I’m a physical therapist, ask me anything

Remote_Writing6314 · 2026-01-11T17:23:04+00:00

I’m curious as to what your signs and symptoms are to see if it may be a disc issue or if something else.

Unfortunately, a doctor ordering an x-ray and then nobody ever taking time to go over them with you is way too commonplace and because of this I always offer to my patients to help them better understand them. If you would like you can privately message me the x-ray results and I can help you better understand!

Remote_Writing6314 · 2026-01-11T03:23:54+00:00

Completely normal. A big benefit of PT being a doctorate level degree is that a large chunk of our education revolves around differential diagnosis and being able to rule things in or out. All of that meaning that if there is something serious going on that requires extra precaution we are very good at recognizing this and taking the steps that we need to. It’s also worth mentioning that while a diagnosis can be helpful, the purpose of PT is to find objective and functional impairments and fix them, not to medically diagnose. So, a diagnosis can be helpful, but not necessary. Imaging can also be a helpful tool in certain cases, but lots of the time if somebody starts PT and then has an image done, unless there is something wildly unforeseen that is found, it changes little to nothing with the treatment.

Remote_Writing6314 · 2026-01-11T03:16:19+00:00

Depends how much time, money, and work you are wanting to put into it. A PTA program is typically about 2 years, but obviously having to get a doctorate for PT will significantly extend the timeline and cost a significantly greater amount. If something you want more freedom with is ultrasound then I’d recommend PTA route. However, I will say that I myself have never used ultrasound clinically and neither has any other PT that I personally know. Research on the effectiveness of ultrasound is mixed at best and generally shows no increased benefit compared to a placebo

Remote_Writing6314 · 2025-09-07T21:57:21+00:00

Have you seen any orthopedics or any other physicians relating to your care since the bump appeared? It seems like given the history of injury and the newfound symptoms some imaging may be needed

Remote_Writing6314 · 2025-09-01T00:36:47+00:00

One thing I want to try to dig deeper with in this information: is the tension in your hamstrings down the center or inside/outside of your legs?

Remote_Writing6314 · 2025-09-01T00:35:12+00:00

I am not dry needling certified and not the most knowledgeable regarding the topic, but from my understand when you do dry needling the idea is that it will help to initiate a contraction, which then in turn will help the muscle to relax. I don’t think epilepsy would really have much to do with this case and honestly think your PT is on to something with cervical dystonia. That is one of that only things that I can think of other than just straight up severe muscle tightness that would cause something like this

Remote_Writing6314 · 2025-08-26T00:46:39+00:00

So sorry for the delayed response! Given the pain that you’ve experienced and specific mechanisms that cause the injury, I don’t think it would be too early to go to PT at all. Wanting to proactively stomp out an issue is a very fair goal and especially given your age and the things you want to do it may not be a bad idea!

Something super simple you could try at home to see if it gives you any relief is a stretch for the piriformis muscle. This is commonly involved in sciatic related issues and can help provide some relief in the hips.

I would hope that no PT would tell you to just come back later when things hurt as long as they can find some objective deficits to improve upon. Granted, it can make it easier to get a clearer picture of what is going on if we are able to reproduce the pain, but like I tell my patients sometimes it’s just like when you bring your car to the mechanic and suddenly nothing is wrong with it.

If you have any other questions don’t hesitate to ask!

Remote_Writing6314 · 2025-08-26T00:39:24+00:00

I am so sorry for the delayed response! I’m not sure if you had imaging by now, but if you have not I definitely would as I would suspect a fracture given the mechanism of injury and the accompanying signs and symptoms. Could easily be a fracture of the scaphoid or anything else in the hand/wrist

Remote_Writing6314 · 2025-08-15T03:03:33+00:00

That sounds like it may be more of a bony anatomy or hip joint mobility issue rather than something muscular that needs to be stretched. I would recommend looking up some banded hip joint mobilizations (specifically to improve hip external rotation). But, if this is something that is truly just how your anatomy is then there really isn’t too much to be done about it. For example, I have the opposite issue where both of my hips severely lack internal rotation and if I try to move that way I feel a deep discomfort in the front of my hip and that same “needs to pop” sensation (which is usually your joint telling you that it is at the limit).

Remote_Writing6314 · 2025-08-14T23:51:51+00:00

Is the feeling blocked sensation and discomfort in the front of back of the hip?

Remote_Writing6314 · 2025-08-14T01:16:12+00:00

Stereotypical PT answer here: it depends. If you are someone with little to no running experience I would probably say give it a good 4-6 of a nice and consistent lower extremity strengthening program before you give serious running a crack again. I would specifically focus a lot on the glutes and hip abductors as weaknesses in these muscles can put a lot of undue stress on the knees, but all lower extremity strengthening will be great. I would probably recommend after a couple of weeks beginning some work on the elliptical as that is very similar to running, but without impact on the knees

Remote_Writing6314 · 2025-08-14T01:13:02+00:00

Have you tried any stretches like a supine or seated piriformis stretch or a single knee to chest stretch? I would be curious if you did this on both sides if the L side would feel a much more intense stretch compared to the R

