JonathanJezequel

Jonathan Jezequel is an experienced physical therapist that enjoys rehabilitating a wide variety of patients. He works diligently one on one with each patient to ensure a prompt and comprehensive recovery and return to function. Jonathan is also deeply interested in the academic and clinical research facets related to physical therapy, which lend a progressive evidence-based approach to his assessment and treatment interventions. He grew up in Costa Rica and is an avid soccer enthusiast and runner.

Jonathan earned his doctorate of physical therapy degree from Columbia University and was the Faculty Excellence in Orthopaedics Award Laureate. He graduated magna cum laude from Wheaton College with a Bachelor of Science degree, where he studied Kinesiology and Applied Health Sciences. Jonathan is currently working toward certifications in both manual and sports therapy through the North American Institute of Orthopaedic Manual Therapy and the National Strength and Conditioning Association respectively.

Jonathan is a member of the American Physical Therapy Association Sports and Orthopaedics Section. He is also a member of the Mid-Atlantic Physical Therapy Associates, an organization whose members are dedicated to the advancement of their manual therapy skills and clinical competence through the disciplines of research and continuing education.

Andrew Pollack discovers what the latest research says about how age and strength interact. Unfortunately, the two relate inversely. But, fortunately, hope is rising on the horizon. Scientists are on the trail, after the scent, and have just to name, compartmentalize, and implicate causes. For the rest, follow this thread.

JonathanJezequel

Gina Kolata provides summary of a “kind of science court“, whose proceedings happened last spring. The exercise gathered various and unbiased medical scientists and asked them to evaluate the effectiveness of any Alzheimer’s intervention. They concluded that there is not a treatment works. Really? What do readers think? Please opine.

JonathanJezequel

Nineteen thirty-six hosted the first orthopaedic joint replacement, a stainless steel arthroplastic hip prosthesis in the stead of native biological tissues. Did the subsequent seventy-four years educate? What does happen when the inanimate meets the biological? With many data purporting joint disease as the leading chronic, disabling condition in the elderly, total joint arthroplasties make sense as they may greatly restore quality of life. But to what extent and for how long? Barry Meier asks these same questions in his recent New York Times column. The read is fascinating. Follow the letter dispatched by Senator Charles E. Grassley of Iowa as it interviews Zimmer Holdings, an orthopaedic device manufacturer, requesting of them data to describe the long term performance of their apparati. There have been vague and circulating whispers of device failure, but no clear consensus. Several surgeons have pointed their steady fingers at Zimmer, but Zimmer has simply pointed back. Follow this thread to learn more and keep your antennae up.

JonathanJezequel

Tags: jezequel, joint replacement, new york times

Running is a tremendous activity. Distinct from walking, running involves a moment where both feet are concurrently borne by the air alone. This moment is also temporary and with consequence. When the ground bears the foot again, and no longer the air, the lower limb is asked to attenuate forces on the order of five to six times the body weight of the participant. Sometimes injuries ensue. Tara Parker-Pope and her running colleague, Brian Fidelman, know these things. Today, in the New York Times Well section, Parker-Pope describes how cycling can offer valuable and protective respite from running while maintaining cardiovascular health. And New York City has much to offer even the occasional cyclist. Check out her article, learn about the City’s many bike trails, and your joints will be in your debt.

JonathanJezequel

In his New York Times column Sean Leahy explores how the National Football League (NFL) is using tougher language to help tackle head injuries. This season each NFL locker room will be necessarily adorned with a concise, informative poster (shown right) that will teach players a series of facts about concussions. The campaign is designed to produce heightened cognizance surrounding the serious nature of head injuries, beginning with the players and filtering out to their families and fans. The poster also educates, in general. Did you know that the majority of serious concussions do not involve a loss of consciousness?

JonathanJezequel

There have been many studies done on the positive effects of exercise in prevention of knee osteoarthritis.  However, how exercise actually affects specific structures of the knee joint is not known.  Urquhart DM et al. recently studied this in a systematic review of evidence of key articles on the topic.  What they found: Although physical activity is associated with increased production of tibiofemoral osteophytes, knee joint space narrowing did not tend to increase. In fact, evidence suggests an increase in cartilage volume and decrease in cartilage defects on MRI.  The results from this review reiterate the importance of exercise; especially to maintain knee joint health.  Consult your physical therapist for a physical activity routine that is safe, individualized, and structured to your knee, injury, and body! Follow the above hyperlinked thread to access the full article. Written by guest contributor Kristine Gneiss, SPT.

