I recently had a follow up appointment with a patient of mine. “Sam” came to our clinic after having failed attempts of treatment from standard Physical Therapy and chiropractic care. His past physical therapist had given him generalized stretching with little to no benefit, and by the time I evaluated him, Sam admitted that, “(he) was not impressed with his therapy treatment.” He had heard about Nick Rinard Physical Therapy, and he was hoping to get the results he desired with us.
During his initial evaluation, Sam presented with limited, painful movements in several motions of the shoulder. The most painful motion was the motion of putting the arm behind him (like he was going to scratch in between his shoulder blades). Incidentally, this was also the motion which initially caused his pain three months ago.
I had Sam passively stretch into the painful motion. This was not a random decision. It was a clinical decision based off of his baselines and has been clearly documented and researched by the works of Mark Laslett. As Sam repeated this movement, the pain dissipated and all of his baselines improved. Sam continued to perform this exercise until his next visit, at which, he reported 95% improvement.
Sometimes the exercise required to fix the mechanical problem is counterintuitive (moving into the pain). A trained mechanical therapist is able to recognize these pain patterns and can make a clinical decision as to what exercise should be performed and interpret the results.
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By Nick Rinard Physical Therapy
14 Mar, 2014
Clinical Case of the Week
ankle pain, clinical presentation, Nick Rinard, Nick Rinard physical therapy, pain-free, Physical Therapy, Portland Oregon, relationship, results, Spine, treatment
By MiKayla Sanocki, SPT
Did you know a back problem can cause symptoms such as pain, decreased strength and decreased sensations into the thigh, calf, ankle or foot? Physical therapists trained in Mechanical Diagnosis and Therapy (MDT) here at Nick Rinard Physical Therapy can determine during the evaluation if any of these lower leg symptoms are coming from your back.
Check out this bizarre clinical presentation we treated at Nick Rinard Physical Therapy:
She did not remember any trauma to the ankle
The patient came to physical therapy for an “ankle sprain” that occurred 3-months earlier. She stated she woke up unable to put any weight on her right foot. The pain had remained constant in her ankle, so bad at times that she couldn’t walk! Upon further questioning, the patient revealed what she had been doing the day before: She had driven 2 hours, on her way home from helping clean a house. During the drive she had discomfort in her buttock and hamstring that made her want to pull the car over to stretch. She did not remember any trauma to the ankle, however, but the ankle pain was the only pain she was experiencing now.
Her ankle pain has caused her to quit running and yoga — two of her favorite activities.
Mechanical Evaluation finds cause in spine
During the mechanical evaluation we found that certain directions of low back movements decreased the pain in her ankle. After being sent home with 1 simple exercise to perform every waking hour – which she did perfectly – she returned within 24 hours reporting 90% recovery in pain! Over the next week we were able to progress her exercises and now the patient reports no ankle pain at all. In only 4 visits we were able to abolish her ankle pain, and she is now getting back to running and yoga!
The patient reports, “I now have the tools to prevent the return of my back and ankle pain”.
Treatment at Nick Rinard Physical Therapy vs Traditional PT
In contrast to MDT, traditional PT would not have uncovered the spinal cause of the patient’s ankle pain. Treatment would have been ineffective since it would have focused only on trying to treat the symptom.
Do you know if your pain in the legs or arms could be coming from the spine? Come see us at Nick Rinard Physical Therapy and find out!
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RinardPT Monthly
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Nick Rinard Physical Therapy
9700 SW Capitol Hwy Suite 140
Portland, OR 97219
Volume 6, Issue 2
March 2014
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Why Wait?
Too often, we get patients in our office who have been in pain for months (or almost a year in Michael’s case! Read his story below). If your pain is not improving on its own, there is NO NEED TO SUFFER! It could take just 3 visits, like it did for Jane, and you can have the tools to treat your pain and get back to living your life to the fullest. Most of our patients are able to self-treat their problem in just 6-8 visits. Get the tools you need now.
Are you currently suffering from pain or injury?
Call 503-244-6232 today!
RinardPT patients get Results:
Don’t take our word for it
| “I hurt my knees in October 2013 while in Mexico. I wish I had called MDT sooner and saved myself four months of pain & difficulty walking. Going down stairs was especially painful. In three sessions I am pain free; getting out of bed, walking, and stairs are no longer painful. Many thanks! ”-Jane 02/12/2014 |
“I was in a car accident in May 2013. I had neck pain and stiffness every day after the accident. I came to MDT of Portland in hopes of being cured. Within roughly 7 sessions, I would say I no longer have any pain. Thank you guys very much-you’re all incredible!”-Michael 02/04/2014 |
 FREE CONSULTATION COUPON
MENTION THIS COUPON AND SCHEDULE YOUR
FREE SCREEN TODAY
(503) 244-6232
In just 5-10 minutes, MDT can determine if your pain is mechanical or not. If so, we can help get you out of pain and back to enjoying your life.
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Remember to “SPRING FORWARD” by one hour on Sunday, March 9th!
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March Events around Portland
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Medical Advisory: MDT is a Superior Form of Physical Therapy
This is page 2, continued from <<Choose your Physical Therapist Wisely
If you sustained your injuries in a motor vehicle accident, or work-related injury, then your chances of getting better are improved if you choose an MDT therapist. There is a financial advantage also since the total cost of your therapy will be less, based on the fewer number of visits MDT uses. Your PIP money will go further, and you will not have to sacrifice a large amount of money out of your settlement just to pay high physical therapy bills. If you are a worker, your case will be less likely to be denied if you are getting better faster, than if your recovery drags on. Believe me, insurance adjusters are less likely to keep your case open if you are not improving in physical therapy.
So you can see that MDT is a superior form of physical therapy. What about MDT compared to Chiropractic care? I tell my patients that Chiropractic treatment is indeed mechanical, but there are two distinct reasons it is not superior to MDT. The first reason has to do with the evaluation, and the second reason has to do with the treatment. A chiropractor first must take an X-ray to make the diagnosis. Unfortunately, there is little evidence to suggest a chiropractic diagnosis is reliable, and therefore, treatment based on an unreliable diagnosis is a guess at best. Secondly, chiropractic treatment is performed to the patient, not by the patient. Any improvement in the patient’s condition, therefore, is dependent on them going back for more visits! As mentioned, MDT treatments consist primarily of exercises that the patient performs so you can treat yourself when not in the clinic. This obviously results in less pain, a speedier recovery, less visits, and money saved!
By reading this essay, you are now equipped with knowledge to seek out the best care possible for your injuries. Don’t waste time going to traditional physical therapy, or chiropractic for many visits. It is better to get an MDT evaluation to determine if your condition will respond mechanically or not, and if it is mechanical, then the treatment is more effective and takes less time!
In closing, I would like to mention how MDT compared to traditional physical therapy in an objective study conducted by a third party. The average improvement in traditional physical was only 78 percent, and it took an average of 11 visits to achieve this. By contrast, MDT got patients 93 percent better in only 6.5 visits! The data speak for themselves. Don’t settle for less effective treatment for your injury – find a Cert MDT therapist who is using the MDT method properly, and get better faster!
Nick Rinard is president of, and a therapist at, Nick Rinard Physical Therapy, a private physical therapy clinic.
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I had Sam passively stretch into the painful motion. This was not a random decision. It was a clinical decision based off of his baselines and has been clearly documented and researched by the works of Mark Laslett. As Sam repeated this movement, the pain dissipated and all of his baselines improved. Sam continued to perform this exercise until his next visit, at which, he reported 95% improvement.
