Repetitive Use injury
Downsides of steroid injections for hip pain – What 3 patients taught me
Three patients with chronic hip pain prompted me to dive deeper into the effectiveness and risks of the common intervention of corticosteroid injection for musculoskeletal pain syndromes. Patient A complains of difficulty lifting his leg to put his pants on when standing and difficulty lifting his leg to transfer into his car. He had a…
Read MoreFalling Off the Wagon Isn’t the End: Learning from Lapses in Exercise & Recovery
During a routine follow-up, my patient “Larry Lapes,” who has chronic ankle and back pain, asked me a question that stopped me in my tracks: “Do you have any strategies that help your patients stick to their exercise routines?” His question prompted me to reflect more deeply on lapses and relapses in behavior change. Behavioral…
Read MoreMusculoskeletal pain which are important steps which are less important?
Thesis: Choosing a diagnosis is an early step in solving non-traumatic muscle and bone pain problems. A diagnosis helps guide treatment, predict how problems will progress, and improve communication. A diagnosis has many functions, including direction for intervention to solve problems, predicting how problems will progress, and assisting in communication. Antithesis: Medical terminology is notoriously…
Read MoreAdjusting the exercise load to manage musculoskeletal pain syndrome
Adjusting the amount of exercise load involves seeking a balance between increasing or decreasing the load. Athletes and healthy individuals the bias is towards increasing the load to improve capacity and performance. For musculoskeletal injuries, post-orthopedic surgery, or musculoskeletal pain syndromes, the bias is towards decreasing the load to facilitate healing and recovery. Tactics to…
Read MoreAdjusting exercise load to optimize capacity performance
When it comes to adjusting exercise loads to optimize performance capacity it necessitates both art and science. “Load management” in athletics and sports is a popular strategy to control the training volume, intensity, and rest to optimize performance while minimizing the risk of injury. To improve performance or capacity, the exercise/load must exceed the individual’s…
Read MoreHow does the natural progression of osteoarthritis influence the management of osteoarthritic flares?
Case Example: Over the last year, on several occasions, a patient has sought assistance for recurring flaring neck pain. Radiographs show moderate osteoarthritic (OA) changes in the cervical spine. A history of mild to moderate scoliosis of the spine has existed since childhood. Over the years, the neck pain has alternated from long periods of…
Read MorePain – What does it feel like? How this information can guide intervention
When describing your pain details can include location, type, severity/intensity, frequency, duration, triggers, and impact on life. When describing the location of the pain it may not be accurate. Pain can be perceived in an area that is distant from the tissue source of the pain. This is described as referred pain, when the pain…
Read MoreMovement-evoked pain measurement for adjustment of interventions for chronic musculoskeletal pain syndromes
If chronic musculoskeletal pain syndrome is like diabetes, then what is a self-administered test to adjust interventions? A thought-provoking article by Jermey Lewis and Peter O’Sullivan suggests “Is it time to reframe how we care for people with non-traumatic musculoskeletal pain” they suggest we have a lot to learn from how other chronic medical and…
Read MoreHormone replacement therapy tendon repair post-menopause
The Dunning-Kruger effect is a cognitive bias in which individuals with limited competence in a particular domain overestimate their abilities. It is when we lack competence that we are most likely to be brimming with overconfidence. The following is a description of how it applies to me. I know everything Early in my career as…
Read MoreDeviant movement resulting in pain – Excessive Toe Out Gait
Asymmetrical movements walking or running are considered deviant or less than optimal movements. The individual in the video below is complaining of musculoskeletal pain in the left lower extremity. What do you see? Do you see the asymmetrical movement? Do you see the right foot is pointing straight ahead, and the left foot is not…
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