Rehabilitation Medicine

At the sidelines of track meets, road races, and ball games, the most common accident isn’t a fracture. It’s someone collapsing. And the first question to ask on the scene isn’t “Are they dehydrated?” but “When did they collapse?" The answer to this question splits the situation into two different worlds: collapsing during the race, and collapsing after crossing the finish line. Collapsing during the race: Treat as the worst-case scenario first If a person suddenly falls to the ground while running, playing, or competing, and wasn’t hit by anything, the correct response is to first treat it as cardiac arrest: call for help, call an ambulance, grab an AED, and start CPR. ...

Let’s start with the most counterintuitive thing: when a kid collapses during hot weather exercise and their mental status is off, the right order is to cool them down on site first, then send them to the hospital. Not call an ambulance and figure it out on the way. The international consensus is blunt—cool first, transport second. Because what determines whether they suffer permanent damage isn’t how fast they get to the ER, but how long their body temperature stays above 40°C. ...

Bottom line up front: If your child has a painful bump just below the kneecap, it’s not growing pains. It has a name: Osgood-Schlatter, also known as tibial tubercle apophysitis. And contrary to what many people have heard—it doesn’t “completely go away when you grow up." I’m writing this for parents who have 10- to 15-year-olds currently running and jumping in sports. How to tell if it’s growing pains Growing pains usually happen in both legs, ache in the evening or middle of the night, and have no clear point of tenderness. By the next morning, it’s like nothing happened. ...

Let me say the most important thing first: sarcopenia is not “just what happens when you get old.” It’s a disease that can be detected—and one that actually improves with exercise and diet. This post is written for two kinds of people: you, if an older adult at home has recently started walking slower or can’t open jars; and you, if you’re past fifty and starting to feel your stamina isn’t what it used to be. The second group is actually more important, because the latest 2025 Asian consensus pulled the age to start paying attention forward to fifty. ...

Let’s start with the most important point: If a senior’s shoulder repeatedly swells with fluid, and you can draw out a large bottle every time, it’s mostly not “simple degeneration,” but another disease. This post is for you if you have an older family member whose shoulder repeatedly fills with fluid, has been aspirated several times, but always swells up again quickly. What is this disease? Inside the shoulder is a group of tendons called the “rotator cuff,” which is responsible for hanging the arm steadily in the shoulder socket. As we age, this tendon group can tear completely. After it tears, the humeral head moves upward, and bone rubs directly against bone. The fine calcium salt crystals ground off fall into the joint cavity, which in turn stimulates the joint lining to inflame and continue the destruction. ...

While prepping for the PM&R board examination, I used an engineer’s approach to solve an old problem for myself: how exactly should I practice past exam questions so I don’t forget them right after? I ended up building a small tool called “Exam Navigator,” and figured I’d tidy it up and open it up to share with anyone who needs it. 🔗 Live Demo (built-in demo account, ready to play): https://exam-demo.drpwchen.com 🔗 Source code: https://github.com/drpwchen/exam-practice ...

Last December, I took Neurodynamic Solutions (NDS) Level 1 and Level 2, taught by Michael Shacklock himself in Taiwan. Shacklock is the founder of the clinical neurodynamics system, and having him walk us through demonstrations step-by-step was a rare opportunity. After finishing both levels, I had taken over a hundred pages of notes, and it completely changed the way I look at “nerve pain.” To be honest, very few courses out there truly target nerves for treatment, which is one of the reasons I went out of my way to take NDS. ...

Ever since becoming a resident, looking for continuing education courses has hit the same pain point every time: ultrasound, manual therapy, foot and ankle, neuro, pediatric rehab… The courses are scattered across a dozen society and institution websites. I’d have to refresh the sites every few days, and I was never sure if I’d actually seen a particular post before. Later on, I set up web scrapers for these course pages in my Home Assistant at home to automatically notify me of new courses, and things finally got a lot easier. But realizing I’d be completing residency soon, this little tool sitting at home wouldn’t be able to keep reminding the junior residents. Figuring I had Claude anyway, I just asked it to scrape all the courses and announcements from these 17 rehab-related societies and institutions, aggregate them in one place, update automatically every 3 hours, and put it on the web for everyone to use. ...