The Journal of orthopaedic and sports physical therapy
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J Orthop Sports Phys Ther · Mar 2020
Case ReportsPosttraumatic Malunion Following Comminuted Scapular Fracture.
A 42-year-old male police officer sustained multiple injuries in a motorcycle accident, including a comminuted fracture of the scapula and several rib fractures. Four months after his injury, the patient was prescribed outpatient physical therapy, after 2 months of which the patient's cervical and lumbar spine function were restored but his shoulder mobility deficits persisted. ⋯ Given his functional deficits, including an inability to return to work, he was referred to an orthopaedist for additional imaging and consultation, which revealed scapular malunion. J Orthop Sports Phys Ther 2020;50(3):167. doi:10.2519/jospt.2020.8927.
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J Orthop Sports Phys Ther · Mar 2020
EditorialOvercoming Overuse: Improving Musculoskeletal Health Care.
This is the first article in a series on "Overcoming Overuse" in musculoskeletal health care. Overuse is the use of services that are unlikely to improve patient outcomes, result in more harm than benefit, and would not be desired by an informed patient. ⋯ We focus on strategies to promote guideline-concordant care in rehabilitation practice and strategies to overcome overuse. J Orthop Sports Phys Ther 2020;50(3):113-115. doi:10.2519/jospt.2020.0102.
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A 35-year-old woman was referred to physical therapy by her primary care physician for right calf pain with gradual onset over 1 year. Following examination, the patient underwent 2 months of treatment; given limited progress, the patient was referred to an orthopaedist. Radiographs revealed several phleboliths and magnetic resonance imaging revealed an intramuscular vascular mass within the lateral gastrocnemius. J Orthop Sports Phys Ther 2020;50(2):110. doi:10.2519/jospt.2020.9091.
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J Orthop Sports Phys Ther · Jan 2020
The Elephant in the Room: Too Much Medicine in Musculoskeletal Practice.
While advances in assessment and management of musculoskeletal conditions have improved care for many people, there have been other, less beneficial developments in the provision of care for people with musculoskeletal pain conditions, one of which is the worrying tendency to provide too much medicine. Too much medicine occurs when the provision of either investigation or intervention (or both) is unjustifiably excessive. ⋯ The authors (1) list 2 common examples of too much medicine, and 2 examples of medicalizing normality, relevant to physical therapy practice; (2) outline the drivers of too much medicine and medicalizing normality; and (3) make suggestions for change. J Orthop Sports Phys Ther 2020;50(1):1-4. doi:10.2519/jospt.2020.0601.
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J Orthop Sports Phys Ther · Jan 2020
Randomized Controlled TrialShort-term Effects of Thoracic Spine Thrust Manipulation, Exercise, and Education in Individuals With Low Back Pain: A Randomized Controlled Trial.
To determine the short-term effectiveness of thoracic manipulation when compared to sham manipulation for individuals with low back pain (LBP). ⋯ Therapy, level 1b. J Orthop Sports Phys Ther 2020;50(1):24-32. Epub 6 Dec 2019. doi:10.2519/jospt.2020.8928.