Imaging: Episode 45

  • In this episode: When should you have imaging done, when is there value and when is it just superfluous.

  • Chip Review: Dieter’s Chocolate Covered Potato Chips

  • Trivia question of the week: In which country would one find 8 of the world’s 10 highest mountains?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!


Imaging as it value relates to orthopedic injury. Musculoskeletal, the spine, extremities, we won’t be talking about cancers or internal organs. Over the past few years imaging has taken on too much of diagnostic role and less of a confirmation role.
Initial imaging was used to confirm what the diagnostician had found. Now we are seeing more of people using imaging to diagnosis.
When we talk about imaging we are referring to plane films aka X-ray, MRI, CT scan and bone scan. You will see ultrasound a little more these days but it is not nearly as common as the afore mentioned group and so we will not discuss ultra sound in detail today.
Plane film is great at looking at bone and bone relationships. Some really good radiologists can infer more from a plane film then that. You will be able to confirm fractures, dislocations, joint space, bone spurs, osteophytes and in the spine vertebra position. Plane film is relatively inexpensive usually around $100 for a set of images. This is probably the most commonly used and in a good number of cases your insurance company will make you get a plane film before an MRI, CT scan, etc…
MRI is probably the 2nd most common type of imaging. This does a really good job of showing soft tissue as well as bone. This can be done with contrast (T1 or T2) or without depending on what you are trying to find. An MRI is $700 and up so it is a good deal more expensive then a plane film. This type of imaging gives off no radiation and is thus safer then the others.
CT scan is pretty similar to an MRI. It gives off a good deal more radiation so it is not used as often. The image quality is high and depending on what you looking for can in many cases be the best tool to use for the job.
The advantage of MRI and CT over plane film is that there is a good deal more detail and you can almost see the area in almost 3D.
Bone scan is the last type of imaging we are going to discuss today. This is primary used to show where certain bone activity is occurring or not occurring. You see this more often with stress reactions or osteopenia/osteoporosis.

Hamstring Injury: Episode 42

  • In this episode: We discuss hamstring injuries. Typical causes, predisposition factors, treatment and prevention.

  • Chip Review: Ikea – Potatischips Saltade (Aidan Bosman)

  • Trivia question of the week: What is the driest place on Earth?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

Hamstring injury. Lets discuss our pet peeve right off the bat. If I hear one more announcer on TV say “ That looks like a hamstring” or “He’s got a hamstring”, i’m going to loose it. We all have hamstrings in fact each of use has 3 on both legs. It is so interesting that this way of talking about it has basically gotten a life of it’s own. Ok I feel better now.
The hamstring has three main parts. The biceps femoris which makes up the lateral portion and the semitendinosus and semimembranosus which make up the medial portion. When you bend your knee you will feel the tendons, almost like guitar strings. One on the outside, biceps femoris one on the inside, semitendinosus and semimembranosus.
The biggest injury you will see here is pull or strain. These are both names for some form of tear. The tear is typically small but you can have large tears. At times there can be a lot of black and blue (ecchymosis) as well swelling. The discoloration is not always indicative of the extent of the injury.
This is one of the tougher injuries because it is difficult to rest. The biggest risk factor for having a hamstring injury is a prior hamstring injury. So that means if you have injuried the hamstring before you are more likely to do it again.
Make sure you don’t try to race back. Once these become chronic they tend to stick with people for a long time. You see it in the professional athlete world. They return in a few weeks, their first real big movement back and they injury it again.
In most cases running is the number one cause. This is often a change in speed accelerating or decelerating. Kicking is not as often the cause but when it is there is typically a much more damaging injury and takes longer to come back from.

Other Podcasts you might be interested in:


Pain: Episode 29


Iliotibial Band Syndrome (ITBS): Episode 9


Sciatica: Episode 34

  • In this episode: We cover Sciatica as it relates to the general population as well as during pregnancy. We also touch on piriformis syndrome and what “double crush” is.

  • Chip Review: Calbee Seaweed & Salt Potato Chips, Huge thank you again to Steve Kovisto

  • Trivia question of the week: What 2 US states have their own time zones?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

In this episode we are going to go over sciatica and will be reviewing the Calbee Seaweed & Salt Potato Chip.
Sciatica, typically people have low back pain and pain in the buttocks. Pain can then extend into the knee or as far as the foot. Following the path of the sciatic nerve distribution. Sciatica affects men and women pretty much equally. It does not have an age range that is really prevalent. You kind of see it across the age ranges. Something that crops up during pregnancy, we will get into sciatica and pregnancy a little later in the episode.
The biggest cause for sciatica is a herniated disk, also nerve root irritation or compression on the nerve. Imaging can be helpful but it does not tell you the whole story. If you have sciatica symptoms and they take an x-ray or MRI and they see something. Don’t panic, don’t freak out. The chances that what is there having just shown up are pretty darn low. Occasionally there can be trauma and sciatic can follow that. But most of the time or a lot of the time this is something that is non-irritable for a period of time. Then something happens and you have symptoms.
There is this thing called “double crush” syndrome. Which means that if you have irritation of the nerve anywhere in your body. But it is not enough to have symptoms. Then you get a second irritation somewhere else along that nerve. Now you get symptoms. With sciatica this is often at the piriformis muscle. Which is right in the center of your buttocks.

Other episodes you might find useful:


Upper and Lower Extremity Posture: Episode 8


Low Back Pain: Episode14

Hip Pain: Episode 15

Radicular Pain: Episode 22

Greater Trochanteric Bursitis: Episode 28

Pain: Episode 29


FAI/Hip Labrum: Episode 21

  • FAI (Femoral Acetabular Impingement) is becoming a common diagnosis. This is a bony change that causes the hip labrum to tear and fray. Both cause pain and loss of sport ability.
  • We review Kettle Brand Spicy Queso Potato Chips, compliments of Judy Kay.
  • Trivia question of the week: The Bullfinch Pub in Boston is better known by what name?
  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.
  • Thanks for listening!!


Today we are going to be covering hip labrum pain, hip labrum tears, hip labrum reconstruction, femoral acetabular impingement (FAI), which all full under the same heading. Then we are going to be reviewing Kettle Brand Spicy Queso Chips, compliments of Ms. Judy Kay.  Thank you Mrs. Kay.


So we are going to start with labrum tears. So the labrum sits around the outside of your hip joint. It helps to deepen the joint; it helps improve stability around there. It is also chock full of pain fibers. It is kind of like a gasket. I learned that from Dr. Parker. You learned gaskets from Dr. Parker?


When you have irritation to that you will feel pinching, you will feel pain.  Most of the time pain with either be in the front of your hip or into your groin.

Very common with people who are super flexible or single limb athletes as we call them if you do a lot of j ump, pushing off or landing on one leg. This is a pretty common injury. Although I think it is often, and this is speculation on my part, miss diagnosed. I has become one of those fade diagnosis. Everyone with anterior hip pain, now all of a sudden has FAI.


A lot of that has to do with the fact that there is now a surgery for it. The surgery is relatively routine. That has only been in the last 10 years. I remember treating a your lady 20 years ago. For hip impingement and there was not really any surgery at the time that could be done for it other then a complicated open procedure or a potential joint replacement. Neither one of those was a valiant option at the time. So we treated it conservatively and low and behold it got better.


We definitely see that a fair amount where you have a small tear and not need surgery. Even if you get diagnosed with a labrum tear, see it on imaging. If it is small enough you can treat it by stabilizing the joint. Treating it with physical therapy working on strength, balance, stability and range of motion.

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