25 posts · 31,055 views
Orthopedic Physical Therapy
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- April 2, 2010
- 10:50 PM
- 1,090 views
Eccentric Training – Overhyped?
by Texasortho in The Movement Science Blog and Podcast
I suppose I’ve been around the world of exercise science for long enough to see plenty of fads come and go. For God’s sake, I just heard about a “cookie diet” while driving home from work today. I’ve oft lamented that the conditioning and rehabilitation communities are sometimes a bit quick to embrace fads. While I’m [...]... Read more »
Slater, H., Thériault, E., Ronningen, B., Clark, R., & Nosaka, K. (2010) Exercise-induced mechanical hypoalgesia in musculotendinous tissues of the lateral elbow. Manual Therapy, 15(1), 66-73. DOI: 10.1016/j.math.2009.07.002
- December 31, 2009
- 04:04 PM
- 818 views
Origins of Tendopathy: Where is the Evidence?
by Texasortho in The Movement Science Blog and Podcast
A significant portion of my caseload consists of helping patients recover from tendon disorders. Rotator cuff pathology seems to comprise the greatest percentage of these conditions at our clinic, but there have been no shortage of patellar tendopathy, Achilles tendopathy, and the ubiquitous (read: worn out) diagnosis previously known as tennis elbow.
I was first exposed to [...]... Read more »
Rees, J. (2006) Current concepts in the management of tendon disorders. Rheumatology, 45(5), 508-521. DOI: 10.1093/rheumatology/kel046
Coombes, B., Bisset, L., & Vicenzino, B. (2009) A new integrative model of lateral epicondylalgia. British Journal of Sports Medicine, 43(4), 252-258. DOI: 10.1136/bjsm.2008.052738
- March 15, 2009
- 01:05 PM
- 1,505 views
Movement Science Podcast: On the Air!
by TexasOrtho in Orthopedic Physical Therapy
Ok folks here we are - my first podcast. This episode explores the relationship between motor learning, motor control deficits, and low back pain. I hope you enjoy my rookie effort and will hang in there as I continue to improve this new feature of my blog. Please let me know if you are having difficulty dowloading the podcast and I will get the bugs worked out asap! I hope to be up on iTunes soon so this should add an additional level of functionality to the show. Powered by Podbean........ Read more »
Allison, G., & Morris, S. (2008) Transversus abdominis and core stability: has the pendulum swung?. British Journal of Sports Medicine, 42(11), 630-631. DOI: 10.1136/bjsm.2008.048637
Hodges, P. (2007) Transversus abdominis: a different view of the elephant. British Journal of Sports Medicine, 42(12), 941-944. DOI: 10.1136/bjsm.2008.051037
Cook, J. (2008) Jumping on bandwagons: taking the right clinical message from research. British Journal of Sports Medicine, 42(11), 563-563. DOI: 10.1136/bjsm.2008.048629
Mulder T, Neinhuis B, & Pauwels J. (1996) The Assessment of Motor Recovery: A New Look at an Old Problem. J Electromyogr Kinisiol, 6(2), 137-145.
Hodges, P. (2003) Pain and motor control of the lumbopelvic region: effect and possible mechanisms. Journal of Electromyography and Kinesiology, 13(4), 361-370. DOI: 10.1016/S1050-6411(03)00042-7
- March 15, 2009
- 12:29 PM
- 421 views
Movement Science Podcast: On the Air!
by Texasortho in The Movement Science Blog and Podcast
Ok folks here we are – my first podcast. This episode explores the relationship between motor learning, motor control deficits, and low back pain. I hope you enjoy my rookie effort and will hang in there as I continue to improve this new feature of my blog. Please let me know if you are [...]... Read more »
Allison, G., & Morris, S. (2008) Transversus abdominis and core stability: has the pendulum swung?. British Journal of Sports Medicine, 42(11), 630-631. DOI: 10.1136/bjsm.2008.048637
Hodges, P. (2007) Transversus abdominis: a different view of the elephant. British Journal of Sports Medicine, 42(12), 941-944. DOI: 10.1136/bjsm.2008.051037
Cook, J. (2008) Jumping on bandwagons: taking the right clinical message from research. British Journal of Sports Medicine, 42(11), 563-563. DOI: 10.1136/bjsm.2008.048629
Mulder T, Neinhuis B, & Pauwels J. (1996) The Assessment of Motor Recovery: A New Look at an Old Problem. J Electromyogr Kinisiol, 6(2), 137-145.
