Ahh, the good ol’ in-service topic for PT students. Lots of memories come flooding back to me here as I dwell upon the days when I had to give mine. This article will go over ten different topics or devices (and why they could potentially make for a great in-service) that will hopefully spark some ideas to help you come up with a truly outstanding presentation.
Click/tap on any of the following topics to instantly jump to that article section for more information!
Some of the best in-service topics for PT students in 2022 can include:
• VR goggles for chronic pain
• Keith Barr’s tendon loading protocols
• The Iron Neck
• Exxentric training/flywheel training
• AlterG Anti-gravity rehab
• 3D printed casts (ActivArmor)
• MonkeyFeet
• The ExoSym
• Xenomelia (“foreign limb syndrome”)
• CytoRich PRP injections
If you want a quick breakdown on what each of these topics is — and why they may be a great idea when it comes to providing an in-service on them, then keep on reading.
AND, just in case you don’t find anything appealing in this list, I have two other articles that both provide plenty of other topics. You can check them out here:
- In-service Presentation & Topic Ideas for PT Students: Ten Great Ideas
- 10 More Awesome In-service Topic Ideas for PT Students
Pro tip: Whether you love or dread having to give an in-service, the key with it all is to pick a topic that you can genuinely find interest in. If you can do this, you’ll give a much better delivery of that topic AND may even have a little fun along the way!
Ok, let’s dive into the topics!
1) VR goggles for the use of chronic pain
What it is
Virtual reality (VR) is becoming more widely accessible to the general population as technology continues to advance. One area of study with VR has been its effects on managing acute and chronic pain in various populations, with incredibly promising results. Literature shows that it may be a highly viable alternative to opioid medications.
Here’s a couple of journal articles to get you started:
- Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis
- Virtual Reality as a Distraction Technique in Chronic Pain Patients
Full disclosure: I don’t understand much of the mechanisms behind it, as I’ve only recently become aware of the use of VR for pain management; our clinic is currently looking at implementing its usage, so I’ve been brushing up on the basics. It seems that at least one of the mechanisms regarding its efficacy is the virtual environment essentially serving as a distraction of the brain from fixating on pain signals. If I were to be putting together an in-service these days on a PT topic of my choosing, it might just be this one.
Who it’s for
With pain being a condition that all human beings are susceptible to, VR usage for pain modulation could be utilized in nearly any type of physical therapy clinic or healthcare-based environment. As a result, individuals who suffer from the effects of acute or chronic pain, be these individuals young or old, could all benefit from this exciting new technological intervention.
Patients can benefit from using this technology within a clinic or at home,
Why it can be a great in-service topic
VR usage for augmenting pain will only become more common as time goes on. And since this technology is becoming incredibly accessible and affordable, having one more tool in a clinic’s or patient’s toolkit of pain-altering modalities might be pivotal when winning the war on pain.
And since patients can benefit from these effects in the comfort of their home, having the awareness and fundamental understanding of VR’s efficacy for pain control is a prerequisite for educating any patient who would like to use VR for their pain.
2) Keith Baar’s tendon loading protocols
What it is
Tendon-based rehab is a topic that any orthopedic-based physical therapist needs to have an absolute superior grasp on. What is taught in PT school around this topic is rather minimal at best (in my humble opinion). As a result, when your patient comes to you with recalcitrant forms of tendinosis, the basics of what you’re taught in school aren’t going to cut it.
Having spent the last year deeply diving into the research of brilliant minds such as Keith Baar and Jill Cook, my patients have greatly benefitted from implementing these research findings into their rehabilitation. There is always more to learn when it comes to tendon morphology and rehabilitation, and I am the first to admit this.
Who it’s for
These tendon loading protocols and other adjuncts can benefit patients of all ages and of all demographics. Tendon pathology is incredibly common, and since every human has tendons, the concepts covered by Dr. Baar can be used for anyone needing to overcome tendinopathic issues.
Why it can be a great in-service topic
Having better understandings of a tendon’s structural composition, how to effectively overcome its stress-shielding response, the critical window for gelatin supplementation, and much more of the phenomena that contribute to effective tendon-based rehab can make for an outstanding presentation. This is especially true if you’re at an orthopedic-based clinic or want to be an orthopedic-based physical therapist yourself.
