The FARM Cast

Join The FARM team as we discuss a case of a desk jockey dealing with tennis elbow, a case of extension-based low back pain being driven by ankle dysfunction in a teen soccer player, and the big question of can you categorize injuries?’.

Join The FARM team to discuss a case of anterior cutaneous nerve pain in an elite gymnast, a case of lateral hip pain tied to a finding of thoracic SMCD in a high school cross-country runner, and a difficult case of trying to discern a thoracic derangement with cervical radicular symptoms.

Join The FARM team as we discuss a shoulder case in which the patient is convinced they need surgery, a case involving a gymnast with strange bilateral lower extremity symptoms, and a classic hip derangement treated using MDT principles.

Join The FARM crew as we discuss how to create a bullet-proof exam process, a case of flank pain resulting in bowel obstruction, and the diagnosis of fibular nerve traction injury in an elite gymnast.

Join The FARM clinicians as they discuss a case of misdiagnosed plantar fascia rupture, and how advanced imaging can lead us toward catastrophizing a scenario that’s remedied by great conservative management and a classic pars injury case.

In this episode of The FARM Cast, we delve into the intricate world of Carpal Tunnel Syndrome (CTS) – a condition that affects millions worldwide. Join us as we unravel the complexities of CTS, exploring its causes, symptoms, and potential treatments. Dr. Beau sheds light on the anatomy of the wrist, explaining how the carpal tunnel, a narrow passageway in the wrist, can become a source of discomfort and pain. We discuss the common risk factors associated with CTS, including repetitive hand movements, poor ergonomics, and certain medical conditions. Listeners will gain valuable insights into recognizing the early warning signs of CTS, such as tingling, numbness, and weakness in the hand and fingers. Our guest shares practical tips on ergonomics and exercises that can help prevent and alleviate symptoms, making this episode a must-listen for anyone spending extended hours on keyboards or engaging in repetitive hand activities. -- Abdalbary SA, Abdel-Wahed M, Amr S, Mahmoud M, El-Shaarawy EAA, Salaheldin S, Fares A. The Myth of Median Nerve in Forearm and Its Role in Double Crush Syndrome: A Cadaveric Study. Front Surg. 2021 Sep 21;8:648779. doi: 10.3389/fsurg.2021.648779. PMID: 34621777; PMCID: PMC8490666. Karne SS, Bhalerao NS. Carpal Tunnel Syndrome in Hypothyroidism. J Clin Diagn Res. 2016 Feb;10(2):OC36-8. doi: 10.7860/JCDR/2016/16464.7316. Epub 2016 Feb 1. PMID: 27042500; PMCID: PMC4800566. Kong G, Brutus JP, Vo TT, Hagert E. The prevalence of double- and multiple crush syndromes in patients surgically treated for peripheral nerve compression in the upper limb. Hand Surg Rehabil. 2023 Dec;42(6):475-481. doi: 10.1016/j.hansur.2023.09.002. Epub 2023 Sep 14. PMID: 37714514. Louie D, Earp B, Blazar P. Long-term outcomes of carpal tunnel release: a critical review of the literature. Hand (N Y). 2012 Sep;7(3):242-6. doi: 10.1007/s11552-012-9429-x. PMID: 23997725; PMCID: PMC3418353. Mills ES, Mertz K, Fresquez Z, Ton A, Buser Z, Alluri RK, Hah RJ. The Incidence of Double Crush Syndrome in Surgically Treated Patients. Global Spine J. 2022 Nov 1:21925682221137530. doi: 10.1177/21925682221137530. Epub ahead of print. PMID: 36321208. Möllestam K, Rosales RS, Lyrén PE, Atroshi I. Measuring symptoms severity in carpal tunnel syndrome: score agreement and responsiveness of the Atroshi-Lyrén 6-item symptoms scale and the Boston symptom severity scale. Qual Life Res. 2022 May;31(5):1553-1560. doi: 10.1007/s11136-021-03039-1. Epub 2021 Nov 20. PMID: 34800220; PMCID: PMC9023404. Mondelli M, Farioli A, Mattioli S, Aretini A, Ginanneschi F, Greco G, Curti S. Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures. PLoS One. 2016 Oct 21;11(10):e0164715. doi: 10.1371/journal.pone.0164715. PMID: 27768728; PMCID: PMC5074522. Pensy RA, Burke FD, Bradley MJ, Dubin NH, Wilgis EF. A 6-year outcome of patients who cancelled carpal tunnel surgery. J Hand Surg Eur Vol. 2011 Oct;36(8):642-7. doi: 10.1177/1753193411410155. Epub 2011 Jun 2. PMID: 21636619. Rozmaryn LM, Dovelle S, Rothman ER, Gorman K, Olvey KM, Bartko JJ. Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome. J Hand Ther. 1998 Jul-Sep;11(3):171-9. doi: 10.1016/s0894-1130(98)80035-5. PMID: 9730093. Sangram, B.S.; Mayne, A.I.W.; Jariwala, A.C. Can we accurately predict nerve conduction study outcome using a carpal tunnel syndrome questionnaire? Surgeon 2019, 17, 156–159.

On this Week In Review, we discuss a common hip flexor tendinopathy in a soccer player treated with fundamentals of movement and breathing, a medial knee pain case that keeps us aware of always having a pain audit and functional audit in our plan, and a look at the links between IBS and pelvic motor control in an elite youth golfer.

On this episode of Week In Review The FARM clinicians discuss a complex case involving cerebral venous sinus thrombosis and the roadblocks that stood in the way of an easy diagnosis, how losing sight of truly treating function can prolong treatment and reduce effective outcomes, and how treating something like chondromalacia patella should be less about the diagnostic moniker and more about the individual case presentation.

In this Week In Review, The FARM team discusses a case involving osteochondritis dissecans of the knee in a competitive gymnast turned pole vaulter, surgical repair of OCD of the knee in a high school basketball player who is now dealing with FAIS symptoms, and a classic lumbar disc derangement with possible functional medicine implications.

Shawn Eno of Xtreme Footwerks joins me today to cover all things orthotics, gait, and biomechanics. I have had the pleasure of working with Shawn for almost a decade now and have learned so much over those years. http://www.xtremefootwerks.com/