Breakthrough Interview with Tom Dalonzo Baker How To Do PT Telehealth

Breakthrough & Tom Dalonzo-Baker on Telehealth for Physical Therapy

Many Physical Therapists are considering making a switch to PT telehealth during this National State of Emergency.

Here's an interview I did with Tom Dalonzo-Baker from Total Motion Release on the topic.

Highlights from the Call:
Continue to test-treat-retest as you would in the clinic.
Use “Directional Preference” treatment systems in a scientific manner.
Tom is offering a free training for owners who want to learn more.

Video Transcript

Full Transcript
Chad:
Hey, everybody, Chad Madden here with Breakthrough. Today I'm talking with Tom Dalonzo-Baker. Tom, just like you and I, is a private practice owner of Total Motion PT. Now you probably know Chip and Deanna who took over the practice. Tom is also the founder of Total Motion Release, you've heard me talk about this. We had a PTA take his course, I think it was 13 or 14 years ago now, and I remember just applying Tom's methods in our clinic and seeing some ridiculous results that didn't necessarily make sense to me. Anyhow, during this state of emergency, I'll call it, as of right now, I wanted to get you some information about how are you possibly going to treat somebody with telehealth? So anyhow, Tom, long-winded introduction, but thank you for doing this. Welcome here.

Tom Dalonzo-Baker:
Hey, thanks Chad. Absolutely. More than happy to help. It's a great opportunity to telehealth, to hopefully open up to, for people to see that we can maybe help and give you guys hope for what's going on in your situation.

Chad:
Awesome. So the first thing that I'd love for you to talk about is I from experience in telehealth, one of the biggest, when we're in the clinic, we can do test, treat, retest. When we're meeting like this with a patient, essentially we want to have that same exact fundamental element in there so we're providing a valuable service online even if we can't provide hands-on therapy or we can't do hands on motion guiding. So with Total Motion Release, how does that work? How would you go through, and if you want to walk me through an exercise right now?

Tom Dalonzo-Baker:
Yeah, absolutely. So look, it's important to have a system down just like you'd have if you're working with them manually. And the thing you need to realize is that we're only ever dealing with motion and that's what's really cool here, right? You're either moving them or they're moving themselves. So all you want to be able to do is to take that area, so if somebody's got a shoulder problem, what are the motions that we want to take them through? So Chad, do you have a shoulder problem, I'd take you through what? Flexion?

Chad:
Yeah. Great.

Tom Dalonzo-Baker:
Go through. I might take you into abduction. All right.

Chad:
Left is bad, Tom.

Tom Dalonzo-Baker:
All right, so abduction. I just want to really focus on that area, let's just say here.

Chad:
Left is-

Tom Dalonzo-Baker:
Let's get some-

Chad:
Oh, come on man. You're killing me. All right.

Tom Dalonzo-Baker:
Awesome. Okay, so is that enough? Is that enough to say that you got what you needed to get there, Chad?

Chad:
I'm aware that my left side has some issues, yes.

Tom Dalonzo-Baker:
All right, so what are some of the ways that we could go ahead and treat that?

Chad:
Okay, so like you and I talked about earlier, or at least what I would know, is if the right side is easier, most of us are familiar with the idea of a directional preference. So if the right side is easier, what I've done when I've implemented TMR in the clinic is I would have the person move the right side and let's say two sets of 12 of abduction and then go back and retest. So we're still using that test, treat, retest.

Tom Dalonzo-Baker:
Correct. Absolutely. Absolutely. So yeah, one of the things is we've got, and I think you were going to share this with us, on the website we've got, on totalmotionrelease.com, I've got a free training for you guys right now that is extensive. It's right there. It even gives you two credit hours CEUs. And it'll get you going into feeling incredibly comfortable on treating people in telehealth. This was just developed about four months ago. I gave you the latest and greatest information. These videos right here that you have are treating. I show you the pretesting, I show you the treatment, I show you the post testing. And it'll give you a very good, wow, I can do that.

Tom Dalonzo-Baker:
And there's three ways in which to test. The entire body. There's three ways to treat the area of injury and we show you a system to do that so you feel comfortable like, wow, this isn't that difficult. In fact, it's pretty simple to do. And my first step is get up there, get the free training. It's going to take you through 15 steps, and by the end of it you're going to say, hey, I'm feeling comfortable with doing telehealth with people. On here I show you how long it lasts, I show you why it works, I show you theories behind it that are very simple to get involved with it. That fair?

Tom Dalonzo-Baker:
So with your shoulder issue, Chad, we could go and try to treat into restriction. It's not lifting very well, we could do it like we're used to, like TheraBands and they don't have TheraBands at home, so we may just treat it. Now we can also shorten that tissue by coming over here, we're actually shortening the tissue on that side. So there's two different ways in which to go about and tackle an issue. It's either going into the restriction or going into ease. And when you get involved in that, it's pretty simple and easy for your people, not only just your therapists but also your patients to grab ahold of that and say, I can do this. So very powerful, very good. I always say just get to the website, watch a couple of videos and say, hey, I think you'll be able to say I can do that.

Chad:
Awesome. So two stories I want to share with everybody watching. Number one is we had a… So again, this is right after our PTA had taken Tom's course. First patient we ever treated in the clinic had a full thickness rotator cuff tear diagnosed. It was two or three years before. She was in her late seventies or early eighties, and because of all the co-morbidities, did not qualify. They wouldn't operate on her, essentially. So we had to go through, and we have this on video, it's actually on an old mini disc. That's how long ago this was.