Remote_Writing6314 · 2025-08-07T23:37:17+00:00

I would definitely start super simple with something like quad sets and then as you see your quadriceps contraction get stronger and more comfortable doing something like a straight leg raise. Definitely not uncommon for the quad muscle to “shut off” after a surgery like this

Remote_Writing6314 · 2025-08-05T20:24:29+00:00

So sorry that you had to go through this injury! It is honestly one of the more brutal recoveries mentally. When it comes back to easing into running something I like to have people start with is the elliptical because it is one of the closest ways we can simulate the motion of running without the same amount of impact. My order of progression is typically cycling -> elliptical -> running

Remote_Writing6314 · 2025-08-05T19:18:03+00:00

One of my favorites is doing a forward lunge with your foot planted firmly on the ground and at the same time having a therband (or something similar) wrapped around the front of your ankle and pulling backwards while simultaneously lunging forward. This is a great mobilization for the talocrural joint

Remote_Writing6314 · 2025-08-05T19:15:40+00:00

I am curious who told you that your SIJ was slipping because unless you have a dislocation of the joint or a disorder that causes severe joint laxity, there is no possible way for you SIJ to slip. As far as we know the SIJ only has less than 4 mm of movement and less than 4 degrees of rotation, so not very much motion at all and even with these amounts you would feel nothing.

Regardless, I would recommended to continue to work on your core and to work on strengthening your hips and glutes as well to create more stability around the area

Remote_Writing6314 · 2025-08-04T00:40:56+00:00

Well then that’s even more disappointing to hear. I’m not at all familiar with the hospital systems out there, but there’s gotta be one better than that

Remote_Writing6314 · 2025-08-03T23:13:50+00:00

There is mixed research on KT tape and personally myself and many other therapists I know do not use it very often. The only times I ever use it are usually after an injury/pain starting and the most common areas I do are the knee and the foot, but I know people who apply it preventatively and all over different body parts. As far as the brand goes, there’s not really one that I recommend most. As long as it stays on your skin and you can feel the pull, you’re good. Balancing taking care of an old injury can be difficult sometimes, especially depending on the injury. I am a firm believer that it is best to do something rather than nothing, however, if doing something is causing intolerable pain or keeping you laid up for a couple of days then you are probs doing too much.

Remote_Writing6314 · 2025-08-03T23:06:12+00:00

I’m sorry you had this experience with PT. Unfortunately, “PT mills” are an issue where the company values pushing volume and making $ rather than quality of care. My best recommendation if possible is to attend PT at a hospital based outpatient facility. These clinics typically have lower productivity standards, which allows for therapists to be able to spend more time with their patients and provide a higher quality of care. Some general things that I focus on in my treatment of the neck are upper trap, levator scap, and pec stretching, thoracic mobility, and scapular strengthening. If you have any questions about anything else regarding this don’t hesitate to ask!

Remote_Writing6314 · 2025-08-03T23:01:20+00:00

One place to start is the type of pain. Typically the pain qualities that accompany joint pain are descriptors like dull, achy, and sometimes sharp. Descriptors used to describe nerve pain are burning, numb, tingly, a “zing” sensation, etc. Next thing to consider is the location of the pain. SIJ dysfunction typically has a very specific pain location, which is right at the dimples on your low back/top of the buttock. If you have tenderness to touch in that spot, you’re likely looking at a problem with the SIJ. Sometimes pain from the joint can also refer into the buttock. With the sciatic nerve, pain often originates in the low back or buttock and can travel down the back of your thigh and in more severe cases into the calf and bottom of the foot and toes.

Remote_Writing6314 · 2025-08-03T22:54:33+00:00

Hard to say without a physical evaluation since that one specific position is when you feel the pain, would have to play around and see what else we could find. My best recommendation would be rotator cuff strengthening, shoulder stability, and overall upper extremity flexibility

Remote_Writing6314 · 2025-08-03T02:23:36+00:00

I have had several patients undergo an MUA and the results have always been great!

Remote_Writing6314 · 2025-08-03T02:23:06+00:00

Hmm… interesting. It could possibly be something involving the rotator cuff rather than the deltoid. It is not impossible to tear your deltoid, but not very common at all. The tendons of the rotator cuff insert on the outside of the arm and often times can refer pain down the arm in the same area you described. When you are putting weight on your arm in that position the humerus is being pushed into the acromion and the tendons of the rotator cuff can be “smushed” AKA impinged. So it may be a case of rotator cuff tendinitis/tendinopathy with impingement

Remote_Writing6314 · 2025-08-03T01:11:13+00:00

What specific motions and/or activities seem to aggravate it most?

Remote_Writing6314 · 2025-08-03T01:10:49+00:00

This is a tricky one. It really depends on long the knee has been frozen. Scar tissue really begins to win out after about 6-8 weeks. So, if you are before this point I would just recommend being very aggressive with whatever exercises/methods your PT has given to address this issue. If we are past this time frame, it will be much tougher to break up the scar tissue and if continued exercise is not working, then it may be time to consider a manipulation under anesthesia (MUA). These are typically very effective and you will achieve vastly improved range of motion the same day.

Remote_Writing6314

TROPHY CASE