Spine Archives - Damien Howell PT

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…

Physical Therapy Telehealth: It works well for some, not for others

The COVID 19 pandemic crisis has many challenges for the standard everyday health care and medicine. The pandemic resulted in a sudden increase of telehealth services. There are reports there has been an 18% increase in the number of healthcare providers providing telehealth services in response because of the pandemic. Healthcare providers and patients are…

Low-Tech Slow-Motion Analysis – “Dance Step to Nowhere

NDeviant 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…

Symptom modification of painful gait

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…

How to exercise to lose weight when exercise is painful

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…

“Deme Bones” – Regional interdependence

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…

Shoe drop – how the pendulum swings

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…

Keeping the Spring in Your Step: Ankle Joint Power & Aging

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…

Lateral Pelvic Tilt Sitting

When oriented normally, the pelvis appears level and symmetrical. But in individuals with a lateral pelvic tilt (also called pelvic obliquity), one side of the pelvis appears lower than the other side. Lateral pelvic tilt can both cause and compensation to avoid musculoskeletal pain. It can be a contributing factor to jaw pain, headaches, shoulder,…

Orthopedic Surgery vs Orthopedic Medicine: Considerations Regarding Elective Surgery

There is a difference between someone who practices orthopedic surgery and someone who practices orthopedic medicine. Orthopedic surgeons are interested in surgical treatment of musculoskeletal problems. Orthopedic medicine practitioners are interested in non-surgical treatment of musculoskeletal problems. Dr. James Cyriax, author of “Textbook of Orthopaedic Medicine,” emphasized this difference. While some orthopedic problems improve with…