Fitness Pain Free

06/04/2026

06/04/2026

📕 Comment "PFPAIN" to receive a free evidence based guide to patellofemoral pain

Want to make single-leg squats, heel taps, and lunges more challenging without adding weight?

Add a heel lift or slant board.

Elevating the heel allows for:
✅ Greater anterior knee translation
✅ Increased knee flexion ROM
✅ Higher quadriceps demands
✅ A more upright torso position
✅ An easy way to progress knee loading during rehab

This simple modification can be especially useful when working with athletes recovering from ACL reconstruction, patellofemoral pain, patellar tendinopathy, or other knee-related conditions.

Too often, clinicians only think about increasing load. But changing body position can dramatically alter the demands of an exercise and create an entirely new progression.

06/03/2026

Awesome Post from showing that discs can heal just like many other parts of the body. Go give him a follow if you haven't already.

💥𝐃𝐢𝐬𝐜 𝐇𝐞𝐚𝐥𝐢𝐧𝐠💥
———
👉I have shared this post in the past, but it’s a good one to bring back every so often as most people don’t realize that many (66.66%) disc herniations reabsorb with time and conservative care.

🧬The images in this post are from a case report from the New England Journal of Medicine (see reference) that documents the spontaneous resorption of a disc herniation without surgery.

🔎Case Study: A 29-year-old woman presented to the spine clinic with new-onset pain in her right leg, accompanied by paresthesia. MRI of the lumbar spine revealed a lumbar disc herniation resulting in substantial spinal stenosis and nerve-root compression (first image).

📗She elected conservative treatment with physical therapy and an epidural injection of glucocorticoids. A second MRI obtained at follow-up 5 months after presentation showed resolution of the herniation (second image). Her clinical symptoms resolved, and she was discharged from the clinic.

🧠The details of this individual’s rehab were not given in the case study, but it is important to know that relatively simple programs that include movements like walking, general low back mobility drills and low-load resistance training exercises help the majority of people.

📘References: Hong J and Ball PA. Resolution of Lumbar Disk Herniation without Surgery. N Engl J Med. 2016.

📙Zhong M, et al. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Pain Physician. 2017.

📒Chiu C, et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015.

06/03/2026

Comment HIPOA and I’ll send you the evidence-based hip OA cheat sheet.

Painful, restricted hip internal rotation should put hip OA on your radar fast.

It is not the only finding that matters, but when internal rotation is both limited and painful, the likelihood of hip OA climbs.

That is exactly why range-of-motion testing still deserves a central place in your hip exam.

If your assessment is getting crowded, this is a reminder to keep the simple, high-yield findings in the mix.

Comment HIPOA and I’ll send you the evidence-based hip OA cheat sheet.

06/02/2026

📕 Comment "HIPOA" to receive a free evidence based guide to hip osteoarthritis

Hip osteoarthritis doesn't always present as obvious groin pain.

If you're evaluating an active adult with hip, groin, buttock, thigh, or even knee pain, these 5 findings should increase your suspicion for hip OA:

✅ Posterior hip pain during a squat
✅ Groin pain with passive hip abduction and adduction
✅ Hip abductor weakness
✅ Limited passive hip adduction ROM
✅ Reduced hip internal rotation ROM

No single test confirms the diagnosis, but when multiple findings cluster together, hip osteoarthritis should move higher on your differential diagnosis list.

One of the most consistent examination findings in individuals with hip OA is a loss of hip internal rotation, often accompanied by pain and stiffness at end range.

Remember: imaging findings alone don't determine treatment. Your clinical examination, patient goals, irritability, and functional limitations should guide management.

06/01/2026

Awesome post from .ortho This is a very important factor to consider when assessing someone with an anterior / posterior drawer because it can look like either injury. Make sure you check out his page, the answer is in his profile under "answervids"

ACL or PCL tear?

Look closely at the exam.

There’s a subtle giveaway here—

if you catch it, you might have a knack for orthopedics.

👇 Drop your answer below

I’ll break it down in another post.



This information is provided for educational purposes only and does not constitute medical advice. Individual conditions vary-please seek evaluation from a qualified healthcare provider.

05/31/2026

Comment HIPOA and I’ll send you the evidence-based hip OA cheat sheet.

You do not need 10 hip tests. You need the right ones.

Some of the most useful findings for hip OA are straightforward:
- posterior pain with squat
- groin pain with passive abduction or adduction
- abductor weakness
- reduced hip adduction or internal rotation.

That is the kind of information that actually sharpens your differential.

This carousel is a reminder that a better hip exam is usually not about doing more. It is about paying attention to the patterns that matter.

Comment HIPOA and I’ll send you the evidence-based hip OA cheat sheet.

05/30/2026

Comment “CSPINE” and I’ll send you my cervical radiculopathy cheat sheet 📩

This isn’t your typical cervical traction…

👉 In this video, I show how to combine manual cervical traction + a median nerve glide to:
• Reduce neck + arm symptoms
• Improve neural mobility
• Create a more meaningful symptom change

Here’s what makes this different:

Most clinicians use traction or nerve glides…

but combining them can be a game-changer for the right patient.

When used well, this can:
Decrease radiating symptoms
Improve tolerance to movement
Create a smoother transition into exercise

If you:
✔️ Feel like traction alone isn’t enough
✔️ Aren’t seeing great results with nerve glides
✔️ Want a more integrated approach

This will help.

👇 Question for you:
Have you ever combined traction with nerve glides, or do you usually use them separately?

05/30/2026

📕 Comment "DISCGUIDE" to receive a free evidence based "cheat sheet" on Radicular Low Back Pain

One of the biggest mistakes clinicians make is avoiding lower body strength training altogether when a patient has low back pain.

Instead, find exercises that allow the patient to train hard while keeping symptoms manageable.
Here are 4 of my favorite options:

✅ Cable Pull-Through
✅ Barbell Hip Thrust
✅ 45° Back Extension Isometric
✅ Single-Leg Cable RDL

All four can be effective ways to load the glutes, hamstrings, and hip musculature while reducing demands on the lumbar spine.

Remember: the goal isn't to avoid spinal loading forever. The goal is to maintain strength, stay active, and gradually increase tolerance over time.