Latest from our blog

Do you care too much?

How far will you go for your patients? Yes, you can enjoy patient’s company.  Yes, you can desire to give them the best possible care and yes, you want to act in their best interests.  But remember it is ultimately the patient who controls the relationship.  Smothering with care can produce resentment, poor compliance and appear unprofessional... [Read more of this post]

The Patients Perspective

It is said that 106,000 patients or more die each year from adverse prescription drug reactions.  Although there are a growing number of people disillusioned with the “pill-popping” culture there is still limited awareness of the services that Physiotherapists provide. There are many reasons why people are resistant to seeking treatment and today... [Read more of this post]

The Myth of Evidence Based Practice

Today’s post is a subject close to my heart. It epitomises the eternal battle between academics and clinicians and the  realities of guidelines implementation  and clinical practice. It’s a summary of a 10 year old article but is bravely written and doesn’t pull any punches ………. How do we practice physical therapy?... [Read more of this post]

The First Consultation

The first consultation has been defined as part of the “cycle of care” with therapist and patient on two  ends of a spectrum working towards a common goal.  The patient is focused on the problem for which they are seeking help and the reasons why they have chosen to seek care at this time. These reasons include: Their understanding of the possible... [Read more of this post]

Musculoskeletal Radiology – New Developments

Two novel musculoskeletal radiology applications came to my attention at a recent conference.  The first related to MRI and the second to Ultrasound scanning using Doppler blood flow measurement. MRI and Subtle Shoulder Pathology The focus of this discussion was from the perspective of the radiologist diagnosing pathology with imaging and correlating... [Read more of this post]

Scapular Control

The role of scapular control impairment in shoulder impingement and neck dysfunction has been widely discussed over the last decade.  A recent position statement was published in the Journal of Orthopaedic and Sports Physical Therapy  (November 2009) outlining the current state of the art.  There were three broad areas of discussion including the... [Read more of this post]

Headache, Orofacial Pain and Bruxism

The International Headache Society originally classified 126 different types of headaches and orofacial pain.  In primary care 3 sub-classifications of headaches allow useful patient categorisation. Migraine Tension type headache Cervicogenic headache. Orofacial pain and Bruxism often compound the diagnosis of headache as there maybe overlapping... [Read more of this post]

Vertebral Artery Dissection

Clinicians using manipulative therapy will be well aware of the potential for vertebral artery dissection and the testing protocols to evaluate competency of the vertebral arteries.  This is considered mandatory as a prerequisite for cervical manipulation on the basis that it can screen out potentially vulnerable patients. Much of the literature... [Read more of this post]

MYOFASCIAL PAIN SYNDROME

The prevalence of myofascial pain syndrome and the clinical observation of trigger points is a phenomena which most clinicians are familiar with.  Since Travell &  Simons in the 1950’s documented pain referral patterns unique to muscle there has been contentious debate regarding the legitimacy of these pain referral patterns, the true nature... [Read more of this post]

Whiplash Treatment

The spectrum of whiplash treatment is a reflection of the diversity of pathology which is encountered and may in turn lead to a variety of clinical manifestations now referred to as whiplash associated disorders (WAD). The initial guidelines on WAD were formulated in 1996 by the Quebec task force. This patient group includes: 27% of subjects who still... [Read more of this post]