2) Well-designed rehabilitation programs for ITB pain aim to progressively overload the injured runner and the ITB to restore tolerance running-specific loads. The loads are not so excessive that the injured ITB is further irritated by extending into tissue overload.
3) Stress shielding, however, is as likely to cause re-injury as tissue overload because the runner will not be adequately prepared for the biomechanical loads that will be encountered during the return-to-run process.
4) Foam rolling is often prescribed for ITB pain. However, foam rolling does not result in changes in flexibility that last more than just a few minutes. ITB pain is likely a compression injury, so it makes little sense to add further compression to the lateral knee.
5) During a typical run, anatomical structures experience a) high peak loads; b) with high levels of energy storage and release; c) in a highly cumulative manner. All three of these components of loading should be addressed during rehabilitation.
6) Peak loads are addressed with heavy, slow resistance training; energy storage and release demands are addressed with plyometric exercises; and, cumulative loading should be addressed by a graded return-to-run program.
7) ITB pain rehabilitation is divided into two main phases; a) Pain Dominant phase and b) Load Dominant phase (Figure 3). These phases are derived from previous works of @ProfJillCook and Purdam (2009) and Fredericson and Weir (2005).
8) Thanks for making it to the end 🙏🏻
👉🏻 Want to learn more about ITB pain rehab? Read this excellent blog by Rich Willy:
‘Iliotibial Band Pain in the Runner Part 2: Treatment’
2) Your patient is doing well, has good strength and is able to run. Now what? Bridging the gap between pain-free running and return to sport requires a clear and targeted program.
How to master your assessment of athletic low back pain. A thread 🧵
👉🏻Inspired by @KellieWilkie
1) Low back pain (LBP) is a top musculoskeletal complaint worldwide, but athletic LBP requires specialized assessment due to its unique features. Keep reading if you want to learn what to screen for in this population.
2) The “shape” of pain is a lesser known alternative to types of pain and neurological symptoms that can give at least as much information. A fingerline distribution of pain mostly represents radicular pain whereas a broader distribution is more likely to be somatic.
The 10 essential skills every modern physiotherapist needs to thrive. A thread 🧵
👉🏻 Inspired by one of our own Physio Network blogs
1️⃣ Clinical reasoning at the heart of our practice. This distinguishes us from a mere “technician”, enables us to assess our patients correctly and allows us to make an individually tailored treatment plan.
2️⃣ Empathy in our communication. We don’t just treat conditions, we treat people. Communication is more than words but also includes active listening and understanding the fears, concerns and goals our patients have.
Heavy Slow Resistance for Lateral Elbow Tendinopathy. A thread🧵
👉🏻 This thread is based on a research paper by @ccouppe et al - reviewed by @ToddHargrove
1) Lateral elbow tendinopathy (aka tennis elbow) is a common overuse injury. This RCT compared the effectiveness of heavy slow resistance training (HSR) with placebo injection, HSR combined with corticosteroid injection (CSI) and HSR combined with tendon needling.
2) 60 patients with chronic unilateral lateral elbow tendinopathy were randomized into three, above mentioned, groups. After receiving their respective needle interventions, each group did 12 weeks of HSR training with elastic bands at home.
Exercises for Medial Tibial Stress Syndrome (AKA Shin ‘Splints’) A thread 🧵
👉🏻 Inspired by @tomgoom
1) Way too often in rehab, people talk about strengthening x, y and z, improving movement control etc. but never what it really means. This thread covers an exercise program used for someone with MTSS and the reasoning behind it.
2) The patient is a young male middle-distance runner who shows a mild weakness in the Soleus, Glute Med and posterior chain. Our aims are as follows: improving local load capacity of the calves and kinetic chain & including weight-bearing exercises to improve bone load capacity.
How to Assess 8 Common Causes of Wrist Pain🧵 A thread
👉 Inspired by our Masterclass with @iangattphysio
Wrist pain is a common complaint in physiotherapy practice. Accurate assessment of underlying causes is crucial for effective management. Here are eight common causes of wrist pain and key assessment considerations for physiotherapists:
1️⃣ Carpal Tunnel Syndrome (CTS): Assess for sensory deficits, positive Tinel's or Phalen's tests, and grip strength. Evaluate for contributing factors like repetitive hand movements, wrist flexion, and systemic conditions. Consider nerve conduction studies for confirmation.