Dr. Vince Gutierrez

06/07/2026

Putting together a quick summary of the research that I am catching up on.

Nothing fancy, just looking to expand the resources that PTs have to see/read research.

06/02/2026

I’m still reading the same research paper i’ve been reading for the past week.

I came across this statement in the article and knew I had to highlight it.

There are so many patients that go to physical therapy and don’t realize the credentials of a person treating them.

Sometimes that person just has on the job training.

That’s not right!

Your insurance company is paying for you to be treated one-on-one by a physical therapist or a physical therapist assistant. Some insurance is now required that the person treating you is a licensed physical therapist. When a patient receives their explanation of benefits, they see that they’ve been billed hundreds of dollars per session.

They aren’t paying that money in total, but some patients don’t know any different.

We better damn well be providing the same level of care to the patient that the patient perceives that they’re paying.

It starts with ensuring that it’s a licensed individual, either a physical therapist or a physical therapist assistant, providing care to that patient.

If a patient is going to be treated by a student, that patient should be aware that it’s a student providing the exercises and treatment. That patient should be aware that it’s a student providing the hands-on treatment.

If that patient is going to be treated by a tech or an aid, the patient should be aware that the person treating them has absolutely no license to treat them. That person should also be made aware that their insurance doesn’t pay for an aide to treat the patient.

I understand, in our profession, the margins are thin. That doesn’t mean that we should be taking shortcuts in order to make a profit.

This is a hill I will fight for and die on.

PATIENTS DESERVE BETTER!

05/31/2026

For those that are entering the profession, I have found that explaining the total knee motion as a total arc seems to help with patient attitude.

Meaning, I don’t focus on the lack of knee extension or the lack of knee flexion, but give the patient a target of -2–115 like in the Delphi study and use 113-115 as the total arc goal for the patient.

This way the patient can track one number over the course of time instead of two.

I happens to be at a garage sale this morning at the same time as a person that was within the first six weeks of a knee replacement, as there was still steri-strips.

I introduced myself as a PT and the first number she gave me was 122 of bend.

The patient didn’t mention the obvious loss of knee extension that I could see with walking and I wasn’t there to burst any bubbles.

Offered encouragement and said keep up the good work.

Reading an article from 2001 and it is good to see a journal article referring to total arc of motion as a goal instead of separating knee flexion and knee extension.

05/25/2026

This is an excellent chart for those students trying to learn the anatomy of the cervical spine. 🤓

When you are out of school for a while, like an old timer like myself, it is nice to have a research paper with a chart that I can refer back to in order to refresh my memory of lessons learned many…many…moons ago.

03/20/2026

Neck pain sucks and could be treated quickly at a relatively low cost.

👇👇👇👇
See comments

02/16/2026

All PTs need to listen to the first 3 minutes of this podcast.

Have you ever said something and thought to yourself…I wish I could get that back?

If you haven’t, I have to ask, do you do any self reflection on your day, your own patient care?

I know I’ve made this mistake at least twice in my career and I fought myself in real time.

In my head it followed with self talk like “you’re an idiot, what were you thinking, I can believe you just said that”.

In the first instance, I lost the patient. The patient self discharged and I know it was because of the words I used.

I created a checklist in my head that essentially says that if I say something that sounds judgmental of the person, then I have to apologize.

It’s alright to have a conversation to judge actions of a person, but it can’t be a judgement of the person.

For instance, (not the patient that I lost), but a real case:

Me: I want you to test the knee and do something that may provoke it, but don’t go beyond turning the pain back on

Patient next visit: I turned the pain and it is much worse than it was last visit

Me: what did you do?

Patient: I did about 50 jumps off the high dive at the beach.

Me: (🤯🤬) did you stop when it was provoked?

Trust me, I wanted to go off on the patient internally, but realizing that I have to accept part of the blame, we had a discussion about what to do next time and then proceeded to treat the inflammatory effect from going up and down the ladder 50 times and then the patient go better over the next couple of weeks.

Long story short, are we going back to assess how we treat and how we speak to patients?

Do we have the humility to understand that we don’t have all of the answers and sometimes we need a Mulligan (the golf version and not the PT version).

Podcast Episode · The Dr. John Delony Show · 09/21/2020 · 42m

12/11/2025

Doing clam exercises with a patient recently.

We did them initially and the patient got away from the exercise so I had to go back and check technique.

Was doing very wrong.

Side story: I’ve been wearing a mask because in the winter months I get nose 🩸unexpectedly without any physical touch to my nose. It will just start dripping.

I had a mask on and it muffled my speech during the session.

I told the patient (regarding clams): “It’s been a while huh?”

Patient heard “Ben wa ball”

If you don’t know what a clam is, look it up.

If you don’t know what Ben Wa Balls are…look it up.

It could’ve fit into the conversation…at least in her head…

😂😂😂

12/03/2025

Recently treated a patient for back pain that had a knee replacement years ago.

We discussed doing exercises on the floor and she said that she hasn’t knelt on her knee since the surgery.

Threw a pad on the floor and started working on different kneeling activities.

Tall kneeling ✅

Tall kneeling eyes closed ✅

Tall kneeling head turns ✅

Half kneeling ✅

Half kneeling eyes closed ✅

patient then proceeded to tell me that I could expect a thank you card from her husband 🫣

If you know someone needing PT catered to their knee(ds), send them my way.

I started seeing patients for Luna, which is like the old school doctor visits, meaning I do house calls.

10/02/2025

There’s no place like home 👠

11/02/2024

Business fair starts at 10 AM.

One out and see all of the local businesses providing services in the area.