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  • News From NEXT: A Moving Account of a Journey Out of Pain and Addiction—And a PT's Crucial Role

    "I failed my marriage. I failed as a father. I failed my career. And I didn't even know it was happening."

    That's how Justin Minyard describes the lowest point in his life, when, after experiencing 2 spine fractures and receiving multiple surgeries, he became addicted to the opioids prescribed to him. He found himself consumed by his pain and his meds—how many he had on hand, when he could take the next one, where he needed to go to get refills. His addiction led to a suicide attempt and 2 accidental overdoses. But most devastating for Minyard was that his addiction hurt the people he loved the most.

    "I let them down," Minyard said. "You didn't want to be around me at that time."

    Now things are different. With the help of an interdisciplinary care team that included a physical therapist (PT), Minyard said he learned how to "make pain a footnote, not the header" of his life and defeat his addiction. He'll be 8 years' clean in July.

    Minyard's moving story was delivered as the keynote address at the opening event for APTA's NEXT Conference and Exposition, held June 12-15 in Chicago. The retired Army Master Sergeant recounted the injuries he received—first during a rescue attempt at the Pentagon during the 9-11 attacks and then while on a mission in Afghanistan—but focused more on what happened afterward: the multiple fusion and other surgeries, the intense pain, and his eventual slide into addiction.

    "I didn't wake up one day and say, 'this sounds great,'" Minyard said of his use of opioids; however, he believes his passive approach to exploring treatment options played a role in his use of drugs.

    "I was not an educated patient; I didn't ask questions," he told the audience.

    After more than 2 years of attempting to manage his pain through opioids and other medications—and becoming addicted along the way—Minyard began to see options for change.

    His last fusion surgery kept him in the hospital for 3 months. Then a physician who called Minyard a "hot mess" offered him another avenue: a pain management program that involved 9 different professionals including a psychologist, psychiatrist, a pharmacologist—and a PT. Minyard took him up on the offer, and moved from what he describes as a "pain-centric to a patient-centric model of care."

    Minyard credits his PT as helping him to accept the idea that, yes, he may be in pain for the rest of his life, but he could work to find ways to manage the pain to make it "more of a footnote, less of a header." Now Minyard says that on most days his pain level is moderate but manageable, around a 3 on the pain scale.

    Minyard also feels that it wasn't just about the physical therapy itself. He thinks his relationship with his PT was also a major factor in his recovery.

    "She wasn't just my PT, but my psychologist, my sounding board, my marriage counselor, my educator of my options, and my kick in the ass," Minyard said. "She was all of those things."

    That recovery included taking his PT up on a suggestion that he try handcycling. He liked it—so much so that he wound up medaling in traditional upright cycling at the Invictus games.

    Even more important for Minyard is how the changed approach to pain management gave him back his life with his family.

    "I am my 11-year-old daughter's soccer coach," Minyard said. "I get to be her coach. I don't know a damn thing about soccer, but I get to be her coach. But I almost lost that. I was this close, multiple times."

    While Minyard credits a single PT with a major role in his own recovery, he told the NEXT audience that the entire profession should be proud of the life-changing work they do.

    "You're going to continue to make such a tremendous impact on countless other patients," Minyard said. "Choose PT."

    Vision in Action: 2019 House of Delegates Sees Important Role for APTA in Host of Professional, Societal Issues

    APTA's outward-facing, forward-leaning vision continues to guide APTA’s House of Delegates. The policy-making body considered 70 motions during the 75th House session addressing a wide range of issues, yet 1 overarching theme was clear: the House believes APTA has the potential to be a change agent for the profession and society at large.

    APTA as Advocate
    Delegates approved multiple motions aimed at positioning the association as an advocate for a more diverse, equitable, and inclusive profession, beginning with a general statement that APTA "supports efforts to increase diversity, equity, and inclusion to better serve the association, profession, and society." The House also unanimously adopted stronger language around the association's commitment to nondiscrimination on the basis of race, creed, color, sex, gender, gender identity, gender expression, age, national or ethnic origin, sexual orientation, disability, or health status; as well as a charge directing APTA to work with stakeholders to advance diversity, equity, and inclusion in all areas of physical therapy, including clinical, educational, and research settings.

    The House also voted to add language to the Code of Ethics for the Physical Therapist (PT) and Standards of Ethical Conduct for the Physical Therapist Assistant (PTA) that more clearly describes the duty of PTs and PTAs to report verbal, physical, emotional, or sexual harassment. In addition, delegates approved revisions to the Standards of Practice for Physical Therapy that better align the document with the APTA vision statement and more explicitly reflect the role of PTs in population health and community engagement. In addition, the House created a single set of core values for both the PT and PTA to replace separate versions for each, noting in discussion that core values are common to PTs and PTAs but discrete from behaviors, which continue to be appropriately described in the separate ethics documents.

    Other profession-focused House actions included unanimous approval of the definition of the movement system as "the integration of body systems that generate and maintain movement at all levels of bodily function," further describing human movement as "a complex behavior within a specific context…influenced by social, environmental, and personal factors." The definition will further strengthen APTA's efforts to promote the movement system as a critical component of the physical therapy profession's identity.

    Societal Issues and population health
    The House passed multiple motions related to the ways both the association and individual PTs and PTAs are connected to larger societal issues. In addition to updating positions on the association's role in advocacy for prevention, fitness, wellness, health promotion, and population health, delegates voted to broaden APTA's ability to respond to health and social issues. The House provided examples of what those broader efforts will entail, approving motions that support taking a public health approach to gun violence, promoting public participation in vaccination schedules, improving health literacy, and supporting the availability in physical therapy settings of the drug naloxone to reverse the effects of an opiate overdose.

    A new area of specialization: wound management physical therapy
    Making it the 10th area of physical therapist clinical specialization, delegates approved the creation of a wound management specialty area for certification by the American Board of Physical Therapy Specialties, a proposal developed by the APTA Academy of Clinical Electrophysiology and Wound Management.

    Finally, in keeping with APTA’s ongoing efforts to follow best practices in governance, the motions deliberated at the House included the second phase of a complete review of all House-generated documents. The review, conducted by a special committee of the House over the course of 2 years, focused on updating, consolidating, and sometimes rescinding documents, resulting in recommendations for changes to more than 100 House policies, positions, directives, and other guidance.