Expert Orthopedic Care, Exceptional Service
  • About
  • Blog
  • Info
  • Testimonials
  • FAQ

Commonly Used Movement for Knee Problems

10/22/2018

0 Comments

 
If a patient has knee complaints - and I rule out the spine as the source - I assess (and usually treat) the knee with repeated movements. Usually the movement is to address the joint position itself, though sometimes the movement addresses a tendon or muscle. Here McKenzie diplomat Joel Laing demonstrates the movement: knee extension with overpressure in partial weightbearing. I used this with a patient last week in fact! There are many ways to move a knee, but this is one of the most commonly used movements. Please remember, even in the presence of arthritis, meniscus, ligament, tendon, or cartilage damage, in most cases joint pain can be rapidly fixed with repeated movements. The typical exercise prescription for home for the knee is 10 repetitions every 3-4 hours. McKenzie clinicians are trained to examine whether your problem falls into the 80% of cases which will respond to repeated movements, and to find which movement is best for you. --Laura
0 Comments

The Spine and Running

10/4/2016

0 Comments

 
Last night was a great night! Runner's Depot in Davie hosted my presentation on the spine and how it relates to running injuries. Runners have a reputation for having a lot of injuries and, worse, a lot of recurrent or persistent injuries. The crux of my talk is that a lot of injuries in the lower extremities are misdiagnosed as local injuries and not correctly as injuries originating from the nerves in the lumbar spine. For example, plantar fasciits is commonly misdiagnosed. Yes, it exists, but not as frequently as it is diagnosed. The hallmark sign of plantar fasciitis is extreme foot pain with first steps in the morning. That usually eases throughout the day, but returns each morning since the plantar fascia is on slack all night as you sleep and is then stretched with your first steps out of bed. If that sign is present, I still investigate the spine to rule it out. But when that hallmark sign is absent (for example, the pain is variable throughout the day or week), the diagnosis of a lumbar spine injury is more likely (or another diagnosis). More specifically, a nerve may be being hit or pinched in the lumbar spine and producing pain along the part of that nerve in the foot. IT band issues, patellar tendonitis, hip labral tears, and meniscal damage are a few other pathologies that come to mind when I think about regularly misdiagnosed injuries. Irritated nerves from the spine can produce pain in any area of the lower extremities and must be ruled out in the decision-making process. And remember, just because something is on an x-ray or MRI does not mean it is causing your symptoms. Images are full of problems in people without symptoms so a clinical diagnosis, in which structures and tissues are individually stressed, is needed.

I don't think that spine injuries are more prevalent in runners; nearly everyone will have a spine injury at some point.  We just need to be able to diagnose them correctly when they do exist.  That way, runners, like everyone else, can get back to doing what they love to do as soon as possible!  --Laura
0 Comments

Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

7/30/2016

0 Comments

 
This study comes from the BMJ, formerly known as the British Medical Journal. I've included the conclusions here and a link to the entire study. This shows once again that surgery for orthopedic issues should be a last resort. -- Laura

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i3740 (Published 20 July 2016)Cite this as: BMJ 2016;354:i3740

  1. Nina Jullum Kise, orthopaedic surgeon1, 
  2. May Arna Risberg, physiotherapist and professor2 3 4, 
  3. Silje Stensrud, physiotherapist2, 
  4. Jonas Ranstam, independent statistician and professor5, 
  5. Lars Engebretsen, orthopaedic surgeon and professor3 6 7, 
  6. Ewa M Roos, physiotherapist and professor8

​Conclusions and policy implications
The observed difference in treatment effect was minute after two years’ follow-up, and the trial’s inferential uncertainty, as shown by the 95% confidence limits, was sufficiently small to exclude clinically relevant differences. Supervised exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Nineteen per cent of participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit. No serious adverse events occurred in either group during the two year follow-up. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no radiographic evidence of osteoarthritis to consider supervised structured exercise therapy as a treatment option.

Find the entire article here: ​http://www.bmj.com/content/354/bmj.i3740?utm_content=buffer795ae&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer
0 Comments

    Orthopedics Blog

    Learn more about the world of diagnosing and treating orthopedics here!
    McKenzie Method


    ​Categories

    All
    Abdomen
    Achilles
    Ankle
    Arthritis
    Assistive Device
    Athletes
    Bending
    Biking
    Car
    Centralization
    Chairs
    Core
    Degeneration
    Diagnosing
    Directional Preference
    Discs
    Ear
    Elbow
    Ergonomics
    Exercise
    Extremity
    FABER
    Foam Rolling
    Foot
    Glutes
    Hamstrings
    Hand
    Headache
    Hearing
    Hip
    Imaging
    Immobilization
    Impingement
    Inflammation
    IT Band
    Joints
    Knee
    Lumbar/Low Back
    McKenzie Method
    Medication
    Meniscus
    Mobilization
    Modalities
    Morton's Neuroma
    Muscles
    Neck
    Nerves
    Numbness
    Obesity
    OST
    Osteoarthritis
    Outcomes
    Pain
    Palpation
    Performance
    Piriformis
    Plantar Fasciitis
    Podcast
    Posture
    Prevention
    Prognosis
    Proprioception
    Quadriceps
    Range Of Motion
    Rehabilitation
    Repeated Movement
    Running
    Scar Tissue
    Shoulder
    Shoulder Blade
    Sinuses
    Sleeping
    Spine
    Spondylolisthesis
    Sports
    Stenosis
    Stiffness
    Strain
    Strength/Strengthening
    Stretching
    Surgery
    Swelling
    Tendon
    Thoracic
    Tightness
    Tingling
    Verbal History
    Video
    Volunteering
    Wrist

    Archives

    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016

    RSS Feed

  • About
  • Blog
  • Info
  • Testimonials
  • FAQ