Thursday, August 21, 2008

Are you getting the biggest bang for your buck?

We've all seen this. A parent or coach approaches you and says, "I read on the internet or saw on the news that ____is the best treatment for ____". My answer is always...but can you measure that? Does it pass the acid test? Can I pull out my tape measure or goniometer and prove it increased painfree ROM? I could care less that it elevated the temperature of some tendon a half a degree centigrade. Did this athlete walk out better than the day before?


Here is an example. The athlete above had a severe grade 2 inversion ankle sprain right after school got out in June. He spent almost a month non weight bearing on crutches. He came to me because he could not sprint without posteromedial ankle pain. The picture on the right represents his L ankle dorsiflexion. The strip of tape closest to the wall is pre intervention, the second is post. The position he is in now is his new pain free ROM.



The whole thing took me about 12 minutes. The pic on the L is me doing some posterior talar glides, along with some tibia ER mobes. 4 sets of 20 reps. In between sets, I had him doing L SLB RLE anterolateral reaches @ ankle height, 20 reps. While he was doing the exercises, I taped one kids ankle, and took care of a soccer player's nose bleed. I then re-tested him. His sagittal plane knee excursion improved 3.25cm, 1.2cm pain free. I sent him outside to do 6x20 meters each of shuffle steps, galloping with LLE leading, and tapioca stepping to the right.



I'm often asked how I have the time to do manual therapy. The total hands on time of this treatment was about 5 minutes. If you see a dysfunction, then why choose an indirect approach? Why was this technique more effective than the silly one on TV? Because the athlete really corrected it all by himself. All I did was provide the scaffolding.

1 comment:

sportsmedguy23 said...

Joe...

Another great job...You do an amazing job of taking complex ideas and making them simple and understandable...Your coaches and student athletes are so lucky to have you looking out for them. All the colleges and pros in the area have no idea what they are really missing out on.

The Athletic Training Education programs in your area should really utilize you as an ACI because those Athletic Training Students would be so far ahead of everyone else coming out of school.

I really need to get out to New Jersey and hang out with you and just watch you work and interact with your athletes...

I really wish you were going to be able to make it up this way for GG4 this November...You'll be missed...Keep up the great work, love coming to the site to see what you're up to...

Take it easy good luck as football games gets going this week...

Pat Donovan