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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Exercise associated muscle cramp (EAMC) is a painful, spasmodic, and involuntary contraction of muscle that occurs during or immediately after exercise. The exact mechanism or cause of EAMC still remains unclear. There is a consensus the first aid treatment of EAMC is to stretch the affected muscle. However, Coppin and colleagues conclude that regular stretching…

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Gait deviations are considered risk factors and/or causative drivers for musculoskeletal pain syndromes. There is a growing body of research showing a relationship between gait deviations and musculoskeletal pain syndromes injuries: shin pain (here, & here,) ; patella-femoral arthralgia (here); IT band syndrome; Achilles pain; plantar heel pain (here, & here). There is growing consensus…

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Deviant movement during walking contributes to the development of or compensation for musculoskeletal pain syndromes. Diagnosis and treatment occur with visual observation and analysis of gait. The use of a smartphone video facilitates the analysis of motion walking. However, there are times when less technological motion analysis is necessary. When dealing with painful musculoskeletal syndromes…

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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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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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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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Put on your high-heel sneakers, Lordy Wear your wig-hat on your head Put on your high-heel sneakers, child Wear your wig-hat on your head Ya know you’re looking mighty fine, baby I’m pretty sure you’re gonna knock ‘em dead – Tommy Tucker Growing up in the 1960s, I remember the song, “Put on Your High-Heel…

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It’s good to stretch a dollar. It’s bad to stretch the truth. But what about stretching your calves? That might depend on whether you believe Dr. Google every time a search result says to stretch sore calves. Calf stretching aims to increase the range of motion (ROM) for ankle dorsiflexion. “Dorsi” is a prefix meaning…

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As we amass more birthdays and get older we tend to walk/run slower, take shorter steps, and fewer per minute. Why do we seem to have less spring in our step the older we get? Kids move fast and crash elderly move slow and crash. One factor is kids have good ankle power elderly have…

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