Health Smartz Online

[Howard Luks MD @hjluks]

https://t.co/leSe5MO95p

[Health Smartz Online @Health_Smartz]

@DrJN_SportsMed Love it - a lot of fun

[Health Smartz Online @Health_Smartz]

Have seen this in the clinic

[James Noake @DrJN_SportsMed]

Consent✅

Runner, cyclist

ACL reconstruction with LET (lateral extra-articular tenodesis) 1 year ago

Good progress with rehabilitation – however at final stages, intrusive lateral clicking & aching on repetitive 30 degrees flexion into full extension with jogging and more intense bike work

OE -

Similar picture to ITB friction syndrome; palpation pain close to lateral femoral epicondyle, positive Nobles compression test
Negative fat pad compression
No meniscal or PFJ signs

MRI (axials T2) –

Oedema / high signal around the LET (in this case, technically a portion of the ITB folded back under the LCL and sutured down)

POCUS video QR code (second half is dynamic flexion / terminal extension assessment) –

Anechoic fluid noted around the LET interface just inferior to the suture (bright) – is this suggestive of inflammation and LET ‘impingement’?

US guided diagnostic injection with LA at this fluid interface 100% abolished pain on incremental treadmill test

It’s possible that impingement is under-reported or recognised; that aside, new lateral knee pain after ACL reconstruction can often be patellofemoral or fat pad in origin due to the change in joint biomechanics and loading patterns, as well as popliteus tendinopathy pain – have these on your radar before thinking about more esoteric causes

Research link –

SANTI group – three times reduced ACL graft failure with LET
https://t.co/cZZtKJUijA

[Health Smartz Online @Health_Smartz]

@DrJN_SportsMed I learnt from Dr Bruce Reid (Essendon Football Club in Melbourne) to always check the syndesmosis and the base of 5th metatarsal in ankle sprains

[James Noake @DrJN_SportsMed]

Radiculopathy, surgical infection & managing it - a clinician's real world experience & observation:

1. Radicular pain - for some - is different level pain; like a rat gnawing your thigh & shin from the inside whilst a poorly gauged UV sun bed is applied externally
2. With these levels of pain, I couldn't care less about the foot drop; it doesn't even come in to the equation; however operating early makes sense esp with objective motor loss
3. Disciitis is hugely rare as a complication. Think re immunosupression, previous high doses of local region CS
4. As I've said a million times before, discogenic somatic pain behaviour is myriad - belt like, corset, groin thigh - my personal pain is worst in groin & thigh
5. If you've had a unilateral discectomy & you develop symmetrical pelvic pain, you've got an infection until proven otherwise - get blood markers at least
6. Disciitis pain is agonising - and equal to having a long bone fracture that can't be immobilised effectively - things start to fuse overnight then you move early am and you want to kill yourself
7. Early physio input is pointless - sleep, eat well, get your head in the right place. Give yourself the time it needs. I didn't.
8. Pain will lag well behind blood & imaging markers improving. Don't give up.
9. It's almost impossible to gauge / titrate load levels vs carry over effect the next few days.
10. Prioritise your mental - not physical health. You don't really have a choice.
11. If the disc infection is aggressive enough, the VBs will auto fuse (see image); but need to monitor which may it uses rg kyphotic - which in itself may require correction at a later date ) esp if causes foraminal stenosis
12. It takes time - I'm not patient!

[Chris Maher @CGMMaher]

Spinal cord stimulation patterns of care, re‐interventions, and costs for private health insurers, Australia, 2011–22: a retrospective observational study - Jones - Medical Journal of Australia - Wiley Online Library https://t.co/I9PWRbkgNk

[Professor Jeremy Lewis PhD FCSP @JeremyLewisPT]

📢📢New paper:
An international consensus on the etiology, risk factors, diagnosis and Management for individuals with Frozen Shoulder: a Delphi study
https://t.co/HNNITTZ5d7

[Health Smartz Online @Health_Smartz]

@myles_physio @tendonpain @EdithCowanUni @MHS_ECU @notredameaus @LaTrobeSEM @apaphysio @TheAusBallet @VicInstSport @JOSPT Well done! That augurs well for TendinsA

[Health Smartz Online @Health_Smartz]

@myles_physio @EdithCowanUni @molly_physio @apaphysio @BradyDGreen @clatella1 @tendonpain @AndreaBMosler @MHS_ECU Congratulations @molly_physio ! Well done - you described this so well at the @sma conference

[Brukner&Khan's ClinicalSportsMedicine @BruknerKhan]

Happy to pop this into the thread again for those who missed it. ❤️

[Myles Murphy @myles_physio]

Breakdown of our latest research on how people with hip OA have impairments in the neural drive to activate their leg muscles 👇🏻

https://t.co/OMjJogdiCG

[Health Smartz Online @Health_Smartz]

@PhysioMilly @ITFTennis Well done Milena - now even more players will benefit from you expertise

[Achilles Tendons @Seth0Neill]

Rehab framework from @colingriffin
@IAS10_2024 #IAS10_24

[Health Smartz Online @Health_Smartz]

Hey Aus Health Authorities - let's fund this!!

[Sean Docking @SIDocking]

🚨OUT TODAY, OPEN ACCESS🚨

Structured education and exercise therapy is COST-EFFECTIVE in delaying/avoiding joint replacements in those with lower pain levels (??? low-value), saving the health system $100M annually!!!

https://t.co/nnA5yebTBL

[Health Smartz Online @Health_Smartz]

#PhysioMilly has loads of high level tennis experience! Highly recommended

[Milena Mirkovic @PhysioMilly]

Where are we located?👇

📍 London Bridge
📍 Belgravia
📲 Online

Get in contact now to start working together 💪 stay tuned for more updates surrounding our clinics 👀

#TennisPhysio #Locations

[Health Smartz Online @Health_Smartz]

Woohoo! Congratulations Myles. So thrilled for you!

[Myles Murphy @myles_physio]

I am so grateful to be awarded >$2million from the @nhmrc, @WAGovernment, @WA_Police to improve health and performance outcomes in #Police Force recruits.

This would not have been possible without the collaboration of an all-star international team!

https://t.co/FJA14582hw

[Health Smartz Online @Health_Smartz]

@PhysioMilly Best wishes Milena!!

[Milena Mirkovic @PhysioMilly]

To find out more about working with me as your tennis physio please get in touch via message or through my website (see link in my bio) ⬆️

Ready to work with those who want to return to play or take their game to the next level 💪

#TennisPhysio #ProTennis #TennisTour

[British Journal of Sports Medicine (BJSM) @BJSM_BMJ]

⚠️ Ice challenge in recent summer olympic games ❄️

NEW #Editorial covering:

1️⃣ The rising consumption of ice 📈

2️⃣ When to use post exercise cold water immersion💧

3️⃣ The environmental impact 🌍

#FREE READ 👉 https://t.co/EsoO99B0CG