Laurie's Blogs.

Thank you to everyone that participated!  Twenty-two of you took the time to provide feedback!  That’s amazing!  Some wonderful answers!  Let’s get to it!



Who answered the call?

•10 Veterinarians

•9 Physios / PTs

•3 Veterinary Technicians / Nurses

The first question:


From your professional background, what areas do you think are / were missing from your basic training in canine rehab / veterinary-animal physiotherapy?  (Please include what training you have to qualify - i.e. CCRP, CCRT, CVSMR, MVetPhys, etc. - more manual therapy training needed, more business training needed, etc.)

From the Veterinarians:

• •Hands on practical anatomy. Manual therapy. Treatment of myofascial restriction (CCRP)
• •More manual therapy training - especially for spines (though I appreciate this is more of an advanced thing, it should be easier to get training about these feels). I'm a CCRT
• •It took me some time to figure out how to "think" through a case. I understood ROM, flexibility, manual therapy techniques, but still wasn't thinking like a "physio" when approaching a patient. We're so used to a ONE, somewhat cut 'n dried diagnoses (i.e. CCL tear; do surgery) as opposed to, "hey, there's muscle tension/trigger points, a ligament sprain etc. all going on in one case and I need to triage and handle several of these right now".......  I also took a LOT of time (probably just me) to feel like I could differentiate tissue qualities (hypertonic v normal v hypotonic muscles, for ex.). You guys (physios) have much better hands than we do for this (of course; it's what you're trained for!!!)  Manual therapy was good; anatomy was great.   I wanted MORE, MORE, MORE gaiting/lameness video/eval time.   I needed more therex demos. I have a HEAVY sports background, personally, and have spent some time training dogs as well, so feel OK with designing therex plans but I think many vets will struggle with this (hence your blog about owners of performance dogs googling rehab topics when they feel their rehab vets "don't get it".
• •CCRP More manual therapy. Business training is often lacking. Communication skills and having difficult conversations. Who teaches that? Gait analysis. The use of videos in diagnostics and treatment adjustments. Sports medicine.
• •I'm a CCRP.  Hands-on learning of manual therapy/massage was very limited.
• •Putting it all together. I took the course a long time ago, so I am sure things have changed.  But at the time, we had a lot of info, a lot of techniques, but no real plan on how to put it all together in a rational approach for Dx and Tx.
• •CVPhys(ESVPS) very lacking in manual therapy so learnt so much with CCRT. Neither gave me much info on therapeutic ultrasound so researched on my own.  Have had to do additional hydro training but can’t expect courses to cover everything and also using different providers adds to the experience but does make a big dent in the pocket!  Minimal business training.
• •Definitely more business training, although unless people are going solo I don't think they would want to sit through it.  I'm a CCRT.
• •CCRT -  Gait analysis and what it means. Especially forelimb.
• •Missing from basic rehab training - more hands-on stuff (manual therapies, joint mobilizations, MTrP stuff).  Basic veterinary training seems to miss everything related to muscular and spinal problems. Neuroreceptor transmission by joints and inflammation cascade are also skimmed over.  When I went to vet school, our neurology training was poor.  Business training was lacking too.  This is the humble opinion of a perpetual student: CCRP, CVMA, CVSMT,  currently pursuing residency in sports medicine and rehabilitation.

From the Physios / PTs

• •Gait analysis, structure/conformation
• •From BSc (Hons) - More manual therapy and business training. Perhaps more work on strength and conditioning too.  Currently doing CCRP and using FourLeg which are helping with some of these areas.
• •PT - more business training
• •BSc(hons) physio; MSC Vet Physio - Animal specific exercise therapy - how to handle animals to get what you are trying to achieve & progress (felt I learnt this in placements and then on the job)  More hydrotherapy experience would have been beneficial for small animal.  Small business management - marketing, how to get your name out there, managing invoicing etc.  More hands on for spinal mobs in small animal - difficult to gain this experience in classroom. / on placement
• •CCRT-  More navigating the vet world (or “how to get the respect I deserve” from another profession”)
• •More education on how to interact with Vets- get them to accept me as a colleague vs interloper.  More education on anatomy and palpation with animals and more about different disease process with animals, more red flags for disease process with animals.
• •I am a CCRT and after I started practicing, I felt that more hands-on skills are needing to be taught. We only had a short amount of time for palpation in each lab session with regard to anatomy, which I felt wasn't enough time. Additionally, coming up with exercises for treatment plans was touched upon, but I felt lost coming out of my courses once I started practicing.
• •Strength training work: exercises and calibration
• •Diploma in Canine Rehab.  Missing - business skills, animal handling skills, behavior recognition

