PT Inquest

When engaging in athletic activities, many physical therapists recommend bracing with the abdominals for stability as a better way to manage loads, but is it? Is it possible that bracing actually increases forces through the body? How might that be? Is Erik's singing in any way tolerable to our listeners?

If your patient has completely torn their supraspinatus, then their humeral head must translate superiorly during arm elevation. Or does it??? In this episode JW and Erik look at a novel kinematic study that found the exact opposite. Remember, there is always more to a hypothesis than, "It makes sense."

Some patients complain of severe pain after rotator cuff repair way more than others. Is this something that can be predicted? Does the extent of the injury have any correlation to postoperative pain? What about specifics of the surgery? Or is it something else? Find out all that and more by listening to "The Gold Episode"!

Erik and JW have a history of skepticism regarding the use of platelet rich plasm (PRP) injections for tendon injuries, but can it have an effect on osteoarthritis? What would they need to see in order to be convinced? Does this article provide that? Or do Erik and JW just hate every new thing no matter what?

Can hamstring injuries be predicted? Does sustaining an injury permanently change something about its function? Is it just a matter of strength or is there something else? How does strength training effect it? Or does it? Time to buy a mfMRI! (Does not stand for "motherf**king MRI" by the way.)

Is eating salt a good thing or a bad thing?! Why do we as physical therapists care? This study actually has to do more with the problem of opinion infiltrating the evidence in what appear to be unbiased studies. How common is this in physical therapy literature? How can we spot it? Is it more than financial bias? Is JW turning into Batman...again?!

Jill Cook and Karim Kahn gave a very interesting lecture on understanding tendinopathy at APTA's Combined Sections Meeting (CSM) in February 2016. PT Inquest decided to take a deeper look. Can disorganized tendon tissue change? If it can't does it matter? When we understand the true nature of tendinopathy, certain treatments become much more plausible and others appear almost silly. Also, Erik provides a poor man's homemade doughnut recipe. Or is it donut?

Uncertainty is not just a reality in life it is a reality of professional practice. The ability to embrace uncertainty is known to have a positive effect on critical thinking and avoiding errors in judgement. That's all great, but do medical professionals acknowledge uncertainty in their practice? Is this harmful to patients? Does it raise healthcare costs? What about informed consent? As William Osler once said, "The greater the ignorance, the greater the dogmatism."

A couple years ago, Alessandro Lelli described his new test for ACL insufficiency via YouTube. Originally known as "Lelli's Test", he first published it in the literature as the "Lever Sign" in late 2014 reporting 100% accuracy. Ok - seemed a little TOO perfect. Now the literature has its first independent study on the Lever Sign so let's take a closer look at this test.

Sure, we know that ACLs get torn and the vast majority of those mechanisms are non-contact. So what EXACTLY happens in those knees? We have some plausible ideas like dynamic valgus, but how does that tear the ACL without any injury to the MCL? How would we answer such a question? Will JW survive the current heatwave in Minnesota?