Approach
I believe the body is a moving, active system and its most powerful healing processes are too. My approach meets you with compassion where you are, and integrates the highest standards in movement science with powerful evidence-based lifestyle-as-medicine principles to empower your health and healing journey.
Movement System Impairment (MSI)
The Movement System is a distinct body system that generates and maintains movement at all levels of bodily function, arising from the dynamic integration of multiple systems of the body (e.g. musculoskeletal, nervous, cardiovascular, pulmonary, endocrine, skin, digestive, psychological/behavioral, etc). I apply this framework to my highly specialized assessment of human movement, its normal variations versus abnormal pathologies, and together with the client, chart an active pathway to restore each individual's optimal movement. The Movement System Impairment approach was developed at Washington University School of Medicine in St. Louis where I earned my entry level Master’s degree in Physical Therapy (MSPT) in 2001, and then returned to complete my post professional doctorate (DPT) in 2010. The Program in Physical Therapy at Washington University School of Medicine is the long-standing #1 ranked program in the country, and the American Physical Therapy Association (APTA) adopted this model of the movement system in 2013 to guide the identity of the profession.
Physical Stress Theory
The Physical Stress Theory is based on the premise that all biologic tissues respond to physical stress In predictable, characteristic ways. The theory was proposed by Drs. Michael Mueller and Katrina Maluf in 2002, but it isn’t novel to any one physical therapy approach nor is the underlying concept ‘new’ to the table in physical therapy practice. Rather, its development created a systematic framework to organize our understanding of tissue injury, and to guide intervention to align stress at a therapeutic threshold for healing and restoring stress tolerance. I studied with Dr. Mueller as part of my post-professional doctorate curriculum and the theory has positively influenced nearly every aspect of treatment approach, from critical thinking processes, to how I educate patients, to how I communicate with inter-and intra-professional colleagues.
Segmental Stabilization
Segmental Stabilization is an approach aiming to re-engage, re-educate and strengthen the smaller muscles close to the joint to provide stability and movement precision while larger muscles spanning multiple joints provide power and movement. This approach proposed by Paul Hodges et al relates specifically to the spine; similar concepts guide application of ‘proximal stabilization’ for treating impairments in the extremities. A common thread of these approaches is woven through the Movement System Impairment approach, to analyze movement impairments as they manifest throughout the kinetic chain and restore optimal movement health considering individualized structural presentations and movement demands.
McKenzie/Mechanical Diagnosis and Therapy (MDT)
The MDT approach is a widely recognized evidence-based approach developed by Robin McKenzie in Australia. It has application in treating a variety of joint disorders, but is most widely known as it relates to disorders of the spine. It employs a systematic examination to determine a movement related diagnosis, and prescribes specific movement stresses to the spine guided by a symptom response called ‘centralization’ (meaning symptoms move centrally as they improve). The technique is carefully dosed to the minimum-necessary force to achieve centralization, and emphasis is on patient-driven exercises as much as possible throughout the therapeutic episode and then with transition to long-term management.
Manual Therapy
Manual Therapy: My approach integrates evidence-based manual techniques with an intuitive touch and thoughtful underpinnings in kinesiology to help promote healing, ease pain and guide a return to movement precision.
Pain NeuroScience
Pain is a complex experience arising from how the nervous system detects and interprets sensory input. The experience of pain is deeply imbedded as a survival tool to identify and respond to danger; it triggers a system-wide ‘stress response’ that has helped our species survive since prehistoric times. In the days of heightened threat from predators, a threat would arise and stress would trigger the fight-or-flight sympathetic nervous system to help us survive. Once the threat of the predator had passed, the body would switch to ‘rest, digest and repair’ mode (called the parasympathetic system) which supports the body to go about its natural processes of healing. This stress response doesn’t differentiate between a Saber Tooth Tiger and a 24-7 string of stressful emails however. The modern-day experience of pain can be boosted and extended by never-ending stressors. Rather than the body moving into the ‘rest and repair’ state after an injury, chronic stress levels keep us stuck in the fight-or-flight neurologic response with our bodies thinking we have to keep the life-or-death battle going. (Ever feel like that? I know I have!) Modern-day chronic stress slows or even stalls the healing process, and research has identified that prolonged pain creates measurable physiologic changes to the entire nervous system that actually alters the way we perceive sensory input. So not only will we heal more slowly, but even when we do eventually heal, the experience of pain can persist due to physiologic nervous system mal-adaptations that have occurred. A comprehensive physical therapy approach will assess and treat not only the injury and its underlying causes, but also work to identify and heal these nervous system mal-adaptations of the chronic pain experience.
Mindfulness-Informed Physical Therapy
I have a special interest in the emerging scientific body of knowledge investigating mindfulness in healthcare (both from the perspective of well-being of health care providers, and as a powerful complement to more traditional Western medical approaches). Over a 6-year personal practice of mindfulness and meditation, I began to connect the dots of mindfulness as an insightful lens through which direct experience of the movement system could better access a broad and deep reservoir of healing potential. I engaged in a diverse study of mindfulness integration in healthcare and physical therapy specifically, and in 2019 took a professional sabbatical to commit to more in-depth study through the teacher training pathway at The Center for Mindfulness at Brown University, and formal course work and professional mentorship with national leaders in integration of mindfulness practices into physical therapy and healthcare.
Lifestyle as Medicine
Our innate healing processes are best engaged when we are well-nourished, getting restorative sleep, effectively managing stress, engaging in positive social connections, avoiding toxins, and getting the right kinds of physical exercise. These 6 pillars of health are the foundation of what is called “Lifestyle Medicine”, and are essential infrastructure for the body to respond in a meaningful way to physical therapy intervention. By focusing on the lifestyle choices that give rise to chronic disease, patients and providers have better outcomes and satisfaction. I am a doctoral member of The American College of Lifestyle Medicine, an evidence-based interdisciplinary collaboration at the forefront of the healthcare movement to treat, reverse and prevent chronic illness through re-alignment of healthy lifestyle behaviors. Lifestyle medicine is the foundation for a redesigned, value-based and equitable healthcare delivery system, leading to whole person health.
“Lisa made all the difference; she is a master at her craft.
I feel so lucky to have worked with her.”
- Past Patient