Recurring Injuries and TRAZER
I’d like to share with you the feedback we’ve gotten from 2 very influential and highly respected clinicians regarding the value added they have experienced through utilization of the TRAZER technology as it applies specifically to recurring injuries that may plague your patients and athletes.
We spoke recently with Dr. Mike Voight, Director of Sports Medicine at Nashville Sports Medicine (The Thomas Byrd Hip Clinic), Professor at Belmont and Vanderbilt Universities and Juan Delgado, Sports Scientist at the Sports Science Lab at NY Chiro and Physical Therapy in Staten Island, NY.
The GOAL is to prepare the person to return to the real world and to mitigate the risk of re-injury.
Right now, the highest incidence of re-injury is in lower back pain and in ACL re-injuries post-surgery (sometimes to the opposite leg), at a rate of re-injury of 20 – 30%. Mike and Juan are getting significantly better results (3-4% or lower).
What are they doing differently?
Their conclusion is that typically, the PT uses 3 things to determine readiness to return to function:
- Pain – is the patient pain free?
- ROM – does he have 100% range of motion?
- Strength – is his strength to within 10% of what it was pre-injury?
Too often, this is the point that many clinicians release their patients.
ARE YOU RELEASING PATIENTS AT THIS POINT?
The above are all isolated capacities and have nothing to do with whether the patient can move. When the patient has satisfied the 3 things above, that means they’re ready tostart their movement training. They then look at whether the movement pattern is functional or dysfunctional? Pain free or painful?
Quite often, a patient or athlete’s injury is the result of having developed compensatory movement patterns to be able to play through pain. A pro athlete might develop 6 – 7 default movement patterns; a weekend warrior might develop only one. But the point is that these compensatory movement patterns are not efficient, typically put stress on other body parts, and ultimately lead to injury. Part of their rehabilitation process is to train them out of those default movement patterns. They use TRAZER to objectively measure these functional movement capacities.
TRAZER sees what the naked eye cannot. The 4 biggest things that they look at are acceleration, reaction time, speed and deceleration (ability to stop). Mike said that most injuries involve deceleration. And there is no clinically applicable, practical way to look at deceleration other than TRAZER.
TRAZER tells you whether there is symmetry between the right and left sides. He said it’s fairly standard to look for less than 10% asymmetrical movement pattern pre-release. But, typically, a person can have a 25 – 30% movement asymmetry and be pain free (but at a higher risk of re-injury).Of course, left and right handedness and training effect can cause some differential, but their goal is 8 – 10% maximum difference.
No one can guarantee that the athlete won’t get re-injured if released back to function with less than a 10% asymmetrical movement pattern and good numbers on the other factors. But what these groups team tries to do is mitigate the risk of re-injury. Look at the risk factors – such as an asymmetrical movement pattern, a slow reaction time, a slow deceleration time – and if those risk factors are there, keep them in rehab.
Our clinicians will often test the patient at their first visit to show them the % asymmetrical movement difference they have. They will then tell them that they need to be at 10% or less pre-release. When the patient is pain free and still has a 30% movement difference, the therapist will remind them of that conversation. By providing the patient with objective, documented feedback, they become more vested in the process. They tend to work harder in order to show progress from visit to visit.
Better Results and better outcomes lead to happier patients, better outcomes, more referrals and easier documentation with insurance.