Shoulder Multidirectional instability & surgical repair

A reflective blog describing the course of treatment over 12 months of a female patient with multidirectional instability, multiple dislocations and her decision to have a surgical repair and stabilisation.

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Informed pain management for LBP

This week we are looking at an article review covering a brilliant paper that has recently been published out of Hong Kong. I have been waiting for a paper like this for some time now, that looks systematically at all the literature behind the current approach to pain management education we are encouraged to provide to our patients about lower back pain.

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Spinal degenerative changes are a natural part of ageing

Spending time deciphering and interpreting the meaning of MRI and CT scans for our patients is a difficult task. How do we know what is normal and what is related to pathology? This blog explores a recent systematic review that provides evidence about the prevalence of normal age-related changes on spinal imaging of the lumbar spine and MRI changes in the cervical spine .

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Modic changes & Spinal degeneration

Dr. Mark Percy, Specialist Radiologist with MIA Victoria, who previously guided me on the topic of VBI and pre-manipulative screening also spoke with me about Modic changes. Previously I didn't completely understand the clinical significance of this term and why as Physiotherapists we need to consider the implications of this word being written on the radiology report. Dr. Percy explains what we need to know about them. 

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Can the risk of Vertebral Artery Dissection be determined with pre-manipulative screening?

Cervical manipulation has inherent risks. One of the the most dangerous adverse effects following cervical manipulation is vertebral artery dissection (VAD). For the past two decades, functional pre-manipulative screening tests have been used by Physiotherapists to identify patients at risk of vertebral artery insufficiency (VBI). Many experts in the field of VAD and cervical manipulation have started to question the clinical validity of these tests and currently there is great uncertainty if the tests themselves are potentially dangerous enough to cause VAD. 

This blog aims to review the risk of cervical manipulation, the clinical presentation of VBI and the current assessment recommended by the Australian Physiotherapy Association. I'm also pleased to include the thoughts and recommendations of Dr. Mark Percy, Specialist Radiologist from MIA Lilydale, Victoria. 

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Meniscus Injury...conservative or surgical management?

Meniscus injuries are common but what is the appropriate management? What clinical factors indicate conservative or surgical management pathways? The main clinical issue currently is the lack of research regarding the efficacy of arthroscopic meniscus repairs compared to a conservative approach. This blog aims to give a clinical overview, so therapists know when surgery or a conservative approach is appropriate.

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