A Picture is Worth a Thousand Words

Well, what if a picture costs you $1000’s and a lot of unnecessary pain and strife? That’s exactly what an MRI can do. MRI technology is a relatively new diagnostic tool. Most of us have had an x-ray, but never an MRI. Now that MRI’s are used to quickly take a snapshot of what may be causing something such as low back pain (LBP), an image that reveals a ‘bulge’ is often seen as not only the route cause of the LBP, but is also the trigger that justifies an immediate surgical intervention.

Tim Flynn, PT PHD, recently shared a post on his blog about the overutilization of diagnostic imaging in the management of musculoskeletal disorders. He discusses a recent post in the New England Journal of Medicine that reveals the resolution of a lumbar disc herniation without surgery.

Too often, I have seen this or read stories of patients who were scared into going under the knife when the imaging revealed this ‘abnormality’, only to later realize that not only is the pain still present, but the dissected area has been compromised and weakened, further aggravating their symptoms.

Surgery is a necessary part of physical medicine for good reason. However, so is physical therapy and manual therapy. Too often, images such as this seem to draw a bold line from symptoms to causation, prompting a surgical intervention. This recent post shows how more conservative measures of rehabilitation may reduce a herniation without the need for surgery. Read More.

Muscle Strains

A strain, sometimes referred to as a pulled muscle, is a muscle injury produced by excessive tensile stress that causes fibers to tear within the tissue. A muscle strain does not usually result from excess stretch alone, but from a combination of tension and contraction. Muscle strains can develop when excess tension is placed on…

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Shin Splints or Compartment Syndrome?

One of the most common overuse injuries affecting the lower extremity is the condition known as shin splints. While the term shin splints routinely is used, especially among the athletic population, it does not represent a specific clinical pathology. Instead, it describes chronic shin pain resulting from overuse. It occurs in two regions of the…

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An Alternative Approach to Stretching

Clinicians, athletes and rehabilitation specialists advocate stretching as a means for injury prevention and treatment. The primary purpose of any stretching technique is to enhance pliability and flexibility in the soft tissues. It is also routinely incorporated with massage in the treatment of pain and injury conditions. There are many different stretching techniques, which all…

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Ganglion Cysts

The highly refined palpation skills of massage practitioners are such that we often identify tissue abnormalities before the client is aware of them. An indication that we should refer a patient for further evaluation is when we identify something we aren’t sure of but know shouldn’t normally be there. One such example may occur with…

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What Is the “End Feel”?

Some of the most valuable assessment information is derived from relatively simple procedures such as passive range-of-motion tests. While many massage practitioners have been exposed to the fundamental concepts of active and passive range-of-motion testing, most have not learned how to use this information effectively in a clinical environment. In this article, we will focus…

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How Accurate Is That Test?

Physical assessment is considered one of the most accurate ways to assess function of the locomotor tissues of the body. While we can often gain valuable information about structural problems through high-tech diagnostic procedures like X-ray or MRI, these procedures tell us very little about the function of the tissues involved in creating and limiting…

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When Is It Tendinitis?

Tendinitis is one of the most common diagnoses for soft tissue pain resulting from repetitive motion. As repetitive motion disorders have dramatically increased, so has the incidence of tendinitis. However, recent investigations into the cellular nature of tendon pathologies have brought forth interesting discoveries that may alter the way tendinitis is treated. In this month’s…

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