In 2021, I have been lucky to have been selected by the authors of the study “Lumbar movement control in non-specific chronic low back pain: Evaluation of a direction-specific battery of tests using item response theory” (Adelt, et al), to participate in their study as an examiner. This participation gave me the opportunity to update my knowledge and understanding...

Experienced clinicians use pattern recognition in their clinical reasoning based on an extensive knowledge base to search for familiar patterns (Feltovich & Barrows, 1984). Pattern recognition offers a quick and effective way to come to a hypothesis as a base to start patient management. However management based on pattern recognition only, may lead to clinicians following their favourite hypothesis...

Have you ever thought about it? This question has probably never been so difficult to answer as at present. When I qualified as a physiotherapist it was easy. Manual Therapy was the mobilisation of joints using passive movement. That was not new. In fact, manual therapy is an ancient discipline that was mentioned as far back as Hippokrates (Pettman...

In a 2019 study, a group of researchers (Barreto et al., 2019), compared and determined the pathological findings visualized in magnetic resonance imaging (MRI) performed on both shoulders in patients with unilateral shoulder pain. The sample consisted of 123 patients (246 shoulders) with the following characteristics: - Chronic intermittent unilateral shoulder pain. - Lateral or anterolateral shoulder pain increases with movement. - Mean...

Why is pain education important? Pain education is a biopsychosocial approach that aims to decrease the threat value of pain by reconceptualizing pain and improving patients’ knowledge about pain.  Broadly, pain education can be divided into two components: pain science education and education about pain management. Pain education can give hope and answers two important questions of patients: “Why do...

Nonviolent communication. Compassion and honesty. Peace. What more could one wish for the world? The process of nonviolent communication (NVC) developed by Marshall B. Rosenberg promotes peaceful talk by excluding moralistic jugements, blame and violence from our language. It includes the understanding and expression of our own feelings, as well as the recognition and expression of our deeper needs, and those of...

My shoulder approach - a journey over the years In my physio-beginnings I’ve learned that in shoulder impingement syndromes there is a mechanical loss of space in between the acromion and the humeral head. Therefore, many forms of treatment have also relied on this paradigm. The focus was on expanding the subacromial space. Active and passive caudalizing. Doctors have sent...

Deadlifts - Is there a place for that in the Maitland concept? Of Course! The deadlift is one of the main exercises in strength training and should also be used in physical therapy to treat patients with moderate back pain . Therefor either the conventional deadlift or an adapted version can be used. First, what’s a deadlift? A deadlift is a technically specified...

There was a recent social media posting that had the conclusion that stretching is „a waste of time“. Since I think the human mankind is a quiet heterogenous sample, we might say that stretching is absolutely fine for a lot of people as it is their way to enjoy moving or using their body. I am surely no stretching advocate...

Introduction As we all face new and unforeseeable challenges due to the current COVID-19 or “Corona-Virus” pandemic, more and more clinical thoughts and implementations turn up. Next to possibilities and applications of new and modern technologies in rehabilitation, like telemedicine, tele-rehabilitation or the use of virtual reality, the patients´ and the therapists´ safety have to be considered, especially when a...

Hey you. Yes YOU! I have some difficulties with my lower back and hopefully you can give me some thoughts and some tips how to handle it. I am 45 years old, 1.72 meters tall and my bodyweight is about 72 kg. I am working as a quality control manager for a pharmaceutical lab, means I am sitting like half of the...

Tracing a zigzag- and a figure-of-8-pattern (with a laser pointer fixed on the head) is an easy and affordable way to test movement sense of the cervical spine. After testing reliability and feasibility of this test(see blog 12/11/2018), there are now results of a comparison between neck pain subjects and asymptomatic participants. Furthermore two subgroups (idiopathic neck pain vs. WAD)...

You have just finished the 3rdlevel of IMTA training. You are interested in further deepening your knowledge in musculoskeletal/manual therapy? Are you looking for an academic recognition of your manual therapy competencies? And you’re ready to go on a new adventure? Now it's possible...we did it!! The Sheffield Hallam University master degree in advanced clinical practice musculoskeletal management requires to obtain...

Recognizing red flags or precaution with a screening process for further treatment is possible already after the first course week in the Maitland Concept! One of the most important things in teaching the Maitland Concept is that the students will be able to transfer what they learned to the clinical ground in their daily practice. At the end of the first...

We all learned that pain is a quite bad indicator for tissue damage. Despite this, we often hear/read that therapists tend to recommend painfree exercises for patients with chronic musculoskeletal disorders. Ben Smith and colleagues performed a systematic review with meta-analysis and compared painfree vs painful exercises in those patients. They found several papers including patients with achillodynia, shoulder...

Goal orientated progression of treatment is most likely one of the most important issues in rehabilitation in general as well as in musculoskeletal management. Several models and modalities of treatment progression have been proposed in literature touching different realms of rehabilitation. Elite sports specific rehabilitation uses, for example, strength and conditioning elements but reconditioning elements and global as well...

Musculoskeletal therapy (NMT) or better neuromusculoskeletal therapy is given an IFOMPT seal in most countries. As a specialized form in physiotherapy, it has a clear competence profile and therefore has a special place in the healthcare system in most countries (www.ifompt.com). In the last decade, the NMT has made a significant paradigm shift. Dominant "hands on techniques" have been...

With great support from Markus, Rebecca and Julia, it was possible to publish one part of my master thesis in an article. We evaluated the intra- and inter-tester reliability of a movement sense test and its clinical feasibility. Tracing a zigzag- and a figure-of-8-pattern (with a laser pointer fixed on the head) is an easy and affordable way to test...

Previous research was conducted under rather controlled conditions not conforming to the procedures usually performed in a manual therapy treatment. Physiotherapists (PTs) in the present study focussed his or her mobilisation or manipulation on the actual area of impairment of each participant. Thus, this study is the first one that investigates the effect of these different techniques on the...

The movement diagram; Geoff Maitland’s heritage, does it hit the nail on the head? (if you double click on the inserted images you will find the enlarged version, this should facilitate reading) I would like to start of with a quote from Maitland’s peripheral manipulation fourth edition edited by the late Kevin Banks and Elly Hengeveld 2005; “The movement diagram...