Rehab Science with Tom Walters

In today's podcast episode, we are going to look at a condition called gluteal tendinopathy, which is a common cause of lateral hip pain due to an irritation of two of the gluteal tendons (gluteus medius & gluteus minimus).  Previously, this type of pain was thought to be caused by trochanteric bursitis, but more recent research has shown that bursitis only accounts for approximately 20% of these cases (see references below). The majority of lateral hip pain cases are now thought to be due to gluteal tendinopathy or irritation of the gluteal tendons where they attach on the side of the hip (greater trochanter).  Risk factors for developing gluteal tendinopathy include: female gender (4:1 female to male ratio), increased body mass index (BMI), excessive hip adduction during walking/running, prolonged hip flexion (sitting) and weak hip abductors muscles (especially gluteus medius and minimus).  Treatment of this disorder is similar to other tendinopathies in that the focus is on gradually loading and strengthening the gluteal tendons via resistance training exercises that target the hip abductor muscles. These types of exercises not only improve the working capacity of the muscles and their tendons, but also help reduce tendon pain.  My YouTube video below includes a a few exercises that typically help people suffering from gluteal tendinopathy. YouTube Link [https://youtu.be/9At4wIEKD78?si=1r8O1lPKe-attgHO] Here are a couple of articles that you can read to learn more about this disorder. 1. Long SS, Surrey DE, Nazarian LN. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis [https://www.ajronline.org/doi/10.2214/AJR.12.10038]. AJR Am J Roentgenol. 2013;201(5):1083-1086.  2. Pianka MA, Serino J, DeFroda SF, Bodendorfer BM. Greater trochanteric pain syndrome: Evaluation and management of a wide spectrum of pathology [https://pmc.ncbi.nlm.nih.gov/articles/PMC8182177/]. SAGE Open Med. 2021.  3. Ladurner A, Fitzpatrick J, O'Donnell JM. Treatment of Gluteal Tendinopathy: A Systematic Review and Stage-Adjusted Treatment Recommendation [https://pmc.ncbi.nlm.nih.gov/articles/PMC8330465/]. Orthop J Sports Med. 2021;9(7):23259671211016850. I hope the information in this episode was helpful and you feel better equipped to treat gluteal tendinopathy related pain. Besides the YouTube video I linked, my book contains comprehensive programs for the 50 most common orthopedic conditions, including one for gluteal tendinopathy. The programs are broken into three phases and include exercises that can be used to help prevent injuries as well as help you recover from an injury. If you want to learn more about my book, visit my website [https://rehabscience.com/book/] or click HERE [https://amzn.to/40xzzaQ] to view the book on Amazon. Thanks for reading and I hope you have a great day! Dr. Tom

Today's episode covers a case I saw in the clinic in which a patient presented with symptoms consistent with a calf muscle strain, but ended up having a blood clot or deep vein thrombosis (DVT). Deep Vein Thrombosis or DVT describes a situation in which a blood clot (thrombus) forms in one of our deep veins. In many instances, this occurs in the calf region and happens after a person has undergone a surgical procedure. Typical symptoms include pain, swelling and warmth in the region. Besides surgery, blood clots can occur when we have been sedentary for extended periods (plane flight, bed rest after an injury, etc). DVTs can become a life-threatening if they break loose and move through the blood stream to the lungs. This situation is referred to as a pulmonary embolism (PE) and blocks blood flow to a portion of the lungs. If you enjoyed this episode, please consider following my podcast on Apple Podcasts or Spotify by clicking the 'follow' button. Also, if you would consider leaving a 5-star review for the podcast, it would mean a lot to me. Thank you!

In today's episode, I speak with orthopedic physical therapist, content creator and entrepreneur, Dr. Caleb Burgess. Caleb is a licensed Doctor of Physical Therapy, a certified specialist in Orthopedic Physical Therapy through the American Board of Physical Therapy Specialties, and a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association. In 2014, Caleb received his Doctorate in Physical Therapy (DPT) from Azusa Pacific University. The next two years he completed a Residency in Orthopedic Physical Therapy and then a Fellowship in Sports and Orthopedic Physical Therapy through Kaiser Permanente Southern California. This advanced training allowed him to become an expert in musculoskeletal conditions both related to the general and athletic populations. Furthermore, as a strength and conditioning specialist, Caleb is qualified to help people develop and achieve higher level performance based goals that extend beyond traditional rehabilitation. To learn more about Caleb's work, visit his instagram account (@dr.caleb.burgess) or his website [https://drcalebburgess.com/].

In today's episode, I interview physical therapist and ACL rehabilitation specialist, Dr. Wesley Wang, DPT. This episode covers much of the current research regarding ACL rehab and will be helpful to both individuals who have suffered an ACL injury or want to prevent one from happening and practitioners who treat patients who have undergone an ACL recontruction.  Wesley is a physical therapist at Healthy Baller, which is located in Rockville, MD. He specializes in treatment of sports injuries and ACL reconstructions. The majority of his patients are middle and high school athletes as well as athletes from various colleges across the country. Wesley's goal is to develop a trusting relationship with the patient while focusing on treating the source of the pain. Treatments prioritize regaining full mobility, strength and confidence to reduce the likelihood of suffering another injury. To learn more about Wesley's work, visit his Instagram account (@wesleywang.dpt) or his website [https://wesleywangdpt.com/].

Today's episode covers sacroiliac or SI joint pain, which is a type of low back pain. The sacroiliac joints are two small synovial joints located on the right and left sides of the low back between the sacrum and the ilium bone of the pelvis. These joints are surrounded by numerous ligaments, which makes them very strong and capable of supporting body weight. Because of their joint shape and the surrounding ligaments, the sacroiliac joints move very little, but are thought to account for a small percentage of back pain cases. Pain associated with sacroiliac joint irritation is usually located on one side of the low back and may radiate into the buttock or back side of the thigh. If you believe you may experiencing pain originating from one or both of your sacroiliac joints, the exercises shown in the video may help.  https://youtu.be/s2bqEP1O6_s?si=MSDpabHhBI58Jae9 [https://youtu.be/s2bqEP1O6_s?si=MSDpabHhBI58Jae9] Reference: Laslett M. Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint. J Man Manip Ther. 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582421/ [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582421/] Here are a few exercise tools that can help you recover from this type of pain. SI Stabilization Belt: https://amzn.to/4gYmkpE [https://amzn.to/4gYmkpE] Trigger Point Ball: https://amzn.to/3Ibw0LJ [https://amzn.to/3Ibw0LJ] Loop Bands: https://amzn.to/3G3D6QS [https://amzn.to/3G3D6QS] *My new book contains comprehensive rehab programs for the 50 most common injuries and pain issues, including one for sacroiliac joint pain. Click the link below to learn more and order a copy! https://a.co/d/1q3BjgP [https://a.co/d/1q3BjgP]