Musculoskeletal Physiotherapy

MSc/PGDip/PGCert MSK physiotherapy: University of Brighton

“Selling” chronic pain: physiotherapists’ lived experiences of communicating the diagnosis of chronic nonspecific lower back pain to their patients

Nick Sullivan , Clair Hebron and Pirjo Vuoskoski (2019) https://www.tandfonline.com/doi/full/10.1080/09593985.2019.1672227 Abstract Introduction: Chronic nonspecific lower back pain (CNSLBP) is a common musculoskeletal condition which can be a source of significant distress and disability for patients. Approaches to managing CNSLBP have been explored in healthcare literature, as has the importance of communication in physiotherapy practice. However,…

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‘I have a High Pain Threshold!’ Part 1

It’s a phrase I commonly hear as a physiotherapist, and yet I still find it tricky to comment on. Reviewing the literature highlights how pain is highly individual and subjective, making it so difficult to fully understand from another person’s perspective (Eccleston 2001). As a clinician, the greater my understanding of the factors influencing pain,…

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Reflection on a clinical placement

Nicolas Bellot is a French physiotherapist working in Brussels, Belgium in a MSK private practice and teaches Musculoskeletal post-graduate courses in France with a company named IAMPT. He is a part time student of the MSK MSc at the University of Brighton. He completed his first clinical placement in October-November 2018 and here is his…

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The immediate effects of serving on shoulder rotational range of motion in tennis players.

Katy Williams and Clair Hebron (2018) https://www.ncbi.nlm.nih.gov/pubmed/30142622 Abstract OBJECTIVE: This study aimed to investigate the immediate effects of serving on shoulder rotational range of motion (ROM) in tennis players by comparing to groundstrokes. DESIGN: Same-subject, randomised, crossover study. SETTING: Indoor hard courts. PARTICIPANTS: Eighteen male and 12 female professional and university level tennis players. MAIN OUTCOME MEASURES: Passive glenohumeral internal…

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The effectiveness of Mulligan’s mobilisation with movement (MWM) on peripheral joints in musculoskeletal (MSK) conditions: A systematic review.

Kim Westad, Frode Tjoestolvsen, Clair Hebron (2019) https://www.ncbi.nlm.nih.gov/pubmed/30583976 Abstract: Musculoskeletal (MSK) conditions are very common and represent a major concern for the society and global health. The manual therapy technique Mulligan’s Mobilisation with Movement (MWM) has shown promising results in treating a variety of MSK conditions. The aim of this review was to systematically review…

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A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength.

Kathryn Palmer, Clair Hebron, Jon Williams (2015) https://www.ncbi.nlm.nih.gov/pubmed/25935843 ABSTRACT OBJECTIVE: This study aimed to investigate the immediate effects of serving on shoulder rotational range of motion (ROM) in tennis players by comparing to groundstrokes. DESIGN: Same-subject, randomised, crossover study. SETTING: Indoor hard courts. PARTICIPANTS: Eighteen male and 12 female professional and university level tennis players….

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A critical evaluation of the efficacy of Pain Neuroscience Education

Christian Hanssen is a physiotherapist working in Norway studying part-time for the MSc MSK physiotherapy. He has kindly offered for the essay he submitted for the introductory module ‘MSK Physiotherapy: evaluting practice’ to be posted. If you are starting your journey on the MSK course, please note that this essay takes a more formal scientific…

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The intra-rater reliability of a revised 3-point grading system for accessory joint mobilizations

Jennifer Ward, Clair Hebron, Nicola J Petty (2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592344/ Abstract Objectives Joint mobilizations are often quantified using a 4-point grading system based on the physiotherapist’s detection of resistance. It is suggested that the initial resistance to joint mobilizations is imperceptible to physiotherapists, but that at some point through range becomes perceptible, a point termed R1….

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The outcome of hip exercise in patellofemoral pain: A systematic review

Catherine Thomson Oliver Krouwel Raija Kuisma Clair Hebron (2016) https://www.sciencedirect.com/science/article/abs/pii/S1356689X16306348 Abstract Patellofemoral pain (PFP) is one of the most common lower extremity conditions seen in clinical practice. Current evidence shows that there are hip strength deficits, delayed onset and shorter activation of gluteus medius in people with PFP. The aim of this review was to systematically review the literature…

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Comparison of surface electromyographic activity of erector spinae before and after the application of central posteroanterior mobilisation on the lumbar spine

Georgios Krekoukias, Nicola J Petty, Liz Cheek (2009) https://www.sciencedirect.com/science/article/pii/S1050641107001137 Abstract Lumbar spine accessory movements, used by therapists in the treatment of patients with low back pain, is thought to decrease paravertebral muscular activity; however there is little research to support this suggestion. This study investigated the effects of lumbar spine accessory movements on surface electromyography…

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The effect of increasing sets (within one treatment session) and different set durations (between treatment sessions) of lumbar spine posteroanterior mobilisations on pressure pain thresholds

Lital Pentelka Clair Hebron Rebecca Shapleski Inbal Goldshtein (2012) https://www.ncbi.nlm.nih.gov/pubmed/22726916 Abstract Spinal mobilisations are a common form of treatment intervention applied by physiotherapists in clinical practice to manage musculoskeletal pain and/or dysfunction. Previous research has demonstrated that mobilisations cause a hypoalgesic effect. However, there is very little research investigating the optimal treatment dose inducing this…

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The initial effects of different rates of lumbar mobilisations on pressure pain thresholds in asymptomatic subjects

Elaine Willett Clair Hebron Oliver Krouwel (2010) https://www.sciencedirect.com/science/article/pii/S1356689X09001878?via%3Dihub Abstract Lumbar mobilisations are commonly used in clinical practice to reduce pain and increase function. Mobilisations to the cervical spine have been shown to reduce pain using pressure pain thresholds (PPTs). Yet there is no evidence to confirm that this happens in the lumbar spine. Furthermore little…

