[djcrusoe0929]

djcrusoe0929 on April 20, 2020 at 11:47 am · in reply to: FAI and Hip Labral Tear #40689

Spencer,

Where exactly are your symptoms? Are they only in the front and more towards the groin? Do you have any other symptoms in your low/mid back (tightness or stiffness) or any where else in your legs (even if they are different than the feelings in your hips)?

How would you describe the sensation of your primary symptoms (and if you have other symptoms too)? What makes your symptoms worse and what helps them?

Anytime someone mentions symptoms on both sides I wonder if the spine can be referring to those locations. There is something that is called Maignes syndrome were the thoracolumbar junction (area between thoracic and lumbar spine) can cause hip pain. I’ve treated a couple of cases of this where conservative management had failed when the hip was the primary focus.

I’ve also found that even if I am treating someone with FAI that manipulation to the the thoracolumbar junction can help with hip pain (there is some nerdy science behind this).

Dan Crusoe PT, DPT, OCS, CSCS

[djcrusoe0929]

djcrusoe0929 on April 12, 2020 at 6:48 pm · in reply to: Concussion and Altitude #40430

I know it has been a little while since @landers2189 ask but I thought I might add a little. During grad school, I worked as a research assistant for one of the leading researchers for concussion.

Pete is spot on that concussion can affect multiple different systems. It can also lead to some autonomic dysregulation. Which can cause some funky symptoms. A few questions I had are as follows:

1) How long ago was the concussion?

2) When your friend crosses 8,000 ft and starts getting lightheaded, is it after exertion or just merely being above 8,000ft?

3)When they experience these symptoms, what is the pattern that they experience them? If they were to rest do they get better, stay the same, or get worse?

4)What kind of fitness do they have? Do you know approximate aerobic and anaerobic threshold? Do they do any training in Zone 4 or 5 and what is there response to that?

So you know why I asked some of these questions. For #2, this would help understand if it’s exertion based or just purely altitude. If it’s just altitude, they could almost do what would look like acclimatization at a lower elevation. Questions #3 indicates how much they could lean into symptoms (usually for long-standing issues you need to lean into symptoms a little). For #4 high levels of exertion can trigger symptoms but, if your friend has a high level of aerobic fitness then it may take quite a bit of intensity to get to that point. Thus the altitude challenges the physiology to that higher level.

There are lots of directions that this could go. Hopefully, this was helpful and not too overwhelming.

Also Pete as an FYI, JOSPT just released a new CPG for concussion.

Hope everyone is having a great Easter and staying healthy!

Dan Crusoe, PT, DPT, OCS, CSCS

[djcrusoe0929]

djcrusoe0929 on September 15, 2019 at 9:32 am · in reply to: Rotator cuff injury #28476

Green light and yellow light exercises are good!

forgot to put that little piece in there

Good luck!

[djcrusoe0929]

djcrusoe0929 on September 15, 2019 at 9:17 am · in reply to: Rotator cuff injury #28475

Alec,

In general you can get into PT/strengthening after a strain pretty quickly.

When I see clients one of the first I’m focusing on is symptom modification, by exploring to see if certain movements or exercises help reduce pain. If there are exercises that we can find that reduce pain right after you can expect to see about a 50% improvement in 3 wks and being at about 85-90% by 8 weeks.

As for how much pain to be working through I normally take to clients about a “stop light”

Green (good to go) -feel good while you are doing it and continues to feel good after

Yellow (caution) – feel a slight increase in pain during and maybe for a little while after but settles back to baseline/doesn’t make you worse the next day

Red (stop) – significant pain during and flares symptoms after

Isometric exercises awesome for the early stages of strains because they tend to be well tolerated and can help reduce pain

[djcrusoe0929]

djcrusoe0929 on September 3, 2019 at 9:00 pm · in reply to: Peroneal Nerve Issue, full knee flexion/extension #27825

First, I wanted to echo Pete’s comments as they are spot on.

Another thing to consider is potentially mobilizing the fibular head along with some nerve mobilizations with a peroneal nerve bias. Has your PT done any of these?

Best Wishes!

[djcrusoe0929]

djcrusoe0929 on April 26, 2019 at 1:37 pm · in reply to: Shin Issues #21016

Maksurayev,

That is a bummer about your shin issue. You did an awesome job detailing what has bothering you but I have some more clarifying questions, if you are game to answer them.

1. Is your aching and burning at mid shin to the inside or outside of the shin bone?
2. How large of size is the area? Does it run vertically along the shin?
3. Is the discomfort constant doesn’t change with activity, constant but changes with activity, or comes and goes?
4. Does the pain change through the day from morning to afternoon to evening?
5. What activities are more aggravating than others? What things are you doing that help it feel better

Other things I was wondering about? How is the style of shoe you are wearing now compared to when you were running at University (thinking about heel to toe drop)? How has your body changed since your time with peak mileage (body weight or other factors)?

Have you cycled or used the elliptical in the past? Or do these make your symptoms worse? These could be viable options to continue to get zone 1 training in. They may not be as optimal, but definitely better than training.

Best Wishes,
Dan

I haven’t really posted much on here. Just as a FYI I am a Doctor of Physical Therapy near Seattle and I just finished up reading Training For The New Alpinism

[djcrusoe0929]

djcrusoe0929 on April 3, 2019 at 9:39 pm · in reply to: Retrocalacneal bursitis #19807

Stuart,

Here is a link for the comparison of heavy slow resistance training vs. eccentrics

There is also some interesting stuff on the need for motor control in tendinopathy rehab here

Hope this helps!
Dan Crusoe