sOcial buTterfly

Implicit bias includes the innate opinions and beliefs we have about the world, and specifically, the people in it. Our implicit bias is like a lens that we see others (and ourselves) through. It is shaped by our culture, our experiences, and our education. In her talk, "You Can't Be What You Can't See," Dr. Gibbs asserts that our cultural identity is a complex thing. Cultural identity is not limited to race, ethnicity, and religion. Someone who is the same race as me could be raised in a far different culture! Identifying with others culturally, nonetheless, is an important part of occupational therapy. Thus, it is essential to identify our biases in order to truly understand our clients. Listening to and grasping the needs, wants, desires, and fears of our clients requires humility and open-mindedness. Our presence (our therapeutic use of self), can lead our clients to be comfortable with who they are and with trusting us with that precious, vulnerable knowledge. ...

The shoulder complex is just like the name suggests-- complex! Functional movements of the arm and shoulder require the clavicle, scapula, and humerus to work together in a kinetic chain. If dysfunction occurs in one joint or body structure in the complex, the function and movement of the whole complex will suffer. This relationship is known as the "scapulohumeral rhythm" and specifically refers to the collaboration of the scapulothoracic and glenohumeral joints. For full range of motion to occur, the humeral head must remain in optimal alignment with the glenoid fossa (1). When reaching above the head, the scapula rotates upward to permit this alignment, as well as to maintain an optimal length-tension relationship among the abductor muscles (2). As the glenoid and humeral head remain in alignment, shear forces are decreased, reducing the risk of friction and associated pain (3). If the scapula does not upwardly rotate adequately, the subacromial space is limited, and the st...

In range of motion and manual muscle testing, positioning of the patient is key to achieving accuracy and consistency. Furthermore, palpating bony landmarks is also critical. Proper body position and palpation is necessary to correctly align the goniometer for ROM testing (1). By palpating bony landmarks, various therapists can place the goniometer in the same position, improving interrater reliability of the ROM measurement (2). Locating bony segments also allows for appropriate stabilization of the body during MMT (3). Palpation is an important tool for recognizing irregularities in bony segments, or identifying tissue swelling that may contraindicate measuring (4). In addition to proper positioning of the patient, putting the limb being measured in the "test position" is also essential for successful MMT. The test position puts the muscle in a position for the greatest contraction, or greatest mechanical advantage (5). This allows for fair and accurate measurement of mus...

Every morning, I start my day with a hot cup of coffee. I begin by sitting in my recliner with my coffee mug clasped in my hands about hip-level. In this position, my arm is adducted and my elbow is flexed about 90°. My wrist is slightly flexed as I grip the handle of the mug. After I bring the coffee mug to my lips, my elbow is almost fully flexed and my arm slightly abducted. Wrist remains slightly flexed throughout the movement. Elbow and wrist flexion occur in the sagittal plane about the frontal axis, while abduction of the humerus occurs in the frontal plane about the sagittal axis. The osteokinematic movement of the elbow is flexion in an open kinematic chain. In terms of arthrokinematics, the concave surface of the head of the radius rolls and glides anteriorly over the convex capitulum of the humerus to increase flexion. The prime mover for elbow flexion is the biceps brachii, which performs a concentric action.

As I reflect on Professor Flick's presentation about health equity and social determinants of health, I am humbled to realize how privileged I am to read at a high level, to have a general knowledge of health lingo (thanks to my mother, a nurse), and the confidence to ask my healthcare providers questions (thanks, higher education and life experience). I learned that this luxury is not shared by all. In fact, communicating with health professionals and even attending routine appointments can be daunting for many people. I realized that being a sensitive, culturally-responsive, and equitable healthcare provider will take more effort and consideration than I ever thought. I now know that I have to be just as vulnerable as my patients and clients. I have to be sensitive enough to recognize that a client might need instructions read to them, or audio-visual aids presented to them in order for understanding about therapy to be attained. This bears the risk of insulting people who feel...