Get Inspired and Lead by Example during the Special Olympics 2018 USA Games in Seattle

@2018USAGames. #RiseWithUs #2018USAGames

The Special Olympics oath: (McCallum, 2008)
Let me win,
but if I cannot win
let me be brave
in the attempt

Last summer, I had the opportunity to join physical therapists, physical therapist assistants, students and a few other members of the community who volunteered for a FUNfitness screening program in Everett during last year’s Special Olympics of Washington (SOWA) Summer Games. FUNfitness is part of the Special Olympics Healthy Athletes initiative to assess flexibility, strength, balance and aerobic fitness of the athletes. Introduced in 1997, FUNfitness is a fitness screening event that is part of the Healthy Athletes program and that was developed in collaboration with the APTA.

Lagging healthcare for those with intellectual disabilities culminated in this program of health education and prevention. Despite a mistaken belief that people with intellectual disabilities receive the same or better healthcare than others, they typically receive sub-standard care or virtually no health care at all. (Special Olympics Organization Health). In 2008, the global adult obesity rate was 12 percent compared to 30.9 percent for adults with intellectual disabilities. (Sunders M, 2008). Healthy Athletes has the world’s largest database of health data for people with intellectual disabilities.


During the Healthy Athletes screenings, Special Olympics athletes receive dental, vision, hearing, foot and general health screenings and receive recommendations for improvement after each screening. Physicians and healthcare professionals provide the screening services at tournaments at no cost to Special Olympics athletes. Special Olympics has set a goal of having 100 locations recognized as Healthy Communities by 2020. (Special Olympics Organization Health).

The Special Olympics movement was born out of the work of Eunice Kennedy Shriver, a constant champion for those with intellectual disabilities. Today, the mission of Special Olympics Washington (SOWA) is “Special Olympics Washington BUILDS Communities and LEADS in Wellness through Sports and Inclusion. (SOWA website, 2017).

As a veteran orthopedic manual physical therapist I was confident that I could help somewhere, but this new adventure brought a little nervous excitement. I had no idea what I was expected to do and I was not sure what the athletes would expect from me. Special Olympics was something I learned about when I was a child. This early education left me with the impression that I would be working solely with an athletic, pediatric population with intellectual disabilities. Wrong. Well partially wrong. The athletes with intellectual disabilities span from individuals age 8 and upward into adulthood.

Under the direction of Natasja Ysambart, PT, DPT, SOWA Clinical Director, and Vicki Tilley, PT, GCS, Special Olympics consultant and trainer, volunteers were oriented to the FUNfitness screening stations: flexibility, functional strength, balance and aerobic capacity. While we waited for the athletes to finish competitions the Summer Games volunteers talked and learned from one another, particularly from the current UW student. We had fun running through the tests and it was nice to speak to a group that works with pediatric patient populations and those who rehabilitate patients with varied neurologic conditions. We also had a brother and sister team of high school volunteers, incredibly helpful as our extra hands.

The athletes that night shined – in their medals, in their dress attire (many of them stopped for screenings on their way to a big dance) and in their smiles. Once the process got rolling, it really became busy. Having so many athletes come for screening and education is inspirational. Earlier we ate alongside the athletes in their cafeteria dining room. One realizes quickly how much more can be done to educate and empower this population. At-risk populations are enabled to thrive with instruction and improvement of their awareness.

While we scrambled through the testing, I noticed that the athletes who received dental tools from the Special Smiles dentists were especially careful about saving their packages and educational materials as they worked through our busy screening stations. Behavioral change can occur when you educate and provide tools to those who want to improve their quality of life. The athletes were learning a great deal from what we tested and discussed that night. And likewise, I was learning from them.

During our testing I met a woman who was a fabulous athlete as proved during her fitness screening. She was also proud but competitive with her fiancé. She introduced the FUNfitness team to her fiancé, showing off her physical fitness while supporting his work on balance for his long-term health. After all, he is part of her future life.

Another athlete moved me during an educational discussion about stretching and her home exercise program compliance. She was not particularly fond of flexibility exercises. She told me about becoming a leader for the Special Olympic athletes.  After some discussion we concluded that her role as a leader in the athletic community meant that she needed to be a strong example for others. This piece was inspiring and motivational to both of us; we all have to lead by example.