Not enough fully licensed physical therapists themselves understand this topic well enough, so you could likely significantly augment their knowledge by speaking on this topic — and likely help your patients out with effective tendon rehabilitation in the process.
To get you started on collecting all sorts of great information, watch this presentation that Dr. Baar gives:
3) The Iron Neck
What it is
The Iron Neck is a specialized piece of equipment designed for strengthening cervical musculature, be it for injury prevention or injury rehabilitation (when appropriate). I’ve been using it on my patients for the better part of a year now and have had a tremendous amount of success using it on the majority of them.
I use it primarily for rehabilitation from whiplash-associated disorder (WAD) following motor vehicle accidents on my patients when the stage of their recovery permits it. Most of them have found it to be very beneficial with pain reduction and improved functional movement for activities of daily living (ADL’s).
There are three different models offered, with each serving a specific population.
Who it’s for
The Iron Neck comes in different models and can be used from early-stage cervical rehab (when appropriate to do so), late-stage rehab, or for injury prevention. As a result, it can be used on healthy or injured general populations as well as healthy or injured athletic populations.
Disclosure statement: I’ve had so much success with this device that I opted to reach out to the CEO of Iron Neck and let them know how thrilled my patients and I have been with it. As a result, they have set me up with an affiliation that provides a 15% discount if you’d like to save money if purchasing any of their produces.
Use the discount code “strengthresurgence” for this discount over on the Iron Neck website. I receive a small commission on any purchases made with this code, which I use to offset the costs of running this website.
Why it can be a great in-service topic
Cervical strength training is often overlooked or even neglected in rehabilitation, perhaps because it can be tricky to perform dedicated strengthening-based movements. And it doesn’t help that there’s not a lot of equipment for it.
The Iron Neck doesn’t break the bank, and it takes up no space, unlike the massive four-way neck machines that are not practical (or cost-effective) for the majority of clinics. If you’re into orthopedics, functional rehabilitation or just want to use a device that offers exceptional versatility without taking up floor space or costing a lot of money, this can be an enticing piece of equipment to deliver your presentation on.
4) Exxentric Flywheel Training
What it is
Flywheel training is a form of resistance training that uses the inertia of a flywheel to generate resistance instead of gravity. As a result, flywheels can offer a superior form of eccentric overload to muscles that can be otherwise challenging for patients to replicate with traditional devices such as dumbbells or Theraband.
Who it’s for
Any patient who can benefit from optimizing their strength training protocols can likely find a benefit with this device, especially if they require eccentric forms of overload to help augment the tendon rehabilitation process.
It can also be a great device for clinics who want to save on floor space while still having a piece of equipment that can offer an incredibly diverse range of resistance on exercises – all without breaking the bank or taking up a lot of valuable floor space.
While multiple companies on the market make flywheel devices, the company I’m most familiar with is Exxentric and its various K-boxes. So, I’d recommend checking them out if this topic is of any interest to you.
Why it can be a great in-service topic
Having equipment that is not only versatile but also able to conveniently offer the precise type of mechanical overload required to optimize various forms of tendon and muscle strengthening can usually pique the interests of physical therapists who spend their days treating these sorts of orthopedic conditions.
It becomes an even more enticing topic when there is a nice amount of literature supporting flywheel training regarding eliciting the therapeutic effects that many patients need to help regain their functionality and decrease their pain.
5) AlterG treadmill (anti-gravity training)
What it is
The Alter G treadmill is an anti-gravity rehabilitation and training treadmill. It works by creating a pressurized environment around the lower body in a manner that lessens the forces of gravity to the lower body. The treadmill can reduce up to 80% of the patient’s body weight in 1% increments.
The results of lessening the effects of gravity allow patients with various lower-body injuries, impairments or conditions to walk, jog, or run in ways otherwise not possible. As such, it affords a unique ability to help patients progress in their rehabilitation of lower-body injuries or full-body injuries.
Who it’s for
The AlterG can be used for various types of lower-body injuries, patients with full-body weakness or specific movement disorders. As a result, it can be utilized for a wide patient population.
Why it can be a great in-service topic
While the AlterG treadmill isn’t likely going to be a device that you wind up bringing into your clinic, being aware of its indications for use isn’t a bad idea, especially if you feel that a patient could benefit by referring them to a facility that has one. This is something that I will do every now and then with a patient, based on their condition and circumstances; there is a facility a short drive across town that uses one for various forms of rehabilitation.
