Motor learning theories – why should progression stop at physical?

Clinical Reasoning, Conditioning, exercise, Exercise Prescription, explicit learning, extrinsic learning, implicit learning, injury, intrinsic learning, learning, motor learning, non linear pedagogy, optimal loading, performance, Physical Therapy, Physio, Physiotherapy, podcast, rehabilitation, S&C, sport, sports medicine, treatment, youth

Plinths and Platforms

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As a younger physiotherapist, I don’t think I ever consciously paid attention to the psychological aspect or power of my job. By that I mean, I didn’t read any research around it – it all seemed a bit wishy-washy and non-tangible. But quickly you realise thata verbal cue that just clicks with one patient turns intoa complex dance choreography with another.. “No, I just wanted you to bend you knee.. why are you doing the worm?”

I’ve talked before about the clinical reasoning behind exercise progression and regression and in doing so, I skimmed the surface of the addition of intrinsic & extrinsic stimuli. So now I want to build on the concepts of motor learning to underpin that exercise progression.

My inspiration for this blog came from a couple of podcasts by the PT Inquest gang, Erik Meira (@erikmeira)& JW Matheson (@EIPConsult). Well actually, first…

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The Knee: Meniscal Injuries

Knee Meniscal Injuries

The menisci in the knee are a common site of injury and irritation, resulting in pain and loss of function. Tears are common in the meniscus and one approach is to have keyhole surgery to have the tear repaired or removed.   Surgery involves minimal disruption of the cartilage and preservation of the existing cartilage tissue. The evidence suggests a rethinking on the management of meniscal tears. I provide a brief report on my thoughts from clinical experience and the evidence on meniscus injuries and their management. 

Introduction

A meniscal injury is a very common injury of the knee, usually resulting from an intrinsic or extrinsic component.  A sudden change of direction or a tackle usually when the foot is planted or if you sustain a fall such as in skiing or even an accidental trip or slip can cause disruption to the meniscus.  These types of mechanisms of injury can and are…

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Massage: A case for the defence

Another great blog from the chaps at plintsandplatforms

Plinths and Platforms

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Just because we can’t prove what something does, doesn’t mean it doesn’t do anything.

The older I get, the more I read, the less I know. I know that for a fact. But recently I’ve started re-reading around the topic of massage and its place in sport and recovery. And with my critical head on, the one thing that I can consistently critique is the literature. The methodology, the participant population, but not necessarily “Massage” itself.

A good starting point for this defence would be to read the antithesis for this blog, a great blog by @AdamMeakins (There is no skill in manual therapy). Adam makes a valid point that there is not a strong background of evidence to support massage. Agreed. And its worth pointing out that a large, very large, part of my practice is exercise based rehab – I’m a strong believer of “move well, move often”…

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Upper Limb Deep Vein Thrombosis

Upper Limb Deep Vein Thrombosis – rare but out there

The Sports Physio

A few months ago I had patient with a suspected Deep Vein Thrombosis but unusually of the upper limb. As this was a rare case and as I have only ever come across this potentially serious complication once before, I thought it would be a good idea to write the case up and and take a look at the literature around upper limb DVTs.

What is a DVT?

A thrombosis is blood clot that occludes or blocks the normal flow of blood through an artery or vein. The risks of a DVT are not just the restriction of blood circulation causing conditions such a compartment syndrome, but more seriously there is a risk of life threatening conditions such as heart failure, stroke and pulmonary embolisms.

DVTs can occur anywhere (I had a patient a few years ago who had one just in the tip of her thumb) however, they usually…

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A pain in the butt… A guest blog by Dr Chris Littlewood

Piriformis syndrome

The Sports Physio

I regularly hear therapists using the diagnosis of ‘Piriformis Syndrome’ to explain to patients their stubborn buttock and sciatic like pains. However, as usual I question this diagnosis, I question its true prevalence, I question the ability of therapists to diagnose it clinically and I really question those who think it needs to be treated by digging elbows, needles or cricket balls into patients backsides!

Piriformis tweet

And I am not alone in questioning this diagnosis, I recently found this good debate on Piriformis Syndrome in which both sides of over or under diagnosis argument are presented and it makes for good reading. I posted this on Twitter a few weeks ago (see above) and following this Dr Chris Littlewood kindly sent me some work he had done on the subject and so I thought I would share it with you.

Regular readers of my blog will know Chris as he kindly…

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How To Ruin Healthcare

Great precise article on healthcare by @cynicalPT

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Tendons, lets talk about inflammation… A guest blog by Ben Dean

It’s all about the tendon

The Sports Physio

So following on from the ISTS 2014 conference on tendons in Oxford a few weeks ago, there was lots of talk and debate during and afterwards about the role inflammation does or doesn’t have in tendinopathy. One of these debaters was/is Ben Dean. Now regular readers to The Sports Physio will know Ben very well as he has written two other excellent blogs on the placebo effect here and another on pain here. Today Ben writes about the controversial topic on does inflammation exist in tendinopathy and if so, do we need to consider it, so with out further ado I will hand over to Ben…

Inflammation: a subject of great controversy but it shouldn’t be…

Many of the great controversies in science, and in this case tendon research, see a debate polarised into a ‘you’re either with us or against us’ type bun fight. I shall not be…

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