Texts, Tech and MDT Helped PT Grow His Practice

Patients can come from lots of places: referrals, marketing, word-of-mouth. Maybe even your living room.

That's what happened to Lee Poston, when a YouTube interview revealed a high-profile prospect.

Poston was watching the CrossFit games when well-known pro Dave Lipson lamented about a nagging back injury that had lingered for months despite treatment by several physical therapists and chiropractors. Poston recognized the problem sounded mechanical right away.

"[Musculoskeletal conditions] can often get better due to time passing (natural history)," he says. "This can lead everyone involved to believe that the even the wrong treatment was successful.

"But, due to the underlying mechanical cause not being addressed, the pain will recur," says Poston, PT, Dip. MDT, CSCS.

An avid CrossFitter himself, Poston reached out to Lipson on Facebook ... and got a reply. Poston credits the McKenzie Method? of Mechanical Diagnosis and Therapy? (MDT) with allowing him to treat Lipson remotely. The two walked through examination, evaluation, diagnosis, prognosis, intervention and prevention exclusively by phone, text messages and email.

How? The evidence-based MDT system begins with a thorough mechanical analysis to establish a "cause-and-effect" relationship between historical pain behavior as well as the response to repeated test movements, positions and activities.

A systematic progression of applied mechanical forces utilizes pain response to monitor changes in motion and function to classify the disorder. Clinicians then develop a treatment program that empowers patients to treat themselves when possible and very little, if any, physical intervention is used.

"Once a patient 'gets it' - that sitting at a computer the majority of an eight-hour day or bending over to lift with poor body mechanics triggers pain - it becomes easier to stop the pain cycle with daily behavior modifications," Poston says.

He established a program for Lipson, who began feeling better after about six weeks of repeating a specific movement every one to two hours each day. That was satisfying enough for Poston, but the case actually became an invaluable marketing tool.

"He later put the experience in an article unbeknownst to me," Poston says. "Since then, I have gotten emails requesting help from as many as 15 different countries."

The owner of Therapeutic Associates of Maui in Hawaii has been able to treat most of them remotely using Skype, mobile and other e-communication, making referrals to local providers when needed. Poston says ineffective physical therapy is a common complaint in the CrossFit community, which gives himself and MDT treatment another niche.

When back pain persists, most athletes are erroneously told by physicians or PTs to strengthen their core or muscles around the injury, when addressing mechanics of the joint will provide a long-term solution, he says. Since this is addressing the actual problem.

With MDT, Poston can provide that solution without geographic limitations. After all, you never know where your next patient will come from.