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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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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Puny 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.

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Side Effects Occur During Gait Training

  A side effect is a secondary effect, typically undesirable effect of a drug or medical intervention. Any intervention that can produce a therapeutic effect can also produce side effects or adverse effects. The current standard of practice is to provide informed consent before beginning evaluation and treatment. Informed consent includes identifying the benefits and…

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Clinical 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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Mountain Athlete: 2-Dimensional Video Slow-Motion Analysis

I have been asked to present a continuing education webinar to members of the National Strength and Conditioning Association. The theme of the program is Human Performance the “Mountain Athlete” What is a “Mountain Athlete”?  Athletic activities that occur in the mountains are skiing, climbing, Spartan racing, adventure racing, trekking, adventure racing, mountain biking, and…

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Better cues & mental practice to improve skillful movements: Are external focus cues better than internal focus cues? It depends

Coaches, athletes, healthcare professionals, verbal cues, use mantras, self-talk, visual imagery, and skill training to improve movement. There are many cognitive strategies commonly used to improve human movement to move faster, farther, injury-free, and/or just look better moving. Types of cues: A substantial amount of research in the area of motor learning examines different types…

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