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Why isn’t my patient’s tennis elbow getting better? 3 tips for treating lateral elbow pain

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One of our more popular posts on our blog was The Physio Matters podcast with Val Jones where they discussed “Tennis Elbow” and treatment options.

We recently came across this great video from physiotherapist David Pope where he looks at “Tennis Elbow”:

In this video, you’ll discover three key research-based tips to help you get your lateral elbow pain patients on track, including:

  • How to make sure you’ve got an accurate diagnosis, and you’re actually treating lateral elbow tendinopathy rather than another presentation
  • Treatments you need to avoid like the plague, that will lead to worse outcomes – Specific exercise instructions you can use with your patients – how much and how often should they get stuck into their strengthening exercises?

Enjoy!

 

Physiotherapy works better when you believe it will help you – new study

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File 20190128 108342 iljlim.jpg?ixlib=rb 1.1
Master1305/Shutterstock

Rachel Chester, University of East Anglia

People with shoulder pain who expect physiotherapy to help them are likely to have a better recovery than those who expect only minimal or no improvement, according to our latest study. We also found that people are likely to have a better recovery if they are confident they will be able to continue doing things that are important to them, such as socialising, hobbies and work.

Shoulder pain affects people of all ages and can become persistent. Injury and overuse are common causes of shoulder pain, but sometimes the cause is unclear. It can disturb sleep, interfere with work, leisure and everyday activities like washing and dressing. Exercise, prescribed by physiotherapists, is an effective treatment for shoulder pain, but not everyone benefits from physiotherapy.

Researchers from the University of East Anglia and the University of Hertfordshire in the south-east of England, together with local physiotherapists, wanted to find out more about the characteristics of people who benefit from physiotherapy compared with those who continue to experience persistent pain and disability.

Knowing the outcome is important for people with shoulder pain as it helps them decide whether or not to pursue a course of physiotherapy.

Our study, published in the British Journal of Sports Medicine, included 1,030 people attending physiotherapy for musculoskeletal shoulder pain in 11 NHS trusts across the east of England. We collected information on 71 patient characteristics, such as age, lifestyle and medical history, and clinical examination findings before and during the patients’ first physiotherapy appointment.

A total of 811 people provided information on their shoulder pain and function six months later.

Not everyone benefits from exercise to ease shoulder pain.
Vershinin89/Shutterstock

Surprise finding

What surprised us was that patients who had said they expected to “completely recover” as a result of physiotherapy did even better than patients who expected to “much improve”.

The most important predictor of outcome was the person’s pain and disability at the first appointment. Higher levels of pain and disability were associated with higher levels six months later. And lower baseline levels were associated lower levels six months later. But this relationship often changed for people who had high “pain self-efficacy”, that is, confidence in the ability to carry on doing most things, despite having shoulder pain.

Another surprise finding was that people with high baseline pain and disability, but with high levels of pain self-efficacy did as well as, and sometimes better than, people with low baseline pain and disability and low pain self-efficacy.

First study of its kind

This is the first study to investigate patient expectations of the outcome of physiotherapy for shoulder pain. Earlier research shows that high patient expectation of recovery predicts a better outcome following physiotherapy for back pain and neck pain, and a better outcome following orthopaedic surgery.

On a similar note, this is the first study to show that higher pain self-efficacy predicts a better outcome in non-surgically managed shoulder pain. Previous research has shown that self-efficacy predicts a better outcome for a range of other health conditions. Also, people with higher self-efficacy are more likely to do the home-exercise programme suggested by their physiotherapist.

If you have shoulder pain, there are several ways to increase your pain self-efficacy. Work with your physiotherapist to understand and manage your symptoms. Practice your exercises together and ask your physiotherapist for feedback, including how to adjust your exercises to make them harder or easier. Finally, make sure you discuss what you want with your physiotherapy and the activities that are important to you.The Conversation

Rachel Chester, Lecturer in Physiotherapy, University of East Anglia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Occupational Therapy – Improving Wrist Range of Motion

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With the explosion of cycling as a leisure and competitive sport, wrist injuries are on the rise and physiotherapists and occupational therapists are having to spend an increasing amount of time treating patients with these injuries.

The team from Baton Rouge Physical Therapy have prepared this short video for demonstrating simple exercises for improving Range of Motion (ROM) of the wrist.

Don’t forget that you can use our 3D Joint ROM tool for measuring Range of Motion (ROM) of the wrist in real-time.

A physical therapist’s chokehold | Vinita Chandra Mody

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The world of physical therapy / physiotherapy is constantly with new techniques and research.

We came across this interesting TEDx talk by Vinita Chandra Mody who is the founder of Stroma Physical Therapy, a boutique practice in New York City.

Vinita decided to open her own practice when she developed a following of loyal patients who attested to the benefits of her unique therapeutic style. She founded ICT by Stroma™ which is a vascular, neural and myofascial technique after years of working with patients and sensing body pulses and their link to symptomatic relief.

Give us your thoughts!

[PODCAST] Jamey Schrier: Growing your physical therapy Business in 2019

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Interested in developing your physiotherapy practice in 2019 and looking for tips on how to achieve your goals?

