Hormone replacement therapy tendon repair post-menopause

The Dunning-Kruger effect is a cognitive bias in which individuals with limited competence in a particular domain overestimate their abilities. It is when we lack competence that we are most likely to be brimming with overconfidence. The following is a description of how it applies to me. I know everything Early in my career as…

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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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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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Cuing to Alter Gait Deviation of Too Long a Step

Cuing to Alter Gait Deviation of Too Long a Step Mathematics helps explain walking or running faster. Step length X steps per minute = speed. In order to move faster there are 3 opportunities take longer steps or strides, increase the steps/minute (cadence), or do both longer steps and a faster cadence. Taking longer steps/stride…

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Gait Analysis – Gait Training for Achilles Tendon Pain

The manner you walk or run can be one of the contributing factors to the development of Achilles tendon problems. If you are experiencing pain in the Achilles when walking or running working with your Physical Therapists and using slow motion video analysis the following model can provide a beginning point to solve the problem.…

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Osteoarthritis – Cartilage and Exercise

  Osteoarthritis is primarily a degeneration, or wear and tear, of the hyaline cartilage that covers the end of the joint surfaces. Osteoarthritis occurs as a result of “the parents you choose” (genetic influence) or as a sequel to a prior joint trauma or injury. There is a great deal of information dealing with the…

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Pain on Bottom of Heel: Faulty Shock Absorption

Pain on the bottom of the heel (Plantar Heel Pain) is a complex problem with variable diagnoses and explanations. And, with variable diagnoses there should be variations in treatment. Unfortunately, the common treatment recommendations do not recognize such variability. Not all pain on the bottom of the heel is the same and not all pain…

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About Damien Howell

About Damien Howell   Damien Howell’s Story Damien’s path to a career in Physical Therapy started with undergraduate study in Health & Physical Education. While participating and lettering in Division III Collegiate Soccer, Cross Country, Basketball, and Track & Field at Frostburg State College, Damien decided the best way to pursue his interest in sports…

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