The few times I’ve referred patients to that particular facility, they’ve been very happy that I’ve done so, as it’s helped them perform higher levels or volumes of running and movement without incurring pain in the process.
6) 3D printed casts (ActivArmor)
What it is
ActivArmor is a company specializing in 3D-printed casts, which can offer numerous benefits over traditional fiberglass casting and splinting. The casts themselves are made from high-temperature thermoplastic-setting plastic, making them waterproof, breathable and much more sanitary than traditional casts. In addition, since they are custom fit through 3D mapping, they create an exact fit of the injured limb.
Who it’s for
ActivArmor casts are for anyone who has experienced specific types of fractures or other orthopedic-based injuries that require splinting or immobilization, be it for athletic or non-athletic populations alike. As a result, this wide diversity of patient populations can be found in nearly any type of physical therapy clinic.
Why it can be a great in-service topic
With 3D-printing technology becoming more commonplace and inexpensive, being up to speed with the latest technological developments in the world of splinting and casting can provide valuable insight to any orthopedic specialists or therapists on staff for where you’ll be providing your in-service.
7) MonkeyFeet
What it is
MonkeyFeet is essentially a way for you to lift dumbbells with your feet. It’s a nifty little product designed by Animalhouse Fitness that is rather ingenious in terms of its design. It’s like a snowboard binding with a small, hook on the bottom side that acts as a means to secure a dumbbell to it.
The amount of lower extremity exercise versatility gained by utilizing this little device is quite remarkable. And for therapeutic rehab, it offers added versatility over resistance tubing or large, gym-based equipment that can take up large amounts of clinical floor space.
Who it’s for
The MonkeyFeet can be worn by healthy and injured populations alike and has indications for athletic and non-athletic populations alike. Young patients, middle-aged patients and even seniors can use this little device.
And when it comes to clipping a dumbbell to it, it really doesn’t take much weight at all for creating a hefty challenge for most people, depending on the exercise, so don’t feel like your clinic has to have rather heavy dumbbells in order to get the most out of this device!
I picked mine up some months ago and have enjoyed using it on myself and for any potential patients who can benefit from its use.
Why it can be a great in-service topic
If you are doing an in-service presentation in an orthopedic-based physical therapy clinic, giving a presentation on a nifty little device that can vastly expand the exercise rehab options for patients looking to either rehab or prevent lower extremity injury. With a cost of under $100 USD and hundreds of exercises to be gained, there are plenty of clinic owners who could find a simple in-service topic on the benefits of utilizing this little device to be an in-service topic worth listening to.
8) The ExoSym
What it is
The ExoSym is a hybridized prosthetic-orthotic device that is custom-made and fitted for an individual’s lower limb. It is similar looking to traditional ankle-foot orthotics. However, its unique design provides numerous advantages for reducing pain and improving overall function. It can be used for various types of lower limb conditions. The carbon fiber struts on the back of the device work in a way that stores energy and then transmit it around a painful area, helping a patient to walk pain-free.
While I have never seen them with my own eyes, the stories I’ve heard from patients who use them have been incredibly intriguing. At our clinic, we actually know of a patient who opted to amputate their lower limb due to chronic pain. At the last moment, they heard about the ExoSym and decided to give it a try and experienced life-changing results from using it, not any different from the testimonies in this video below:
Who it’s for
Since the ExoSym can be used for anyone experiencing specific types of lower leg conditions, it could be utilized for a broad population demographic. This means that the ExoSym could help patients with orthopedic conditions or perhaps certain neurological conditions as well.
Why it can be a great in-service topic
Orthotic devices are commonly utilized within numerous types of physical therapy clinics. Having an idea of some of the newer advancements that are taking place within the world of orthotics could bring valuable insight and information to clinical instructors, especially if the clinic’s primary caseload consists of individuals with lower limb pain, mobility issues or other limitations that can be remedied with orthotic devices.
9) Xenomelia
What it is
Xenomelia is a condition occurring in individuals in which they feel that a particular body part of theirs, such as an arm or leg, does not belong to them. It is sometimes termed “foreign limb syndrome.” The notion of an individual’s body part not belonging to them can be so strong in some individuals that they opt to undergo amputation of that particular limb or body part.
