Adam Stenman

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Adam Stenman

Adam Stenman

@AdamStenman

Educator of Swedish primary care physios. 9:27 Ironman.

Uppsala, Sverige Katılım Kasım 2011
1.6K Takip Edilen636 Takipçiler
Adam Stenman
Adam Stenman@AdamStenman·
It's true, and that goes for plenty of other msk issues as well. But all RCTs show non-responders and hyperresponders. A very regular challenge clinically is to try to get a poor responder to a better responder. Looking at a large dataset and saying that nothing outperforms the basics you already do is not too helpful for the poor responder. Sometimes you can find things to tweak in the physical program and sometimes it's lifestyle factors that's your best bet.
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Greg Lehman
Greg Lehman@GregLehman·
@AdamStenman And if we are honest about the research “good loading programs” don’t outperform any other type of loading (stretching) or “off loading” (orthotics)
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Adam Stenman
Adam Stenman@AdamStenman·
There's not many conditions where I really try to advocate for patients to REALLY consider surgery. A symptomatic spondylolysis+-spondylolisthesis is absolutely one of them. Sometimes it's just not possible to create enough stability with physiotherapy. I'll gladly help patients through conservative care for as long as they are motivated but some simply does not improve enough to be able to do what they want, sometimes that's even just sitting at a dinner table, without significant pain and paresthesia. That said, lumbar fusion is still no joke and recovery is often long and slow. I hope Rich will continue to improve and I absolutely believe he will run again in the future.
richroll@richroll

You are wrong and this tweet is irresponsible. Sure, many conditions can be resolved short of surgery. In my case I spent a decade exploring every alternative remedy you can name with the top people in each respective discipline—from PT to PRP, peptides and every progressive protocol you can put a label on. Yes, I did all the glute activations. Yes, I read Sarno’s book. Yes, I saw all ‘the guys’ all my LA & NYC friends insisted are uniquely suited to heal me. Nothing moved the needle. My pain increased and numbness expanded. Surgery solved it. I wish I had done it years ago. I would have avoided years of unnecessary suffering. Sometimes surgery really is the right thing to do. In my case it was 100% the best option. An option I would have benefitted from taking advantage of years ago but didn’t in part because of people like you who associate a very personal decision to undergo surgery as if it is a shameful moral failure.

