A Dozen Sports Medicine Pearls 30+ Years of Clinical Practice ...
A Dozen Sports Medicine Pearls 30+ Years of Clinical Practice ...
A Dozen Sports Medicine Pearls 30+ Years of Clinical Practice ...
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Because…<br />
Rather…<br />
• Restoring ROM<br />
• Strengthening the injured part<br />
Modalities<br />
• Gradual return to training and competition<br />
#4: The patient who isn’t improving<br />
according to an expected time frame<br />
• The problem…<br />
• The solution<br />
– Change the treatment<br />
or<br />
– Change the diagnosis<br />
• Example:<br />
– Patell<strong>of</strong>emoral disorder<br />
– Victim<br />
– Culprit<br />
#5: Victim or culprit<br />
#6: Beware the consequences <strong>of</strong> your<br />
imaging<br />
How about this case<br />
The MRI<br />
Back<br />
– Thornbury and colleagues demonstrated a sensitivity <strong>of</strong> MRI for<br />
herniated discs <strong>of</strong> 0.89 to 1.0 but a specificity <strong>of</strong> only 0.43 to 0.57<br />
– Asymptomatic patients: disk bulges (52%) and protrusions (27%)<br />
Shoulder<br />
– Kautzner 2008: accuracy <strong>of</strong> MR for diagnosing labral tears was<br />
68%<br />
– Bergin 2009: MR arthrography: sensitivities <strong>of</strong> 86% to 91% and<br />
specificities <strong>of</strong> 86% to 98%<br />
– <strong>Clinical</strong> significance<br />
Knee<br />
– 61% who had meniscal tears had not had any,pain, aching, or<br />
stiffness during the previous month.
Change language