This is a simple case of persistent pain felt in the right sternoclavicular joint and clavicle region with somatic referred pain into the right trtrapezius and scapular region. These may be missed if the trapezius and scapular pain are dominant. The standard active, passive and isometric resisted shoulder tests are sufficient to identify the problem, but some additional tests that target the clavicular joints, plus tenderness on the STC Joint line helps to confirm the clinical diagnosis. The special orthopaedic tests for rotator cuff lesions are unnecessary and usually confuse the picture. In most cases the STC joint is visibly swollen. The treatment of choice is intra-articular corticosteroid injection. This rarely fails to rapidly abolish the pain, and only occasionally is a second injection required. Movement therapies are routinely unsuccessful, often aggravating the pain.
Posted by Dr Mark Laslett on Monday, September 17, 2018
GPs have rubbished popular and "fad" treatments for osteoarthritis (OA), including opioids, acupuncture, glucosamine,…
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From Wisconsin to Oregon: A DPT Students Perspective
My journey to the Oregon began in early August as I traveled from the Midwest town of La Crosse, WI. As a graduate student in any physical therapy program you are expected to perform at a high academic level every day. This didn’t change when I began my 4-week clinical at the Nick Rinard Physical Therapy clinic.
I began my time with Nick in a whirlwind. We started with a full head of steam and never looked back. Each patient was treated with special attention and an individual plan of care. Patients came in to see Nick for every ailment under the sun and there was always something that Nick was able to give the patient, even if it was just information that no medical professional had ever told the patient. I was amazed at the results Nick was able to achieve with his approach to physical therapy, using the mechanical diagnosis therapy. His approach puts the tools of treatment in the hands of the patient, and the results speak for themselves.
Each day has been a new learning opportunity, leaving me with tools to use in my future practice. I am very grateful for this opportunity and the time Nick has taken to answer my questions and challenge me to be the best future PT possible. As a future physical therapist, I would highly recommend the Nick Rinard Physical Therapy Clinic. These clinicians have the experience, skill, knowledge and care that go above and beyond what is expected. If you find yourself stuck with pain, lack of mobility, or just need a medical professional to explain what’s going on Nick Rinard Physical Therapy is the first place you should go.
Patrick Griffith, SPTMore
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Technically speaking your knees (the joint parts) do not affect stride since running is a “mid-range” motion. Walking, on the other hand, does involve end range extension, so limited extension could have an effect – but not in running. Pain in the knee is likely to affect your ability to tolerate a running stride, and your body will find ways to avoid pain – thus affecting your stride in varying ways. There is no typical way this happens, so if you have knee pain, you need to have a good mechanical examination to find out how to best treat or manage it.More
'Directional preference of the extremity: a preliminary investigation'. Well done to the folks from Maccio Physical…
Low back pain is one of the most common causes of disability in the world. A recent study found that “Out of 291 conditions studied in the Global Burden of Disease 2010 Study, LBP ranked highest in terms of disability (YLDs), and sixth in terms of overall burden.” With a large range of different types of back pain it can be extremely frustrating finding relief from this type of pain.
Luckily there has been a large effort to find the best approach to dealing with low back pain. A 2018 study comparing healthcare costs for patients with a diagnosis of low back pain between the ages of 18 and 64. Interventions studied included differences in opioid prescription, health care utilization, and timing of PT intervention. This study found that patients who saw a PT at first had a lower utilization of high‐cost medical services (MRI, surgical intervention, emergency room visits) as well as lower opioid use.
Another study looked at the differences in long term outcomes in patients with spinal stenosis given PT or surgery. The results of this study after 2 years found that patients “did not differ significantly between patients who had undergone surgery and those who avoided surgery.” This shows that physical therapy alone is a much safer, cheaper, and equally effective choice.
Understanding your back pain and using your own body to fix itself has proven to be the least expensive and best outcome tool when dealing with low back pain. Therefore be your own advocate when dealing with new or recurring back pain and try PT first!
Frogner, B. K., Harwood, K., Andrilla, C. H. A., Schwartz, M., & Pines, J. M. (2018). Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health services research.
Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., & Murray, C. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, 73(6), 968-974.
Minetama, M., Kawakami, M., Nakagawa, M., Ishimoto, Y., Nagata, K., Fukui, D., & Sakon, N. (2018). A comparative study of 2-year follow-up outcomes in lumbar spinal stenosis patients treated with physical therapy alone and those with surgical intervention after less successful physical therapy. Journal of Orthopedic Science, 23(3), 470-476.More