Integrative Physical Rehabilitation is the Future of Comprehensive Pain Management! ... FNOR is a Pioneer in this Field.
A Brief History of FNOR
The FNOR integrative approach to physical therapy was developed by a multi-disciplinary team as a project to develop a better, physical therapy-dominant approach to Failed Back Surgery Syndrome (a highly problematic and treatment-resistant subset in Lower Back Pain, itself the largest and most problematic musculoskeletal complaint).
The project led to the development of a highly effective, integrative approach to physical therapy, which serves not only as an excellent training system for modern rehabilitation specialists but also as a positive response to the resounding call for better strategies in pain- and injury management.
"Possibly the most fortuitous outcome of this project has been that as the FNOR approach became more integrative, it began to yield better and faster clinical results... and more satisfied practitioners!"
As medicine embraces the integrative approach, physical therapy's response is encapsulated in the FNOR approach... Efficient, Less Costly, More Effective, and Person-centered Rehabilitation for people suffering from pain and complex injury.
Why FNOR will make you a much better Pain- and Physical Rehabilitation Specialist.
We are confident that by completing the FNOR program, as a rehabilitation professional, you will enjoy...
- Improved Success with PAIN!: FNOR emphasizes pain management as a priority. The program includes some novel approaches to addressing pain, including the adoption of recent discovery in neuroscience.
- Faster, More Efficient Therapy: The FNOR approach is based on the "FNOR Rehabilitation Matrix" concept, which facilitates an integrative approach to physical rehabilitation (by addressing the multiple dimensions of pain and injury). The system was developed in a high-volume, orthopedic physical therapy environment... the course aims to avoid marginally useful "frills", focusing on presenting the highest leverage interventions in a rational approach intended to serve the spectrum of pain and injury sufferers.
- The Ability to Harness the Nervous System for better, Orthopedic outcomes: FNOR is a pioneer in the merging of neurorehabilitation and orthopedic physical therapy. Our program, 10 years in development, is based on the idea that pain (and physical injury) occurs in physical structures but is experienced in a range of functional dimensions of the brain and nervous system. Each of these areas must be addressed to be successful in the rehabilitation of the patient in pain. Fortunately, by addressing both domains, results tend to improve both in effectiveness and efficiency.
- Greater Practitioner Enjoyment and Satisfaction: One of the unfortunate potential consequences for practitioners who face the challenge of rehabilitating chronic pain and complex injury is professional burnout! Owing to its strong foundation in the integrative paradigm, practitioners of FNOR not only enjoy greater clinical success but also enhanced satisfaction, enjoyment and stronger, therapeutic relationships with their patients due to multiple aspects intrinsic to the FNOR program as well as the integrative medical approach.
- Better INTEGRATION: The FNOR integrative physical therapy approach is developed by an multi-disciplinary team and is interdisciplinary in nature. The system is highly adaptable and compatible for range of rehab environments (e.g. high volume PT clinics; single-practitioner practices; and large, multi-center systems where a consistent therapeutic framework and patient approach is indicated.)
WHO IS THE PROGRAM INTENDED FOR?
While FNOR was developed as a program primarily for physical therapists (physiotherapists) (DPT, PT), our program has been taught to a variety of rehabilitation specialists across the world, including physiatrists and physicians (MD, DO), chiropractors (DC), nurses (RN, MSN) and ancillary staff (PA-C, PTA).
The current program is open to rehabilitation specialists with an interest in improving outcomes in pain-, post surgical- and post injury- rehabiliitation from each of these professions: DPT, PT, DC, MD, DO, PA-C, RN, MSN.
Our program is instructed by a multi-disciplinary team with varied clinical backgrounds and is intended to promote interdisciplinary cooperation and an integrative approach to physical rehabilitation.
THE 4 KEY AREAS OF VALUE IN THE FNOR OFFERING:
The FNOR program is not a typical rehabilitation course series: It is not (or at least not entirely) a technique course. It is not an educational review of current academic material or the presentation of a single topic of focus. It isn't a "neuro" or "ortho" course.
