Patellofemoral pain: management

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More useful stuff from Lee Herrington’s (@leehphysio) talk at Northumbria Uni last night!

Patellofemoral pain rehab!

1) Find out what they can do with minimal symptoms so you’re not flaring it up, but don’t deload completely or you’re giving yourself more work to do later!

2) Improve blood flow. Even just a pedaling machine is good for this.

3) Tape, brace or give orthotics if necessary as a *temporary* way to change the loading on the joint and then…

Strengthen quads (but forget about isolating VMO please!)

And get glutes going! (but not with those weird side lying abduction things)

Pretty simple really: as @GregLehman says, calm shit down, build shit back up 🙂

(Oh and there’s a TPMP podcast with Lee here: http://chewshealth.co.uk/tpmpsession1/)

-Tom

Patellofemoral pain: diagnosis

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Good slide from Lee Herrington’s (@leehphysio) talk at Northumbria Uni last night.

Spotting patellofemoral pain!

Why would PFP present as *posterior* knee pain? According to Lee, it’s because the “homunculus” in your brain has a very small representation for the knee. So the brain isn’t too good at localizing pain in this area.

Another interesting point was that it might not be quite right to reassure patients that their clicky knees aren’t a big deal! If someone has severe crepitus in their knee on a motion palpation test, that’s a pretty good sign (specific) they have cartilage damage, although it won’t pick up everyone (it isn’t sensitive).

But, if the crepitus is only mild or moderate, it’s not such a good test. Here’s the paper: http://search.proquest.com/…/fulltext…/6F6322D4F2E6426FPQ/1…

(Oh and there’s a TPMP podcast with Lee here: http://chewshealth.co.uk/tpmpsession1/)

-Tom

Choose wisely!

Choose wisely!

http://www.sciencedirect.com/…/article/pii/S1836955317300164

The Australian Physical Therapy Association just put out this article, “Wise Choices”, about the problem of low value healthcare in physio.

Physios are usually optimistic about the benefits of their diagnoses and treatments, but sometimes underestimate the costs. These costs are not just in time and money, but also the cost of making a person into a patient.

The authors say that physio curricula should include material on the concept of low value-healthcare, and the dangers of overdiagnosis and overtreatment. And, crucially, strategies to avoid these things, because it’s easier said than done!

For a brilliant full discussion about this, listen to this episode of @ptinquesthttp://ptpodcast.com/pt-inquest-episode-104-the-costs-of-l…/

-Tom

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