Symptom modification of painful gait

By Damien Howell

Symptom modification procedure is common practice in the Physical Therapy profession. This procedure involves identifying the specific movement, posture, and/or activity that reproduces the patient’s symptoms. Historically diagnosis of musculoskeletal problems was based on examination which selectively provoked musculoskeletal tissues by compressing or stretching the various tissues to provoke the symptoms. This provided direction for…

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Pain walking/running deviant gait – self treat &/or seek expert assistance

By Damien Howell

Experiencing pain when walking or running can be a complex problem. Asserting a hypothesis is a systematic way to solve complex problems. A hypothesis is an “if-then statement” or conditional statement which can be tested, accepted, or refuted. Hypothesis: If you have pain walking and/or running, then gait analysis to determine if there is a…

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As a patient, how do I get my healthcare provider more engaged in my care plan?

By Damien Howell

The goal of any relationship between a healthcare provider and patient is that both parties feel they are invested in favorable health outcomes. How they get there is the question. The underlying assumption is that a high degree of engagement from the provider and the patient will result in better outcomes, costs less, and may…

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How to exercise to lose weight when exercise is painful

By Damien Howell

High body mass index (BMI) is significant factor in low back pain, osteoarthritis; hip osteoarthritis; knee osteoarthritis, plantar heel pain. Weight loss intervention for pain reduction Decreasing body weight is an effective intervention to decrease musculoskeletal pain. Research by Stephen Messier at Wake Forest U, looking at individuals with painful osteoarthritis of the knee who…

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Healthcare Whisperer versus Con Artist

By Damien Howell

The popular idiom of a “whisperer” is used to describe an individual who has special skills to interact with humans or animals to alter behavior and achieve outcomes that others cannot. What are the characteristics of a whisperer? A whisperer: Has high level of empathy Has specialized skills Focuses is understanding Uses body language communication…

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“Deme Bones” – Regional interdependence

By Damien Howell

The common reframe from the old spiritual song “dem bones” is the “toe bone is connected to foot bone”. In the medical community this concept of mechanical connectiveness is referred to as “regional interdependence”. Regional interdependence is seemingly unrelated impairments in remote anatomical regions of the body may contribute to and be associated with a…

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Analysis of Movement with Smartphone Video

By Damien Howell

Physical therapists are movement specialist according to the American Physical Therapy Association. Addressing issues related to the human movement system is what Physical Therapist do. The movement system is collection of systems (cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal) that interact to move the body or its component parts. Visual observation and analysis of movement…

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Total Knee Joint Replacement – Are You Satisfied? Gait Analysis & Training Can Provide Post-Op Improvements

By Damien Howell

Pain and stiffness associated with osteoarthritis in knee joints can result in a limp, gait deviations and gait compensations. Gait deviations are variations from what is perceived as normal walking or running. These deviations are described as limitations, restrictions or weaknesses that lead to lack of mobility, stability or symmetry of movement. Gait deviations also…

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Gait Deviation – Excessive Inward Rotation of Hip Joint

By Damien Howell

Excessive inward rotation of the hip joint can be a contributing factor to development of repetitive use injuries of: Lateral hip pain (gluteal muscle tendinopathy) Buttock pain (piriformis syndrome) Anterior knee pain (patella femoral arthralgia) Lateral knee pain (IT band syndrome Shin pain (posterior tibial tendinopathy) Plantar heel pain This video first illustrates the gait…

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