The course was developed for the high-volume, results-driven rehabilitation practitioner that primarily deals with clients in pain. It is intended to make rehabilitation easier and more effective through developing an approach and skillset for the modern, rehabilitation specialist:
The following outlines the Four Areas of Greatest Value in terms of content in the FNOR program:
1. THE FNOR (INTEGRATIVE) THERAPEUTIC MATRIX:
2. A “TRUCK LOAD” OF HIGHLY PRACTICAL PAIN TREATMENT PROCEDURES!:
3. NOVEL APPLICATIONS TO DRIVE THE BRAIN & NERVOUS SYSTEM TO BOOST ORTHOPEDIC OUTCOMES!:
4. USEFUL CLINICAL TECHNIQUES:
FNOR includes a number of highly-practical, intentionally selected clinical techniques, ranging from manual procedures, methods of mobilizing various tissues of the body (e.g. joint capsules), diagnostic methods, therapeutic exercises and more. Some of these are novel (developed by the FNOR team) while some are proven clinical techniques presented within the context of the FNOR approach. All techniques are selected for their utility (in other words: we kept what worked best and disregarded the rest).
Why and How Does FNOR utilize Clinical Neuroscience?
Above: FNOR co-founder David George briefly discusses the role of clinical neuroscience in FNOR's Integrative Physical Rehabilitation Approach.
The FNOR program is a pioneer in the integration of Neuroscience with Orthopedics. A practical understanding of the brain and nervous system is important in physical rehabilitation is that pain is largely a nervous system experience and as such is modifiable by techniques that modify the brain. Further, the multimodal FNORTM approach is based in part on the premise that the brain is best stimulated by therapies that are tailored to the individual’s unique nervous system and by directing this therapies at affected areas of the nervous system.
By emphasizing the nervous system’s role in function and dysfunction, the FNORTM system approaches common clinical challenges, such as joint injury, chronic pain, joint instability, motor dysfunction, post-surgical pain and associated cognitive and behavioral sequelae, through the therapeutic window of the brain and nervous system. By understanding the nature of the brain and nervous system’s roles in injury, better rehabilitation of even the most stubborn “orthopedic cases” becomes accessible and way more efficient.
How is this going to make YOU a Better Rehab Specialist... IMMEDIATELY?
Better Results! Better with Pain! Ability to Work Faster & More Efficiently! More consistent success with musculoskeletal complaints! Consistently Improve patient Quality Of Life (not just alleviate pain)!
Above: Some practitioners discuss the changes FNOR has made in the practice, even in the earliest stages of the program.
Most attendees report that the FNOR program markedly improved their skill and confidence in rehabilitating patients in severe pain... immediately following their first course, this is particularly true of lower back pain. Furthermore, most report that the FNOR approach allowed them to deliver quality results more efficiently. No matter what your rehabilitation background or stage in career as a professional, if you are seeking simple, effective, evidence-based, systematic approach to rehabilitation, it is likely that you will benefit from the FNOR program.
As rehabilitation practices seek to expand their services, it can become difficult to manage the complexity of increased services, techniques and approaches - the FNOR framework simplifies the rehabilitation approach, in a reproducible system that is a solid structural foundation to any rehabilitation practice that can be individualized and modified according to the unique needs of the practice.
I have heard that FNOR is "heavy" in Gait, Movement & Biomechanical Analysis. Why?
While biomechanics and gait analysis are very active fields of study, the FNOR program pioneered the application of gait analysis as a foundational element in the treatment of bodily pain (most notably lower back pain). As we've trained a growing body of professionals across the world, this aspect of our program has since been adopted and mimicked by a number of other rehabilitation approaches, owing to the sound theoretical foundation and tremendous effectiveness of this approach.
Above: Drs Nick Studholme & David George of the FNOR team having a little fun as they demonstrate a little about FNOR's strong foundation in biomechanics (please note that the dates expressed in this video have passed!).
This said, not all approaches to gait and biomechanical analysis are equal: FNOR has also pioneered the use of video kinematic analysis technologies to both analyze and educate patients. In fact, a member of our own, innovative, clinical development team has co-developed a unique, affordable, software technology for this purpose (to analyze gait and movement to a fine degree) and members of our team are deeply experienced in the application of gait and biomechanics-based diagnosis, serving as consultants to technology developers in this field. Video kinematic analysis of biomechanics is an invaluable tool for directing a solid rehabilitation approach (allowing the clinician to more quickly and accurately identify the source of injurious movement, often associated with maintaining persistent pain, such as lower back pain.)
FNOR's application of gait analysis does not typically result in the application of common "gait rehabilitation" techniques. Rather, the very refined analysis that our therapists learn is used to guide and measure the outcomes of focused therapeutic interventions.
