Clinical Reasoning

The Core Stability Problem

The Core Stability Problem

When I refer to “Core Stability” I mean teaching patients isolated contractions of transverses abdominus and multifidus. This is then usually progressed (depending on the practitioner) to having the patient contracting these muscle in functional movement patterns. The end aim being reduction of pain and improvement in function. From my perspective the “core stability” direction started following […]

By November 2, 2014 2 Comments Read More →
In Pursuit of Pathology

In Pursuit of Pathology

I have recently attended a couple of seminars that have mentioned how newer and better MRI units will begin to be used in the attempt to identify pathology in patients with musculoskeletal pain. Now this sounds a fantastic and a worthwhile cause, especially if it enables us to identify symptomatic pathology in a patient population […]

By September 11, 2014 2 Comments Read More →
Red Flags for Low Back Pain- Research Update – July 2014

Red Flags for Low Back Pain- Research Update – July 2014

Sorry for the delay in posts. I was pleased to recently be asked by the Western Australian branch of Musculoskeletal Physiotherapy Australia (MPA) to present a day of lecturing on their annual “Spinal 1” course, and an evening seminar on “Red Flags for Low Back Pain”. Hence my last couple of months have been taken […]

Cold Hyperalgesia Testing

Cold Hyperalgesia Testing

I have often read in the literature the view that Cold Hyperalgesia is suggestive of more “severe” pain states and hence poorer prognosis. For example: Van Oosterwijck et al (2013) reported in their Systematic literature review on the evidence for central sensitisation in chronic whiplash that: The outcome of the processes involved in central sensitization […]

Neurological Examination for Radiculopathy

Neurological Examination for Radiculopathy

I found this recent article regarding neurological examination for radiculopathy interesting. Al Nezari et al (2013) conducted a systematic review and meta-analysis of the literature investigating the diagnostic accuracy of the neurological examination to detect lumbar disc herniation with suspected radiculopathy. The authors found 14 studies that investigated three standard neurological examination components (sensory, motor, and reflexes) […]

By February 12, 2014 2 Comments Read More →
Treatment of Chronic Pain?

Treatment of Chronic Pain?

Hopefully anyone seeing the title of this post will not be clicking on it thinking that I have the answers to chronic pain……please note the maze in the cover image and the question mark at the end of the title! Lets be honest, the outcomes that chronic pain patients are achieving, via all forms of […]

By January 30, 2014 2 Comments Read More →
MRI Findings in Low Back Pain

MRI Findings in Low Back Pain

Hopefully we are all familiar with the current view that most lower back pain is “non-specific” in nature. What this means is that there is no obvious finding on imaging (MRI etc) that can explain a cause of the patients pain. But what is some of evidence base in relation to MRI findings in low […]

By December 11, 2013 21 Comments Read More →
Clinical Diagnosis of Meniscal Tears in the Knee – Research Evidence

Clinical Diagnosis of Meniscal Tears in the Knee – Research Evidence

Hi all. This post continues on with the theme relating to the “usefulness” of clinical tests. The time the topic of this post is “Clinical Diagnosis of Meniscal Tears in the Knee – Research Evidence”. Once again this post throws values around for sensitivity, specificity, LR’s etc. So here is some information from a previous […]

By November 23, 2013 3 Comments Read More →
Diagnosis of Spinal Pain – Research Evidence

Diagnosis of Spinal Pain – Research Evidence

For this post I wanted to continue the trend of posts regarding the usefulness of clinical tests to diagnose specific “structural” dysfunctions. The previous post being about the hip, this post being about “spinal” clinical tests. How useful are our clinical tests in the diagnosis of spinal pain? I think the article by Cook and […]

By September 23, 2013 3 Comments Read More →
Centralisation, Part 1: Mechanical pain, mechanical diagnosis and the Wrasse bite

Centralisation, Part 1: Mechanical pain, mechanical diagnosis and the Wrasse bite

Another great post from this blog by Louis Gifford. A blog well worth following.

By September 2, 2013 0 Comments Read More →
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