Not all patients who have this condition experience it to the extent of wanting amputation; it exists on a continuum, with it being a mild nuisance for some and seriously troubling in severe cases.
Here are some articles to get you started with learning some of the science behind this condition:
As a physical therapist, you will come across individuals throughout your career who reveal within their subjective history (or at other times) peculiar sounding symptoms, ranging from feeling like they sometimes feel as if one of their limbs is detached from their body, or that they feel like they’re living with a body part that doesn’t actually belong to them.
There is nothing wrong with these individuals from a psychological perspective; the issue seems to be more so coming from neurological “quirks” within their central nervous system, particularly with the brain’s ability to produce accurate body imagery. Think of it as the close relative to phantom limb pain.
I have seen a small handful of these individuals already in my young career, with patients feeling profound relief when I tell them that I understand what they’re telling me and that it’s not simply “all in their head.”
Who it’s for
Xenomelia isn’t fully understood, but it can affect any individual, meaning this type of condition could show up in any type of physical therapy rehabilitation setting or facility. As a result, physical therapists in any specialty designation will likely hear a patient report these sorts of unusual symptoms at some point in their professional career.
Why it can be a great in-service topic
Often, individuals who have xenomelia will report pain in ways that don’t seem to make sense or add up, as if their pain isn’t “playing by the rules.” Body imagery training can often improve their pain and the feeling that their limb doesn’t belong to them. I have learned much of this from my mentors at Tower Physio, much of which has been extensively studied by Dr. Shawn Gibbons, owner of SmarteRehab.
When pain doesn’t make sense, or these types of body imagery complaints are revealed, a different physical therapy style is required to address the underlying CNS issues that are likely driving the problem.
This is a fascinating world that could provide dozens of different in-service topics in and of itself and can serve as a highly valuable in-service on a condition that many practicing clinicians are unaware of altogether or lack the understanding of how to best treat it from the perspective of a body imagery disorder.
10) CytoRich PRP injections
What it is
PRP (Platelet-rich plasma) injections are becoming a more common treatment intervention for specific patient populations, and staying on top of the newest forms of this promising treatment technique is a smart move to make, as it will likely only become more and more common in the future.
CytoRich-PRP is essentially a newer form of standard PRP. It contains an enriched anti-inflammatory/catabolic component in addition to standard platelets. More specifically, it contains a high concentration of anti-inflammatory and regenerative agents. If you want to learn more specifics, check out The Institute of Human Mechanics‘ website.
Unlike standard PRP, CytoRich-PRP has two components: a regenerative and an anti-inflammatory component. The regenerative component is similar to PRP, while the anti-inflammatory component is enriched with anti-inflammatory, anti-catabolic and regenerative proteins that increase CytoRich-PRP therapeutic potential compared to PRP treatment.
Who it’s for
The intended benefit with these additional substances added to traditional PRP is to treat various tissues that are unhealthy or damaged, which can include chronic conditions such as tendonitis, muscle tears, and degenerative joint conditions such as osteoarthritis.
Since PRP injections are likely to only become more common in the near future, and since these injections can help treat a wide variety of orthopedic issues, patients who receive or are candidates for PRP will likely be found in orthopedic-based clinics.
Why it can be a great in-service topic
Having an understanding of PRP injection therapy is certainly a good start, and staying on top of the newest treatment interventions within this realm of therapy can help show your clinical instructors that you know your stuff, as well as helping give your patients accurate information about the PRP world in general.
Final thoughts
Hopefully, the ideas within this article have helped point you in a direction that helps you come up with some noteworthy in-service topics. Again, the key is to find a topic you’re genuinely interested in, as it will ultimately help you craft an excellent presentation and impress your clinical instructor(s) and any associated colleagues you’re working with at the time.
Have fun, work hard, and have a little fun along the way!
Hi! I’m Jim Wittstrom, PT, DPT, CSCS, Pn1.
I am a physical therapist who is passionate about all things pertaining to strength & conditioning, human movement, injury prevention and rehabilitation. I created StrengthResurgence.com in order to help others become stronger and healthier. I also love helping aspiring students and therapists fulfill their dreams of becoming successful in school and within their clinical PT practice. Thanks for checking out my site!