Hodges, P. (2003) Pain and motor control of the lumbopelvic region: effect and possible mechanisms. Journal of Electromyography and Kinesiology, 13(4), 361-370. DOI: 10.1016/S1050-6411(03)00042-7
- December 28, 2008
- 11:07 AM
- 1,418 views
Are you an expert clinician?
by TexasOrtho in Orthopedic Physical Therapy
If you've been reading my posts for a little while now, you might have noticed I place a high value on education. I've been teaching as an adjunct instructor for over eleven years at a local university and regularly take students on clinical rotation. After a recent four-week (entirely too short) rotation with two year-one PT students, I found myself looking back on to their experiences at the clinic and wondering what I could have done better. They both had a great experience, but I couldn't he........ Read more »
Jones M. (1992) Clinical reasoning in manual therapy . Physical Therapy, 72(12), 875-884. DOI: http://physicaltherapyjournal.org/cgi/content/abstract/72/12/875
- December 27, 2008
- 09:05 PM
- 1,733 views
Manual Therapy: What is REALLY going on?
by TexasOrtho in Orthopedic Physical Therapy
Earlier in my PT career I often called B.S. on forms of treatment that didn't seem to pass the smell test. Manual therapists in particular seemed susceptible to jumping on the bandwagons driven by chiropractors (i.e. adjustments, active release therapy, and craniosacral therapy). Not only did I try to avoid any professional association with whom I perceived as quacks, I went out of my way to disprove their methods. As you can imagine, telling someone who believes in Santa Clause "there really is........ Read more »
J BIALOSKY, M BISHOP, D PRICE, M ROBINSON, & S GEORGE. (2008) The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy. DOI: 10.1016/j.math.2008.09.001
- December 13, 2008
- 10:29 PM
- 1,731 views
Stiff posterior capsule? Maybe not...
by TexasOrtho in Orthopedic Physical Therapy
It is common practice for physical therapists to include an assessment of the posterior glenohumeral joint capsule in patients with shoulder pain. The rationale is that a tight posterior capsule may exert a "Diablo" effect on the proximal humerus and reducing the subacromial space. This is further substantiated by the obeservaton that GIRD (Glenohumeral Internal Rotation Deficit) often seen in throwing athletes is due to limitations of the posterior capsule. These two clinical observations form ........ Read more »
A POSER, & O CASONATO. (2008) Posterior glenohumeral stiffness: Capsular or muscular problem? A case report. Manual Therapy, 13(2), 165-170. DOI: 10.1016/j.math.2007.07.002
- December 13, 2008
- 10:08 AM
- 1,724 views
More with less: Conservative management of massive rotator cuff tears
by TexasOrtho in Orthopedic Physical Therapy
Massive rotator cuff tears within the medically unfit population are a difficult clinical scenario for the medical profession. The nature of the pathology often indicates a surgical intervention, but the procedure is often deemed to be too high risk. The present investigation prospectively assessed 17 patients with massive rotator cuff tears after treatment with an anterior deltoid rehabilitation program. Patients were videotaped attempting active shoulder elevation both before and after the reh........ Read more »
O LEVY, H MULLETT, S ROBERTS, & S COPELAND. (2008) The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. Journal of Shoulder and Elbow Surgery, 17(6), 863-870. DOI: 10.1016/j.jse.2008.04.005
- December 13, 2008
- 10:05 AM
- 1,439 views
Peripheral nerve function during shoulder arthroplasty
by TexasOrtho in Orthopedic Physical Therapy
The incidence of peripheral nerve injury during shoulder arthroplasty is reported between one and four percent. However as these numbers are based on retrospective chart review, the actual incidence of intraoperative nerve dysfunction has not been clearly revealed.The present study utilized intraoperative nerve monitoring to identify the frequency, type, and predisposing factors for peripheral nerve injury during shoulder arthroplasty. Thirty consecutive patients undergoing shoulder arthroplasty........ Read more »
S NAGDA, K ROGERS, A SESTOKAS, C GETZ, M RAMSEY, D GLASER, & G WILLIAMSJR. (2007) Neer Award 2005: Peripheral nerve function during shoulder arthroplasty using intraoperative nerve monitoring. Journal of Shoulder and Elbow Surgery, 16(3). DOI: 10.1016/j.jse.2006.01.016
- December 13, 2008
- 09:57 AM
- 808 views
More Neuroscience from the "Ortho Guy"
by TexasOrtho in Orthopedic Physical Therapy
Well the semester is finally over. Man I never thought there would be so much to my neuroscience course. It has been an eye opening process that has improved my clinical reasoning and given me a few extra tools in my therapeutic box!I thought I might take the next few weeks to share some of the topics discussed this semester. On the surface, some of th issues related to neuroscience seem only peripherally related to orthopedic practice. Upon further review, many hit really close to home for many........ Read more »
Baron, R. (2000) Peripheral Neuropathic Pain: From Mechanisms to Symptoms. Clinical Journal of Pain, 12-20.