The athletes and volunteers that I met that day were truly motivating. Everyone was excited about their sports performance, the dance that was being held that night and their future.

The Special Olympics USA Games will take place in Seattle from July 1-6, 2018. Hundreds of volunteer providers will be needed to offer screenings for thousands of athletes who will come from around the country to compete. Visit our web page to find more information and for links to sign up to provide screenings or to sign up for other volunteer opportunities.

Robin Schoenfeld
PTWA Vice President



Help Observe National Physical Therapy Month

The heat of summer made one last push as we moved into “school season.” Hard to think it will be fall very soon!

NPTMLogoColor 2017I would ask that you consider some sort of observation of National Physical Therapy Month (NPTM) in October. The American Physical Therapy Association (APTA) recently posted resources for your 2017 planning.  National Physical Therapy Month resources may be found at . Plan to share your observations with us (PTWA) and our national association (APTA).

This form of professional advocacy is critical. We must tell the public who we are and what we do. Tell the public why you are the reason to #ChoosePT. Let them know of your education and scope of practice. You make differences in people’s lives…as long as they know who you are. Not everyone knows who you are and what you do as a professional. Take the opportunity to leverage your voice to the public during NPTM.



Erik Moen PT
PTWA President

Rich Content and Networking at CSM

Combined Sections Meeting (CSM) 2017
San Antonio, TX

Washingtonians flocked to San Antonio to attend the most-attended CSM in APTA history. Can  you believe there was 14,000 PT, PTA, respective students and exhibitors there? That is a lot of PTs. Why do they go? Excellent programming that addresses their needs specific to their practice interest, a huge exhibit hall, alumni, section and industry receptions, excellent keynote/featured speakers and plenty of networking with friends and peers from around the country. Our great state of Washington was well represented in leadership, presentation, industry and social aspects.

Also featured are state and federal affairs updates. This is where we are updated on processes with the definition of dry needling in the states practice of physical therapy, license compact initiatives, concussion management and continued work to repeal the therapy cap.

Discussion took place regarding the incorporation of the new evaluation codes. Continued work and practice with their use in billing will be critical. The new evaluation codes have far more complexity then our previous 97001 and 97002. Physical therapists can do their part by reliably following the code criteria to clearly define their clients as low, moderate or high complexity. The resultant data will help to better understand physical therapy practice and our interventions. The APTA has numerous resources on its website. APTA was recognized nationally for their efforts in association education regarding the new evaluation codes.  Our Arizona friend Helene Fearon accepted the award on behalf of the APTA.

Want to get involved? I strongly believe that return on your association membership comes through your active membership. APTA does have volunteer opportunities for committees and task forces.  The March 1st deadline is quickly approaching.

As this is a blog, I will conclude my summary comments. It is safe to say that the entire coverage of a meeting like CSM cannot be fully covered in the length of a blog. CSM certainly is an exciting, material rich meeting. CSM is the meeting for you if you are thinking of attending a national meeting for the first time. See you in New Orleans next February!

Erik Moen_EditedErik Moen
PTWA President

Congratulations to Apple PT on the Celebration of its 30th Anniversary

It was an honor to be asked to speak at  Apple Physical Therapy’s 30th anniversary party held on October 18, 2014 at the LeMay American’s Car Museum in Tacoma, WA. Below is a copy of that speech. Congratulations to long-time PTWA member, Randy Johnson, PT, DPT and his team at Apple PT.

Randy was kind enough to invite my husband, Tom and I to attend tonight’s event. I’m proud to stand here and boast about how much Apple PT has contributed to the physical therapy profession.

Randy’s been an APTA member longer than me (by two years)!

Apple PT has so many talented team members. Many of Apple’s PTs are board certified in the areas of orthopedics, sports and women’s health. Board certification is dear to my heart; it’s my most cherished professional achievement. Thank you to all of you who strive to attain our profession’s highest standard of advanced practice.