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Adam Stenman
Adam Stenman@AdamStenman·
Well I do some tests to make sure it's not anything else and to inform rehab. Admittedly usually not too in depth initially. But for example checking MTP-1 ROM is a good idea if you want to try the popular heel raise variation with MTP-1 in extension. Number of reps until failure is interesting to create a good loading program and to follow up. I would probably also be more likely to recommend orthopod input if they have some acquired flat foot, if not I'll just tape around the heel. Surely I'm also against meaningless tests that will not inform diagnosis or influence treatment but no reason to call any clinical testing a useless charade.
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Greg Lehman
Greg Lehman@GregLehman·
@AdamStenman Why clinical tests are relevant to create a rehab program for plantar fasciitis? I see a lot of testing here that doesn’t inform practice and would change nothing if you followed basic guidelines or created a compressive program.
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Adam Stenman
Adam Stenman@AdamStenman·
@a_dicander Samma här. Min ADHD var utom kontroll. Hade inte ork för något, glömde allt, gick ner i tid på jobbet för att sova och vila mer. Hade inte ens jättelågt ferritin, det var typ 26 eller så. Förbättrades drastiskt av en infusion.
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les chants du cygne
les chants du cygne@a_dicander·
@AdamStenman För flera år sen trodde jag min psykiska sjukdom hade förvärrats plötsligt men det var blodbrist till följd av järnbrist. Fick panikångest flera gånger om dagen, vilket jag aldrig haft så ofta och mycket innan. Behandling hjälpte. Sökte alltså akut psyk egentligen.
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Glagrisen
Glagrisen@Grisknorren1·
Hittade bild på nätet - det finns alltså medicin mot hjärnbrist 😁🙌🏻
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Adam Stenman
Adam Stenman@AdamStenman·
A long time ago I made a diet plan for my mum (60 year old, sedentary, 160cm) and sister in law (35y, 180cm). They ate avg 1200 and 1800 calories daily for 3-4 months and my mum lost 8kgs and sister in law 12kg. None of them had done any such planned and persistent effort at weight loss before, just crash diets. I used mostly foods that they didn't have to weight themselves to minimize "user error". Initially they both thought they ate "so much!!" but ofc it got gradually tougher and tougher to stick to the plan and in the end they were quite sick if it. But of course they did not defy physics and if you'd ask them before this if they had a hard time losing weight they would have said so. The first few weeks they didn't even believe they would lose weight because it was so much more food than previous crash diets, but during their diets they learned a lot of how to cut and they have kept most of the weight of for like 10y now.
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Jason Helmes
Jason Helmes@anymanfitness·
"1200 calories is starvation" is a psyop. If you are: - a woman - have a desk job - short - over 40 (perimenopause territory) Your maintenance calories are between 1500-1600 If you want to lose fat, you need to create a deficit somehow
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Adam Stenman
Adam Stenman@AdamStenman·
A long time ago I made a diet plan for my mum (60 year old, sedentary, 160cm) and sister in law (35y, 180cm). They ate avg 1200 and 1800 calories daily for 3-4 months and my mum lost 8kgs and sister in law 12kg. None of them had done any such planned and persistent effort at weight loss before, just crash diets. I used mostly foods that they didn't have to weight themselves to minimize "user error". Initially they both thought they ate "so much!!" but ofc it got gradually tougher and tougher to stick to the plan and in the end they were quite sick if it. But of course they did not defy physics and if you'd ask them before this if they had a hard time losing weight they would have said so. The first few weeks they didn't even believe they would lose weight because it was so much more food than previous crash diets, but during their diets they learned a lot of how to cut and they have kept most of the weight of for like 10y now.
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Paulo Costa
Paulo Costa@BorrachinhaMMA·
Today I achieved it. MY Black bull 🐂 I come from an underdeveloped country—a Third World nation with a low HDI—an HDI comparable to that of countries like Algeria or Gabon on their very best days. There in Brazil people’s shit on streets and u can’t walk safely with ur iPhone cause they gonna stab u in the belly.My father died when I was very young, yet he gave me exactly what I needed in terms of experience. My mother, though very poor, raised two children amidst great hardship, yet she did so with honor. I am the fruit of a miracle that succeeded; for this, I am grateful for everything I achieve. I am not worthy of Divine mercy, yet Your grace, O God, is sufficient for me.
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Adam Stenman
Adam Stenman@AdamStenman·
@zenbrainest A very tolerable treatment in patients with treatment resistent depression, giving a clinically meaningful effect for many participants. I'll take it as a W.
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Jem Arnold
Jem Arnold@jem_arnold·
Pick a threshold, whichever one you want! Getting a number is cheap. Knowing what the number means and what to do with it is far more valuable
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Adam Stenman
Adam Stenman@AdamStenman·
@GregLehman Surely, but the "everything's fine" rhetoric isn't really helpful when one tries to figure out how to modify.
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Adam Stenman
Adam Stenman@AdamStenman·
@TDekkersPhysio Nicely done! VOMS is a great test that everyone should practice to perform clinically in patients with head/neck trauma and persistent headache, dizziness/nausea and brain fog. Often these symptoms are seen as benign/functional for some reason.
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Thomas Dekkers | Spinal Specialist Physiotherapist
SACCADES during smooth pursuit testing 👀 Patient with persistent symptoms 2 years post-RTA: • Headaches • Brain fog • Neck and back pain On smooth pursuit (neck neutral), note small corrective eyes saccades at end range. In isolation, these can be normal. However, reproduction of headache and nausea during testing is not typical (as occurred in this patient post-testing) and may reflect altered sensorimotor control. We then used the test therapeutically (within tolerance ) 🎯 alongside cervical, lumbar and global conditioning. 📉 Outcome: ~70% symptom reduction over 6 months Complete resolution in these presentations is often difficult. He still experiences headaches with stress and fatigue - But he now manages triggers more effectively. ----- Recommended Reading from Julia Treleaven (2024) — pubmed.ncbi.nlm.nih.gov/39307043/ ----- Thank you to this patient for agreeing to share these videos. Please comment respectively.
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Adam Stenman
Adam Stenman@AdamStenman·
@skitten_hund @made_in_cosmos HSP is a distinct presentation of autism no doubt about it. The rigidity HSP's show about the topic is kind of a tell as well.
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skitten_hund
skitten_hund@skitten_hund·
Yes, this is called HSP, highly sensitive person, and I have it. I thought I was just retarded but my therapist told me it's a different spectrum in itself. You take a thousand years to make a decision because you're thinking of all the moving parts and all the consequences, extremely sensitive to the micro expressions of others, outgoing, et cetera. Welcome to the club! 🤍🙏🏻🌹
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Maria Made in Cosmos ✨
Maria Made in Cosmos ✨@made_in_cosmos·
is there something like the opposite of autism where you're exceptionally skilled at reading people and love being around them, and instead of perceiving the world through categories you see it all as divinely connected and full of signs everywhere
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Adam Stenman
Adam Stenman@AdamStenman·
@JeromeOfPrague1 @bryan_johnson Tendon issues can be purely a diseased adaptation to high load, like in a fit and healthy runner. They can also be rheumatic presentation, common in spondylitis. But a very large percent of tendon issues, especially in those over 50, are largely driven by metabolic disease.
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Tim the Enchanter
Tim the Enchanter@JeromeOfPrague1·
@bryan_johnson Ya know what causes thickened Achilles tendons? Running a lot, like super high volume. You know who has sudden cardiovascular events? Older ultra-runners and marathoners. correlation is not causation.
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Bryan Johnson
Bryan Johnson@bryan_johnson·
Your ankle is a window into your heart. A new study found that patients with a thickened Achilles tendon were nearly twice as likely to experience a major cardiovascular event within three years of a coronary stent procedure. An observational study retrospectively compared outcomes for 1362 participants with coronary artery disease undergoing PCI, examining differences between patients with and without Achilles tendon thickening (defined as ≥8 mm in men or ≥7.5 mm in women). Patients with thickened Achilles tendons faced a 99% higher risk of major adverse cardiovascular events (MACE) over three years (28.4% vs 17.9% for those with and without thickening, respectively). (MACE was defined as all-cause death, nonfatal myocardial infarction, stent thrombosis, stroke, and clinically driven target-vessel revascularization.) Thickened Achilles tendons were more prevalent in patients with the more severe, rapidly developing, and less stable acute coronary syndrome (ACS) (24.3% had thickened tendons) compared to patients with the more stable chronic coronary syndrome (CCS) (13.7% had thickened tendons). Among ACS patients, having a thickened Achilles tendon was a significant predictor, increasing the risk of a recurring major cardiovascular event within the next three years by 4.7 times. The findings suggest that Achilles tendon thickening may serve as a prognostic marker in patients with cardiovascular disease, with special value in predicting early recurrence of major adverse cardiovascular events in patients with acute coronary syndrome. While the analysis did not include blood cholesterol levels and does not establish causation, one plausible explanation is that Achilles tendon thickening reflects cumulative exposure to elevated LDL cholesterol over many years. This may be especially relevant in familial hypercholesterolemia, a genetic disorder characterized by markedly elevated LDL cholesterol, in which Achilles tendon thickening is also used as a diagnostic criterion.
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Adam Stenman
Adam Stenman@AdamStenman·
Many tendinopathies are largely metabolic in origin. Just like OA. Still responds to directed loading but I will not be surprised if GLP-1's will be a breakthrough in msk medicine in the next 5-10 years. I even believe they will be able to create selective GLP agonists that have only effects on connective tissue receptors.
Bryan Johnson@bryan_johnson

