Physical Therapy Archives - Damien Howell PT

On-line mentoring reflective learning

John Dewy wrote, “the experience alone does not necessarily lead to learning; it is the reflection that makes sense of the experience to us and hence makes the experience meaningful for us”. Experience does not equal learning. We do not learn from experience we learn from reflection on experience. Experience does not equal knowledge. Reflection…

Plantar fasciitis v tendinopathy words matter – stretching exercises are overrated

Why is the plantar region the only region of the body where the terminology of fasciitis is used? Fascial tissue is present throughout the body including the ankle, knee, hip, back, and abdominal regions of the body. Yet, we do not use the term knee fasciitis or back lumbar fasciitis. We know that stretching exercises…

Choices of interventions for musculoskeletal pain syndromes: decrease pain, improve impairment, resolve dysfunction

There are multiple and varied interventions that can tackle the contributing factors of pain, impairment, and dysfunction that occurs with musculoskeletal pain syndromes. Pain impairs an individual’s ability to function Impairment is loss of use or derangement of any body part, organ system, or organ function. Dysfunction is an alteration of an individual’s capacity to…

Walk this way – Run this way

What way should we walk? What way should we run? Mel Brooks and Gene Wilder wrote the script for the movie “Young Frankenstein” in which the character Igor the hunchback shows Dr. Frankenstein “this way”, and hands him his cane, expecting Dr. Frankenstein to mimic his hunched, contorted shuffle, which Dr. Frankenstein cordially does. This…

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,…

Musing on Empathy and Pain

Empathy is more than compassion and caring. Empathy is putting oneself in another person’s shoes and actually feeling what that person feels. Recently, I experienced a flare of rheumatoid arthritis with significant disabling hip pain. Deep in misery, I searched for the positive side of my suffering. I thought: “This means I will have more…

IT Band Syndrome – Controversy Regarding Stretching Exercise

The Iliotibial (IT) Band is a tendon on the lateral aspect of the hip/thigh/knee. It is a large, wide, thick tendon. A tendon is a structure that attaches muscle to bone. IT band syndrome is a typical injury occurring in runners. A commonly recommended treatment for IT band syndrome is stretching exercise. Searching Google for…

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…

Shoes too big for foot contributes to injury

A majority of all people are in shoes that are incorrect shoe size according to Fawn Evenson director of the Footwear Industries of America. There are two potential errors when selecting what size shoes to wear. Either the shoe will be too small for the foot or too large for the foot. In my experience…

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…