Physical Therapy Archives - Damien Howell PT

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…

Shoe Soles: Stiff Rocker Bottom Sole versus Flexible Sole “Barefoot”

There are many things to consider when selecting shoes, including comfort, injury and energy expenditure. Arnie Davis a Certified Pedorthotist has coined the term shoes with rocker bottom soles are the proverbial “aspirin” for chronic foot problems. A rocker sole shoe is recommended to help manage a number of painful injuries including: low back pain;…

Knee Pain Wringing Out – Gait Deviation

Knee pain can develop because of a “wringing out”. I am not referring to banging a bell ring, but the counter-rotation motion that can occur at the knee joint. The knee joint consisting of the thigh and lower leg moves on three different planes of motion. The knee can flex and extend. The knee can…

Back Pain Dilemma – Keep on Walking

Walking is commonly recommended by many medical professional associations for management of back pain. Walking is purported to be beneficial counteracting the potential deleterious effects of bed rest, maintaining functional abilities, stimulating use of spinal core muscles, keeping the general benefits of aerobic exercise, and providing pain reduction effects. Pain Walking can provide relief to…