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PROfiles: Emilio Puentedura | Manual Therapy and Pain Science

Amy Bowman, OPTP Staff Writer - April 20, 2020

Following Fate

Emilio Puentedura (who is fondly known as “Louie”) was first introduced to physiotherapy through his older sister Vicky who had contracted polio at the age of 18 months. Seeking better healthcare for her, Louie’s family uprooted from Madrid, Spain, and moved to Melbourne, Australia, in the early 1960s. Unable to sit up on her own, Vicky was enrolled in a school for children with disabilities at the age of seven and began working with a physiotherapist who provided in-home hydrotherapy treatments in extremely hot water. Louie, who was only five years old at the time, remembers wanting to get into the hot water: “I would say ‘I want to go in! I want to go in!’ and the physio kept telling me that I couldn’t. And then I’d put my feet in—and they would fly right out, and I’d yell, ‘it’s too hot!’” remembers Louie.
He also remembers the wood and steel brace his sister was required to sleep in. “When she didn’t sleep in it, it was leaning up against the wall—in the dark it looked like a scary monster,” said Louie. “I remember crying a lot because I was scared of that damn thing,” he added. Although they seemed scary at the time, these events helped shape Louie’s future professional life.

Louie at 10 years of age.
Louie at 10 years of age.

Physiotherapy: a life changing experience

Within several months of treatment, Louie’s sister was walking with the help of a walker and continued to become stronger over the years—eventually securing a full-time job, getting married and having three daughters. Vicky’s physiotherapy experience was life changing for her, and made a profound impact on Louie, too. “I think subliminally I must have realized there were some cool things being done for my sister and ultimately, I think that experience inspired me to go into medicine,” he said.
Being only one point shy of getting into medical school, Louie enrolled in a core program in physiotherapy and liked it so much he decided to stick with it. Transferring into the full-time physiotherapy program required an interview with the head of the school, which seemed to bring Louie’s path full circle. During the interview, the head of the school had a big smile on her face and asked Louie if he remembered her—he didn’t. “The last time I saw you, you were five or six years old,” she told him. “I recognized your name, and you look just like the little boy I remember.” That’s when Louie realized he was meeting with the physiotherapist who had helped his sister walk for the first time so many years before.

Manual therapy as a systematic way to evaluate and treat people

Louie’s transition from school into his professional life included a job at a school for children with disabilities, followed by a job working with geriatric patients. Eventually he settled on orthopedics, and in 1983 he completed a graduate diploma in manual therapy—which is one of his areas of specialty. “Manual therapy was covered very little in my undergrad program because there was a belief that it could hurt people or wasn’t really effective,” said Louie. “But when I learned more about it and started using it, I realized how effective it really can be. It’s a systematic way of evaluating and treating people—and it’s not dangerous if you use it with common sense and sound clinical reasoning,” he added.
Although a proponent of manual therapy treatments, Louie began to come across patients who suffered from such severe chronic pain that they couldn’t be touched due to their heightened sensitivity. This led Louie to pain science—and the work of Geoff Maitland, Louis Gifford, Lorimer Moseley and David Butler. It also led him to Adriaan Louw, who became a good friend and a co-worker when Louie signed on to teach at Midwest Spine Therapists—a seminar company Adriaan and his wife, Colleen, were running. Around 2006 the organization became the International Spine and Pain Institute and some of Louie’s courses, including Thrust Joint Manipulation, have since been incorporated.

Louie in Australia where he worked as a physiotherapist, 1981.
Louie in Australia where he worked as a physiotherapist, 1981.

Marrying into a family dynasty of physical therapists

Fate seemed to step in once again when Louie was working in Ballarat, Victoria, where he met and eventually started working for Peter Rice, a physical therapist who was very skilled at manual therapy and spinal manipulation. Louie was introduced to Peter’s daughter, Danielle, and was so fond of her that he proposed four years later. “I married into an incredible family dynasty of physical therapists,” said Louie. “Both my father-in-law and mother-in-law were physical therapists and my wife’s grandparents and great-grandparents way back at the turn of the century—the 1890s—were physical therapists in Australia,” he said.  
An opportunity to work at an outpatient clinic in Yuma, Arizona, brought Louie and his wife Danielle and their three children Ben, Georgina, and Alexander to the U.S in 1995. He completed a post-professional Doctorate in Physical Therapy at Northern Arizona University in 2005 and after receiving a job offer to teach, he decided he needed to further his education. He received his PhD in Physical Therapy at Nova Southeastern University in 2011 and served as a faculty member at the University of Nevada Las Vegas for 10 years, as Assistant and then Associate Professor of the Doctor of Physical Therapy Program. 

Shaping careers and changing lives through teaching

Now a Professor at Baylor University in the accelerated hybrid-model Doctor of Physical Therapy Program, Louie is inspired to help young PTs with a passion for learning to become the best they can be by helping them learn clinical reasoning skills, along with manual handling skills. In this role, he is helping shape the course of many students’ careers and providing them the opportunity to go out and make a positive difference for people who are struggling with pain and physical challenges; Call it a profession. Call it a mission. Call it fate. Whatever you choose to call it, it certainly seems like it was meant to be.
Emilio is a Professor at Baylor University in the accelerated hybrid-model Doctor of Physical Therapy Program. He is the co-author of a variety of books including Thrust Joint Manipulation Skills for the Spine, Pain Neuroscience Education and Integrating Manual Therapy and Pain Neuroscience.


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Amy Bowman, OPTP Staff Writer

Amy is a Minneapolis runner, cyclist and yoga enthusiast who enjoys writing about health and wellness, physical therapy and fitness topics.

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