- December 13, 2008
- 09:57 AM
- 923 views
More Neuroscience from the "Ortho Guy"
by TexasOrtho in Orthopedic Physical Therapy
Well the semester is finally over. Man I never thought there would be so much to my neuroscience course. It has been an eye opening process that has improved my clinical reasoning and given me a few extra tools in my therapeutic box!I thought I might take the next few weeks to share some of the topics discussed this semester. On the surface, some of th issues related to neuroscience seem only peripherally related to orthopedic practice. Upon further review, many hit really close to home for many........ Read more »
Baron, R. (2000) Peripheral Neuropathic Pain: From Mechanisms to Symptoms. Clinical Journal of Pain, 12-20.
- December 13, 2008
- 09:15 AM
- 1,448 views
Calcaneal and Plantar Nerves: Overlooked contributors to heel pain syndromes?
by TexasOrtho in Orthopedic Physical Therapy
So I'm sitting here in my living room watching coverage of the latest impending apocalypse (Hurricane Ike) churn in the Gulf. You might think it's an odd time for this Gulf Coast native to be thinking about heel pain, but here I am...thinking about heel pain. We can discuss the reasons I have no life at a later date.Diagnoses seem to come in spurts in this clinic and I've recently been referred several cases of both infracalcaneal and retrocalcaneal heel pain. As with many of my treatment approa........ Read more »
Rose JD, Malay DS, & Sorrento DL. (2003) Neurosensory Testing of the Medial Calcaneal and Medial Plantar Nerves in Patients With Plantar Heel Pain. The Journal of Foot and Ankle Surgery, 42(4), 173-177.
- August 3, 2008
- 08:19 AM
- 793 views
Are you CPR Certified?
by TexasOrtho in Orthopedic Physical Therapy
Fortunately I'm not talking about through the Red Cross. As important as this life-saving skill is, it may be just as important to understand the nature of a more trendy form of CPR in the world of rehabilitation science: The Clinical Prediction Rule.Prescriptive clinical prediction rules on topics such as lumbar manipulation, traction, and even anterior knee pain have emerged recently in our rehabilitation literature. The fact these reports exist underscore the fact that we are actively engaged........ Read more »
John Childs, & Joshua Cleland. (2006) Development and Application of a Clinica Prediction Rule to Improve decision making in physical therapist practice. Physical Therapy, 122-131.
- June 23, 2008
- 12:03 AM
- 792 views
Persistent Pain: An Independent Disease State?
by TexasOrtho in Orthopedic Physical Therapy
I recently began reading C.S. Lewis' The Problem of Pain. As with many of Lewis' writings, it is remarkable in both it's depth and simplicity. So many questions arise when it comes to the issue of pain, particularly for this therapist. Because I don't like weak links, I figured I'd better start looking for answers!One aspect of a good question is that it often gives rise to more even better and more clinically relevant questions. Many physical therapists (myself included) emerge from entry-level........ Read more »
M COUSINS. (2007) Persistent Pain: A Disease Entity. Journal of Pain and Symptom Management, 33(2). DOI: 10.1016/j.jpainsymman.2006.09.007
- June 4, 2008
- 12:37 PM
- 971 views
Adverse Events of Chiropractic Care: Transparency Now!
by TexasOrtho in Orthopedic Physical Therapy
So I've been binging on literature lately....One of my first courses at Texas Tech's doctoral program is Advanced Clinical Practice for the Cervicothoracic Junction and Thoracic Outlet. Let me be the first to say I had no idea this part of the body would be quite so involved and interesting at the same time.Our weekly assignments involve reading research ranging from randomized clinical trials to anatomical reviews. After only one week in this program, I've already picked up some good informatio........ Read more »
Eric Hurwitz, Hal Morgenstern, Maria Vassilaki, & Chiang. (2005) Frequency and Clinical Predictors of Adverse Reactions to Chiropractic Care in the UCLA Neck Pain Study . Spine, 30(13), 1477-1484.
