By Mark Yanai

Happy New Year!

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HAPPY NEW YEAR FROM THE F&L OHANA!

As we ring in the New Year and recover from the holiday festivities, I look back at what was accomplished in 2014 in gratitude. This past year was a banner year for F&L with many blessings bestowed on our organization.

THE BIG MOVES:

– Our Nuuanu Clinic closed after 13 years of operation at the Pali Medical Arts Building and moved to two locations at Kuakini Plaza and Tower.

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– Our Kaneohe clinic closed after 15 years of operation on the corner of Kam Highway and Pua Inia St. and moved to join our Aquatic and WORC sites at the Kokokahi YWCA.

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NEW BEGINNINGS:

– In celebration of WORC’s first anniversary, we held an Open House at the Kokokahi site for the medical community in Worker’s Compensation to show them our facility and the services we offer.

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– A weekly WOD (work out of the day) at our WORC site for anyone who wants to learn new exercises, break a sweat, challenge themselves and have some fun!

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– A Caregiver Workshop at our Kailua clinic gave tips and instructions to teach families how to provide safe and careful ways to assist loved ones.

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– Our Mobile Therapy Program started in October to address a needed area of physical therapy for those who have difficulty with an outpatient clinical setting. More on this on my next blog!

VOLUNTEERS, PT STUDENTS, CO-OPS AND MORE:

– We continued our relationship with Northeastern University in Boston with our Co-Op Program with three outstanding students in Jessica, Ariel and Melissa. See our previous blogs for their experiences.

– This year we hosted more than 20 students from around the nation including Pacific University, Washington University, AT Still University, Loma Linda University, Montana University, and Northeastern University. We continue to have a strong commitment to Kapiolani Community College and their PT Assistant program as we provide clinical instruction for their students.

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– F&L hosted two NAIOMT courses this year and continued our intention to become a training site for mentorship of NAIOMT professionals.

– We are now certified providers in Graston Technique and FMS Assessments.

F&L’S HIGHER PURPOSE!

– As a Value-Based Organization, we continue to be involved in community activities such as the Arthritis Walk, School Supply and Food Drives, and Susan G. Komen Race.

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– Hope you were able to get your car cleaned at our annual FREE car wash! We appreciate the community’s support of our organization throughout the years!

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– Keep up with our monthly craziness at F&L! Check out and like our Disney-themed Physical Therapy Month on our FACEBOOK page. Click here.

– INSTAGRAM! Follow us on our new site to keep up with what’s new at F&L. Username: @fukujiandlum

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Halloween

We look forward to the new year and continuing to love and serve our community in 2015!

By Mark Yanai

Selective Functional Movement Assessment

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On June 20-21st, I attended a SFMA workshop at Queen’s Medical Center. SFMA stands for Selective Functional Movement Assessment, which is a comprehensive system used to classify movement patterns and direct manual therapy and therapeutic exercise interventions. The class was taught by Dr. Michael Voight, PT, and Brandon Gilliam, DPT, from the North American Sports Medicine Institute.

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The SFMA helps rehabilitation professionals incorporate a movement pattern baseline into the musculoskeletal examination. It creates a pattern-specific perspective of how the patient moves in relationship to his/her anatomical information and medical diagnosis. I became interested in SFMA after reading Gray Cook’s book called MOVEMENT.

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The class was well taught and interactive. The practical portion was excellent as Brandon gave the attendees an exercise progression to address dysfunctional movement patterns that the assessment system targets. Watch this video as Brandon shows a basic exercise for Rolling.

A big part of F&L’s company culture is ‘To Embrace Change’, a key value which we strive to live by each day. With SFMA being a new system, I am excited to incorporate it into our practice methods as it will greatly assist our physical therapists in assessing and treating patients. So when you come in to see one of our therapists, don’t be surprised if they take you through an assessment that looks at movement patterns of your entire body.

By Deb Matsuura

Aquatic Physical Therapy For Arthritis

Did you know that Arthritis affects 1 out of 5 families in Hawaii? That’s about 79,000 adults and over 1200 keiki who suffer from some form of Arthritis here in the islands. Many of us are familiar with one of the more common forms of Arthritis called Osteoarthritis (OA), found mostly in knees, hips and hands. The Arthritis Foundation defines OA as, ” the breakdown of cartilage (the part of a joint that cushions the ends of the bones and allows easy movement) and as it deteriorates, bones begin to rub against one another.”

