17 Years of Physiotherapy Lessons with a Clinical Scientist
This is a guest blog written by a new member of the Embodia Instructor community, Dr. Stephen M. Shaffer.
Steve is a clinical specialist, educator, and scientist with seventeen years of experience in the physiotherapy profession. His professional experience has involved extensive time managing chronic pain as well as both complex and rare cases. In clinical practice, he places an emphasis on research-informed evaluation and management as well as manual therapy, clinical reasoning, and shared decision-making.
Let's dive in and learn from Steve!
What types of services do you provide? Who can benefit from your services?
I provide head to toe services for orthopaedics. In brief, I would describe myself as a pain specialist.
As a result of my extensive orthopaedic training, I have been afforded many opportunities to specialize in just about every anatomical region. This has led to an enjoyable and satisfying career because I get to work with a very wide variety of patients. Or, as I like to say, I don’t think I’ve ever had a boring day in the clinic. For example, every time I’ve worked in a large practice or system I quickly become known as the person who gets results with complicated patients and rare diagnoses.
In addition to treating patients with routine diagnoses such as acute lower back or knee pain, I have also worked with people that have rare genetic disorders and autonomic nervous system dysfunction. While the greatest satisfaction I get from all of this is watching people get better, I am also perpetually entralled by my work. There is never a dull day in the clinic when you are learning from anatomy and physiology.
What's the best continuing education course/conference you've ever taken?
While I value each of my post-professional experiences, the fellowship program that I completed at the University of Illinois at Chicago was by far the most valuable professional experience I have ever had. For 12 months I was enrolled in a program where I was surrounded by clinical and academic specialists.
As a fellow-in-training, I was exposed to a steady and constant barrage of high-quality information. While in that program I essentially re-learned how to function as a healthcare professional. I re-learned how to think, interact with a patient, handle a patient physically, and even how to begin thinking not just as a clinician but also as an academic. While I began to learn all of these things in my entry-level training, re-learning them at a higher level of education was a profoundly beneficial experience. It’s certainly true that studying at UIC was at times brutal and grueling but it was also certainly both exceptionally rewarding and thoroughly life-altering. I wish every physiotherapist could experience a program like that one.
What is the book that you’ve gifted most frequently?
The book that I have gifted most frequently is Kon-Tiki by Thor Heyerdahl. For those unfamiliar with this story, Thor was a Norwegian adventurer who developed a theory about how Polynesia might have been in part settled by people from western South America. He theorized that they sailed on balsa wood rafts across the Humboldt Current. When his contemporaries rejected this theory, in 1947 Thor decided to travel to Peru, build a balsa wood raft, and set sail across the Pacific.
If you like adventure stories then this book is a must-read.
There is also an interesting black and white documentary that was released in 1950 as well as a full-length film from 2012. The more recent film was the first Norwegian film ever nominated for both an Oscar and a Golden Globe award and I highly recommend checking it out.
What's your favourite blog, podcast or online resource?
I am definitely a podcast geek so I couldn’t pick just one. In fact, I have never owned a TV and get most of my local, national, and worldly information from podcasts. However, if I had to pick one to highlight on this platform for a physiotherapy crowd then I would choose the AAOMPT Podcast.
Several years ago I proposed to the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) that they start a podcast. As a result, I was put in charge of the project. As of February 2020 we have put out 35 episodes and we are going strong. If you want to hear stimulating conversations about all sorts of orthopaedic topics then check out our podcast at: https://aaomptpodcast.simplecast.com.
What types of online courses are you providing and who are they for?
To get things started, I’ve recorded three lectures.
One introduces people to the usage of physiotherapy services for the management of migraine headaches. This is one of my favourite topics because fixing migraines, which are obviously ubiquitous, changes a person’s life and I get the privilege of fulfilling that role on a frequent basis. I wish all outpatient, orthopaedic physiotherapists could make migraine headaches disappear. If we ever accomplish that goal then it would be a transformative maneuver for our profession. Regarding my role in that process, it is going to take me a bit longer to get all of my related and more clinical lectures uploaded so, for now, people will have to be satisfied with an introduction to the topic. There will definitely be more to follow on this.
The other two lectures are related to each other.
