CSM 2020
As a second year student at the University of Illinois at Chicago, it’s tradition to attend the Combined Sections Meeting. After our final class on Wednesday, two thirds of my class headed to Denver, excited for research and the outdoors.
Day 1
After an early wake up call Thursday morning, I kicked off the conference at a few sports sessions, including one identifying the neural regions associated with kinesiophobia post injury (thalamus and corticospinal tracts). I then made my way to the exhibit hall and tried out a body weight support system. The vendor strapped me into a harness that supported 35% of my weight. I felt light on my feet when walking, but wondered how the system would react to a fall. I was told to avoid any balance strategies and plummet toward the ground. The system quickly recognized what was happening and gently lowered me to safety.
The final session of the day discussed patellar and Achilles tendinopathy, so popular that I watched from the overflow room. Tendons adapt well to increasing load, but current Achillies tendinopathy protocols mainly include body weight exercises. Dr. Tyler Cuddleford wondered how much therapists can load those with tendinopathies. He showed that patients responded well to eccentric calf raises on a leg press machine with over 300 pounds! Dr. Rich Willy then took us through a case of a volleyball player with patellar tendinopathy. Rest is contraindicated for tendinopathies, so athletes need to keep up with the demands of their sport while rehabbing. Along with strengthening exercises, the player adjusted his biomechanics to reduce pain but maintain similar jumping heights.
Day 2
Day two began with a talk about return to sport (RTS) for lower extremity injuries. Dr. Mike Reiman summarized the current state of RTS, arguing there is room for improvement (potentially only 55% of athletes return to sport post ACL surgery). Dr. Dan Lorenz then focused on the specifics of RTS testing. He led the audience in multiple refrains of “what we permit, we promote.” For certain tests, rather than accepting an 85% or 90% limb symmetry, therapists should target much closer to 100% and be more strict when assessing quality of movement (no knee wobble, smooth and stable landing).
The poster session followed, where the UIC community supported my fellow classmates and their literature review of the McKenzie Method for low back pain patients.
Day 3
Day 3 began with a talk on sleep and aging. The intersection of sleep, aging, and morbidities correlates with less healthy patients, and therapists are encouraged to screen for sleep disorders. Dr. Cathy Ciolek described how she works with skilled nursing facilities to improve sleep quality of the residents. She minimizes sleep disturbances by increasing time between patient safety checks as appropriate, using headlamps with red light, oiling squeaky cart wheels, and moving the location of the clock in/clock out machine away from patient rooms. Dr. Catherine Siengsukon then provided tips for all patients: maintaining a regular sleep schedule, avoiding excessive napping, and creating a relaxing bedtime routine. More specifics are described in her 2017 article in PTJ.
I scheduled my return flight for Saturday evening, so my final talk of the conference was the afternoon session on hamstring strain injuries. Dr. Bryan Heiderscheidt cautioned that almost everyone in the room was at an increased risk for injury (risk increases at age 23). Though high speed running provides a protective effect, the absence of daily gym class and recess in adult lives may explain a pulled hamstring from a work softball outing.
Attending CSM proved to be a valuable experience. The 18,000 therapists in attendance inspire students and highlight the incredible opportunities in the field. Specifically, I decided to become more involved and join the sports section. I’m excited to return next year in Orlando!