Treatment
Which Side of the Bed After Orthopedic Surgery? A Simple Rule to Reduce Pain Getting In & Out
Historically, the protocol for orthopedic joint replacement surgery was an overnight stay in the hospital the day of the surgery. Now, the majority of elective orthopedic surgeries are done as outpatient and discharged to home the day of surgery. Right after elective orthopedic surgery, getting in and out of bed, chairs, and toilets can be…
Read MoreBreaking the Pain – Loneliness Cycle: Small Steps Toward Connection & Recovery
What if some of what we call “nonproductive” time in healthcare is actually contributing to health, and what does that mean for physical therapists who treat people whose worlds have become smaller because of chronic pain? Earlier in my career, I worked in an outpatient Physical Therapy clinic where productivity demands often left little time…
Read MoreFoot Pain – Lifestyle Changes
After assisting a patient with several musculoskeletal concerns over the years, I received a new request that helped me recognize a recurring pattern among similar requests from other patients. He was requesting assistance in obtaining custom orthotic shoe inserts for foot pain. Shoe orthotics is an intervention that, over the years, I have developed an…
Read MoreWhen Tendons Turn to Fat: Lessons in Clinical Uncertainty
Dunning-Kruger effect – I know everything: For years, I explained to my patients the benefit of strengthening exercises in degenerative tendinopathy in a simple way: A tendon contains many fibers. If some are damaged or torn, strengthening may improve the capacity of the remaining healthy muscle-tendon units to compensate. Over time, the damaged fibers may…
Read MoreDamien Howell Physical Therapy Blog Ranked Among The Best In The World
Damien Howell Physical Therapy has just been named in the Top 100 Physical Therapy Websites & Blogs for Physiotherapists in the world! We have been ranked 59th in the world! Check out the list HERE Damien has a long history as a leader & educator for physical therapy-related issues & techniques. His blog was a natural…
Read MoreThe patient who couldn’t open an email – & why that matters more than “I have fallen & can’t get up.”
I couldn’t read the consent screen on the kiosk at my pharmacy. The font was smaller than my patience. The credit card reader was smaller than my smartphone. The prompts felt endless—and suspiciously designed to sell me something. Somewhere in that process, I was asked to sign something I couldn’t even see. Later that same…
Read MoreWhen the “Protective” Position Isn’t Protective: A Counterintuitive Observation in Rotator Cuff Tendinopathy
A single-patient observation suggests that muscle–tendon length may influence shoulder pain more than we assume. A Counterintuitive Patient Response A patient’s answer to a simple question about her shoulder pain stopped me in my tracks. When I asked what eased the pain, she replied: “When I position my arm above my head, it feels…
Read MorePain Severity vs Pain Irritability: Why the difference matters in musculoskeletal care
A recent patient with shoulder pain persuaded me that pain intensity does not always reflect the clinical seriousness of a condition. Pain irritability – how easily pain is triggered and how long it lasts – often matters more for guiding treatment decisions. A 65-year-old male reported right shoulder pain. When queried, when did it start…
Read MoreHow to mitigate risks & enhance benefits of DIY care of non-traumatic musculoskeletal pain
My January 2026 visit to my healthcare provider was shocking: my coinsurance deductible is twice as much as last year. My health insurance company increased my premium by 25%. Around the same time, I am doing a “do-it-yourself” repair of my Wi-Fi system. My Physical Therapy practice is a one-man shop. So, one of my…
Read MoreHow Horizontal Body Proportions “Inverted Triangle” Can Relate to Back Pain
A current patient with recalcitrant back pain is challenging me to look for innovative strategies for treatment. This 29-year-old male has a 3-year history of low back pain. The pain occurs daily, with an average intensity of 3 out of 10. The symptoms are worse with prolonged sitting. Worse on days that he is more…
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