Tom Dalonzo-Baker:
That's a long time.

Chad:
We had her abduct each side, I think with the left side she ended up having maybe 70 degrees. It was very limited. Horrible scapular winging, the whole deal, just no control there at all. We go through everything, we found a contralateral hip restriction. We ended up having her do some seated straight leg raises, and I remember as George was going through this, I said, there is no way that this works. I can't wrap my head around this anyhow.

Tom Dalonzo-Baker:
You're doing legs to, quote, fix shoulder. Is that correct?

Chad:
Yeah, exactly. So anyhow, and we said, okay. Mary is a fictitious name. And I'll say, “Mary, raise your arm.” And she said, “I don't know why you're having me do all these movements.” Her daughter was there and her daughter is very, very loud and she went off like a… She caught it and the patient, Mary, did not even realize that her arm got better. She was a seven out of ten pain before, now she had no pain at all. Her daughter is freaking out. Everybody in the room is looking over and we're like, wow, there is something here that we can't explain but we don't really care. We just know it works.

Chad:
Second story is when I treated the gentleman from Calcutta, India over 18 months, we did tele-health. He was, I don't know why I remember this number, 7,937 miles from Calcutta to Harrisburg, so we were 8,000 miles apart. I treated him once a month and I was paid for the entire treatment plan but we got to a point of where… And he had three level disc herniation on an MRI before the treatment. I wrote about this in both of our books on back pain and we were featured in a local paper and got some local press coverage out of it regarding telehealth. Big secret was I used TMR when we got him to a certain point and he still had some restrictions, primarily unilateral hip restrictions. We just couldn't seem to shake it with normal exercise. I said, “Hey, let's do a general screen.” We took him through five or six, I forget what it was called at the time.

Tom Dalonzo-Baker:
Fab six.

Chad:
Yep, fab six. We took him through those movements and we found two restrictions. Off the top of my head I believe it was thoracic rotation was one and I think he had a hip restriction as well. We treated him with your system and that was the game changer for him. He was 70% better, and by the way, when he was done with treatment he went back and got another MRI showing complete resolution of all three levels of disc herniation. So if you're watching this and you're considering telehealth, you're going to need a system to treat people where you're getting effective before and after, rather than just taking people through exercises, which is I think an essential part once you correct their movement. TMR can do that for you. I'll leave it at that.

Chad:
So if that doesn't convince you to check out-

Tom Dalonzo-Baker:
Let me jump in here for a second because you know [inaudible 00:00:09:37]. I just want to add a little bit. We were talking about left to right side and all of a sudden he jumped from shoulder to leg. I want to give this idea that pretty much we as clinicians, if somebody comes in with a shoulder pain, we're looking at neck, shoulder and ribs. That's the general area that we go to.

Tom Dalonzo-Baker:
When you do understand about lengthening and shortening tissue, you're going to have three areas of the body but you're going to realize every extremity, every area of the body, the left side and the right side, the left side can be used to fix the right side. The bottom right side can be used to fix the right side. And the left side can be used to fix the right side. When you see that you're going to be able to go, whoa, I can just move the body, seeing what's going on in it and have an idea and a system to test and to give them that to treat. Because a big thing that you're going to notice with TMR is your skillset is going to be given to the patient, which is incredibly powerful. So they're going to be able to help the other 23 hours out of the day, too.

Chad:
Yeah, and Tom, we've seen that time and time again where somebody has a shoulder or a cervical issue, we ask them their medical history and it's like, oh, nothing really going on. But I do have a total hip, total knee, or an ankle surgery, and then we resolve the restrictions that they have there and then all of a sudden their shoulder or their neck moves better.

Tom Dalonzo-Baker:
We've got jaw pain people, they can open their jaw and we go, “Hey, do a leg raise.” And the right side's horrible, the left side's really good. We do the left side a bunch, the right side picks up, their jaw opens up, and you go, what? And it may sound so far fetched, and we're not trying to do that because the system can start anywhere from single digit addition if you will, all the way up to trigonometry. But it's very simple and easy to progress through and I do recommend… There's so many people asking about the telehealth, but some of you guys are so concerned about can we do it and can we be consistent so that people go, well, I don't want to do that.

Tom Dalonzo-Baker:
My recommendation is if you've got concerned patients that they go, well, I'm not sure that's going to work, offer them a session. Let them see it. You can even bring into Zoom and you can have multiple people. You can do your workshops via this too if you need to. Or you can just have, hey, on Monday night we're going to do this, anybody who wants to attend to see how well it works, you can do that if you happen to be one of the places that is closed down. Hopefully you haven't. I know Washington's getting pretty bad.

Chad:
I am hoping we are essential.

Tom Dalonzo-Baker:
I was just at the chiropractor right before this meeting and stuff and he said everything's flowing really nicely and he said a couple older patients have called in, so he wasn't… He's on the same idea.

Chad:
Yep. Yeah, we did have record attendance last week. I'm hoping that holds up this week as well. But Tom, I appreciate your time. I know you're a busy guy and thank you very much for sharing your system here. I appreciate it.

Tom Dalonzo-Baker:
Hey, you bet, Chad.

Chad:
Thanks.

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