Uncategorized | Musculoskeletal Physiotherapy

The Management of Carpal Tunnel Syndrome

The Management of Carpal Tunnel Syndrome by Vinoth Ketheeswaran Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy where there is a compression of the median nerve at the wrist as it passes through an osteofibrous canal known as the carpal tunnel. In addition to the median nerve, the carpal tunnel contains the carpal…

Are Nerve Sliders and Tensioners Effective for Sciatica? (Part 2)

Seeing the Wood for the Trees What is ‘Sciatica’?! ‘Sciatica’ is used to describe a host of back-related leg pain presentations of different causes; Bogduk (2009) argues that ‘sciatica’ is outdated, and as pain physiology has evolved so should nomenclature. It is well established (Genevay et al., 2017; Ostelo, 2020; Schmid, Fundaun and Tampin, 2020)…

Are Nerve Sliders and Tensioners Effective for Sciatica? (part 1)

As an MSK physiotherapist aligned to a spinal pathway I treat a lot of people with sciatica. It is a condition I find frustrating to treat and have inconsistent results with. I was recently asked to clinically reason my use of nerve sliders and tensioners and realised how little I knew of their supporting evidence….

How we may be misdiagnosing peripheral entrapment neuropathies. (Part 2)

Hi All I last posted Part 1 of my blog assignment June 2020 which can be found here. I have since returned to Eastbourne for my Upper Limb Module and it has been great to get back into academia and catching up/meeting others from the course. It has also reminded me to post part 2…

How we may be misdiagnosing peripheral entrapment neuropathies. (Part 1)

The purpose of this blog is to critically review how I and other physiotherapists assess and diagnosis peripheral entrapment neuropathies (PEN) and make the case that there may be inadequacies in the way we do so. To demonstrate this, we will encounter a fictitious case study with annotated thought processes labelled “Brain” to suggest how our findings…

Neuro-dynamic Mobilisations in Clinical Practice and the Experience of Radicular Symptoms

Part 1 of this Blog presented literature on the efficacy of NDM, with some supporting its use in painful radiculopathy. In discussing NDM use in clinical practice, it is worth noting that although natural history and conservative treatment like NDM can be favourable for these conditions, at 12 months post onset, at least 33% of…

How effective are ‘Sliders’ and ‘Tensioners’ in the management of Lumbar Radicular Pain and Radiculopathy?

Blog by Claire Powell MSc Musculoskeletal Physiotherapy student Illustrations by Laura Jazwinski Low back pain with leg symptoms is a presentation that I commonly see in my workplace. In a recent clinical case discussion with a colleague, we considered sliders and tensioners as an intervention for painful lumbar radiculopathy and they stated, “There isn’t evidence…

The craft of writing: weaving a golden thread.

The challenging of writing for postgraduate studies can be met with an array of emotions; anticipation, apprehension and perhaps even paralysing anxiety. So how are you going to get started, what skills do you need to demonstrate, and how are you going to make your work a pleasure to read? And it doesn’t end there;…

‘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,…

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…

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…

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…

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…

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…

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,…

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…

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…

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…

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…

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…

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…

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…

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.