Your ankle is a window into your heart. A new study found that patients with a thickened Achilles tendon were nearly twice as likely to experience a major cardiovascular event within three years of a coronary stent procedure. An observational study retrospectively compared outcomes for 1362 participants with coronary artery disease undergoing PCI, examining differences between patients with and without Achilles tendon thickening (defined as ≥8 mm in men or ≥7.5 mm in women). Patients with thickened Achilles tendons faced a 99% higher risk of major adverse cardiovascular events (MACE) over three years (28.4% vs 17.9% for those with and without thickening, respectively). (MACE was defined as all-cause death, nonfatal myocardial infarction, stent thrombosis, stroke, and clinically driven target-vessel revascularization.) Thickened Achilles tendons were more prevalent in patients with the more severe, rapidly developing, and less stable acute coronary syndrome (ACS) (24.3% had thickened tendons) compared to patients with the more stable chronic coronary syndrome (CCS) (13.7% had thickened tendons). Among ACS patients, having a thickened Achilles tendon was a significant predictor, increasing the risk of a recurring major cardiovascular event within the next three years by 4.7 times. The findings suggest that Achilles tendon thickening may serve as a prognostic marker in patients with cardiovascular disease, with special value in predicting early recurrence of major adverse cardiovascular events in patients with acute coronary syndrome. While the analysis did not include blood cholesterol levels and does not establish causation, one plausible explanation is that Achilles tendon thickening reflects cumulative exposure to elevated LDL cholesterol over many years. This may be especially relevant in familial hypercholesterolemia, a genetic disorder characterized by markedly elevated LDL cholesterol, in which Achilles tendon thickening is also used as a diagnostic criterion.

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Adam Stenman
Adam Stenman@AdamStenman·
@parakeetnebula That flat, slow way of talking reminds me of people who smoke plenty of weed and when questioned about it will reply something like "it's impossible to die from weed, actually it's been proven to reduce lung cancer"
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Adam Stenman
Adam Stenman@AdamStenman·
@AgnesWold @moderaterna Och även om man hittar en cancer som "borde" behandlas hos en 82-åring, vad skulle det göra med livskvaliteten kvarvarande år? Många i den åldern är inte alls ängsliga inför döden utan är lyckliga över livet de levt och önskar sig verkligen inte en krävande behandling.
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Agnes Wold
Agnes Wold@AgnesWold·
@moderaterna något tidigare om man redan är 82 år, eftersom den förväntade kvarvarande livslängden kanske är fem år. Man måste beakta alla andra dödsorsaker som ansamlar sig efter 75 års ålder
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Moderaterna
Moderaterna@moderaterna·
Idag kallas inte kvinnor som är över 75 år till bröstcancerscreening, även om var fjärde bröstcancerdiagnos upptäcks hos kvinnor som är 75 år eller äldre. Det är helt orimligt. Enligt bröstcancerrapporten från 2025 skulle dödligheten minska med 30 procent om äldre kvinnor fortsatt fick kallelser till regelbunden mammografi. Därför vill vi nu slopa åldersgränsen för bröstcancerscreening. Ålderism hör inte hemma inom sjukvården. Kan vi rädda fler kvinnors liv, då ska vi göra det. Det är både rätt och rättvist.
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