Simply put, we believe that painful conditions (especially of the pelvis and lumbar spine) are often associated with abnormal gait patterns. Restoration of normal gait patterns frequently facilitates resolution of pain.
What "sort of things" (material) are presented in FNOR courses?
FNOR courses are highly practical. While each FNOR lecture provides the theoretical rationale (evidence) for each practical topic, the entire program is hands-on and intended to develop the practical skills required of a modern, physical rehabilitation specialist.
Each module is focused on presenting a rational approach to the disorders featured in that course such that as you take the whole program, you will develop a "whole body, whole brain, whole person" approach to rehab. This will include a range of different techniques, concepts and approaches.
Here are some examples of the type of material you might expect in an FNOR course:
- Tissue and Joint Mobilization Techniques (not joint manipulation or 'adjusting'): A rational approach to targeted tissue mobilizations.
- Pain, Pain, Pain! A Range of Effective, Pain Treatment Techniques (incl. a number of novel (some patented) methods, ranging from manual therapy methods to analgesic technologies for mitigating and resolving pain. FNOR was developed to solve the pain problem in persistent post-surgical pain (failed back surgery syndrome) - it's our strength as a program.
- Approach to Nerve-Mediated Pain (not "nerve flossing" or "nerve gliding"): The FNOR program is a leader in the application of therapeutic techniques for mitigating neurogenic inflammation (a burgeoning field of discovery in medicine) and ubiquitous, nerve-mediated pain. The FNOR team also draws on deep experience (and credentials) in the application of neurodiagnostic technologies.
- Brain, brain, brain! CNS Stimulation & Rehabilitation Techniques (techniques developed from translational research and neurorehabilitation are adapted to promote rapid gains in stability and strength and meaningful improvements in level of function.
- Efficient Biomechanical Analysis Techniques (incl. Application of Video Kinematics in Gait Analysis) in the assessment of Biomechanics: The FNOR program is the pioneering program in the application of these technologies in the context of persistent pain and complex injury (esp. lower back pain). Techniques will be taught by highly experienced experts in the application of these technologies.
- Intelligent, Personalized Structure to Rehab Programming, incl. FNOR's Approach to Therapy Progression based on "Neuro Cues" (a novel approach developed by the FNOR team referred to as "layering", which guides progression of therapeutic programming based on evolving feedback from nervous system.)
- Management of Complex, Multi-System Injury (incl. concussion, mTBI) - an approach based on addressing musculoskeletal and central systems simultaneously for improved levels of function in multi-system injury (such as those incurred in high-impact, contact sport).
- Integrative Case Development and Implementation (incl. pharmacologic and surgical considerations). Our multi-disciplinary team presents an integrative paradigm, incl consideration of common therapies, such as pharmacotherapy.
- Application of Therapeutic Technologies (incl. several, highly effective and novel applications of neural and neuromuscular stimulation (neuromodulation).)
- Post-surgical to Return to Play Rehabilitation (FNOR's multi-disciplinary team presents an integrative approach to rehab that considers the range of presentations from post-surgical to return-to-field-of-play.
- Supportive Devices (a rational approach to ancillary procedures such as taping and supportive devices) FNOR emphasizes a shift from "everything and the kitchen sink" approach to modalities to a rational approach, based on an integrative paradigm.
Is this Program Appropriate for a Sports Rehabilitation Practice?
Yes. While FNOR is not developed as a "sports specific" training program, the program heavily emphasizes a novel approach to rehabilitation of conditions and injuries commonly associated with sports (e.g. ACL rehabilitation, tendon complaints and concussion).
Above: Physiotherapist (Physical Therapist) for Welsh National Football Team and English Premier League Football team briefly discusses his experience with FNOR.
Our program has been apparently well received by a number of sports specialists from around the world, from a number of specialties incl physical medicine and rehabilitation (physiatry), physical therapy and chiropractic.
Above: President of FICS (International Federation of Sports Chiropractic) & published author on topic of running, discusses his experience with FNOR.
Our approach to rehabilitation has also been adapted and applied by sports, training and conditioning specialists, including been adapted to large sports programs at college and professional level.
Above: Matt Shaw sports conditioning specialist discusses his program's experience with FNOR. Matt reported that FNOR markedly reduced injury and improved performance in athletes, across multiple sports, in their program.