We're joined again by Dr. Adrian Miranda of the web series Gross Anatomy on youtube. He was supposed to tell a story of working for a high volume clinic coming off of an esteemed residency program. But our geek mode took over and we ended up recoding an episode all about our love of movies, Tom Cruise, his crazy running gait, and how PTs should think when they view a great action scene. Have you ever thought of these things as a clinician when you watch your favorite movies or shows?
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Andrew discusses a recent case with a curious finding. Bilateral Infraspinatus atrophy one side greater than the other. No myotomal or dermatomal overlap, no pain, no trauma or recent infection. What do you make of it? Any similar cases in your experience?
Untold Physio Stories is sponsored by
The Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.
Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.com
Curv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
We're joined by Dr. Adrian Miranda of Gross Anatomy Web Series on youtube. He tells his origin story of expectation of high school graduate, to earning his doctorate, teaching residency, and eventually forming a PT based entertainment company! Be sure to check out Gross Anatomy on youtube!
Untold Physio Stories is sponsored by
The Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.
Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.com
Curv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
.jpg "Untold Physio Stories - Have You Ever Heard of Collagen Supplementation?")
Erson chats with Dr. Sean Wells, author, nutrition specialist, speaker, and Modern Rehab Mastery mentor. Recently, Sean gave a talk on wholistic treatment for orthopaedic conditions in the older population. After being asked about collagen supplementation repeatedly, his biases were challenged.
Dr Well's site can be found here - Nutritional Physical Therapy
Untold Physio Stories is sponsored by
The Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.
Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.com
Curv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
.jpg "Untold Physio Stories - Breathing is a Habit")
In this episode, Erson goes over a telehealth series of visits with another PT. What started out as a traditional lumbar radicular or neuropathy complaint rapidly turned to trying a LOT of different and non traditional treatments. Are you aware that over breathing/hyperventilation can affect many different systems in the body? Listen to this podcast to find out more.
Untold Physio Stories is sponsored by
The Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.
Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.com
Curv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
Keeping it Eclectic...
Back pain is a common ailment that many of us have experienced at some point in our lives. One specific type of back pain, known as discogenic low back pain (LBP), is characterized by pain originating from the intervertebral discs (IVDs) in the spine. Despite extensive research, the exact causes of discogenic LBP have remained elusive. However, a recent study conducted by Seiji Ohtori and his colleagues sheds new light on the underlying mechanisms of this condition.
Through the use of animal models, researchers have made significant discoveries regarding discogenic LBP. They have found that sensory nerves grow into the inner layer of the lumbar IVDs, and this nerve ingrowth is induced by certain inflammatory substances called cytokines.
These cytokines, such as tumor necrosis factor-α and interleukins, stimulate the ingrowth of sensory nerves into the discs. Moreover, nerve growth factor has been identified as a key player in inducing this nerve ingrowth. Animal models have also revealed that disc degeneration triggers the production of collagenases, enzymes that break down collagen, leading to hypermobility and pain.
Sinuvertebral Nerves
Further insights into the mechanisms of discogenic LBP have been gleaned from the examination of degenerated human IVD specimens. These specimens have revealed sensory innervation and nerve ingrowth, similar to what has been observed in animal models. The presence of cytokines in human discs suggests a shared mechanism with animal models.
This indicates that the findings from animal studies can be applied to human patients as well. In addition to sensory innervation and cytokine involvement, sensitization of sensory nerve fibers innervating the IVDs is a crucial factor in discogenic LBP. When these nerve fibers become sensitized, they become more responsive to pain stimuli, leading to heightened pain perception.
Psychosocial factors also play a role in the perception and experience of pain associated with discogenic LBP. Factors such as stress, anxiety, depression, and social support can influence an individual’s pain experience. Understanding the interplay between these psychosocial factors and the physiological aspects of discogenic LBP is important in developing comprehensive treatment approaches.
Understanding the underlying pathomechanisms of discogenic LBP opens up avenues for potential treatment strategies. To effectively manage this condition, it is crucial to prevent sensitization of sensory nerve fibers within the IVDs. This can be achieved through targeted interventions that aim to suppress the pathogenic increases of cytokines. By reducing the levels of pro-inflammatory cytokines, such as tumor necrosis factor-α and interleukins, the ingrowth of sensory nerves into the discs can be controlled, thereby reducing pain.
In addition to cytokine regulation, addressing disc hypermobility is an essential aspect of treating discogenic LBP. Hypermobile discs can magnify pain and further damage the disc structure. Treatment options such as physical therapy and specific exercises can help stabilize the spine, reduce hypermobility, and alleviate pain. Other interventions, such as spinal manipulative therapy and epidural steroid injections, may also be considered in certain cases to manage pain and promote healing.
Discogenic low back pain is a complex condition with multiple underlying mechanisms. The research conducted by Seiji Ohtori and his colleagues has provided valuable insights into the pathomechanisms of this condition, highlighting the role of sensory nerve ingrowth, cytokines, and disc hypermobility. By understanding these mechanisms, health professionals can develop more targeted treatment approaches to help patients suffering from discogenic LBP.
One innovative product that aids in the understanding and communication of discogenic LBP is the Professional LxH Dynamic Disc Model by Dynamic Disc Designs. This model accurately represents the structure and function of the intervertebral discs, allowing health professionals to visually demonstrate the impact of disc degeneration, nerve ingrowth, and hypermobility to their patients. By using this model during patient consultations, health professionals can help individuals better comprehend the nature of their condition and the rationale behind the recommended treatment approaches.
Check out MMT's Exclusive Blue Nucleus model!
Andrew is back talking about a colleague's recent case. This is a new grad, only practicing for 5 weeks or so, but kudos to his differential diagnosis skills and applying the Wells Criteria for Pulmonary Embolism. If you're not familiar with it, its something you should keep in the back of your mind, especially with post op patients, those who have been recently immobilized, or with history of Cancer or PE.
Untold Physio Stories is sponsored by
The Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.
Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.com
Curv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices.
One of the most frequently asked questions I get at Modern Manual Therapy courses is, "How do you explain SIJ dysfunction without us...