First, one is about the patterns of referred and radicular symptoms. Unfortunately, I find that most clinical professionals know way too little about referred and radicular symptoms. This causes them to have errors in their clinical thinking when evaluating and managing patients. Fortunately, it doesn’t take a whole lot of effort to start figuring out what you’ve been missing. Second, I uploaded a lecture on T4 Syndrome. This poorly understood diagnosis is controversial, superbly fascinating, and extremely common. While few people have heard about it, if you learn how to identify T4 Syndrome then you’re going to start finding it everywhere. Additionally and more importantly, if you learn how to treat it then you’re going to start changing lives one patient at a time. T4 Syndrome is a truly fascinating neuromusculoskeletal phenomenon and I believe every orthopaedic, neurological, and medical provider should know how to identify it.
What is one aha moment that you’ve had that changed you forever? What did you learn from this?
I remember during my fellowship training when I fully realized that I spent the preceding years not thinking sufficiently broadly or thoroughly. At that point in my career, I was already a specialist via residency training in orthopaedics and I was providing above-average clinical services. However, there were still some serious flaws in my overall approach to physiotherapy. Then, as a result of the expert guidance of Dr. Carol Courtney and her highly qualified faculty, I began to think more thoroughly and scientifically. She taught me how to be a clinical scientist and for that I will be eternally grateful.
If you could have dinner with anyone, alive or dead, who would it be?
If I could have dinner with anyone alive or dead then I would have two dinner guests. What’s more, while I would have so many questions to ask and statements to make, I might remain silent the entire time. That’s because I would invite to this conversational feast both Charles Darwin and a modern evolutionary biologist.
Darwin, displayed impressive and profound skills when observing the hints and clues that were surrounding him. For thousands of years, humans lived alongside that evidence without ever putting the puzzle pieces together. Darwin, on the other hand, not only identified and put the pieces together but he did so without knowing what DNA was. He also didn’t know anything about epigenetics, a more recent discovery that I guarantee he would find fascinating.
As I’m thinking about this exhilarating fictional dinner, I realize that a great way to start things off would be showing the short film “Your Inner Fish,” which highlights some of the work completed by Neil Shubin. In fact, not only would Dr. Shubin’s work be a great thing to catalyze conversation but he would be a fantastic person to host at this dinner with Darwin.
Dr. Shubin would also likely be as enthralled by the prospects of this theoretical conversation as I would be. I think we would be three geeks in a pod as we engorged on knowledge and intrigue. That point having been made, I have officially decided that I could not be a silent observer. I certainly could not hold back and that should have been obvious from the start.
Where can we learn more about you?
My courses are now available on Embodia Academy. You can learn on your own time and schedule. I have three courses to choose from!
- T4 Syndrome: Identifying, Explaining, and Managing a Common but Peculiar Diagnosis
- An Introduction to Physiotherapy as a First Step Intervention for Migraine Headaches
- Referred and Radicular Pain Patterns in Orthopaedic Physiotherapy
Stephen M. Shaffer, PT, ScD, FAAOMPT, FCAMPT
Dr. Shaffer is a bilingual (English-Spanish) clinical specialist, educator, and scientist with seventeen years of experience in the physiotherapy profession. After graduating with a master’s degree in physiotherapy he went on to complete residency, fellowship, and academic doctoral training in advanced orthopaedics. Initially he spent years traveling the United States as a contract physiotherapist but currently works in private practice in Ontario, Canada. During his career he has specialized in the evaluation and management of spinal, extremity, jaw, and headache disorders. Additionally, his professional experience has involved extensive time managing chronic pain as well as both complex and rare cases. In clinical practice he places an emphasis on research informed evaluation and management as well as manual therapy, clinical reasoning, and shared decision-making. Dr. Shaffer prides himself on making sound decisions on behalf of his patients and strives to ensure that they gain maximal benefit from their healthcare experiences.
In addition to clinical practice, Dr. Shaffer is a researcher with experience on topics related to the temporomandibular joint (TMJ) and advanced practice physiotherapy rights. He also has experience teaching post-professional courses on neck, jaw, and headache disorders. Currently, he is an active member of the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT; https://aaompt.org) and is credentialed through the Canadian Academy of Manipulative Physiotherapy (CAMPT; https://manippt.org). When not busy with these professional activities, Dr. Shaffer leads a team of contributors for the AAOMPT Podcast, an interview show that addresses a wide array of topics related to orthopaedics, and serves as a peer reviewer for an array of scientific journals.