My 10 year old son last week said “Dad, why do you ask so many questions?” My son’s question is precisely why I have chosen to have a career as a physical therapy expert witness. I have always been fascinated by the complexity of the human body. Just think about how many parts in the human body have to work together in order to perform something as simple as a squat to pick something up off the floor. Next time you go up the stairs don’t forget how fortunate you are that your brain, spinal cord, nerve, muscles, and joints are all working optimally to propel your body up the stairs. An expert witness in any field must have the desire to seek out the truth in a legal case. Along with having a high level of education, significant clinical experience, and excellent communication skills, the physical therapy expert witness must [...]

In my last blog I let you know that 80% of Americans will have low back pain at some point in their life. Although there can be many causes of low back pain, I’m sure in your medical legal career you have had clients with lumbar disc injuries. Let’s talk just for a minute about the terms you may hear when working with your clients. The healthy lumbar disc is a beautiful work of art! When intact, the healthy disc is made up of cartilage which sits in between two vertebrae. This cartilage helps to provide stability and shock absorption in the low back. Anatomically the disc is made up of a center part called the nucleus pulposus. Surrounding the nucleus is 10-12 rings of collagen called the annulus fibrosus. So far this makes perfectly good sense! The confusion can set in when people start using different terms to describe their [...]

 Human beings were created for movement. Yes it is true that every part in the body, just like every part in a car, has a lifespan. However, the lifespan of the body part is much longer when properly taken care of. Likewise, a car properly maintained can last years and years. Modern day society and technology have changed the demands we place on our body. Lack of activity has caused much harm to the body’s musculoskeletal system. I know you have heard of the “Use it or lose it” phrase. So many people now lose it because of the low level of physical demands placed on their body. Recently I took a family vacation to Chicago. I took a 2 hour trip around the Chicago shoreline…on a Segway! Instead of walking and exercising all the muscles in my body (including my heart!), I was standing while this modern day machine did [...]

Just like physicians, physical therapists all must follow their individual state practice act. If you have ever worked in a grocery store, you will understand what I’m about to say next. There are about as many differences in practice acts as there are types of lettuce for customers to purchase! The idiosyncrasies of each individual state practice act can be overwhelming. For example, in Missouri where I practice, a physical therapist can only delegate care to a Physical Therapist Assistant (PTA), a PT student, or a PTA student (the student must be at the site doing a clinical affiliation, they can’t be a student working as an employee at the site). However, many states have much less restrictive delegation rules. Another hot button item is physical therapists performing a treatment called Dry Needling. Missouri has no formal opinion on whether or not a PT can specifically do Dry Needling. Some state [...]

The domain of the physical therapist is the neuromusculoskeletal system of the human body. A PT goes through rigorous university training in order to pass the Boards exam to legally treat this very complex system. A physical therapist treats a variety of conditions which can cause pain, including but not limited to the following: Strain and sprains of the soft tissues of the body. Disc injuries in the spine. Nerve trauma causing pain or weakness in any of the extremities. Repetitive trauma caused by poor work ergonomic set up and/or abnormal posture. Arthritic conditions of the joints. As an attorney you will most likely be involved with malpractice cases where the physical therapy standard of care is in question. In legal cases the question becomes did the physical therapist cause harm to the patient by practicing below the acceptable standard of care level. In some cases this is obvious. However, some [...]

I always say that Physical Therapist A is not equal to Physical Therapist B is not equal to Physical Therapist C. Physical therapists are not a homogenous group. The level of post-graduate education is an important differentiator of the physical therapist population. All licensed physical therapists are required to complete physical therapy school and pass their Boards examination. That has not changed throughout the years. However, the type of degree has changed throughout the years. Physical therapists graduating before approximately 2000 graduated with a Bachelor’s degree in Physical Therapy. Beginning the mid 1990’s physical therapy programs began transitioning to a Master’s level degree. Beginning in the 21st century PT schools then began to evolve into a Doctorate level degree program. Regardless if a physical therapist has PT, MPT, or DPT after their name, the level of education is very similar. The differentiator is what the physical therapist does with their education after [...]