Surgery vs non-surgical intervention -Decision for musculoskeletal pain syndrome

When deciding whether to proceed with irreversible intervention such as elective or discretionary orthopedic surgery it is essential to consider the biases of the surgeon, non-surgical healthcare provider, and the patient. For many orthopedic injuries especially nontraumatic or less acute musculoskeletal pain syndromes surgery can be an intervention option. For many if not most musculoskeletal…

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Butt pain – Isometric Exercises

“Butt Pain.” has different tissue diagnoses. Possible diagnoses are sciatica; piriformis syndrome; gluteal tendinopathy; hamstring tendinopathy; bursitis; hip arthritis; and others. There are many treatments for butt pain. My “go-to” exercise for butt pain is isometric contractions of the gluteal muscles. In my experience rarely is trying to “stretch it out” effective treatment for butt…

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Optimizing human movement requires clarity of description of movement

To know where you are going you must first know where you are. To optimize human movement, analysis of human movement is required. To identify optimal human movement clear qualitative and quantitative descriptions are needed. When describing human movement confusion occurs when we fail to clearly identify a frame of reference and reference point. 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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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…

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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…

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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…

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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…

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“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…

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