Someone with OA may have difficulty making specific movements when using a joint as it can cause pain and stiffness.  When OA starts to affect one’s daily activities, Physical Therapy can play a vital role in decreasing pain and improving movement. Patients with OA can be prescribed therapy to treat their arthritic symptoms. F&L offers various types of therapy programs for patients with Arthritis, but the Aquatic Therapy program is especially designed to provide patients a comfortable setting where they can perform exercises in the water, resulting in less stress on the joints. Click Aquatic Therapy program for more information.

Let’s get you back to doing the things you love and enjoy doing!

Get the Facts on Arthritis:

Myth #1: Arthritis is just minor aches and pains associated with getting older.
Fact: Arthritis is actually a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions that can affect people of all ages, races and genders.

Myth #2: Arthritis is not a serious health problem.
Fact: Arthritis places a growing burden on the health care and economic systems in this country.

Myth #3: People with arthritis should avoid exercising.
Fact: Exercise is a valuable tool in the fight against arthritis.

By Mark Yanai

Dr. Stu

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On Tuesday March 11, 2014, Dr. Stuart Wakatsuki passed away after a long battle with cancer. He was an orthopedic surgeon with The Windward Orthopaedic Group, specializing in foot, ankle and sports medicine.  

Dr. Wakatsuki was a graduate of Punahou School and  St. Louis School of Medicine in Missouri. He then became a foot and ankle specialist through a fellowship at Allegheny University in Philadelphia. With an exceptional reputation on the Windward side as a skilled surgeon who demonstrated the highest ethical standards, he always remained a humble and caring professional.

His Celebration of Life was held on Saturday at the Aloha Shriners Beach Club in Waimanalo.

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Personally, I’ve know Stuart since high school when we competed against each other in athletics. To the staff of F&L, Stuart was known simply as a friend. He was an integral part of F&L’s decision to plant roots on the Windward side. Owner Art Lum summed it up best:

“A champion in all walks of life. Any thoroughbred comes from a pure breed. A recognized and well respected family line. His dad, Judge Wakatsuki, stood firm and tall in his years on the bench. His mom, an avid supporter of UH sports teams and family. Her eyes, like Stu’s, spoke of the enthusiasm and vitality in their walk in life.

Stu never strayed the solid line of integrity and goodwill. There was no question in the strike zone, always consistent in calling the balls and strikes. He often paused during discussions, asking for clarity.  Whether the topic was on medical diagnosis, business owners flaps, family and father matters, husband issues, and/or SPORTS, you could count on him to give you his decision and the basis behind it.

Like a Champion, he valued preparation and peak performance. He hated losing and was quick to go to the drawing board to formulate a new strategy. His battle with Cancer was no different. With each pitch that was thrown, he knew exactly his role. To call the shots in taking care of family, friends, and colleagues.  He knew his days were numbered and left his legacy in the stories shared by all in this past Saturday’s Celebration of Life. Champions live on and in my book, a true Hall of Famer.”

We will miss Stuart greatly. Rest in peace.

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By Mark Yanai

What’s a WORC WOD?

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It’s 6:00 am…the Kaneohe roosters are crowing, the sun still sleeping and it’s the perfect time for a workout. Your body is fully charged from a good night’s sleep and you can’t wait to get to W.O.R.C., not because you like to work but because you love W.O.R.C. (Windward Occupational Rehab Center) where every Thursday, a group of die hards meet before the crack of dawn to get in a WOD (Workout of the Day). It all started on New Year’s Eve of 2013 with a group of guys who wanted to get in one last workout before the end of the year. Since then, the group has evolved to whomever wants to show up at early in the morning and start the day with some good ‘ol sweat.

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The format of the WOD changes every week. You never know what you’ll end up doing when you walk through the door. It’s not crossfit, but a blend of functional exercises that include TRX, kettlebells, sandbags, sleds, pulleys, medicine balls, etc. The workouts are usually high intensity interval training (HIIT) with some form of competition. We always include the competitive part which usually gives everyone a little more motivation to push themselves.

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The WOD means something different for everyone but the intent isn’t to lose weight or build muscle. The intent is to find out something about yourself. How do you control your emotions when you’re pushing yourself physically? How do you feel when you compete against others and especially, yourself? How much gratification do you get when you accomplish something as a team?

If you want to be a part of the WORC WOD, all you have to do is show up – Tuesdays, 6:00 am .  That’s the hardest part. Once you do, you’ll get to experience a great group of people who come together once a week and have a lot of fun.

