Patellofemoral Pain: 2018 Consensus statement on exercise therapy and physical interventionsns

Patellofemoral Pain (PFP) is an umbrella term that describes peripatella or retropatella pain in the absence of other pathologies. Other descriptions for PFP include patellofemoral pain syndrome, anterior knee pain and chondromalacia patellae (Brukner et al, 2017) and is common in loading activities such as squatting, running and stair ambulation (Crossley et al, 2016).

Although numerous intra and extra articulating structures could be responsible for the production of PFP, the actual cause is not entirely understood (Collado and Fredericson, 2010). One consideration is that PFP is a result of an increased loading through the knee, causing peripatella synovitis or damaging the articulating patellofemoral cartilage which, although avascular and aneural could result in an inflammatory cascade that produces synovial irritation (Brukner et al, 2017).

PFP has shown to affect adolescents, young adults, elite athletes as well as members of the general population with incidence rates varying between 15%-45% and is considered one of the most common types of knee pain (Smith et al, 2018).

Full story at PhysioSpot

More doctor visits can lower risk of suicide attempts in fibromyalgia patients

Fibromyalgia patients who regularly visit their physicians are much less likely to attempt suicide than those who do not, according to a new Vanderbilt University Medical Center study published in Arthritis Care & Research.

Patients who did not attempt suicide were at the doctor an average of 50 hours per year versus less than one hour per year for the group who committed self-harm, according to lead author Lindsey McKernan, PhD, assistant professor of Psychiatry & Behavioral Sciences, Physical Medicine & Rehabilitation.

“Fifty hours versus one hour – that’s a staggering difference,” McKernan said. “They might have been at one appointment in a year and this disorder, fibromyalgia, takes a lot to manage. It takes a lot of engagement.”

Full story at news-medical.net

What are the causes of unexplained muscle aches?

Muscle aches can occur in adults and children. In many cases, sore and aching muscles are nothing to worry about and will resolve without medical treatment. However, muscle aches can sometimes be a symptom of an underlying illness.

Common causes of muscle aches include:

  • overexertion
  • trauma to an area of the body
  • viral infections

Muscle aches, also known as myalgia, can be felt in any area of the body that has muscles. Depending on the cause, the discomfort may be mild or extremely severe.

Full story at Medical News Today

Treatment after Traumatic Shoulder Dislocation. A Systematic Review.

The shoulder is the most commonly dislocated large joint and it is often occurred by additional soft tissue injuries such as labral tears. Dislocations can occur in two directions: anterior and posterior with trauma being the leading cause of injury. Most often the trauma is from a posterolateral force on the shoulder with the arm in an abducted, externally rotated and extended position, dislocating the shoulder anteriorly. There are many other factors and causes which can contribute to a dislocation however let’s focus on trauma.

If you dislocate your shoulder, let’s say on the rugby field, there is usually only one treatment option and that is a closed reduction. This can happen immediately or once you arrive at a hospital in the emergency department either way it is potentially risky as may caused secondary damage. Interestingly there are over 20 different manoeuvres described for how to reduce a dislocated shoulder. If you’re interested in what technique to use and when to use it then there is a technical report linked below. *Disclaimer this article in no way suggests you should perform a reduction unless you have undergone appropriate training and have experience.*

Full story at Physiospot

Study: Estimated 1 in 3 Medicare Beneficiaries Receiving Inpatient/SNF Rehab Report No Improvement in Function

Authors of a new study on inpatient and skilled nursing facility (SNF) rehabilitation say that when it comes to patients’ own opinions of their progress, an estimated 1 in 3 Medicare beneficiaries are likely to report experiencing no improvement in functioning while they were receiving rehabilitation in those settings. And those rates can trend higher depending on certain demographic and health-related variables.

The study, published in the Journal of the American Medical Directors Association, analyzes survey responses from 479 Medicare beneficiaries who received inpatient or SNF rehabilitation between 2015 and 2016. Data were drawn from the National Health and Aging Trends Study (NHATS), with respondents comprising a nationally representative sample of the Medicare population.

