Simon Ruse

@northwoods1980 100 per cent agree with you. Risk asymmetry. Love this post. Care is reducing worry, that is worth something.

But these hard-core, anti-imaging Physio‘s, if it’s their back, they can do what they want and keep themselves in the dark guessing, I will also never understand the love w nonspecific LBP We don’t do serve for headaches, abdominal pain and most else. Happy Friday

7 mos of S1 radicular sx. Finally got MR. I honestly don’t care what population guidelines say if it’s my back, I will pay what I need to so I at least have a better understanding of what we’re dealing with. Or an understanding of what we’re NOT dealing with.

@hjluks Rower?

@hjluks STIR may be important on MRI for stress reactions. Oblique XR and SPECT my vote too.

@northwoods1980 It’s unlikely that surgery is the best option in this case, IMO.

If I went to my GP for support with any chronic condition, I would get the following subsidised by Medicare: - Surgery - Imaging - Opioids - Injections You know what Medicare would not subsidise? - An effective group education and exercise program Pls fix this @Mark_Butler_MP

@thebricksession @DrJN_SportsMed Consider @tendonpain too.

Hey @DrJN_SportsMed I’d like to invite you on my podcast to discuss what you do and to offer my listeners the most up to date protocols for tendon issues. I understand if you’re busy. Thanks in advance.

@northwoods1980 You can help a back pain patient without them. It is one of many options to teach movement control and awareness; decrease fear of, and experience movement and load the spine and ab muscles in a relatively safe way. They are legitimately good exercises, at risk of being oversold.

Where does this whole “McGill big three” fit on the b.s….oversold to…legitimacy spectrum?

@northwoods1980 Interesting case. I wonder if the remaining fibres can adapt to a level better than or comparative to ‘cut and repair’. Needs a quality re-loading program. Likely better non-operatively managed with optimal loading IMO.

1 yr later (now 3T Canon vs 1.5 GE for prior but both T2FS w different fat sat)…shows some repair, less bone edema and footprint cysts…but still symptomatic.

18yof w partial thickness articular sides SS tear, minor bursal fraying, pain…positive impingement testing and SS exam testing…not sure sporting info. Sent to PT…

@GregLehman @DrJN_SportsMed @northwoods1980 @bretcontreras Train wreck of personal attacks on Greg…

@DrJN_SportsMed @northwoods1980 @bretcontreras It was me. It was bloody horrible

I asked my wife if she wants to travel to Melbourne and attend a “Glute conference”. That didn’t go well. In all seriousness, is this for real? Glute “conference”? I wonder if my CME funds will apply for this?😂

@DrChrisBarton @LaTrobeSEM @GLAD_Australia @HSkouteris Would love to chat you about this @DrChrisBarton if you’d like to. I have an impression we (our clinic) can (and is) doing this. It’s within a complex multi-variate scenario. Funding model is a barrier.

Looking forward to discussing what our @LaTrobeSEM team has learnt through our experience with @GLAD_Australia - how do we facilitate implementation of #highvalue care. Also very excited to learn from @HSkouteris too! Feb 17, join if you can! 👇👇👇👇👇

@RodWhiteley Bring the funk.

If there was one thing I'd like to make compulsory, it would be listening to some funk at least every 8 hours Wouldn't need much, just a few bars, but the world would definitely be a better place. Prove me wrong #bootsycollins

LOCALISM "At Fed level, libertarian; state, Republican; local, Democrat; family/friends, socialist." @ggraham citing broth. Vincent.

@PalingClaire 👏👏😁

Thanks if you made it to the end :) Interested to hear about people's opinions & other reading!

Ever wondered if you sport is going to wear your discs out or make them stronger? I did some reading to figure it out. Follow the thread – Your thoughts and opinions welcome as always!

@AdamMeakins IMO, if: 1. seeding the thought that exercise won’t necessarily make pain worse, and 2. improved frontal plane mechanics and sagittal plane power are more important that specifically loading glutes. Sham exercise may appear as good! The treatment hierarchy for GTPS differs to AT

A RANT ON SHAM REHAB Just because some studies show sham or placebo exercise can be as effective as specific or strengthening exercise for some MSK conditions, eg pubmed.ncbi.nlm.nih.gov/29715073/ This does NOT mean we can start giving sham exercises or just anything you feel like 🤦‍♂️

@AdamMeakins Not true. Although some would posture to want it that way.

Just had this sent to me by a physio in Australia! 😲 So have most Aussie physios decided to abandon ‘hands off’ treatments and pass them all to exercise physiologists? Are physios in Australia now only ‘hands on’? If so thats really disappointing and saddening!

@DrJohnOrchard Potentially afraid of rorting of the simple solution? Could effective bureaucratic oversight be welcomed by genuine businesses wishing to provide such care? Tip: pay the expert practitioners and business owners more than bureaucrats! Measure service growth not outcome initially.

$6 million dollars to look at the relationship between psychotropic drugs & genetics🧐...but we know that Exercise both prevents & treats mental illness. Aust govt still charges GST on Exercise Physiology & still gives SEM patients a lower Medicare rebate than they got in 2009.

@JohannesK97 @AdamMeakins Dear patient, I’m glad you don’t need surgery because we don’t do that anymore. You’ll still be in pain for a bit. But, don’t worry, it’s better than what we used to do! Not amazingly reassuring... ‘here’s the best path for you to regain full functionality and minimise your pain’

@AdamMeakins Just my thoughts. We tell our patients their x-ray findings are not as important as once thought. But not having the changes are better? Kinda feel the two messages go against each other IMO. Thoughts?

If you want a healthy spine... get up of your arse and use it more! New data shows physical INACTIVITY has a strong association with spinal disc degeneration! sciencedirect.com/science/articl…

@hjluks @Brad_Beer @tomgoom Hey @hjluks how did you go with this one? How long after she stops running does the ache continue. Any chance it’s PAES?

Associational study - physical activity clearly marker of good health and perhaps good health practices. People who exercise regularly amore likely to make better choices in other aspects of healthy living. Doesn't exclude possibility of direct effect of exercise on brain health

INJECTIONS💉for Rotator Cuff Related Shoulder Pain If you are considering one, recommending one, about to do one have a read of: ncbi.nlm.nih.gov/pubmed/27469590 bjsm.bmj.com/content/early/… In @timcook80's review, one study demonstrated good results at 26 weeks with lidocaine and saline🤔