Search results for: second
Second Opinion Physical Therapist
Getting and providing second opinions regarding medical care is a common practice. Getting and providing second opinions from a physical therapist is a less common practice, but why? Decisions regarding healthcare can by very important. There are times and situations when getting a second opinion regarding healthcare advice are a prudent action. Studies have shown…
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 MoreDo Running Shoes Prevent Injuries? Revisiting Evidence Two Decades Later
Twenty years ago, runners were told that the “right shoe” could prevent injury. Today, despite an explosion of research and technology, the answer remains surprisingly complicated. In 2006, my blog post Evolution of the running shoe: evidence & opinion,” my central observation was that runners often overestimated the role of footwear in injury risk. Shoes…
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 MoreHip-Spine vs Spine-Hip vs Both – 3 Case Examples Lessons Learned
An 80-year-young woman visited her primary care physician with “pain going down my leg”. She had difficulty grocery shopping, picking up her small dog. X-rays showed osteoarthritis in her lumbar spine, and she was diagnosed with “sciatica.” The doctor referred her to a spine surgeon, who ordered an MRI and gave her an x-ray-guided spinal…
Read MorePhysical Therapy telehealth lessons learned mistakes made
My perception of my abilities in providing telehealth video conferencing Physical Therapy or Physical Therapy service online follows the Dunning-Kruger effect. The Dunning-Krueger effect is a process of overestimating and underestimating our abilities and competence. When I began offering telehealth Physical Therapy in 2017, I initially overestimated my abilities. Over the past seven years, I…
Read More20250329 draft Physical Therapy Online Telehealth
Physical Therapy Online Telehealth Call 804-647-9499 for a free discussion to determine whether a telehealth visit (live video conference) is right for you, or whether a face-to-face consultation is more appropriate. There may be times when a face-to-face assessment of your musculoskeletal problem isn’t convenient, or you may just want a second opinion or to…
Read MoreMusculoskeletal pain which are important steps which are less important?
Thesis: Choosing a diagnosis is an early step in solving non-traumatic muscle and bone pain problems. A diagnosis helps guide treatment, predict how problems will progress, and improve communication. A diagnosis has many functions, including direction for intervention to solve problems, predicting how problems will progress, and assisting in communication. Antithesis: Medical terminology is notoriously…
Read MorePhysical Therapy Online Telehealth
Physical Therapy Online Telehealth Call 804-647-9499 for a free discussion to determine whether a telehealth visit (live video conference) is right for you, or whether a face-to-face consultation is more appropriate. There may be times when a face-to-face assessment of your musculoskeletal problem isn’t convenient, or you may just want a second opinion or to…
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