Po-Wei Chen, MD

Po-Wei Chen, MD Po-Wei Chen, MD

Physiatrist · Hualien Tzu Chi Hospital, Taiwan

Turning the recurring hassles of clinical work, study, and research into tools.

Manual & exercise therapy × Self-hosting & code × AI & learning

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Clinical & EvidenceRehabilitation medicine × critical appraisal × research methods AI WorkflowsRebuilding study and knowledge work with AI Building & LivingSelf-hosted services × time management × personal growth

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Rotator cuff tear notes cover

Rotator cuff tears and calcific tendinitis: if you cannot lift your arm, do you really need surgery?

Let me start with the most common misconception: Rotator cuff tears are very common, they aren’t always what’s causing the pain, and they don’t always require surgery. I wrote this for anyone whose shoulder hurts, who can’t lift their arm, or who’s been told after an exam that “your rotator cuff is torn” or “you have calcification in your shoulder.” What exactly is the rotator cuff? The bones in your shoulder are shaped a lot like a golf ball sitting on a tee: the ball is large, and the tee is shallow. ...

Note · October 23, 2026 · 39 min · 8175 words · 陳柏威 Po-Wei Chen
Screenshot of the out-of-plane needle angle page: the syringe rests against the probe, and three angles map to three depths

Out-of-Plane Needle Depth: Dr. David Wang's Three Angles, Now a Web Page

I’ve joined the prolotherapy volunteer clinic every year since 2023. This year (2026-10-03), Dr. David Wang (David C. Wang, DO, founder of Virtuosity Physical Medicine in Reston, Virginia, USA) taught a method for out-of-plane needling. The whole system comes down to three angles and three numbers, and as soon as I heard it I wanted something I could pull out and check at any time. So when I got back, I turned my recording into notes (using lecture-to-notes, a tool I open-sourced earlier), then built a web page around it. It’s bilingual (English and Chinese) and made for phones first: ...

Post · October 3, 2026 · 6 min · 1102 words · 陳柏威 Po-Wei Chen
child and youth exercise prescription notes cover

How much exercise do kids need? At what age can they lift weights?

Let’s start with the most frequently asked, and most counter-intuitive, statement: As long as someone teaches the movements and an adult is supervising, elementary schoolers can do weight training, and it won’t stunt their growth. What really gets kids hurt isn’t lifting heavy things, but having no instruction, no supervision, starting too heavy, and progressing too fast. If even one of these four things slips, injuries happen; if you do all four, the injury rate is lower than many ball sports. ...

Note · September 30, 2026 · 32 min · 6797 words · 陳柏威 Po-Wei Chen
De Quervain's de Quervain disease stenosing tenosynovitis notes cover

De Quervain's: Holding Your Baby and Scrolling Your Phone Hurt the Same Tendon

Let me start with the most common misunderstanding: De Quervain’s is not “weak wrists,” nor is it “sore muscles from holding a baby too long." Instead, it’s about two tendons at the base of your thumb. The tunnel they share gets narrow and thick, and the tendons can’t glide through. So resting makes it hurt less, but as soon as you go back to the original movement, the pain comes right back. It won’t resolve itself just because you sleep a few more days. ...

Note · September 28, 2026 · 27 min · 5742 words · 陳柏威 Po-Wei Chen
plantar fasciitis notes cover

Plantar Fasciitis: The First Step in the Morning Hurts Most, But Insoles Shouldn't Be Used Alone

Let me start with something a lot of people don’t know: if you get an X-ray for heel pain and see a bone spur, that spur usually has nothing to do with your pain. One study looked at a thousand random foot X-rays. Thirteen percent had bone spurs, and of those, only 40 percent had ever experienced heel pain. Conversely, many people in agonizing pain have completely normal X-rays. So the spur isn’t the culprit. What’s actually hurting is the fascia attached to your heel bone, which has been repeatedly pulled until it developed micro-tears and degeneration. ...

Note · September 25, 2026 · 29 min · 6125 words · 陳柏威 Po-Wei Chen
osteoporosis notes cover

Osteoporosis: No Symptoms, but Stopping the Wrong Meds Causes Fractures

Let me start with the one thing you need to remember most: osteoporosis has almost no symptoms before a fracture. It doesn’t ache, it doesn’t hurt, and it isn’t uncomfortable. The bones hollow out bit by bit. By the time you have symptoms, you’ve usually already crushed a vertebra just bending over to lift something, or fractured your hip slipping in the bathroom. So the phrase “I’m perfectly healthy, I don’t feel anything wrong” is completely useless when it comes to osteoporosis. ...

Note · September 23, 2026 · 41 min · 8582 words · 陳柏威 Po-Wei Chen
osteoarthritis knee degeneration notes cover

Your knee is "degenerating", now what? What actually works in osteoarthritis

Let me open with a sentence that makes a lot of people relax: knee osteoarthritis is not a one-way street where the cartilage grinds away and that is the end of it. It is closer to an imbalance — the body’s rate of repairing the joint has fallen behind the rate of wear. That gap can be narrowed, and the things that narrow it happen to be the cheapest things on the list. ...

Note · September 20, 2026 · 30 min · 6214 words · 陳柏威 Po-Wei Chen
Trigger finger notes cover, stuck finger, injection or surgery

Trigger finger: when your finger gets stuck and needs prying open, should you get an injection or surgery?

Let’s start with the most common misunderstanding: the place that hurts is usually not the place that’s broken. Almost everyone with a trigger finger points to their middle knuckle and says, “It gets stuck here.” But the real problem is at the base of the palm, that ring where the finger meets the palm. This is why the doctor presses your palm, not the spot you’re pointing at. This is written for those whose fingers get stuck in the morning, who feel pain when gripping things, or who have already been told they need an injection. ...

Note · September 16, 2026 · 24 min · 4981 words · 陳柏威 Po-Wei Chen
Frailty notes cover

Frailty isn't just ageing: start with "lately I get tired so easily"

Let me say the most important thing first: when older folks walk slower, complain of being tired, and lose their strength, it’s not “just getting older." It has a name—frailty—it has clear diagnostic criteria, and the earlier you deal with it, the better you can stop it. I’m writing this for anyone with older relatives at home. What is frailty, exactly? Frailty isn’t a disease; it’s more like your body’s savings account running low. ...

Note · September 16, 2026 · 30 min · 6370 words · 陳柏威 Po-Wei Chen
What the permission prompt is asking you: default asks every step, plan mode can only read, accept edits allows edits, auto mode only asks for dangerous ones. Press Shift+Tab to switch.

What is the permission prompt actually asking? Four modes, auto mode data, and Codex equivalents

Last week I gave an intro class on AI agents for some anesthesiologist friends. The post-class feedback was interesting: “permission prompts and auto mode” showed up near the top of two different lists. A lot of people voted it “most useful,” but a lot also voted it “didn’t understand.” That means it’s important, but the pacing of a single class just wasn’t enough to cover it. I’ll explain it all here in this post. ...

Post · August 21, 2026 · 7 min · 1287 words · 陳柏威 Po-Wei Chen