Post-op hip pain-is it really the hip?

Many people have labral tears in their hip but is surgery the only solution? More often than not, there are secondary issues causing the labral tear in the first place, especially when someone still has lingering issues that the surgery did not address. Does a lack of control in the foot cause a hip labral tear? An overactive pelvic floor? Join the Tough To Treat podcast and find out!


Do You Have Back Pain With Sitting?

What to do when you have back pain with sitting? How do you get to a seated position? You squat of course!!

Low back pain with sitting is extremely common. I had it for years when I worked on a trading floor. Thankfully, I had an extension cord for my headset and was able to get up and move while talking to clients.

The key to “good posture” is to vary it. Plain and simple! There is no right or wrong way to sit and thinking otherwise is misguided. Just get up and move!

When you do have back pain with long periods of sitting, think about your bias. What I mean is, how are you sitting? Are you sitting all day turned to the right looking at your computer, or are you writing and taking notes while on a conference call, leaning on your desk at the same time?

This may seem trivial but if you do them day and day out, for weeks, months, years, it adds up and could potentiate a back problem. If you do suffer from back pain with prolonged sitting, look at the ergonomics of your office and notice what you do all day-it could be quite revealing! And furthermore, look at your squat, that may be even more telling!

Have a torn labrum in your hip? Is it really the cause of your hip pain?

Did you know that the source of your persistent hip pain may come from your foot or even your pelvis? One of my patients found this out after a surgical procedure to repair a torn labrum in her hip. Just because you are looking down the barrel of an MRI saying that you have a torn labrum, does not mean that it is necessarily the original cause of your problem. It certainly became the victim in this case. Ultimately, you need to find the source of your problem and then change your strategy around it. Enjoy!



Really? The Cause Of My Knee Pain Is Not My Knee?

This is a short one on why the source of your knee pain may not be your knee. One of my patients who is a competitive golfer had chronic unresolved knee pain. Watch this short two minute video and find out the source of his knee pain. You do not have to be a golfer to watch, trust me!!



My Philosophy on Healing the Whole Person

Say hello to yourself and goodbye to pain!  I explain in this short (less than 2 mins! ) video on my unique problem solving approach to help you get rid of persistent pain!





How I successfully transitioned from Wall Street to Physical Therapy

People often ask me how I made the transition to Physical Therapy after a successful career on Wall Street.  After all, they say, “Isn’t bond trading different than treating patients?”   Not really. It is all about problem solving.   You have had persistent knee pain and want it gone, yesterday.  That is a problem that needs solving.  Chances are it’s not your knee, especially if your symptom is a chronic one.

My clients on Wall St were the institutional kind, think central banks, hedge funds etc. They wanted to figure out how to strategize to maximize return or minimize loss.

After all, isn’t that what you want,  to be able to squat in the gym without knee pain, for example? Maximum potential, minimum loss?

I was asked to give a speech this past November at our inaugural Women In PT Summit here in NYC on how I used my experience on Wall Street to grow my PT career and practice. Excerpts are below. It’s short, I promise!!

I really took charge of my mindset when I started on the trading floor and how I viewed myself in a very male dominated profession.   The second thing I did was identify my strengths. One of them is that I am a Learner and I love problem-solving !   The third is that I became a educator both for myself, my clients and patients.

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Is Your Dog Walking You?

Do you know the feeling when you walk your dog and the leash is WAY out in front of you and the dog is looking back at you eagerly? Or maybe not!!  That is the sign that the dog is leading YOU down the street.

I have many patients who walk their dogs and often complain of neck and shoulder pain.  That could be a sign that the dog is walking you.  This can of course vary, depending on the size of your dog,  But a little tug here and there even with a small dog can cause some aches and pains in an otherwise healthy neck.

Patients often complain of neck tightness and generally grab the part of their neck just above their shoulders and want to massage it in the hopes that it will make them feel better.  More often than not, this area is being put on tension or elongated when the leash is in that hand and the dog is way ahead of you.  Simply put, when your leash hand is  held is out in front, it puts stress and strain on the neck and shoulder muscles on that same side.

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Treating the whole person and not just a body part

The value of being treated as a whole person and not just a body part.

If you have pain in one part of your body, let’s say, your knee. The longer you have this symptom, the more you incorporate this “pain” as part of your overall body image. You identify with it. That is why it is so important that when you see a Physical Therapist you receive a clinical evaluation from head to toe. Be open to other regions of your body causing your pain . A dysfunction in the foot or hip, is not an unusual cause of knee pain.

Integrating not just the physical, the knee, but the emotional, how we deal with our knee pain, and the intellectual, understanding why we have it and finally the spiritual, knowing and believing that we will heal and get better, is the epitome of a true holistic approach to musculo-skeletal health and well being.

A patient of mine had a knee replacement about 5 years ago, and did not really get full pain relief from the surgery. In the years following the surgery, she tried numerous injections, pain medicine etc without much relief.

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Let’s put the HEAL-ing back into HEAL-thcare


When people come to you in pain, what do you do? Do you sit there and ask them a litany of questions, writing them down without making any eye contact? Or do you just listen and hope that you remember everything later?   Or do you do a bit of both?

Take yourself out of the picture and put yourself in your patient’s shoes.

Ego is big thing in health care. We have all seen it, whatever profession you are in. The ego is such a mind suck when it comes to treating patients one on one.   Leave it on the table for crying out loud. The ego will never win my friends. It is too hungry and will never get satisfied.

But your soul will. Your ego should not make your business decisions. Your soul should.

Doing one on one work as we do, we develop a special bond with our patients.   When I worked on Wall Street, I developed this same special relationship with my clients. Completely different professions but the principles are the same. It is called TRUST.

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Does your foot hurt when you go up on your toes?

Question: Are you unable to perform a relevé without foot pain?

Truth: Pushing off through the front of your foot is what happens when you walk, when you do calf raises in the gym and when you have to perform a relevé multiple times during a performance. Whether you know it or not, this type of movement requires the synergistic action of many parts of your body.  Also known as the kinetic chain in action.



Story: A Broadway show actor was referred to me with chronic complaints of right foot pain. She was unable to do a relevé. She also had problems going up stairs, wearing her performance shoes as well as standing on one leg. She had physical therapy elsewhere and a PRP (platelet rich plasma) injection with little relief.

Problem: I always check baseline posture to see if there is anything jumping out at me that I should be aware of. If there is, I then see if it changes with the movements I evaluate. For this patient, there were a few things that jumped out. She was standing with more weight on her left leg and her thorax (ribcage) was rotated to the right. This is no surprise as she most likely offloaded her right leg for months. However, this position was causing more torque in her foot, thus making the initial problem worse.

This in turn causes compensatory twists up the chain until finally the body can right itself to face forward. Compensating like this for many months tends to change our body schema and our brain maps, such that if we were to put ourselves in a better position, we would think it is not normal, or we would feel “crooked” so to speak. Trust me, there are a lot of people who feel “off”, and walk around pain free. And that’s fine.

But when it comes to high-level performance, correctness of movement and balance play a much larger role.

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