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...

A recent article reports a synthesis of literature concerning PAIVMs & stiffness, including the results of different modelling studies as well as in vivo measurements. Spinal PA movements behave ‘as if’ there are limitations of local segmental mobility and are large enough to be perceivable by manual palpation: A synthesis of the literature, Tuttle N, Musculoskeletal Science and Practice, 2018. Have a...

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...

Ha! There was not much going on our Blog recently, but here we have the long-awaited food for thought! Rolf has faced us with some very important questions, going much in depth to the topic of Movement Diagram - an issue closely connected with the manual therapy world.  He makes us look at it from many different angles and invites for discussions…...

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...

“You’re not seeing the world as it is, you’re seeing the world in terms of your ability to act.” This is one of my favorite quotes in medical science and was made by Jessica Witt, professor for cognitive psychology. In the Müller-Lyer illusion shown in the title picture, perceived length can change by adding different arrows to the same line....

Autonomous Practice: The good news is that Physiotherapy is becoming an autonomous profession in more and more countries around the world. I understand that Physiotherapists in Switzerland are currently looking into the possibility of gaining direct access for the profession and congratulations have to go to Poland where our colleague Zbyszek Wronski had a large role to play in progressing...

self-treatment

It is the day after…. The day after Blue Monday. The, so called, most depressive day of the year. If you believe the story, everybody with great ideas/wishes for the coming year like losing weight, quit smoking, drinking less beer/wine have already given up hope in obtaining this goal. My wish for the next year, which I haven’t given up...

In a study recently published (Herzog, Elgort, Flanders, & Moley, 2017), the same patient, a woman, 63 years old, with a history of low back pain and L5 radicular symptoms in her right leg visited 10 different imaging centres in a period of three weeks. The findings of the MRI´s were compared to a reference exam (two of the...

 Hey guys! You all have a mobile phone, don’t you? Well! You’ll find here a few apps that might be of use in your daily work!   Nerve Whiz   Is there a neurological pattern you do not recognize? Can’t you remember which sensitive areas a nerve refers to? Do you need to have a look at the brachial plexus? Created by the Michigan University, Nerve Whiz...

SYMPHYSIS SYNDROME

Our Assumes related to clinical patterns and whose presentation are influenced through the constitution of the patient, the age of the patient, „norms“, which the therapist has learned, clinical patterns, the work eperience of the therapist and many many more factors. These factors are not very instincted if you are a beginner and have to evolve. If the work experience...

"Functional demonstration (FD)” Early in the P/E process, there is a point of “functional demonstration (FD)”. Let’s say our patient complains about the pain in the scapular region during rotation to the right. We can ask the patient to show us the movement (MVT). The 1st aim of FD is to get an asterisk. But if there is more than...

Lateral elbow pain; finding the pain driver? A need for dualistic reasoning! Lateral elbow pain and movement dysfunction has been subject to a great amount of studies with a wide variability of produced results (5,9). A vast number of local structures and local biomechanics have been accused of being the potential peripheral, structural, driver of symptoms, either through ultrasonographic differentiation...

Screening tests, more questions than answers? A whole series of different screening proposals are being used in musculoskeletal medicine for all sorts of different reasons. The offer goes from red flag screening to sports related pre-participation screening. Many of the screening tests are though not universally accepted and conflicting evidence is frequently found in literature (2). Below I’ve listed up some...