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Friday, May 3, 2019

Putting the Pieces of the Injury Puzzle Together


My practice of medicine has much to do with trying to put pieces together of a puzzle. The puzzle being why an injury or pain syndrome occurred, or how to fashion a successful rehabilitation program for a patient. The image below can also stand for all the members of a team gathered to help a patient.


When a patient presents with pain, the Rule of 3 holds reign in establishing why something happened. The Rule of 3, and commonly 4 or 5, stand for the factors that had to exist for a problem to develop, a sort of perfect storm. One simple example is from a patient I saw yesterday. The patient has a tibial stress fracture from running. The injury occurred in clear overuse fashion (Cause #1). The injury, which is to a bone, occurred during a time of low Vitamin D (Cause #2). The runner is a overpronator who had recently prior to the injury switched from Stability shoes to barefoot technology shoes which proper transitioning period or running style changes (probably Causes #3, #4, and #5). By putting these pieces of the puzzle together, the patient was be successfully rehabbed, and the injury will not reoccur. 

2 comments:

  1. This comment has been removed by the author.

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  2. My question is not on this particular subject, but I didn't know where to post it.
    I am 65 years old and in 2018 I had a sudden onset of tendon pain that grew increasingly worse over the course of nearly a year; and during that timeframe I was treated for UTIs with Cipro by 3 different doctors.

    I recently became aware of the relation between Ciprofloxacin and tendon ruptures and mentioned it to my podiatrist today, but he was reluctant to make a correlation of cipro and my injury and discouraged me from exploring that possibility. Why?

    ReplyDelete

Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.