Full story at APTA

Father’s and son’s injuries lead to the mother of all therapy bills

“So you have to take your block of wood, shape it, sand it, paint it, use your imagination,” Lopez said, pointing to some favorites from derbies past that sit on a shelf in his home office — cars in the shape of an ice cream cone, a penguin and an Altoids peppermint box.

But one derby project lives in infamy: an S. Pellegrino bottle on wheels. It was the brainchild of his son Theo, then 9, in the fall of 2016, a time when Lopez recalls he was frantically busy at work.

Full story at news-medical.net

Customized resistance exercise helps female fibromyalgia patients improve health

Fibromyalgia and resistance exercise have often been considered an impossible combination. But with proper support and individually adjusted exercises, female patients achieved considerable health improvements, according to research carried out at Sahlgrenska Academy, Sweden.

“If the goal for these women is to improve their strength, then they shouldn’t be afraid to exercise, but they need to exercise the right way. It has long been said that they will only experience more pain as a result of resistance exercise, that it doesn’t work. But in fact, it does,” says Anette Larsson, whose dissertation was in physical therapy and who is an active physical therapist.

As part of her dissertation, she studied 130 women aged between 20-65 years with fibromyalgia, a disease in which nine of ten cases are women. It is characterized by widespread muscle pain and increased pain sensitivity, often combined with fatigue, reduced physical capacity and limitation of activities in daily life.

Full story at news-medical.net

Dr. James Andrews, on preventing youth sports injuries: Take time off, don’t specialize

One of the nation’s foremost sports orthopedic surgeons said Wednesday night in Orlando that the best medicine to help prevent youth sports injuries is to avoid playing year-round and not to specialize in one sport.

And don’t approach a child’s athletic pursuits like he is a miniature version of Tom Brady or LeBron James.

“Don’t treat 6- and 7-year-old kids like they’re professional athletes,” Dr. James Andrews told an audience of about 100 at Florida Hospital Orlando. “They’re not ready for that level of high-intensity training.”

Andrews, 73, has operated on many top professional athletes and is the team doctor for several franchises, including the Tampa Bay Rays. He was in Central Florida as part of the hospital’s Distinguished Lecture Series and in support of his book, “Any Given Monday,” about how to avoid injuries in youth athletes.

Full story at the Orlando Sentinel

Scrutinizing Medicare coverage for physical, occupational and speech therapy

For years, confusion has surrounded the conditions under which older adults can receive physical, occupational and speech therapy covered by Medicare.

Services have been terminated for some seniors, such as those with severe cases of multiple sclerosis or Parkinson’s disease, because therapists said they weren’t making sufficient progress. Others, including individuals recovering from strokes or traumatic brain injuries, have been told that they reached an annual limit on services and didn’t qualify for further care.

Neither explanation stands up to scrutiny. Medicare does not require that older adults demonstrate improvement in order to receive ongoing therapy. Nor does it limit the amount of medically necessary therapy, for the most part.

Full story at news-medical.net

End of Therapy Cap a ‘Long-Awaited Gift’

The end of the hard cap on payment for therapy services under Medicare was big news for patients and the profession—a fact that hasn’t escaped the notice of The Washington Post.

The March 1 edition of the Post featured a story from Kaiser Health News on the elimination of the cap, which is described as a change “buried” in the federal spending plan approved by Congress in February, albeit one that “reveals much about how health care financing often gets done—or undone—in Washington.”

The article recounts the birth of the cap in 1997, efforts to repeal it, and the regular scrambles to apply temporary exceptions to the policy. And to help illustrate the long slog that finally led to repeal, Kaiser reporter Shefali Luthra retells the story of an ambitious physical therapist who left his practice in Michigan and headed to Washington, DC, nearly 20 years ago to help advocate for an end to the cap. His name: Justin Moore, PT, DPT—as it happens, the same Justin Moore who’s now CEO of APTA.

Full story at APTA