Apple PT sent many of its talented employees to engage in PTWA leadership roles, such as on the Board of Directors and Legislative Committee. Randy has served on the PTWA Finance and PAC committees, the PPSIG executive board and the national PPS Section membership committee. Apple PT had three employees receive the PTWA PT and PTA of the Year awards: Tom Kabeary, Lisa McCann and Lorien Farren. Andy Wodka was appointed by Governor Inslee to serve on the licensing board last year.

When I think of Apple PT I remember that Apple was the first and largest clinic to close the door for the day so its team could participate in PTWA’s Legislative Impact Day in 2009. This continued until the big storm day a few years ago, but Apple still sends many of its team each year.

Apple PT graciously permitted PTWA to host a negotiation meeting with an opposing stakeholder group at Apple’s corporate office in 2008. Randy grilled us a delicious salmon fillet for lunch. The entire other team declined to stay and join us for lunch. Too bad, it was their loss. But, I learned a valuable lesson that day; it’s futile to negotiate with people who refuse to sit down and share a meal with you.

Randy is our Chapter’s Key Contact for Congressional District 8. I had the opportunity to go with Randy to meet Congressman Reichert in person to talk about physical therapy issues this past April in Washington, DC. It was a pleasure to meet the Congressman and it was obvious how much he leans on Randy for his opinion.

Apple PT has always been a corporate partner with PTWA. We couldn’t thrive this well without Apple PT. Apple PT members have always been strong contributors to our WPT-PAC.

What do I think of when I hear the name Apple PT? Innovators, leaders and givers (givers of time, resources and talent). PTWA is truly grateful for all you do for our physical therapy profession. Thank you.

PTWA President Elaine Armantrout

Fall Conference Breakfast Forum about Alternative Payment System

Please join us Friday morning at 7 a.m. on October 26th to welcome back Karen Jost, PT, MS, Senior Payment Specialist for the APTA Payment & Practice Management Department. Karen is a former PTWA member and worked for Labor and Industries in Tumwater, WA for a number of years.

Karen is the keynote speaker for the Professional Issues Forum at the Fall Chapter meeting at the Tacoma Convention Center. She’s presenting an overview on the APTA Alternative Payment System (APS). APTA proposes to reform payment for outpatient physical therapy services by transitioning from the current fee-for-service, procedural-based payment system to a per session payment system. APTA believes that a system that categorizes patients based on the severity of their condition and intensity of the interventions required better reflects the professional clinical reasoning/judgment and decision making by the physical therapist, improves provider compliance, reduces administrative burdens surrounding current payment models, and is consistent with and enhances payer recognition of the value of physical therapist-directed care. The APS would consist of 3 evaluation codes and 9 examination and intervention codes for a total of 12 codes.

For more information go to the APTA website and search under Payment Reform. Visit to register for this and other conference events.

Elaine Armantrout, PT, DSc, ECS

PTWA President

PTA SIG Roundtable at Fall Conference and November Video Conference to Feature Discussions on New RCs Adopted at House of Delegates

During APTA’s House of Delegates in June, two RCs passed that affect PTAs. RC 14 allows a PTA to directly supervise a PTA student and RC 3 opens the door for PTs to dictate physical therapy care to health care practitioners other than PTAs. There is still much to be decided regarding the details of RC 3, so keep your ears open. The PTWA PTA SIG has scheduled two meetings to discuss the details of these decisions. The first will take place at PTWA Fall Conference at the Greater Tacoma Convention & Trade Center during the SIG Roundtable Discussions on Saturday, October 29 from 7:30 to 8:30 a.m. Breakfast is included for conference registrants and may be purchased on site for non-registrants. The second will be another statewide video conference on November 2, 2011. Future announcements will be made but both meetings will require PTA SIG membership, which costs $10 for APTA members, $20 for nonmembers.

Lisa McCann, PTA
PTWA PTA Student Liaison to the Board of Directors

Contact if you have any questions.

APTA Oncology Section Offers Course on Breast Cancer

The APTA Oncology Section will host “Breast Cancer Rehabilitation,” presented by Barbara E. Nicholson, PT, MSPT, CLT-LANA, October 1-2, 2011 at Kadlec Medical Center, Richland, Wash. The course is open to PTs, PTAs, OTs and OTAs who are interested in working with patients who have breast cancer or are already working with this population because of shoulder dysfunction.