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An investigation into the potential hypoalgesic effects of PA mobilisations on the lumbar spine as measured by pressure pain thresholds

Oliver Krouwel Clair Hebron Elaine Willett (2010) https://doi.org/10.1016/j.math.2009.05.013 Abstract Mobilisation of the spine is a common technique used in clinical practice. Studies have shown that mobilisation to the spine can decrease pain. The optimum treatment dose for achieving this has not so far been investigated. Previous studies that demonstrate the pain relieving effects of mobilisations…

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Student researchers

Over the years, a number of students of the MSK course have successfully published the research they conducted during their studies. Many have also presented at national and international conferences.  Please find links to some of their work here. Very well done everyone who went onto to present and publish!!  

Katy Williams

A short video from Katy Williams, a former MSK student working at the University of Bath. Katy talks about her experinces on the MSc MSK. She also talks about her research project, progressing to writing for publication and plans to presenting at a forthcoming conference. Please find a link to Katy’s research here https://www.sciencedirect.com/science/article/pii/S1466853X18301986 Thank…

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The role of patient expectations in physiotherapy Part 2: How patient expectations can guide and enhance treatment.

In this second part of my blog I am going to discuss how patient expectations can help to guide and enhance treatment. Expectations are a major factor that can influence clinical outcomes so if they are not established prior to treatment, not only treatment success, but also patient satisfaction may be affected (Bialosky et al…

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The role of patient expectations in physiotherapy Part 1: how expectations can influence clinical outcomes

When I first assess my patients I usually ask them what their expectations of physiotherapy are. I want to know what they think will happen during their physiotherapy treatment and, more importantly, what they want to get out of it.  If I can find this out this I am hopefully more likely to provide some…

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Return to play following ACL reconstruction; do we need more time? Part 2

  The second part of this blog aims to review the more common outcome measures that can be utilised to assess return to play readiness, and how these are integrated into our rehabilitation. This will hopefully give some direction as to maximise our patients’ chance of successful return to play.   Time Based Outcomes A…

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Return to play following ACL reconstruction; do we need more time? Part 1

“When will I be able to compete again?”. The question I seem to be asked multiple times a day as an MSK physiotherapist, especially in relation to Anterior Cruciate ligament (ACL) reconstructions. Patients who have undergone this surgery seem to be bombarded with a wide variance of answers, creating fear and avoidance which potentially leads…

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Manual therapy : Journey from faith to facts

Do spinal mobilization / manipulation techniques have a role in treatment of patients with LBP? When I first trained to graduate as a physiotherapist, I learned techniques to mobilize joints of the back. At this point of my life I had absolutely no idea of any form of critical thinking. When I began my MSc,…

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Thoracic Outlet Syndrome; are clinical tests useful?

Following on from the first blog that was unable to draw associations between anatomical variations and thoracic outlet syndrome (TOS); I thought it would be beneficial to review the currently used clinical tests, underpinned by a few questions, such as, are these tests valid? Does the research support using these tests in clinical practice? How…

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Is there an association between Thoracic Outlet Syndrome and anatomical variation?

Blog by Steph Proffitt, MSc Musculoskeletal Physiotherapy student: Thoracic outlet syndrome (TOS) is not a particular forte of mine and I can probably only count on one hand the number of times one of my colleagues has asked “could this person have TOS?” when they are confused by a patient presentation. I therefore took this…

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Exercise Adherence; The Battle Continues

This post has taken a little time to put together with a house move and Christmas in the middle. I hope you enjoy reading it and can take something from it that you may find helpful with your own patients. It certainly has refreshed and changed my practice when it comes to exercise prescription. Within…

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The Person, the Patient, the Physiotherapist

When is a person a patient? Or for that matter, do we see our patients as people? What really is the role of the physiotherapist today? By Eoin Kealy Musculoskeletal Physiotherapy student. These were some of the presenting questions when I commenced my MSc in MSK physiotherapy. Continuing professional development is essential in physiotherapy and…

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Mentoring: What’s in it for you?

By Chris Mercer, Consultant physiotherapist, Western Sussex Hospitals NHS Foundation Trust. When I was asked to write something about my experience of mentoring University of Brighton MSc students on placement, my default setting was to think about the academic studies I would use to support and champion the role, and the evidence base I would use…

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Finding Time. The Battle for Adherence.

So, have you done your exercises?As an MSK physiotherapist I frequently prescribe exercise as part of my treatment.   Patients often report that they find it difficult to complete exercises. This has led me to question my understanding of the factors influencing adherence to exercise, and the ways in which I can help this.  In this…

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The magic of assessment

  “We haven’t done much on treatment”. This is common feedback that we receive every year from Physiotherapy students about to go on placement for the first time. Often followed by we don’t know how to treat “a shoulder” or “ a knee”. Apart from the obvious annoyance on our behalf that 1. The person seems…

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Stop and think: how is philosophy relevant to physiotherapy practice?

  Historically philosophy has been largely absent from physiotherapy pre-registration training and literature. However there has been a move towards considering philosophy in relation to physiotherapy, so is this about pretentious academics, ruminating in corduroy jackets with elbow patches, or is this relevant to clinical practice and if so how? Philosophy seeks to provide conceptual…

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Musculoskeletal Physiotherapy at the University of Brighton, UK

Welcome to our Musculoskeletal Physiotherapy blog. Please visit our blog where you will be able to meet the course team, alumni of the course, clinical mentors and students on the course. Some students on the course will share their blogs, case studies and thoughts on their learning journey.  

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