Whole vs part method of learning to walk/run a new way: deviant to less deviant
When learning a new physical skill an individual, therapist, or coach can choose to practice a new skill in whole or part. Motor skills learning can be practicing the whole movement or part of the movement. In whole practice acquiring a skill is by practicing the movement in its entirety, whereas the part that practices…
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Exercise prescription – Art & Science
Exercise while not a drug can behave like one. Exercise can help in the management of chronic diseases and offer pain relief for individuals suffering from musculoskeletal pain syndromes. Like prescribing drugs, the concept of dosage applies to exercise prescription. A dose-response to exercise is not unlike drugs however the minimum dose, dose-response, and maximum…
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Adding observation of deceleration forces to diagnosis & treatment of movement system impairment syndromes & musculoskeletal pain syndromes
Shirley Sahrmann and colleagues share an elegant clinical reasoning process model to diagnose and treat musculoskeletal pain syndromes and movement system problems. The movement system is physiological organ systems that interact to produce movement of the body and its parts. The basis is alignment in a deviant position and repeated deviant movements in a…
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Diagnostic imaging pros & cons – be careful what you ask for
There are many reasons to request a diagnostic image such as a radiograph (X-ray), MRI, sonogram (ultrasound), and CT scan. They are to diagnosis a pathology/trauma; determine treatment options; screen for contraindications; biomechanical analysis; provide reassurance; medical legal reasons; and financial gain for the healthcare provider. Requests for diagnostic imaging must come from a licensed…
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New developments in joint replacement surgery & rehabilitation
The use of joint replacement surgery for hip and knee pain has evolved greatly since I started my Physical Therapy career many years ago. Younger individuals are having joint replacement surgery. Data from 2000 to 2009 for individuals from 45 to 64 years old there was a 188% increase for total knee replacement surgery. For…
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What do you do when Dr. Google isn’t cutting it?
Searching for information online for personal health and medical issues has become commonplace. Estimates are more than 1/3 of persons in the U.S. use the internet for information on their symptoms. More than 60% of US adults have searched online for information during the past year according to the Pew Research Center. There is a…
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Gait deviations clustering gait deviations – injury – new data
In a previous blog article, I discussed the question “Is there a gait deviation or cluster of gait deviations which is common across musculoskeletal pain syndromes?” The consensus is currently there is no definitive evidence suggesting one gait deviation or cluster of gait deviations occurs more frequently or is more important than another. More research…
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Choice of feedback for learning new movements
A common practice when addressing painful musculoskeletal pain syndromes is the symptom modification procedure. This procedure involves identifying the specific movement, posture, and/or activity that reproduces the patient’s symptoms. The symptom modification procedure alters performance. It is relatively quick as it occurs in one session. Altering performance is different than learning. An altered performance is…
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Downhill running – up does not equal down
Running uphill does not equal downhill running. The faster speed of running downhill does not equal the slower speed of running uphill. The rule of thumb expressed in Jack Daniels’ Running Formula the classic book by running guru Jack Daniels, states that every percent gradient of uphill will slow you by 12 to 15 seconds…
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