From the RVTs / Vet Nurses

• •I feel there needs to be more specific disease process learning and the aftermath of that disease.  i.e. Herniation of a disc and becoming/remaining paraplegic deep pain negative after surgery. How to rehab traumatic issues and help maintain them afterwards, body and spirit. CCRP CCMT
• •CCRP- more manual/ massage therapy and more business training. Also, learning more about rehab for cats and how to incorporate that into the rehab practice.
• •I think the "anatomy of movement" was lacking in my Vet Tech background, I learned a lot from my PT colleague when I went into rehab.

Question 2:


Since completing your basic canine rehab / vet physio training, what skills or knowledge have you obtained that you find invaluable in practice?  (i.e. Fear Free certification, Massage, Spinal mobilization or Spinal Manipulation, Acupuncture, Vestibular rehab, Myofascial release, Business & Marketing training, etc.)

Here I have grouped the comments and will rank them from the most popular down to ‘one-of’ thoughts or suggestions.


#1.  Myofascial Release

#2   Spinal / Joint Mobilization or Manipulation

#3   Business / Marketing

#4   Acupuncture / Dry Needling

#5   Massage

#6   Sports Conditioning / Exercise Discussion / Sports Medicine

#7   Bracing / Splinting / Orthotics / Prosthetics

#8   Low Stress / Fear Free Handling

#10 Hydrotherapy, Kinesiology Taping, Respiratory Physio, Vestibular Rehab, More Electrotherapy, Research, Assistive Devices / Mentorship / General Pathology and applying physio principles to cases, Advanced Neurology, & Teaching owners how to have fun with their animals as part of the rehab process.

Question 3:


Anything else you’d like to say?

• •I love your online subscription FourLeg.com! It is wonderful and a wealth of knowledge that I refer to often for cases. So, thank you!
• •You are awesome Laurie, and I truly enjoy your weekly emails. You are a ray of sunshine
• •Lots of hands on training, it's invaluable!
• •I LOVE using massage in my largely geriatric/chronic pain practice.
• •Basically, as you suggest, KEEP LEARNING! The basic course is awesome, but there's SO MUCH MORE to know. Facebook groups/listserves are essential to be able to ask about weirdo cases. 
• •The list is long. I never stop learning! 
• •Manual therapy courses with Laurie Edge-Hughes are excellent!
• •I have learned and continue to learn so much from my patients. There's no substitute for on the job learning.    
• •Spinal mobs courses were ace but need to find a mentor to provide confidence in using techniques learned
• •Always room for more learning and you won't come out the classroom a specialist - best thing I did was sub contract and continue to learn from another physio in the early days of setting up.
• •How to fit rehab within a general practice
• •Bracing, splinting
• •Personal opinion - Veterinary rehabilitation is a fear free/reduced sector.  While I support the concept, and encourage the training in these techniques, I feel that it has become over marketed and diluted in its goals with frequent recertification and rebranding constantly.
• •Wolfe kinetic technique training (manual therapy from Dr Tammy Wolfe at the K9 Body Shop in Arvada, CO.  
• •VetFest (in the UK) is great for rehab ideas!

There you go.  Looks like folks have a lot of the same answers.  Of course, we have to recognize that the basic courses are just that - basic. Tip of the iceberg if you will.  However, it's good to see where seasoned practitioners have identified areas that they wanted to grow and areas of learning that they felt they benefitted from, because we can ALL look at these lists and think "Yay!  I want to learn that too!" and then seek out ways to learn!

I hope this provides you with some inspiration to move forward in your learning!
Cheers,
Laurie