Foot & Ankle
Should we discharge from Physical Therapy
Why is the terminology “discharged from Physical Therapy” used? I have not heard of anyone being “discharged from dentistry”. I have not heard of anyone being discharged from massage therapy. The meaning of “discharge” is – to relieve of a charge, load, or burden; or to release from confinement, custody, or care; or to set…
Read MorePlantar fasciitis v tendinopathy words matter – stretching exercises are overrated
Why is the plantar region the only region of the body where the terminology of fasciitis is used? Fascial tissue is present throughout the body including the ankle, knee, hip, back, and abdominal regions of the body. Yet, we do not use the term knee fasciitis or back lumbar fasciitis. We know that stretching exercises…
Read MoreChoices of interventions for musculoskeletal pain syndromes: decrease pain, improve impairment, resolve dysfunction
There are multiple and varied interventions that can tackle the contributing factors of pain, impairment, and dysfunction that occurs with musculoskeletal pain syndromes. Pain impairs an individual’s ability to function Impairment is loss of use or derangement of any body part, organ system, or organ function. Dysfunction is an alteration of an individual’s capacity to…
Read MoreSurgery vs non-surgical intervention -Decision for musculoskeletal pain syndrome
When deciding whether to proceed with irreversible intervention such as elective or discretionary orthopedic surgery it is essential to consider the biases of the surgeon, non-surgical healthcare provider, and the patient. For many orthopedic injuries especially nontraumatic or less acute musculoskeletal pain syndromes surgery can be an intervention option. For many if not most musculoskeletal…
Read MoreSensory preference & learning optimal movement
There are many cognitive strategies to cue, prompt, and provide feedback to improve movement. Theory of focus of attention The dominant theory proposed by Gabriele Wulf and colleagues is providing cueing, prompting, or feedback to facilitate learning to move in a more optimal way is using an external focus of attention is more effective and…
Read MoreOptimizing human movement requires clarity of description of movement
To know where you are going you must first know where you are. To optimize human movement, analysis of human movement is required. To identify optimal human movement clear qualitative and quantitative descriptions are needed. When describing human movement confusion occurs when we fail to clearly identify a frame of reference and reference point. A…
Read MoreAdding 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…
Read MoreGait 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…
Read MorePuny Calf Muscles Syndrome
It is time to replace the common belief that stretching exercises should occur before exercise or sporting activity with a newer concept that strengthening exercises for the calf muscles should occur before exercise or sporting activities. During warm up for exercise & sporting activity make a conscious effort to walk with spring in your step. Reactivating & reversing puny calf muscles can prevent injury, increase athletic performance, forestall old person shuffle, & look better.
Read MoreClinical Predictive Rules for Management of Plantar Heel Pain
Medical professionals rely on clinical practice guidelines to have better outcomes, lower utilization of care, and lower costs. These guidelines have limited value since they often fail to keep up with new research findings or recently available diagnostic or therapeutic interventions. For example: clinical practice guidelines are available for plantar heel pain (plantar fasciitis) from…
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