Repetitive Use injury Archives

“Deme Bones” – inter-limb deviation related to the musculoskeletal pain syndromes

“The toe bone is connected to the foot bone” is the common reframe from the old gospel song “Dem Bones.” The concept of mechanical connectedness or regional interdependence applied to musculoskeletal pain syndromes suggests that in addition to examining a patient’s local area of complaint examination of the adjacent joints above and below the primary…

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…

Half Seat Lateral Wedge for Lateral Pelvic Tilt Sitting

Shoe lifts or lifts in the shoe are a common treatment for leg length discrepancy. Why are lifts not used for lateral pelvic tilt when sitting? In a previous blog article, I described lateral pelvic tilt and anatomical versus functional lateral pelvic tilt. Lateral pelvic tilt can result from individual structural variation, and defective chair or…

What is harder than learning? Unlearning

This image from Roger von Oech’s “A whack on the side of the head” 1983 has intrigued me for years. The idea that we get rid of ideas or concepts is thought-provoking. How do we know when to reject ideas? What is the thought process we use to unlearn something? My understanding of learning new…

Plantar 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…

Choices 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…

Walk this way – Run this way

What way should we walk? What way should we run? Mel Brooks and Gene Wilder wrote the script for the movie “Young Frankenstein” in which the character Igor the hunchback shows Dr. Frankenstein “this way”, and hands him his cane, expecting Dr. Frankenstein to mimic his hunched, contorted shuffle, which Dr. Frankenstein cordially does. This…

How 2D video motion analysis facilitates problem solving, reflective learning, & identification of novel interventions

The referral of this gentleman in the video below was for an exercise program for chronic right knee pain. The patient and the referring Physician Assistant expressed expectations that an exercise program would help decrease his pain so he could return to playing recreational basketball. There is ongoing controversy about whether high-intensity quadriceps strengthening exercises…

Telehealth PT Benefits – Statutory Barriers Across State Lines

With the weakening of the covid 19 pandemic, I expect the utilization of Physical Therapy services by telehealth will decline. However, the necessity of learning to provide and receive Physical Therapy services via telehealth uncovered benefits of this service model including: Eliminating time spent traveling to and from appointments and time spent waiting for care…

Sensory 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…