Posts by Damien Howell
Physical Therapy telehealth lessons learned mistakes made
My perception of my abilities in providing telehealth video conferencing Physical Therapy or Physical Therapy service online follows the Dunning-Kruger effect. The Dunning-Krueger effect is a process of overestimating and underestimating our abilities and competence. When I began offering telehealth Physical Therapy in 2017, I initially overestimated my abilities. Over the past seven years, I…
Read MoreMusculoskeletal pain which are important steps which are less important?
Thesis: Choosing a diagnosis is an early step in solving non-traumatic muscle and bone pain problems. A diagnosis helps guide treatment, predict how problems will progress, and improve communication. A diagnosis has many functions, including direction for intervention to solve problems, predicting how problems will progress, and assisting in communication. Antithesis: Medical terminology is notoriously…
Read MoreHow to fact-check health medical information from Chatbot AI, & internet sources
The growth of Chatbot artificial intelligence (AI) improves access and efficiency of obtaining information about health and medical issues that individuals are facing. Internet websites, blog postings, social media platforms, and Chatbot AI searches are convenient starting points for quick health and medical information. However, how do we know what you read and hear online…
Read MoreWhat is the alternative to I have fallen, & I can’t get up? – improve strengthen flexibility “just do it”
A patient with Parkinson’s syndrome, living alone expressed to me his frustration. He had fallen and was unable to get back up. He pissed on himself. He used his fall alert system via the internet to notify the rescue squad. In addition to the embarrassment, he felt about not being able to get back up…
Read MoreAdjusting the exercise load to manage musculoskeletal pain syndrome
Adjusting the amount of exercise load involves seeking a balance between increasing or decreasing the load. Athletes and healthy individuals the bias is towards increasing the load to improve capacity and performance. For musculoskeletal injuries, post-orthopedic surgery, or musculoskeletal pain syndromes, the bias is towards decreasing the load to facilitate healing and recovery. Tactics to…
Read MoreAdjusting exercise load to optimize capacity performance
When it comes to adjusting exercise loads to optimize performance capacity it necessitates both art and science. “Load management” in athletics and sports is a popular strategy to control the training volume, intensity, and rest to optimize performance while minimizing the risk of injury. To improve performance or capacity, the exercise/load must exceed the individual’s…
Read MoreHow does the natural progression of osteoarthritis influence the management of osteoarthritic flares?
Case Example: Over the last year, on several occasions, a patient has sought assistance for recurring flaring neck pain. Radiographs show moderate osteoarthritic (OA) changes in the cervical spine. A history of mild to moderate scoliosis of the spine has existed since childhood. Over the years, the neck pain has alternated from long periods of…
Read MorePain – What does it feel like? How this information can guide intervention
When describing your pain details can include location, type, severity/intensity, frequency, duration, triggers, and impact on life. When describing the location of the pain it may not be accurate. Pain can be perceived in an area that is distant from the tissue source of the pain. This is described as referred pain, when the pain…
Read MoreOrthopedic surgery is not always necessary – coper vs non-coper
A diagnostic image such as an MRI can show significant structural damage such as a complete tear of the anterior cruciate ligament (ACL), a complete tear of the rotator cuff of the shoulder, a herniated spinal disc, or other musculoskeletal tissue damage. In 1983 Frank Noyes and colleagues in a seminal study of patients without…
Read MoreMovement-evoked pain measurement for adjustment of interventions for chronic musculoskeletal pain syndromes
If chronic musculoskeletal pain syndrome is like diabetes, then what is a self-administered test to adjust interventions? A thought-provoking article by Jermey Lewis and Peter O’Sullivan suggests “Is it time to reframe how we care for people with non-traumatic musculoskeletal pain” they suggest we have a lot to learn from how other chronic medical and…
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