JonathanJezequel

First comes the hamstring. Anders Hauge Engebretsen et al. of the Oslo Sports Trauma Research Center recently published a prospective cohort study that investigates intrinsic risk factors for hamstring injuries among male soccer players. Within the framework of excellent study design, Engebretsen and his team recruited and inspected five hundred and eight professional caliber footballers for an entire season (Engebretsen AH et al., 2010). A sample size of this breadth typically generates wonderful statistical power. Tracing previous work of these same scientists reveals a great many studies, each reminiscent both in power and in population. This sort of pedigree predicts data of tremendous quality. A fortiori, Engebretsen et al. assign responsibility of greater than twenty per cent of all acute soccer injuries to the posterior thigh, namely the hamstrings. Other excellent thinkers have also published many original papers, or gathered and integrated them as reviews, in the pursuit to more fully understand this injury. The reader is guided to the 2010 and 2005 works of Heiderscheit et al. and Petersen and Hölmich, respectively, for excellent reviews. For original research questions the reader is in turn directed to the 2009 work of Greig and Siegler and the 2003 work of Brocket et al.

And now the aside. A thread that runs common through these and innumerable other research studies regards the sport, the native context, under which these incidents transpire. While the data are varied, with some confidence Australian rules football alone rivals soccer in hamstring muscle strain injury rate. Therefore, with South Africa as host and as thirty-two proud nations prepare to field their very best to participate in one of the great tournaments of the world, the PT Project will watch with interest, asking questions as the beautiful game unfolds. Noteworthy of special mention is Cesc Fabregas, the calculating Arsenal captain of the English Premier league and strong midfield presence for the nation of Spain. He was recently ranked the sixth best player set to compete in the World Cup tournament. He also waded through a recurrent hamstring strain for much of his professional season past. What exactly does this mean? In their most recent paper, Engebretsen et al. find previous acute hamstring damage to more than double the reinjury risk. But Arsenal staff brilliant physiotherapists. Eagerness reigns as the PT Project anticipates, and invites the reader to anticipate, the extent to which their good work will serve to curb reinjury.

JonathanJezequel

Introductory Remarks. An injury that considers twenty-three years old and, once applied, predicts for greater than one third of its recipients a probable and swift reinjury exacts resolute study and strict attention, unpartitioned between other interests (Engebretsen AH et al., 2010; Heiderscheit BC et al., 2010; Greig M and Siegler JC, 2009; Arnason A et al., 2008; Gabbe BJ et al., 2006; Petersen J and Holmich P, 2005). Hamstring muscle injuries reach these criteria and further. So familiar in prevalence, are they, and yet so ephemeral in understanding. In their classic paper Best and Garett submit, “there is a complex, poorly understood neuromuscular coordination pattern that may help explain why the hamstring is injured” (Best TM and Garett WE, 1996). Like sleuths snuffling across but never directly along the fleeting trail, other great minds of the world have devoted great resources to great research and concede largely the same (Heiderscheit BC et al., 2010; Engebretsen AH et al, 2010).  Therefore, despite having been reviewed extensively, a want of still more critically processed understanding exists. The next several weeks will explore this injury, ask questions and seek synthesis of current data. As trajectories are noticed and patterns built, comments are welcome and encouraged to help grow the body of information.

Let’s explore this topic together.

JonathanJezequel

As goes the caution for information consumption: always consider the source. Here, the source has been considered and the information is recommended. In “Rescue Your Back: A guide for a new approach to back pain“, Cathy Mahon, a robustly experienced physical therapist, tackles a common yet deceptively byzantine pathology. She gathers complex information from varied sources and irons it out into convenient forms, accessible to all. While the book targets anybody with back pain, Mahon’s insightful clinical reasoning offers a nice model for the health care professional, too.

JonathanJezequel

So reads the title of a Wall Street Journal column authored by Melinda Beck, tucked under the Health Journal section. In said article, Beck unpacks platelet-rich plasma (PRP) therapy for the conservative management of orthopaedic pathologies. And she unpacks well. The reader is encouraged to follow this thread to learn more.

Beck appropriately takes broad ink strokes, here, to adequately cover a topic of this complexity and breadth. In consequence, however, several appended details must yet receive further consideration. Namely, the efficacy of PRP, although still young in research, but nevertheless intimating promise, may target tissue out of its native context. Without discretion, PRP therapy tends to exalt tissue healing as an end in and of itself. Now, while in part this is important and necessary, and at times independently so, the environment, the context, in which the tissue first met pathology must be canvassed. It must be determined how and when the tissue behaved, and what upon, so that following successful PRP therapy the healthy tissue is not simply returned to an unhealthy, unmodified environment.

JonathanJezequel

1. Core Strength or Core Confusion
2. Barefoot Running: Separating Facts From Myth
3. Move to the beat of your own drum
4. Fatigue from cycling…is it in your head?
5. Managing a Hyperkyphotic Spine. . .