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I am (was) a high mileage runner that suffered an IT band injury after layoff Jan '05. Before my injury I averaged 150 - 200 miles per month. I took time off to heal a hamstring. When I returned I'm assuming I overdid the mileage.

The IT injury was severe. After taking 23 weeks off, therapy, and cortisone shots, I started running again. Apparently too much too soon, as I'm again hampered with discomfort in the knee.

Can some one answer me why inflammation takes so long (as in weeks) to go down? Also, when starting to run again at what progress can I hope to make. In other words; How much is too much to soon?

Thank you,

Layne
Milwaukee, WI

I am (was) a high mileage runner that suffered an IT band injury after layoff Jan '05. Before my injury I averaged 150 - 200 miles per month. I took time off to heal a hamstring. When I returned I'm assuming I overdid the mileage.

The IT injury was severe. After taking 23 weeks off, therapy, and cortisone shots, I started running again. Apparently too much too soon, as I'm again hampered with discomfort in the knee.

Can some one answer me why inflammation takes so long (as in weeks) to go down? Also, when starting to run again at what progress can I hope to make. In other words; How much is too much to soon?

Thank you,

Layne
Milwaukee, WI

Can the Chiropractic Profession Find a Road Map to Cultural Authority From Physical Therapists?

Yet another hint in April's issue of Dynamic Chiropractic that physical therapists are a growing threat to the chiropractic profession. Craig Liebenson, DC offers some sound advice to his profession. Will they listen? Of course, patients don't care about any professional rivalries that may exist between our professions. They simply want to get better and will seek care from any health care professional who offers the best care. So, the best thing we can do is focus on being evidence-based practitioners. Combined with our transition to a doctoring profession with increasing access to patients early in the care process, many issues will sort themselves out nicely by a persistent focus on doing the right (ie, providing the best care) thing for our patients.

John

New Technique called Virtual Physical Therapy

On first read, I thought this came from The Onion.  Howver, it appears to be a legit program running in Philadelphia.  Virtual Physical Therapy.

How about this gem from the first paragraph:

"Just the mention of physical therapy and those words conjure images of boring, painful, repetitive exercises, but it doesn't have to be that way..."

and the clincher:

"What also got old was the physical therapy doctors prescribed..."

I wish I was making this up.

Does it qualify for Medicare's one on one coding?

Thoughts?

Larry

Matching Therapy to Type of Low Back Pain May Improve Outcome

We recently blogged about a paper published in Spine by Brennan and colleagues (also EIM bloggers) reinforcing our understanding that nonspecific LBP should not be viewed as a homogenous condition; rather, outcomes are imprved when sub-grouping is used to guide treatment decision making. Check out the recent press covereage in Medscape Medical News.

John

The Bronze Lady

In speaking with therapists who utilize McKenize principles in their decision-making process, they are quick to remind you that the McKenize system is more than just extension exercise (ie, the fabled prone press up). Diplomates in this system in particular are quick to remind you. Fair enough. However, it seems odd then that their top research award each year is called 'The McKenzie Institute International Extension Award'. It's even known within the Institute as "The Bronze Lady" and is presented to someone who has made an outstanding contribution to education or research in the field of Mechanical Diagnosis and Therapy.

We should applaud the Institute's efforts in publishing clinical research to assist in the physical therapy decision-making process, espcially efforts to identify relevant sub-groups. However, it seems paradoxical and counterproductive to name your top award as an 'extension' award if in fact the Institute is trying to tone down perceptions that the McKenzie system is all about extension. See for yourself. Here is the logo:

Perhaps my understanding of their desire to reverse the common perceptions that McKenzie equates to extension exercise (namely the prone press up) is false. McKenzie Diplomates or others, feel free to chime in.

John

 

Freedom to Blog

I am currently listening to David McCullough's 1776 on my iPod - a great listen so far reminding me of the great sacrifice made by thousands of patriots who have gone before us. I came across this piece of news about blogs reminding me that other countries don't share our same values. Freedom of speech did not come free for sure. We are fourtunate that Evidence in Motion and millions of other bloggers in our country are free to blog away.

John

Bell Curve

John & EIM gang,

I may have posted this article before... 3 things go when you get older: Memory...and I can't remember the other 2! This week's theme of P4P prompted me to dig up & re-read a wonderful article by Atul Gawande MD, title 'the Bell Curve'. The article is about excellence in medicine, and not. Read and enjoy. I've also attached a Q & A with the editor of the New Yorker.
Britt

Download the_bell_curve.pdf Download the_better_doctor.pdf

Download the_better_doctor.pdf

Pay for Performance: The Train Has Left the Station, but Where Is It Taking Us?

Here is an excellent brief video commentary on the implementation of pay for performance (P4P) incentives into the health care system. It's coming.

John

CAT Scratch Fever!!!!

Sorry, Ted Nugent fans, nothing here for ya….other than probably raising a few memories with the title (but John did get to sit next to him for ~2 hr. plane ride this fall.......what a story!!).  However, for EBM fans you will be excited to know that the Evidence In Motion CAT Bank is back online and now accessible.  This site contains CATs specific to physical therapy practice. 

If you don’t know what a CAT is, you can find out everything you wanted to know about CATs as well as access some excellent CAT resources (CAT maker, CAT search engine, etc.) 

We look to expand and grow our CAT bank with future deposits so keep your electronic book mark (better yet, del.icio.us tag) on the electronic scratching post.

 

Rob

Evidence that PT has hit the "big time"

While watching my second favorite TV show, The Sopranos (second only to 24 due to its irregularity in seasons), I was quite suprised to see physical therapy highlighted.  Here was the scenario:

Tony, head of the family, has been shot in the abdomen by his old, confused Uncle Junior (accident vs. another attempt by Junior to prove his craziness and get an insanity plea during his forthcoming and everlasting trial?).  The Family and particularly his misguided loyal wife, Carmella, stands vigil while the "Boss" is in a coma.  Carmella when asked by one of the family members, tells how tough it is and paricularly how the ****** insurance company has denied PHYSICAL THERAPY!  (how would you like to be at that end of a pre-auth?).   Later in the episode, one of the family members hands Carmella a package of bills obtained by a major score of a Columbian drug ring  (10% or 100K which the Family authorized at their attempt to "take care of Tony"-although the amount of the bust is disputed by Paulie Walnuts one of the captains who really needs PT after the injury he sustained in the raid).  It is mentioned to Carmella that the money is to take care of the medical bills including needed REHABILITATION.

Thanks Mr. Chase, I couldn't be prouder.  We have hit the big time.

Any fans out there?  BTW, get the cookbook.

Larry