- May 14, 2008
- 07:43 PM
- 1,172 views
The Core: From Development, Through Distortion, to a Potential Solution
by TexasOrtho in Orthopedic Physical Therapy
I began working in outpatient physical therapy as an exercise physiologist back in 1996. At that time, I had no intentions of becoming a physical therapist and was busy trying to carve a niche in my profession as a strength and conditioning specialist. Back then, both the exercise science and physical therapy communities were running wild with this new form of training that would revolutionize the way we manage orthopedic conditions and enhance performance on the field. Like cave dwellers witnes........ Read more »
Karen Barr, Miriam Griggs, & Todd Cadby. (2007) Lumbar Stabilization. American Journal of Physical Medicine , 86(1), 72-80. DOI: 10.1097/01.phm.0000250566.44629.a0
Marc Sherry, Thomas Best, & Bryan Heiderscheit. (2005) The Core: Where are we and where are we going?. Clinical Journal of Sports Medicine, 15(1), 1.
- April 19, 2008
- 07:08 AM
- 1,614 views
Diagnosis of Patellar Malalignment: A Work in Progress...
by TexasOrtho in Orthopedic Physical Therapy
If you've been reading my previous blogs, you'll see that I often need to be dragged kicking and screaming into a adopting traditionally held beliefs of the physical therapy profession. As much as some of my colleagues would like otherwise, I will likely hold on to this stubborn characteristic until the day I croak. The upside to my eternal skepticism is the drive to finding evidence supporting or refuting specific approaches to a clinical problem.I have previously admitted having guer........ Read more »
Tony Wilson. (2007) The Measurement of Patellar Alignment in Patellofemoral Pain Syndrome: Are We Confusing Assumptions With Evidence?. Journal of Orthopaedic and Sports Physical Therapy. DOI: 10.2519/jospt.2007.2281
- April 18, 2008
- 11:46 PM
- 1,695 views
The Centralization Phenomenon: Prevalence and Predictive Value
by TexasOrtho in Orthopedic Physical Therapy
A recent research report in JOSPT investigates the centralization phenomenon including its prevalence among cervical and lumbar cases, and its relationship to treatment outcomes. In keeping with the spirit of standardizing and refining our methods and language, this article is definitely a step in the right direction.In this study, centralization is characterized as "spinal pain and referred symptoms that are progressively abolished in a distal-to-proximal direction in response to therapeut........ Read more »
Mark Werneke. (2008) Centralization: Prevalence and Effect on Treatment Outcomes Using a Standard Operational Definition and Measurement Method. Journal of Orthopaedic and Sports Physical Therapy. DOI: 10.2519/jospt.2008.2596
- April 5, 2008
- 09:47 PM
- 1,781 views
TKR: How much motion should we expect?
by TexasOrtho in Orthopedic Physical Therapy
I'm not sure how this happens, but certain diagnoses seem to come to my clinic in clusters. I see a fair amount of primary TKR in my clinic. For the most part, patients undergoing primary arthroplasty seem to do very well in our clinic subjectively and functionally. Fortunately for all of us, I doubt my outcomes far exceed or lag behind many of you treating the same population.In spite of the numerous successes we see with primary knee arthroplasty, you may share my frustration with those p........ Read more »
M RITTER, J LUTGRING, K DAVIS, M BEREND, J PIERSON, & R MENEGHINI. (2007) The Role of Flexion Contracture on Outcomes in Primary Total Knee Arthroplasty. The Journal of Arthroplasty, 22(8), 1092-1096. DOI: 10.1016/j.arth.2006.11.009
- March 30, 2008
- 08:35 PM
- 1,043 views
SIJ Motion: I still can't feel anything
by TexasOrtho in Orthopedic Physical Therapy
Early in my PT career, I thought I had the hands of a guerrilla. No condition made me feel more like a primate than during my evaluation and assessment of sacroiliac dysfunction. We must have spent 4-6 weeks in school studying motion and palpation tests for the SI joint and I really felt I had it down.After a few weeks of practicing and seeing a ton of spine cases at the clinic I was working, I had an epiphany: What would happen if these tests were found to have little evidence supporting th........ Read more »
Adam Goode, Eric Hegedus, Philip Sizer, Jean-Michel Brismee, Allison Linberg, & Chad Cook. (2008) Three-dimensional Movements of the Sacroiliac Joint: A Systematic Review of the Literature and Assessment of Clinical Utility . Journal of Manual , 16(1), 25-38. http://jmmtonline.com/
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