Jerry Hesch Melissa. very well stated. A few weeks back I treated a very bright person who could see through the marketing hype of a treatment program in which if rehab for a protracted period of time and large cost got to that end-point without results, then person gets funnelled into the other similar program, different diagnosis. We both ask, at what point does the clinician NOT know that diagnosis B is more relevant than diagnosis A and she declined and declined all efforts to funnel her towards surgery which was initiated at the very beginning! On the 3rd visit and final visit I sent her home with a letter and a video and we were both clear that there was a palpable hard mass just below the knee sitting against the common peroneal nerve; hence her lower leg pain was NOT caused by pelvic asymmetry/SIJD?Occult DIsc. Given the inital ankle injury and pattern of pain; why did no one treat the top of the ankle whcih is the superior tibio-fibular joint just below and lateral to the knee? Clinicians that are experts need to be expert in all joints all regions of the body and exam all not just focus on one area of expertise. Also, experts know when NOT to pursue their favorite intervention. If they do not, they should not be called expert.
Dr. Jerry Hesch, DPT, MHS, PT
Married with 4 grown kids. Earned my Doctorate at A.T. Still University in Tempe, AZ, MHS at the University of Indianapolis and my BS PT at University of New Mexico. I enjoy working with my hands and particularly making glass objet d'art.