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Sunday, July 18, 2010

Philosophy of Treating Athletic Injuries (Part II)

The patient’s main goal is to rid himself or herself from the problem as soon as possible with no recurrence. The health care provider’s main goal is to safely rid the patient of the problem with no recurrence. Should the patient rest a day, two days, two weeks, three months, etc? Should the patient self treat the problem at home to save expenses, or be seen in therapy daily, weekly, etc? Should an elaborate work-up on the cause be pursued? Should every ache and pain be x rayed, bone scanned, MRI ed, casted, injected, etc? Should every possible cause be treated, even if this would entail months of treatment and huge expenses to the patient?

The purpose of these several posts is to bring the patient closer to the doctor/therapist in making decisions on treatment care. It is a joint venture and both must know what the other is thinking.

There are a few common athletic injuries in which the doctor or therapist immediately realize that the patient’s problem is very serious. The crack or snap that is heard, the amount of sudden swelling, the severe intense pain, the total inability to walk without pain, the inability to bend a joint without severe pain, the history of years of pain without relief, all signal the doctor/therapist to regard this injury as almost special and definitely serious. Complete investigation should be performed in all of these cases.

Fortunately, these are the rare injuries. Definitely, five percent or less of all athletic injuries fall into this category. Most of the time, the injury was gradual, with no to minimal swelling, only moderate aches (level 5 pain at most), with no limping with walking, running, skating, dancing, etc.

All body parts are freely movable. The symptoms have existed for 3 months maximum. Should be easy to treat? Sometimes. All those other variables play so much of a role.

The doctor or therapist must have basic rules that guide them in their treatment of athletic injuries. A starting place with most injuries develop from there. For each doctor or therapist, these basic rules are very different. Hence, the reason that some are successful at treating sports injuries, others not. But even the best doctor/therapist cannot put all the pieces together all the time for every patient. And, of course, the patient feels let down, misdiagnosed, ripped off, etc. Can this be prevented? Sometimes it can. If the basic trust in the doctor and therapist is there, the patient will communicated his or her frustrations. This forces the health care provider to re-evaluate the course of action and accept failure, change directions, etc. Usually the doctor/therapist is busy treating 1000 patients actively at any one time, all in different stages of healing, without the ability to individually check on the progress of each patient. The patient must follow up, inform if there is no change for the better, and positively help in the healing. There can be physical reasons a treatment regimen fails. We must avoid failure from patient frustrations and lack of communication and distrust in the doctor/therapist and patient relationship. Fortunately, 90% plus of patients get better when communication is free flowing.

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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.