Clinical Conversations

Fall is just a day away…

It has been a busy and wonderful summer at Nick Rinard Physical Therapy!

We are excited about getting you pain free from summer injuries so that you can slide into your favorite fall activities!

While a lot of injuries can occur during activities, it’s just as common to injure yourself slouching on the couch with your feet up.

Of course the chill of fall can cause you to start to creak like the brittle leaves that fall, it is best not to ignore these symptoms just because they happen every year.

Your seasonal pains could point to a chronic condition that could easily be treated.

With winter just around the corner take care of your aches and pains now before they get worse.

Nick Rinard Physical Therapy is ALWAYS here to help!

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Pseudo Tennis Elbow: A Commonly Misdiagnosed Mechanical Problem

Lateral epicondylitis, more commonly known as “tennis elbow,” is a pathology that is familiar to physical therapists and the general public.  What is lesser known is “pseudo tennis elbow,” a mechanical problem with a very simple solution!  Unfortunately, therapists whom are not familiar with the utilization of mechanical diagnosis may unknowingly miss this common elbow derangement.  As a therapist practicing the McKenzie method of mechanical diagnosis, Nick Rinard Physical Therapy has diagnosed elbow pain patients as derangements (or pseudo tennis elbow).

Symptoms

Our patient, “Jane” presented to therapy with intermittent right elbow pain, worsening over the last 3 months. Jane reported difficulty with gripping, lifting, carrying and global limited function of the right arm.  Jane described symptoms as “variable” meaning she could perform a task that produced his elbow pain. Then, perform the same task or movement again without experiencing any pain at all!  This variability of pain is the hallmark of a derangement and should not be misdiagnosed as a tendonitis, which would indicate inflammation (in which case pain would be constant).  Jane rated worst elbow pain as a 6/10.

Physical Therapist Evaluation & Findings

Objective findings included pain with passive elbow flexion and extension as well as pain with active wrist extension and with gripping a tennis ball.  Because of my experience as a mechanical therapist, I am familiar with a technique called a mobilization with movement (MWM), developed by Brian Mulligan (a colleague of Robin McKenzie).  The mobilization provides a lateral force over the ulna at the elbow joint. While the patient applied this force, she was able to grip the tennis ball PAIN FREE!  This same technique was applied for other painful baselines and achieved the same results of ABOLITION OF ALL PAIN!  This ability to turn symptoms off with a mobilization indicates an elbow derangement and the MWM is used as the treatment strategy.

Patient Homework and Outcomes

Jane was asked to perform the MWM utilizing the lateral glide while gripping a tennis ball to be performed 10-20 times every hour.  The theory is that this mobilization is repositioning the joint in order for it to articulate correctly, resulting in improved range of motion and strength after.  Jane returned to the clinic the next day with reports of at least 25% improvement! Objective findings were retested and nearly all baselines had improved in less than 24 hours!  Jane returned 1 week later and reported an 85% overall improvement with symptoms.

Get Your Own Mechanical Assessment

Don’t be misdiagnosed! Straightforward pathologies which require one exercise to treat are commonly missed with standard treatment.  This results in extra therapy visits, and more of your time and money.  It is worth your time to see if your pain has a MECHANICAL component.  A simple solution may otherwise be missed.

Get your pain correctly diagnosed at Nick Rinard Physical Therapy.

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Have a happy and safe Labor Day.

May all of us at Nick Rinard Physical Therapy wish you, your family and all friends a very safe and happy Labor Day.

The office will be closed on Monday, September 5th, to recognize and honor the labor movement of the late 19th century. We will be back in the office Tuesday to take your calls.

Please don’t hesitate to leave a message or send an email to help@rinardPT.com and we will respond to you as quickly as we are able.

We are always here for you.

 

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Get the correct diagnosis at Nick Rinard Physical Therapy.

Sometimes knee pain is actually a back problem! Nick Rinard Physical Therapy makes sure to get the correct diagnosis every time!

“I had continuing knee problems and had seen other physical therapists.

This felt like my last efforts to resolves issues if I could.

With Katie’s awesome attention and care, she weeded through my knee problems and determined it might be a back issue, based on one of our conversations.

Our plans switched to restoring my back and core.

As a result, knee issues decreased!! I am back to running longer distances with no knee issues!

I have the tools/exercises to continue strengthening!

(Teagan was also an amazing student intern – loved that Nick and Katie took her on and helped her hone her skills. She took everything on very well.)”

Jennifer

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Do insurance terms have you confused?

Challenges of our unstable economy is that our community must face unpredictable health care coverage and bizarre terms insurance companies use to deny patient visits. 

Patients discover, often way too late, that their insurance does not cover them when they need it most.

Health insurance plans are misleading patients with vague terms such as “medical necessity” and “prior-authorization”.

With these terms patients can suddenly find themselves with unexpected health care costs, after having the impression they were covered.

It is up to patients to get wise to their health insurance loop holes.

Our patients have found, regardless of all costs, that the quality of care Nick Rinard Physical Therapy gives exceeds all else.

We strive to simplify patients’ decisions by providing fast, efficient care that guarantees results.

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Get your life back!

Nick Rinard Physical Therapy is here to help give you the tools to take control of your pain and get your “normal life” back!

“My back was hurting to the point of limiting my activity.

I am able to pick up light things I couldn’t lift anymore.

I can comfortably hold my cat.

Slowly but surely improving in every checkpoint.

Cooking and cleaning got easier as well.

I am hopeful of a normal life again with the help of this office.

I can’t thank you enough.”

Alesandra

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