Exercise prescription – Art & Science

Exercise while not a drug can behave like one. Exercise can help in the management of chronic diseases and offer pain relief for individuals suffering from musculoskeletal pain syndromes. Like prescribing drugs, the concept of dosage applies to exercise prescription. A dose-response to exercise is not unlike drugs however the minimum dose, dose-response, and maximum…

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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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New developments in joint replacement surgery & rehabilitation

The use of joint replacement surgery for hip and knee pain has evolved greatly since I started my Physical Therapy career many years ago. Joint replacement is occurring in younger individuals Younger individuals are having joint replacement surgery. Data from 2000 to 2009 for individuals from 45 to 64 years old there was a 188%…

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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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Downhill running – up does not equal down

Running uphill does not equal downhill running. The faster speed of running downhill does not equal the slower speed of running uphill. The rule of thumb expressed in Jack Daniels’ Running Formula the classic book by running guru Jack Daniels, states that every percent gradient of uphill will slow you by 12 to 15 seconds…

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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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