Pt Inquest

Systematic reviews are a great tool to boil down decades of research into a single paper. But what if those decades of research were full of low quality studies? Can we make strong "Level 1a" statements from that? Well, as long as those statements are vague it looks like you can. What should we do when the evidence doesn't support or refute something? (HINT: Be skeptical!!!)

Running is bad for your knees. It will wear them down and lead to arthritis. We've all heard it and it makes sense, right? But does that really happen? And what does this have to do with Uranus?!

Can we predict injuries in athletes? Is it like screening for disease or is this kind of screening a different animal? Will this episode be the greatest thing since sliced bread?!

What is required for rotator cuff tendinopathy? Scapular stability? Manual therapy? What if you just gave exercises? How about just one exercise? In this episode we explore all of that as Erik explores living in an apartment again for the first time in 15 years.

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?

When dealing with a high ankle sprain (syndesmosis injury) Grade I never requires surgery whereas Grade III always requires surgery. But what about Grade II? In this episode we explore predictors of syndesmotic instability when assessing a Grade II sprain and the return to sport prognoses. All this while JW approaches absolute zero!

Sports-related concussions have been getting more and more attention over the past decade. The growing understanding of the potential for developing chronic brain disease is creating a cause for concern. Are sports medicine professionals managing concussions differently today? How well do we understand this process? Has Erik had too many concussions over the years to form a complete sentence? Here is a link to the NATA Position Statement on Management of Sport Concussion.

It's that time of year again and the PT Podcast Network crew are in the holiday spirit! The gang got together, as best they can scattered across the world, to share a little eggnog and make fun of each other. So pour yourself a drink, sit by the fire (or pool in the Southern Hemisphere), and enjoy a little holiday cheer.

It is well known that quadriceps strength asymmetries are commonly seen in subjects who have difficulty returning to sport after anterior cruciate ligament reconstruction (ACLR), but does that asymmetry correlate to a specific presentation on landing mechanics? What do we know about second injury in these subjects? Can we do anything about it? We ask these and many other questions when we chat with lead author from The Ohio State University, Laura Schmitt, PhD, PT! Also, this is the last podcast of the current 12 episode season before we go on our usual 3 month hiatus. While we're gone, catch up on previous episodes or check out some of the other shows on the network!

There is a belief out there that weak hips may cause patellofemoral pain, but this article found the opposite. How can we make any sense out of all the ambiguity? If only we had a Masters in Biomechanics. Luckily special guest Greg Lehman does! For more info on Greg including his teaching schedule, visit his website!

Orthopedic surgeons have a lot to consider when they are deciding whether or not to recommend surgery for rotator cuff tears, but how do they implement that decision process in practice? What makes a surgeon more or less likely to go towards early surgery vs physical therapy? Will JW take "the Bard-Parker solution"???