Tim Ireland

Physiotherapy is a profession not a “treatment” PTs are heath care practitioners with 6+ years post graduate studies #physiotherapy

If the knee looks good, it probably is. That includes ROM + dynamometry (don't guess, assess). Local problems cause local inhibition, so good strength makes the knee less likely. Post-activity knee pain + even a hint of hip history? Check the hips. More nickilicphysio.substack.com/p/patients-pla…

The Dunning Kruger concept is universal. Mentoring can help flatten the curve so the fall into the Valley of Despair isn't so big. Encouraging unlearning (or knowledge shelving) as well as learning, in the constant presence of a caseload, can do the rest. open.substack.com/pub/nickilicph…

@NickIlic_Physio @drjohnhaiti What fingers do you use to apply this palp pressure Nick? I use my 2nd/3rd fingers and just generally work my way down and then do the same but more laterally biasing into more of the paraspinal muscles.

@drjohnhaiti That said, young clinicians should be taught how to find the cervical column with the patient in supine, and head rotated the opposite way. It takes some practice to get through the musculature, but then specificity of level isn't usually required.

I think one of the reasons Cervical Spine referred pain is so commonly missed is because it can be completely fine on ROM and functional assessment, UNTIL it is locally and accurately palpated, which often reproduces the symptoms. New Grads/Students rely on the ROM Ax too much.

@adamdobson123 @BillingMartin Never let it stop you Adam. Keep up the great work. Creating content you are passionate about out, and sharing it with the world is something few have the confidence to do!

I've never met him. Had some spats on here in the past. Blocked. Time has past. Let's just all get on and attempt to raise each other up. Or leave each other alone. I am hard at work developing a resource that I can be proud of. Take feedback, always learning. Why someone would want to frivolously bash you out of context is just unbelievable to me. It won't stop me

Waking up to Mr Poulter, who blocked me, slandering me over an individual video of me performing a pSLR. Doesn't name me, knows I can't reply. The only standard part of a pSLR is the straight leg raise it's self. I show one video of countless videos out of context & this person responds in the most gutless, pathetic way imaginable. You talk about bullying. I won't play about now. Unblock me & talk like a human being or leave me do my thing.

Be a clinician not a technician.

“once you give something a label it loses all meaning” Something I remember reading from @thomas_jesson that’s rattled around in my head lately. I think you said that at least Tom! 😂

@thomas_jesson Just bought all 3! Have really enjoyed all the content you have put out over these last number of Years. Keep it up. Love it.

@thomas_jesson Can’t wait!

@adamdobson123 Love the SINSS.

With some minor exceptions, clinical practice decisions are guided by your patients' modifiable factors & things like SIN factor, not best guess pain mechanisms. This has not aided the patient outcome & is kinda abstract. Think RESTORE trial.

@NickIlic_Physio Once I have a finished product I will send it to you to check it out.

@pttimyyc and key joint lines, knee, ankle, thumb CMC, 1st mtp etc

Trying to put together a master document of KEY palpation areas for Physiotherapists (boney landmark, muscle, joint, nerve, etc). If anyone has ANY resources for ANY area and is kind enough to share them with me I would greatly appreciate it! :)

@NickIlic_Physio Yes! Totally. Master the "basics' before you worry about other stuff.

@pttimyyc It's a good idea 👍 Tendons and their attachments. Nerves in tunnels/choke points. Common and red flag bony stress sites. Common fat pad culprits. All the sites where poking it, and being pain-free, had been shown to be reliable at ruling a condition out.

@NickIlic_Physio Great tip! Makes it more fun for the practitioner as well.

"Show your working" Patients enjoy being on the diagnostic journey. I verbalise my assessment for patients and think out loud during the physical exam. "how's that? ____ oh that means it's less likely X because of Y & Z____ what about that, painful? Ahhh ok so that means blah"

The goal is not to just “re-hab” people. It is also to help people “re-inhabit” their lives again.

Your rehab plan is only as good as your ability to articulate it to your clients. Clear. Concise. Simplify. Simplify again. Simplify one more time. Email them a copy.

@DrJN_SportsMed Just thinking about this based on how deep those structures really are!

@DrJN_SportsMed Thanks for the great thread James! Question regarding the DGS. People claim they can accurately dry needle the deep external rotators to “release” muscle/“desensitize” the nerve. In your opinion is it possible to even target these muscles accurately with that technique?

Documented consent for images & data ✅ Thread 🧵 'Deep gluteal syndrome' or piriformis syndrome - a patient's journey Over-diagnosed & a diagnosis of exclusion really... the neurogenic thoracic outlet syndrome of the pelvis? 🧐 It does exist though

Our Neck Series: Part 3 The 3rd of our 3-part #ClinicalInsight series on the neck is on 'the stiff neck' - a standard unilateral stiff neck with rotation. We discuss +ve responses to treatment & propose a simple treatment model. Full piece here: bit.ly/3tUPEcq 🧵1/7

@Flawless_Physio Improved active muscle stiffness?

Progressive daily hopping exercise improves running economy in amateur runners: a randomized and controlled trial: 2023 🔍 Study Overview: 🏃‍♀️🏃‍♂️34 amateur runners (Age: 29 ± 7 years, comprising 27 males). 📆 Over 6 weeks, the exercise group did 5 minutes ⏰ of double-legged hopping daily. The hopping bouts lasted 10 seconds each ⏳, with the number of bouts gradually increasing and rest periods shortening.📈 📊 RE, peak oxygen uptake (VO2peak) 🌬️, and respiratory exchange ratio (RER) 🔄 were measured at three 🏃‍♂️ running speeds before and after the intervention. 🔍 Findings: 1️⃣ 6 weeks of daily hopping exercise can enhance running economy at higher speeds (12 and 14 km/h) without affecting maximal aerobic capacity. 2️⃣ The benefits are pronounced even when the hopping regimen is kept simple and done for only 5 minutes daily. 3️⃣ No reported injuries or side effects from this hopping exercise protocol.👍 🔍 This aligns with earlier research that plyometrics, like hopping, can boost running performance, especially at greater speeds. 🧐 One point of discussion is what's driving these changes. Tendon stiffness, metabolic factors, or alterations in running mechanics? #runners #runningcommunity #runchat

@PTPintcast This is great advice. Thanks.

So, the next time you're PUZZLED that people aren't flocking to your solution, ask yourself... "Have I put as much effort into communicating the solution as I have in creating the solution?" If the answer is NO, start talking/writing/recording...

I feel like everyone uses the "BRIDGING THE GAP" in #physicaltherapy With all of these bridges... why are there still gaps? Wann know why? 👇