By Mark Yanai

Valuing the Physical Therapist Assistant

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Ross Suyemura, P.T.A., L.M.T., Stacey Hertzog, P.T.A., Jessie Dullaga, P.T.A., L.M.T.
Physical Therapist Assistants at W.O.R.C.

At F&L, we greatly value our Physical Therapist Assistants because they are essential to our operational model that consists of a special team of physical therapists, therapist assistants and massage therapists. We often meet as clinicians to share our treatment approach so that we can provide a well-rounded and comprehensive treatment to our patients. We believe all of our assistants possess competent skills as health care providers and have the utmost confidence in them to provide excellent care to our patients.

Unfortunately, the current trend in many outpatient therapy clinics in Hawaii is to provide care on a one-to-one basis by a physical therapist without the use of physical therapist assistants. More clinics are adapting to this model and marketing it as an approach that is more consistent and of higher value. Because of this new model, assistants are starting to be seen as lesser skilled clinicians to the general public and other healthcare professionals. Even the insurance companies are following suit and trying to dictate this model by reimbursing treatments based on who delivers the care.

However, this is a flawed view. As a physical therapist, I depend on my assistants to provide the same care to our patients as I would on a one-to-one basis. We enjoy having assistants as part of our team and fully support their profession. Other medical professions use a team approach including doctors and medical assistants, dentists and hygienists, and nurses and nurse aides.

Our organization also has a strong teaching culture where we provide opportunities for student internships from schools like Kapiolani Community College that have PTA programs. We have had many students come through our doors from these programs and are proud to say that more than half of the assistants employed by F&L are graduates of KCC.

Regardless of the day or time you are treated at any of our clinics, you can be assured that our staff is well trained. More than one pair of eyes on a patient provides a greater overall picture for optimal treatment. But beyond the technical skills that our assistants possess, the most important quality they all have is empathy. It’s a value that we look for in all our employees. It’s often said in the medical field that “people don’t care how much you know until they know how much you care.” – John C. Maxwell

In addition to being knowledgeable in the physical therapy field, our assistants are unique in that they are able to incorporate their various backgrounds into their patient care. We are fortunate to have assistants that are licensed massage therapists, certified personal trainers or have been lifeguards and firefighters.

We recognize that our operational model of treatment is different than the current trend. We are a special company that follows our values and not trends. We stand by our employees and see great value in each and every one of them.

 

By Mark Yanai

2014 University of Hawai’i Strength Clinic

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This past weekend, I was lucky enough to attend the 2014 HAWAII STRENGTH COACHES CLINIC at the University of Hawai’i. The clinic is run by Tommy Heffernan, a member of the UH football and baseball teams from 1988 to 1991, who handles the overall operation of the strength and conditioning program at UH. David Woodward D.P.T., one of our physical therapists at F&L’s W.O.R.C. site, joined me for two days of lectures and presentations by some of the top strength and conditioning coaches in the U.S.

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Speakers included Robert Dos Remedios (Oregon State), Gary Beamer (Hawaii), Henry Ruggeirio (Univ. of Washington), Brian Neal (Univ. of Mississipi St.), Kari Woodall (Univ. of Wisconsin), and Patrick Ivey (Missouri). Each of these strength coaches brought their expertise and unique experiences to this outstanding clinic by educating coaches, medical professionals and athletic trainers on how to improve performance, decrease injuries, and gain a greater understanding of the importance of strength and conditioning.

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Also in attendance were Dr. Elizabeth Ignacio (IMUA Orthopedics) who spoke about injury prevention and Mike Skogg (Skogg Kettlebell) who talked about kettlebell training.

One of the highlights of the weekend listening the honorable Judge Kaulukukui Jr., who spoke about Hawaiian values and leadership. We were given the opportunity to meet him and we hope to get to know him better as we found out that he resides on the Windward side and also practices martial arts right next to our W.O.R.C. site at Kokokahi YWCA.

David and I look forward to implementing many of the concepts that we picked up this weekend and are already looking forward to attending next year’s clinic.

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By Mark Yanai

High Acceleration – Low Amplitude

This weekend, myself and two of our therapists spent the last few days learning manipulation techniques from Erl Pettman, PT, MCSP, MCPA, FCAMT, founder and faculty member of NAIOMT (North American Institute of Orthopedic Manual Therapy). Twice a year, Fukuji and Lum hosts this PT educational program on Oahu. Erl himself, has been coming to Hawaii for the past twenty years, traveling from his clinic in Abbotsford, Canada, to teach students to become certified manual therapists by the .

