FAKTR continues to utilize the most up-to-date research available regarding the application of manual and soft tissue therapies along with exercise protocols to improve patient/client outcomes.
Given the recent climate regarding the overuse of opioids and surgery, clinicians are seeking
non-invasive treatment options for athletes and active individuals that achieve positive results with minimal expenditure of resources and time.
Historically, FAKTR has been rooted in treatment utilizing instrument-assisted soft tissue manipulation. Over time, the FAKTR Concepts have evolved to be utilized with many different soft tissue interventions; such as cupping, compression floss, laser therapy, acoustic wave therapy, massage and other release techniques. The purpose for these interventions is to uniquely affect the physiology of the body in a predictable and reproducible way. With this in mind, FAKTR is based on five concepts of treatment; static, motion, resistance, function and proprioception. Each of these concepts represents a possible provocative position or motion. Using this ideology, FAKTR clinicians are trained to treat patients/clients in these positions or motions, based upon progressive overload. For example, if a patient has pain through shoulder abduction (Motion concept), treatment is administered while that movement is performed for 30-45 seconds or until pain is relieved. Attendees of this course are educated on the proper selection of soft tissue therapy, if required, based upon the patient’s history and presentation. In this way, the patient’s plan of care is individualized to their health status and needs.
If pain has subsided with motion, the clinician will then ask the patient to try any movement that would reproduce their complaint. Treatment is then provided in the same fashion as above.
Next, the patient is assessed and treated against resistance, such as using an elastic band, to resist shoulder abduction. This process is continued through the FAKTR Concepts until the person is mostly or entirely out of pain and function has been restored. The FAKTR Concepts have a system of test-treat-retest inherently built into patient treatment. Further, it is not necessary to go through all five FAKTR Concepts. If the patient’s symptoms do not appear until Function, the clinician would begin treatment at Function. Ideally, the five FAKTR Concepts are intended to be a clinical guide to progressing a patient through care with careful, well-planned decisions tailored to the patient.
A recent systematic review by Smith stated that pain during therapeutic exercise offered benefit in the short-term. This study helps to reinforce the idea that pain does not need to be and should not be a barrier to therapeutic exercise. It also demonstrates that pain drivers are
not limited to the musculoskeletal system. Exercising through pain helps to establish
self-efficacy and a positive mental attitude towards pain. We realize that pain is multifactorial and our approach to treatment during provocative movement provides us with the opportunity to teach course attendees about the biopsychosocial pain model and its significance in individualizing patient care. In doing so, the instructor is able to dissect the 3 BPM drivers of pain and systematically evaluate the most likely cause(s) of that patient’s pain. When Engel unveiled this model in the late 1970’s, he suggested that these 3 components of the model were never meant to be isolated, that they were overlapping and dynamic and that they would be represented differently in each person. As such, course attendees are shown the tools and strategies to identify the potential drivers of a patient’s pain. Course attendees will receive a brief review of evidence-based outcomes assessments, such as the Orebro MSK Pain Questionnaire, Yellow Flag Questionnaire, Pain Catastrophizing Scale and Pain Self-Efficacy. Further, we will discuss the importance of a practitioner’s carefully chosen words and how they can help or harm a patient’s outcomes.
To assist course participants in identifying the biological/pathoanatomical drivers of pain, the instructor will conduct a brief review of orthopedic test clusters, clinical prediction rules and a variety of evidence-based, clinically relevant examinations; this may include functional movement assessments, testing for neuropathic pain or special tests for proprioception and strength. A prime example would be conducting an ankle range of motion assessment that reveals decreased ankle dorsiflexion from a previous injury. Growing evidence demonstrates that this is a common finding with ankle sprains and that it can have negative effects throughout the kinematic chain, particularly in the knee, hip and low back. A significant amount of time is spent during the FAKTR course on evaluation, as this is a crucial step in determining the appropriate course of action for a patient.
During the course, each area of the body is instructed as a separate lecture and hands-on module. Participants are paired in groups of 2-3 people to ensure maximum hands-on participation. Modules begin with the aforementioned assessment(s) and review of key history points germaine to each body area. After assessing, they will receive hands-on training utilizing instrument assisted soft tissue mobilization (IASTM), myofascial decompression/cupping, compression floss bands and hands-on techniques.
Keeping in-line with current data and best practices, this course includes exercises studied and suggested by the likes of Hodges, Cook, Purdam, Rio, McGill, Janda, Liebenson and many more. Course attendees will learn how to incorporate a wide variety of relevant, rehabilitative exercises for each area of treatment based upon examination and clinical findings. Course instruction will include assessment and treatment of the spine, upper extremities (shoulder to fingers), lower extremities (hip to toes), buttocks, SI Joints, abdomen and diaphragm. At the end of most modules, students
will also be taught biomechanical taping techniques for prophylactic purposes, as well as support of treatments provided. This style of tape is not applied for the purpose of directly addressing pain complaints, but rather to offload and change the joint position of the involved area. As this style of tape is a burgeoning area in rehab, the current and limited research has been provided for attendees to review.