Pain - What Do Fractals Have to Do With It?

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Real-Time Visualization of Joint Cavitation

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How do you explain to patients what the cracking/popping sound is when you manipulate them? How about when they stretch or move on their own and get their own audible cracks? You can find anything on youtube, while looking for recent articles on Cavitation, I found a great youtube video showing a the cavitation in real-time. I normally describe the cavitation as a negative pressure within the fluid filled joint capsule. The negative pressure forms a gas bubble, which is normally diffused into the synovial fluid, then pops from the movement or distraction of the two surfaces coming apart. I usually use my two hands clapsed together and pull them apart to create a suction effect. I may now just show them this video instead! Key Points cavitation is normal you can only get it with movement it doesn't put anything back into place the decrease in tone/tension and increase in mobility should be reinforced continuously until it's the new normal patient's don't n...
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Top 5 Fridays! 5 Things in Physical Therapy We Cannot Ignore Anymore!

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This post… has been a long time coming. It’s needed. It will not be comfortable. And, it shouldn’t be! If you’ve read any of the below posts… 3 Positive Culture Shifts PTs NEED To Make 3 Business Competencies PTs NEED To Know And, this post from March of last year:  Bridging The Gap . You know what I’m about, and, you know for the most part that I nigh annoyingly positive, constructively inclined, and inherently optimistic. Rarely, do I flat out say something needs to stop. Well… today is one of those rare days. 5 Things in Physical Therapy We CANNOT Ignore Anymore 1. The Debt It isn’t just because there are, for the most part, daily online conversations about the tremendous student debt happening in the field of allied rehab therapy. It’s not just because I get regularly flooded by questions in my many inboxes on the matter of personal finance and career path. The reason we NEED to talk about the debt, isn’t even for the sake of student debt, itself. I believe it...
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Patient Rated Outcomes Measures in Chronic Pain

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The use of patient-rated outcome measures (PROM), often in the form of questionnaires, is a key part of our evaluation and re-evaluation. They play an important role in documenting activity limitations, levels of disability, quality of life, response to interventions and they help provide a quantifiable measure of subjective complaints. As our knowledge of chronic pain broadens, we are beginning to appreciate that there are modifiable risk factors that contribute to the development of long term pain and disability . For example, fear avoidance beliefs and behaviours, fear of movement, high levels of anxiety and depression, low satisfaction with work and catastrophization beliefs. Several outcome measures are currently available to clinicians to help guide their clinical reasoning by identifying these risk factors and dig deeper into how they play a part in the patient’s pain presentation. The purpose of this blog is to look specifically at outcome measures and explore how they...
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