Chronic pain patients and athletic injuries can be troublesome so we dive deep into GRIP Approach with Dr. Benjamin Fergus DC. It’s a blend of the popular rehab ideas but with a pre-post exam to show global functional movement restored and pain relief.
His passion to learn more and to help the specific type of patients that just weren’t getting better by other doctors and the struggle with always having to do so much trial and error with different approaches to see what works for a patient plus trying to discharge them were the catalyst to start formulating this new GRIP approach to movement and pain relief.
Chronic and complex pain/disease cases and surprisingly athletes can have similar functional deficits in global movements that can create pain, less than optimal performance and hinder being released from care.
GRIP takes lots rehab ideas, breaks them apart, then streamlines them to be easier and more effective.
What are the benefits to a global motion ie: squat to pick up something or a lunge, compared to isolating a muscle group on a machine?
Dr. Fergus has a huge following in Japan (courtesy of Kaiso) and the approach resonates with their thoughts on rehab, he goes into why and what that means.
What marketing is he doing to grow the GRIP Approach system?
Dr. Benjamin explains how this is a diagnostic system to evaluate a person for rehab and may end up replacing the McKenzie, SFMA or DNS evals in your office.
What’s your beef with patient’s perception of persistent pain aka Subjective Variability? For example: it hurt two days ago but today at the doctor’s office it doesn’t really hurt as much.
What are your approaches to moving away from subjective pain scores to objective evaluation regardless of pain?
Questions to ask to shift conversation from Pain to Function?
- What things are you having trouble doing?
- How long have you had trouble doing them?
- What have you tried to overcome this but failed to work?
This approach can come off as a mechanical analysis but he explains how it’s actually a nervous system challenge.
Superficial treatment like IASTM or Pin and Stretch don’t lead to long term deep structural changes (they do inhibit the discomfort from movement and increase range of motion though).
What can change deep structures?
- Chiropractic adjustments of a restricted joint to normalize mechanotransduction
- Deep compression with cross friction the size of a nickel for 2-10 minutes. (can change extracellular matrix, elastic changes and normalize cells in the area.
- Needling techniques (Dr Moz) which can irritate the cells, but in a good way.
Should you use a thumb, elbow, Steel Instrument or maybe technology called Shockwave? Shockwave is acoustic percussive waves that can penetrate deep and shown to make changes.
Let’s define reciprocal inhibition, concentric and eccentric motions.
Logistically, how much time does a GRIP exam take and what would a typical office visit look like and take time wise?
Why do you prefer global movement and less concentric type exercises.
What does a typical patient encounter look like? We adjust, do soft tissue and we evaluate with global positions but then we teach at home exercises that they might do 3-4 times a day.
How do you handle the athletic trainers, massage therapists that learn everything that you teach them or paid for them to learn and then they leave in 6 months?
Hint: contracts and educational reimbursements
Clinical Rehabilitation – Pavel Kolar, Foot Orthoses and Other Forms of Conservative Foot Care – Thomas C. Michaud, D.C., Human Locomotion The Conservative Management of Gait Related Disorders – Thomas C. Michaud, D.C., Clinical Neurodynamics A New System of Neuromusculoskeletal Treatment – Michael Shacklock
facebook.com/gripapproach and ig www.gripapproach.com
Benjamin Fergus, developed the GRIP Global Rehabilitation and Injury Prevention Approach and lectures internationally 20-30 courses a year and its translated into 7 languages. GRIP Approach largely focuses on chronic pain, limitations in activity, and patients who are running out of options. Major influences come from Dynamic Neuromuscular Stabilization, Fascia Research, Leon Chaitow, David Butler, Thomas Michaud, and Michael Shacklock work.
Show notes can be found at http://www.adoctorsperspective.net/115 here you can also find links to things mentioned.