Scottisms
Trochanteric bursitis does not exist for the most part; it is almost always something else causing the lateral hip pain.
Scapular dyskinesia is a popular diagnosis that is looking for a definition (like fibromyalgia).
Sciatica or compression of a component of the sciatic nerve is rare (but not in the Lafayette, Indiana area) and has not been shown to be caused by repetitive lifting, bending, or twist.
Research has not shown that stretching can prevent injuries.
almost all traditional mechanical factors deemed culpable in NSLBP (Non-Specific LBP) have been debunked in recent years.
In order to help folks with NSLBP and other musculoskeletal problems one must first de-program them; thus education is paramount to success.
For a program to be successful, patients must receive the same message based on available evidence from all involved in their care.
Ruptured or herniated discs, and degenerative changes are common findings even in you asymptomatic people, or as Josh Levin MD says it, “a normal MRI is abnormal”; most imaging is not helpful and may lead to harms for unproven, risky and costly interventions, i.e injections, medications, imaging, surgery.
Most times a referral for NSLBP should be made only when it is known that therapy has not been helpful and there are no “yellow flags (psychosocial issues)”
There is only one proven intervention for NSLBP that is effective, safe, and low cost and that is Physical Therapy with manual therapy and/or manipulation, exercises, and education.
A Physical Therapy evaluation can help delineate the problem. The orthopedic PT has been shown to be equal in outcomes to the fellowship trained orthopedic surgeon but generates lower costs.
The overall effect on the quality of life of NSLBP is low in the very young and adults that do not seek healthcare for it. Medical management usually exacerbates the problem, not relieve it.
Most rotator cuff tears - even full thickness - do not need surgical correction; many times care plans are based on imaging findings versus clinical findings, contrary to most expert and evidenced based guidelines.
Psychosocial issue and depression are infrequently addressed or poorly managed in folks and often leads to medicalizing medical over treatment or treatment that is risky, and not likely to produce a good outcome
Ed Scott PT, DPT, OCS