In this podcast Jamey is sharing his practice freedom methodology to practice owners all across the country who are looking for financial prosperity and a better quality of life. His book, The Practice Freedom Method: The Practice Owner’s Guide To Work Less, Earn More, And Live Your Passion, has been an Amazon #1 best seller.

In this episode:

-How to establish a clear vision and find the why behind your goals

-Why comparisons to others will keep you small

-The importance of sharing the narrative behind your practice with your team

-Planning and budgeting for the bottom line that aligns with your goals

[WATCH] Gait Training After Surgery

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Have you or a patient recently undergone surgery that has impacted your gait? Are you finding your movements unstable or uncoordinated?

Pain – or the EXPECTATION of pain can severely impact your ability to move comfortably following surgery and it takes specific exercises to help your rehabilitation.

The Prehab Guys have prepared a series of exercises in this video which are a variety of different gait training tasks.

Remember that you can use 3D Joint ROM to measure Range of Motion in your knee or ankle and capture the quality of the patient movement to help you analyse and manage rehabilitation activities.

[PODCAST] Interviewing The Movement Maestro

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In this episode of the Healthy Wealthy and Smart Podcast the team interviews Dr. C. Shanté Cofield, aka The Movement Maestro, who is a former Division with a passion for movement.

Shanté is the creator of The Movement Maestro, a website and social-media based platform devoted to all things human movement and mobility related.

In this episode they discuss issues critical for physiotherapists looking to build their practices including:

-The importance of understanding the why behind a goal before setting the goal

-Why boundaries are important to set before pursuing your goals

-How to bring human connection into social media

-Building a supportive community that will serve you

[PODCAST] Interpreting Surface EMG

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On this episode of the Healthy Wealthy and Smart Podcast, I welcome Andrew Vigotsky and Dr. Nick Rolnick back on to the show to discuss Andrew’s paper, Interpreting single amplitude in sports and rehab sciences.

In this episode, the team discuss

-What information can you conclude from a surface EMG study

-The limitations of surface EMG research

-What to look for in a surface EMG methods section

About Dr. Nicholas Rolnick:
Nick is a licensed physical therapist, the founder of the Human Performance Mechanic and the co-founder of Blood Flow Restriction Pros. He received his Doctor of Physical Therapy Degree with academic honors from Columbia University in New York City.

Through his work as a physical therapist his goal is to keep his patients in perfect balance, have the skills to recognize asymmetries and help patients enjoy the benefits of pain-free movement.

He teaches across the United States as a clinical instructor for SmartTools Plus and is an adjunct faculty member at Concordia University – Chicago where he teaches Kinesiology I and II in their MS Applied Exercise Science Program. He also speaks nationally and internationally on the use of blood flow restriction therapy for various diagnoses and populations.

About Andrew Vigotsky
Andrew is currently a PhD student in Biomedical Engineering at Northwestern University, where he studies neuromuscular biomechanics. He has published papers in areas ranging from rehabilitation to surface electromyography methodology and biomechanical modeling. His dissertation works aims to understand the neuromechanical implications of muscular heterogeneities.

[PODCAST] Dr. Kristen Schulz: Avoiding Exercise Burnout

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On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor, DPT guest hosts and interviews Dr. Kristen Schulz, on how to make exercise fun. Kristen is a Physical Therapist and running coach who helps runners achieve their next PR without nagging injuries.

She is the creator of the Run Your Life Method, an online course providing a comprehensive and individualized approach for runners. Run Your Life’s mission is to provide runners the resources (prehab, rehab, strength training, recovery, nutrition, training, and mindset) they need to stay healthy, so they can enjoy the sport they love for their entire life.

In this episode, they discuss:

-How Kristen’s exercise routine has evolved into adulthood

-Kristen’s favorite go-to exercises -How variety in activities can help you avoid burnout

About Kristen:

Kristen is a Physical Therapist and running coach who helps runners achieve their next PR without nagging injuries. She is the creator of the Run Your Life Method, an online course providing a comprehensive and individualized approach for runners. Run Your Life’s mission is to provide runners the resources (prehab, rehab, strength training, recovery, nutrition, training, and mindset) they need to stay healthy, so they can enjoy the sport they love for their entire life. Kristen’s passion for her work stems from suffering a number of injuries herself. She ran competitively in high school and college with plans of continuing to improve her running times after college. However, injury after injury kept her from reaching her goals. It wasn’t until she started incorporating a comprehensive approach to running that she found herself able to run without constantly being injured. She finds great joy in being able to teach others how to do the same. Kristen has had the opportunity to live in many different parts of the country and currently resides in North Dakota. She graduated from Northern Michigan University with a degree in Exercise Science and Spanish, completed her Doctorate of Physical Therapy at Rocky Mountain University of Health Professions, and is a Certified Strength and Conditioning Specialist (CSCS).

About Jenna: 

Jenna Kantor (co-founder) is a a co-founder of the podcast, “Physiotherapy Performance Perspectives,” has an evidence-based monthly youtube series titled “Injury Prevention for Dancers,” is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt