How do you say Spinal Manipulation in Italian?

During my visit to Italy this month, my friends and I were in search of a museum in Bologna. The museum closed early that day (in Italian time, what’s closing an hour early?), but we found something even better! The Associazione Italiana Fisioterapisti was hosting a seminar on the 50-year history of their national physical therapy association in conjunction with the World Confederation for Physical Therapy World Physical Therapy Day September 8.

As my friends rolled their eyes while thinking I was never going to leave the exhibit, I took photographs of the past and present Italian physical therapist displays. The best ones are the spinal manipulation photos. I now have evidence that the rest of the world is leaving us in Washington state behind in standards of care.

At dinner that night I shared this discovery with the rest of our group. I am now sharing it with my fellow PTWA members. Salute!

Dr. Elaine Armantrout, PT, DSc, ECS
PTWA Legislative Committee Chair

Check out Elaine’s photos on the PTWA Flickr page.


PTWA Members Represent at Town Halls Across the State

Thanks to your efforts during the August legislative recess, PTWA had representatives at town hall meetings in almost every district in the state. Members attended town hall meetings in six of the nine legislative districts in Washington – two of the three remaining districts didn’t even hold town hall meetings!

In addition, PTWA members visited a district office in District 6, conducted a practice visit in District 7, and participated in an invitational telephone round table discussion in District 2.

We still lack cosponsorship of APTA’s key legislation, so please continue making contact and district office visits to your congressional representatives. Find links to APTA’s health care reform site on the PTWA home page.

PTWA Conference Offers Great Education and More

I like to attend PTWA conferences on a regular basis for several reasons. I live in a relatively small town and often feel out of touch with what is going on at a state level. The conferences get me up to speed and it is always interesting to know of staffing issues as well as reimbursement. I also think it is important to support my professional association especially in the political arena.

I also use the social times at conferences to catch up with friends. It is often the only time I get to see people in such a nice environment.

The education that is offered is always very good and very cost effective. Sometimes I think people would rather have more ‘hands on’ courses, which is not feasible but you always learn a lot from the lectures. The quality of speakers is always good and it is so nice to get nationally renowned speakers without the expense of travelling out of state.

I think we all get a little stale working in our own little world especially when busy and I always find the conferences renew my energy to improve my skills and recognize what a great profession we have.

Margaret A Fletcher, PT
Wenatchee Orthopedics

To register for PTWA Fall Conference visit

Functional Motor Changes with Dynamic Orthotic Systems in Pediatrics at PTWA Fall Conference

Over the past 10 to 20 years, there has been a paradigm shift in orthotic construction and function from systems that are very stiff and deliberately blocking movement to manage an “ideal alignment” to very intimate fitting ultra-flexible systems which invite movement control by containing movement around biomechanical neutral orientations; systems that are so flexible and reactive that they both guide movement control and assist motor learning and the process of regaining a more balanced and functional position.

Research in human biomechanics, neurophysiology and soft tissue structures shows a very high inter-relationship between the dynamics of these systems, point to an immense degree of plasticity throughout life (especially in the very young) and the requirement for precise increments of movement throughout the systems.  I am very pleased to be able to share some of my fascinating journey with these dynamic orthotic systems which offer very practical and expanded treatment possibilities to you as a therapist and functional improvement and support to the persons with neuromotor and muscloskeletal impairments who you are trying to help.  Even though I have worked primarily with Pediatric populations over the past 40 years, these systems work equally well with adults of any age.

I am very pleased to be able to share some of my fascinating journey with these dynamic orthotic systems which offer very practical and expanded treatment possibilities to you as a therapist and functional improvement and support to the persons with neuromotor and musculoskeletal impairments who you are trying to help.

Nancy Hylton, PT, LO
Presenting Functional Motor Changes with Dynamic Orthotic Systems in Pediatrics
at PTWA Fall Conference

Powers’ Biomechanics Class Immediately Applicable

I took Dr. Power’s class at the PTWA Spring Conference in 2006. At the time, I was a third year PT student finishing up my final internship and getting ready to graduate and start working in outpatient orthopedics. Dr. Powers’ class completely changed my approach to treating both patello-femoral pain syndrome (PFPS) as well as other knee and hip problems (IT band syndrome, bursitis, etc) by focusing on strengthening the gluteus medius. Before taking this class, I had patients doing bridges or wall squats with a ball between their knees which promotes the adductors or abduction exercises that facilitated TFL instead of gluteus medius tightening the IT band even more. Since then, anyone I see with a hip or knee problem I focus on strengthening their gluteus medius per the information I learned in this course. I have used the knowledge from Dr. Powers’ class in my three-plus years of practicing in outpatient orthopedics and have seen it work time and time again particularly in adolescent females with PFPS. I personally have knee pain because of PFPS but haven’t had a problem since working on my own hip strengthening (or doing the exercises with my patients). I would recommend Dr. Power’s class to anyone who has an interest in orthopedics. He is a dynamic presenter, has wonderful visual materials to follow, and his class is full of information you can apply to your practice immediately.

Sarah Watson, PT
Apple Physical Therapy

To register for Powers’ class, visit

Carrie Hall, PT, MHS, Recalls Dr. Powers’ Seminar in 2006

I attended Dr. Powers’ seminar on Lower Quarter Biomechanics in 2006. Dr. Powers gave a dynamic presentation on the most current research regarding biomechanics of gait with wonderful video animation of real-time kinematics. It is tough to make that material engaging, but he pulled it off! I remember thinking that all PTs involved in LQ rehabilitation should attend this course.  He presented the components of gait in a logical manner with emphasis on the interrelationships of the foot, ankle, knee, and hip. The video he presented demonstrated the interaction in real time and slow motion. In addition, he presented evidence-based data regarding evaluation and treatment of patellofemoral joint (PFJ) dysfunction. Using kinematic MRI and EMG data, he critically reviewed long held, but poorly researched, areas of evaluation and treatment of the PFJ. He challenged the participants to reconsider beliefs regarding the etiology, evaluation and treatment approaches of the PFJ, and provided alternative ways to think about evaluation and management of this challenging region of the body. As a specialist in diagnosis and treatment of movement impairment, I enjoyed his emphasis on the importance of the foot/ankle and hip as they relate to kinematics of the knee and PFJ. After looking at his agenda for this year, it appears that he has expanded his evidence based data to involve conditions at the foot, ankle and hip. Whether or not you attended in 2006, I encourage all PTs involved in treating LQ conditions to take this course. The review and update on gait kinematics will strengthen your knowledge and analysis skills regarding the LQ and insights into PFJ kinematics and associated regional impairments will undoubtedly change the way you diagnose and treat these regions.  I know I would not miss it!

Carrie Hall, PT, MHS
Movement Systems Physical Therapy, P.S.

Register for Dr. Powers’ course at PTWA Fall Conference Oct. 23-24 in Tacoma: