Posts by Damien Howell
How 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…
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…
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…
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…
Read MoreHormone replacement therapy tendon repair post-menopause
The Dunning-Kruger effect is a cognitive bias in which individuals with limited competence in a particular domain overestimate their abilities. It is when we lack competence that we are most…
Read MoreMom’s words of wisdom make sense
Mother’s Day is a fun time to review some old wives’ tales that abound in the health and wellness arena. My mom used to say, “the difference between a man…
Read MoreDeviant movement resulting in pain – Excessive Toe Out Gait
Asymmetrical movements walking or running are considered deviant or less than optimal movements. The individual in the video below is complaining of musculoskeletal pain in the left lower extremity. What…
Read MoreUnderstanding the Nuances of Disease, Syndrome, & Uncertainty in Musculoskeletal Pain
Disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to an external injury. Syndrome…
Read MoreUsing symptoms &/or sign modification procedure to manage musculoskeletal pain syndrome
The symptom modification procedure is a clinical reasoning process and is a common practice in the Physical Therapy profession. The symptom modification procedure involves identifying the specific movement, posture, and/or…
Read MorePath of least resistance is not always the best option – sometimes it is better to have some stiffness
There are three possible relationships between movement and musculoskeletal pain syndromes. There is either too much movement, not enough movement, or an optimal amount of movement. When a muscle tendon…
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