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Published August 19, 2018 at 1200 × 848 in That’s not how it works…

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🤓SUNDAY NITE STUDY🤓 . Heres a nice way to revise and remember the posterior shoulder spaces and the neurovascular structures they contain! . One condition to keep an eye out for is Quadrilateral Space Syndrome which can often mimic and be misdiagnosed as sub acromial pain. . It is rare but symptoms are often vague, transient and sporadic. However compression to the axillary nerve and posterior circumflex humeral artery can produce neurovascular symptoms such as coldness, cramping, and numbness! . It mainly occurs in those who do regular overhead activities and sometimes after trauma such as dislocation or humeral fractures! . #shoulderanatomy #shouldergeek #shoulderpain#shouldercomplex #physio #physiotherapy #rehab #physicaltherapist #physiotherapist #dptstudent #dpt #geek #nerd #anatomy #biomechanics #notallabouttherapeuticalliance 😋

🖍THE THIN RED LINE🖍 . Disappointment is the gap between expectation and reality! . Try to close it as soon as possible! . Patients often have unrealistic expectations around their issues and problems! . For example, a classic mismatch between patients expectation and reality I hear daily is time, that is how long it will take before they start to feel they are improving or getting better! . Many patients expect things to improve immediately, or in a few days which is perfectly understandable when in pain and unable to things you want. However, we know that often it will take much longer than they expect. . Therefore clear honest rationale explanations and advice about why things take longer than expected is essential to manage patients expectations and bring them closer to reality and AVOID disappointment and more importantly over treatment! . #physiotherapy #physiotherapist #physicaltherapist #physicaltherapy #physio #DPT #dptstudent #expectations #disappointment

💥EVIDENCE💥 . Admit it or not, this IS how you use evidence! . Recognise it, accept it, deal with it! . #HumanNature #Biases #ThinkingFast #ThinkingSlow #physiotherapy #physicaltherapist #physicaltherapy #dptstudent #physio #evidence #research #science #sciencedoesntcarewhatyoubelieve

👌HOOK GRIPS👌 . After my last video demonstrating some different types of grips 👉 I had a few people pipe up about how the hook grip I demonstrated was NOT a hook grip! 😱 . Well it was, so there 😏 A hook grip by definition is when the finger MCPJs are not flexed and the PIPs and DIPs are in flexion! . I think the confusion and disagreement comes from the other grip that’s often called a hook grip in weight lifting and S&C where the thumb is placed under the first two fingers and the bar as demonstrated here! . Personally I think this is better called a thumb lock grip rather than a hook grip to avoid confusion! . So technically both are right... but I’m more right! 😜 . Either way just grip it and rip it!!! . #Grips #HookGrip #EveryonesAnExpert #GripIt #GripItAndRipIt

😱BENT BACKS🤔 . There is a shit tonne of fear mongering and bull shit around bending and picking things up within healthcare and training. . Many insta-physio-gurus claim that any and all spine bending and lifting is risky or harmful and should be avoided always from 100kg deadlifts to picking up a pair of socks! . This is complete and utter nonsense, our spines bend a lot in day to day tasks and activities and there is no evidence that doing this is more risky or harmful than not doing it. . In fact despite all the advice to keep our spines straight and only lift with our legs on social media and on manual handling training in the work place its made no difference to the rates or prevalence of low back pain! . Interestingly some studies have shown that lifting with a bent back is more energy efficient, and also has no significant difference in lumbar spinal compression forces than lifting with a straight or neutral spine as commonly believed (Hagen 1993, Kingma 2010, Verbeek 2012). . So I think we can all relax a little and recognise and celebrate that our spines are robust and resilient to bending and twisting and lifting things up of the floor. . However, I dont think this means we can be totally blasé and carefree about bending and lifting as some have started to advocate. . I do think there are some people and some circumstances when a more straighter and braced spine is a sensible idea, such as a novice lifter beginning to deadlift heavy weights . However, again I don’t think it needs to be as overly strict or as complicated as some make out. . As always its about using some common sense and finding the middle ground, but also recognising that there will ALWAYS be exceptions to the ‘rules’ . Now go and pick that sucker up! . #physiotherapy #physiotherapist #physicaltherapist #physicaltherapy #back #bending #lifting #backpain #slippeddiscs #spinesarerobust #gradedexposure #deadlifts #lamargant

😴SWEET DREAMS😴 . There are lots of thoughts and ideas on what are the best and safest sleeping positions to prevent neck, back, and shoulder pain. . Most only advise one position, often talking about keeping your spine straight and aligned, pelvis in neutral and with arms and legs fully supported. . However, there is actually little evidence that ANY sleeping position is bad or harmful for you! . This paper published last week by Holdaway et al (2018) in BMC msk disorders, found no association of any sleeping position and the development of shoulder pain in 760 people. . So my advice to people when I’m asked whats the best sleeping position, is find a position that is comfortable for you, and that you don’t have to think or worry about! . In my opinion thinking and worrying about your sleeping position is far more ‘risky’ than any actual sleeping position. . So relax and remember your body is robust and resilient to most positions that you go to sleep in... although personally I wouldn’t recommend any of the examples on the last page! . So night night, sleep tight and sweet dreams! 😴 . #physiotherapy #physiotherapist #physicaltherapy #physicaltherapist #physicaltherapystudent #dptstudent #sleep #pain #posture #position #sleepingbeauty #sleepless #shoulderpain #neckpain #backpain #bedtime #comfy #nightnight #sleeptight #sweetdreams

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