Orthopaedic Manual Physical Therapy Journal Club Previous Discussions

The Ortho-Manual Physical Therapy SIG's Journal Club met on Thursday, March 30th from 7:30PM to 8:30PM EST.  See the article below that was discussed.

Narrative Review Little League Shoulder:  Proximal humeral physis widening is only one piece of the puzzle, its time to consider posterior glenoid dysplasia.  JSES International; Myers N, Kennedy S, Arnold A, et al.

Click here to access this article.

Previous Articles Discussed

• Spinal Manipulation and Perineural Electrical Dry Needling in Patients with Cervicogenic Headache:  A Multicenter Randomized Clinical Trial.  The Spine Journal 21 (2021) 284 - 295; Dunning J, Butts R, Zacharko N, et al.

Click here to access this article.

• 2022 Bern Consensus Statement on Shoulder Injury Prevention, Rehabilitation, and Return to Sport for Athletes at All Participation Levels.  Journal of Orthopaedic & Sports Physical Therapy (2022) Vol.52 Issue 1, pages 11 - 29

Click here to access this article.

• Chronic Mortise Instability - Part 1:  Functional Anatomy of the Ankle Mortise

Written by Dr. Chad Howland, PT, DSc, DPT, SMT, CMPT

Introduction

An underlooked cause of chronic ankle instability (CAI) is an unstable mortise. An unstable ankle mortise arises from ankle sprains of moderate-to-severe trauma. This type of lower limb instability alters the rear foot and midfoot biomechanics, resulting in premature loading of the medial foot (i.e., sudden foot flattening), and impaired absorption and propulsion during gait. The sequela of an unstable mortise produces concomitant clinical conditions ranging from an acquired flat foot, posterior tibialis tendon dysfunction, hallux valgus, and metatarsalgia1 . Extrinsic to the foot and ankle, the unstable mortise can produce altered motor control, evidenced by muscle inhibition and facilitation patterns of the lower limb, pelvic girdle, and spine. Altered activation within specific neuromuscular sets can produce hip internal rotation mal-tracking (credit to Gail Molloy (https://denverptis.com/our-team/gail-molloy/)2 , SI-joint dysfunctions (innominate rotations and sacral torsions), and lumbar spine disorders (disc injury and functional instability)1,2 .

The purpose of this initial commentary is to describe the functional anatomy of the ankle mortise. Subsequent posts aim to answer the following questions.

1. How does ankle mortise instability occur?
2. How do we identify ankle mortise instability?
3. How do we restore ankle mortise stability?

To read the full article, click HERE.

• Cuboid Syndrome
  Written by Dr. Chad Howland, PT, DSc, DPT, SMT, CMPT

What is cuboid syndrome and its clinical presentation?

"Cuboid syndrome is a debilitating foot condition caused by a disruption or subluxation of the cuboid bone due to a change in the structural integrity of the calcaneocuboid joint (Jennings and Davis, 2005). This syndrome is often associated with sinus tarsi, lateral foot, and mid foot pain. Given the lack of reliable tests, this syndrome can be challenging to identify. A physical therapist must link the subjective history, injury mechanism, physical exam, and their own clinical experience to establish a probable hypothesis. Therefore, recognizing the cluster of signs and symptoms becomes essential." 
To read the full article, click HERE.

If you have any questions or comments please contact Chad at howlandc@husson.edu.