Attendees will receive 1.6 CEUs, 16 contact hours, for attendance. Registration closes Sept. 9, 2011 and costs $475 for section members, $525 for other APTA members and $600 for nonmembers.

Here are some thoughts from Nicholson on how PTs can help improve the lives of breast cancer survivors.

Physical Therapists Help Improve the Lives of Breast Cancer Survivors

Barbara E. Nicholson, PT, MSPT, CLT-LANA

There are 2.6 million breast cancer survivors in the United States.[1] These courageous women are mothers, friends, sisters, wives, partners, daughters and grandmothers.  They will see surgeons, oncologists, radiation oncologists, nurses, social workers, integrative medicine physicians and physical therapists. The side effects of breast cancer treatment can create functional and physical impairments that can keep these women from doing activities that bring joy to their lives. It can be the mother who does not have the strength to lift her child, the athlete who wants to return to her sport or the woman who needs her arm strength to return to work. As PTs we can assist in decreasing the side effects of cancer treatment that can lead to frozen shoulder, pain, upper extremity weakness and lymphedema.

Axillary web syndrome can occur one to eight weeks after the surgical removal of axillary lymph nodes for breast cancer staging.[2] This disorder is characterized by fibrous bands or cords that originate in the axilla and may extend to the wrist or palm. Cording is palpable when the shoulder is in 90 degrees of abduction. 2 These cords have been found to consist of sclerosed lymphatic vessels and veins. Women with axillary web syndrome will complain of pain or they may have difficulty lifting their hand above their head. Shoulder range of motion will be most limited in abduction. In physical therapy treatment we can educate them on the benign nature of this process, teach gentle shoulder and trunk exercise and perform myofascial release techniques to decrease cording. This treatment can help decrease painful guarding that may lead to frozen shoulder.

Six to twelve months after breast cancer surgery 50 percent of women report shoulder range of motion restrictions.[3] Breast reconstruction can also contribute to limited shoulder range of motion. Expanders or implants placed under the pectoralis muscle can cause an anterior pull of the scapula, changing the scapulo-humeral rhythm and creating impingement.

Radiation treatment can cause fibrosis in the pectoral muscles increasing tension over the expander or implant. These physical changes can be reduced with rotator cuff and postural muscle strengthening, stretching, joint mobilization and myofascial release techniques.

Breast cancer related lymphedema may occur after the removal of axillary lymph nodes. The reported incidence of this lymphedema ranges from 7 to 47 percent.[4]   Risk factors depend on the number of axillary lymph nodes removed, radiation treatment, infection and body mass index. Lymphedema may affect the upper extremity, trunk and breast. It can cause achiness, decreased shoulder motion, weakness, difficulty wearing clothes and self-esteem issues. Recent research is beginning to show that early treatment of lymphedema can decrease the progression of this chronic condition and allow the patient improved function and mobility.4

Working with women with breast cancer is an extremely rewarding experience for both the practitioner and the patient. Physical therapy plays an important role in improving the quality of lives of women who are healing from breast cancer. Our techniques greatly improve shoulder range of motion, strength, tissue mobility and decrease lymphedema, allowing patients to gain trust in their ability to heal and strengthen their bodies again. If you are interested in learning more about working with breast cancer survivors, the Oncology Section of the American Physical Therapy Association is offering a course in Richland, Wash. October 1-2, 2011. For more information and to register please visit

[1] SEER Cancer Statistics Review Bethesda , MD: Nation Cancer Institue,

[2] Moskovitz A, Anderson B, Yeung R, Byrd D, Lawton  T, Moe R.: Axillary web syndrome after axillary dissection. Amer J Surg 2001; 181: 434-439

3 Thomas- MacLean RL, Hack T, Kwan W, Towers A, Miedema B, Tilley A.: Arm Morbidity and Disability After Breast Cancer:  New Directions for Care.  Journal Club.  Oncology Nursing Forum 2008; VOL 35, No 1:65-71

4 Stout-Gergich N, Pfalzer L, McGarvey C, Springer B, Gerber L, Soballe  P: Preoperative Assesment Enables the Early Diagnosis and Successful Treatment of Lymphedema.  Cancer 2008; VOL 112, No 12.