the symptomatic side to while performing a straight leg raise to increase tension of the nerves. 
Key points
The importance of diagnosis was emphasized as it will allow the practitioner to use the right technique to help the patient. If a neurodynamic test is abnormal and clinically relevant, a neurodynamic approach should be attempted to help the patient. If the neurodynamic test does not reproduce the patient’s symptoms, a different approach should be pursued to help the patient. A neurodynamic approach is not a panacea, it has it’s time and place just like other techniques. 
The goal of the treatments are to find a movement that the patient can perform without pain. The movements are then progressed in difficulty until the patient can perform the movement that was once painful. For example, many of the movements begin with moving a joint while side-lying and gradually incorporate more complex movements while progressing to a standing position. The treatment approaches are an excellent example of graded exposure to movement. 
When moving a joint, there will be 20 percent more strain on the nerve in a localized sequence. By modifying the sequence of movement, the stress can be reduced on the nerve. For example, most straight leg raises start with the knee extended then moving the hip into flexion. This sequence will increase the strain on the sciatic nerve in the hip. If we change the sequence by starting with the knee bent then flexing the hip, we might be able to reduce the pain associated with hip flexion by reducing the stresses placed on the nerve. 
Nerves are mechanosensitive. When nerves are placed under enough force, they will produce symptoms. When treating an abnormal neurodynamic problem, the symptoms need to correlate to the patient’s complaint. Symptoms (pain, numbness, tingling, etc…) can be provoked when enough force is applied, but that doesn’t mean that it is abnormal or relevant to the patient. 
Conclusion
For practitioners treating neuromusculoskeletal conditions, the Clinical Neurodynamics course will provide the essential framework for helping patient’s with dysfunctional neurodynamics. After this course, practitioners will have the tools needed to thoroughly assess and treat abnormal mechanics in the nervous system. 
A special thank you to Dr. Michael Li and the guys at Jetset Rehab for hosting the workshop! 

(Special Thanks to Dr. Michael Braccio for sharing his blog with us! find more blogs on www.michaelbraccio.com )

*** We look forward to bringing back Dr Shacklock in the fall of 2017 and in 2018 for more neurodynamics courses! Stay tuned.....

Happy Hour, Jetset Style

After the lecture there is usually a rush for the exit door.  If you have a good group, often friends are made and networkng contacts are made.  Such was the case for our complimentary post Neurodynamics course happy hour.

Thanks to Michael Shacklock for hanging around to answer questions after class and having a few beers with us.

 

Follow us on social media for updates on our soon to be announced course in Las Vegas on Sept 23. 

Our current courses are up! Click Here! 

IMG_4006.JPG
IMG_4004.JPG
IMG_4003.JPG
IMG_4002.JPG
IMG_4009.JPG
IMG_4008.JPG
IMG_4010.JPG