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I first met Erl five years ago when I took the Level I class for the NAIOMT certification. NAIOMT is one of the toughest manual therapy certifications that a PT can acquire. The course this weekend and next will cover six days of advanced techniques to equip us with the skills to perform high acceleration, low amplitude thrust techniques to the spine, ribs, and pelvis. These techniques require a high level of knowledge and skill that are acquired through the three previous levels of classes and testing.

While the class is physically and mentally challenging, it is perhaps the most rewarding learning experience of my professional career. I definitely  will use the knowledge that Erl has given me on a daily basis and consider him my clinical mentor. I hope to hone these techniques in the next few months to master them before taking my certification exam.

 

By Mark Yanai

Are you ready for some football?

Football’s Back!!!!

This week the NFL officially kicks off its regular season schedule and with that millions of people will tune into the games starting with Thursday’s game between the Denver Broncos and the Baltimore Ravens. Over 10 million viewers watched Peyton Manning of the Denver Broncos throw 7 touchdowns in leading his team to a opening night win. And with that, hundreds of games will be played from Thursday to Sunday, from Pop Warner, high school, college to the professional level.

For me, watching football changed after having my son, Kaleo, play high school football. He began playing Mighty Mites Pop Warner football in Arizona and has continued his career at Linfield College in Oregon. While it was fun watching him run with the ball as a 7 year old, I never thought it was anything other than a recreational activity that my son would enjoy. As I watched other parents yell and scream at the coaches, referees, and their own kids, I never understood the level of emotion that football involved. I was just hoping that my son would enjoy the game and make lasting relationships and memories.

It was when my son first received his first concussion during the first week of JV practice that I decided to use my profession to get involved. He was diagnosed with a concussion that would keep him out of the first week of school and practice. One of the athletic trainers at Moanalua High School, Cynthia Shimoda called me and informed me of his injury. During his junior year, I asked Cynthia if I could assist the training staff as a volunteer. I had no experience being involved with high school athletics, so it wasn’t surprising to me that I felt a little out of place trying to work on teenage boys as a physical therapist. For one thing, not many of the football boys knew who I was. My son didn’t go out of his way to acknowledge who I was even though I appeared at practice everyday and was on the sidelines for every game. Second, most of them didn’t know what a therapist does and so I was considered another trainer. But I tried to provide something different from the trainers and focused on treatment of injured players and prepping them for returning them to the field.

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It wasn’t until I was able to help some of the players that I began to feel useful. I was able to help with rehabbing sprained ankles, shoulder dislocations, and various soft tissue strains and sprains. Athletic trainers have so many different responsibilities to handle that I felt most useful working on strength and conditioning activities to lessen their workload. I was also able to help with other sports that were in season like girls volleyball and cross country. I learned a ton from the two trainers for Moanalua, Cynthia and Reid Takano. I was so impressed by the way they were able to treat on the field on a moments notice and how they were able to use their skills on the sidelines. I came to appreciate their importance to the football team. Football is such a violent sport and people who aren’t on the field really can’t comprehend how dangerous the sport really is.

And that’s why my view of watching football has changed. I used to have my favorite teams and I would never miss a game but watching my son play I realized several things. I was more involved when I knew the players. I saw that winning wasn’t as important as much as coming out of the game healthy. It changed my view that I was more likely to cheer for certain people than for certain teams or schools. I still enjoy watching a good game. I love watching teams compete and how a community can come together to support a team. But now I watch for with a cautious eye and hope more for an injury free game. Especially one that involves people that I know. I find myself paying attention so that if an injury does occur, it will help me understand the situation and how to treat the person.

I still love to watch my son play. I see the way he loves the game and how much being a part of a team means to him and as a parent, you always enjoy watching your kids dreams come true. Right now he is competing to be a part of a nationally ranked college football team which will push him to compete on a higher level than he’s ever experienced. He’ll have to train his body to handle the rigors of college football and I hope to be a part of that growth in him. I’m sure he’ll have some injuries during his college career and I hope to help him get through that.

So as you tune in to watch your favorite team this year, think about why you love football and why you spend so much time watching it. Enjoy all the big plays and the success of your favorite players. And when you do see someone get injured, look for the people who run onto the field to treat the player and cheer for them, as they are just as much a part of the team as anyone else.

Mark Yanai, M.P.T. – physical therapist, husband, father of three, sports fanatic and shoe lover