💡 The Clinical Dunning-Kruger Illusion

Young clinicians: Competence doesn’t happen with time.

🚩 Textbook cases? Rare.
🚩 "Gold-standard" treatments? Hit or miss.
🚩 Social media rehab hacks? More rabbit holes.

The Valley of Despair is real, but you can climb out. 🧵👇 The Dunning-Kruger curve is misleading.

It makes it seem like competence just "happens" over time. It doesn’t.

Real experience = Time + Caseload + Learning + Unlearning.

That first overconfidence spike? It happens FAST. The climb to competence? DECADES.

1/ Got butt pain when sitting, running, or stretching? You might have Proximal Hamstring Tendinopathy (PHT). Let’s talk about how to manage this literal pain in the ass (no quick fixes, just evidence-based strategies). 🍑🧵👇 2/ PHT is a tendon issue at the 'sits bone' (Ischial Tuberosity). It gets cranky with compression & excessive load, we don't think its inflammatory (that's a rabbit hole for the nerds 🐇🕳️). It seems rest & ice won’t cut it. ❌

1️⃣Two major plantar fasciopathy clinical guidelines are getting attention currently.
Here’s what they say! 🧵👇
🔗 BJSM 2021: Morrissey et al. doi:10.1136/bjsports-2019-101970
🔗 JOSPT 2023: Koc et al. doi:10.2519/jospt.2023.0303
#Physio #PlantarFasciitis #Rehab #HeelPain 2️⃣ What’s the difference?

📌 BJSM (2021) → Mix of systematic review, expert opinion & patient values.
📌 JOSPT (2023) → Strictly evidence-based from RCTs & meta-analyses.
👀 BJSM is practical & adaptable, while JOSPT is more rigorous & structured.

/1 Nice review in March 24 issue of @PhysioNetwork by @iangattphysio .

"TFCC tear" is one of those well known therefore oft diagnosed injs.

My local hand Doc agrees:
MRI looks like one thing, then a scope finds another.
LT lig tears can masquerade like a TFCC, & ViceVersa.

/2 The old saying "just because you haven't seen it, doesn't mean it hasn't seen you" might apply here, however clinically I rarely diagnose a "TFCC" injury.
I just manage as "ulnar wrist compartment pain" until proven otherwise.