The Acromioclavicular joint (ACJ) is a relatively simple joint.

It has very little movement…

It joins the clavicle or collarbone to the acromion (shoulder)…

MCL (medial collateral ligament)injuries are very common but there are a lot of misconceptions about how to rehab these injuries.

When do you start?

Can you do exercises in the brace?

The shoulder is more complicated in many ways than other joints like the knee or ankle.

But that does not mean you can’t still get quick results…

Connect before you correct.

This is so important to the effectiveness of your patient assessments and your ability to find the right patient diagnosis.

On the final instalment of my success series I was joined on the podcast by Katie Davis, private practice and women’s health physiotherapist.

Katie was a wealth of experience in the NHS and private sectors and is a specialist in women’s health.

On this episode I had another special guest as part of my success series as I was joined by Gareth Robinson, sports physiotherapist and current personal therapist to one of the world’s top golfers.

We recorded this podcast as Gareth was away in Abu Dhabi on the golf circuit and we delved into what life is like as a therapist travelling around the world working with a top golfer.

In this special guest podcast I was joined by current lead physiotherapist for the Great Britain Olympic Taekwondo team, Ben Harper.

Prior to his current role in Olympic sport Ben has been involved in professional rugby union and rugby league, most noticeably with the Leeds Rhinos, Castleford Tigers and the Huddersfield Giants, the later where he was the Head of Physiotherapy and Rehab.

As part of my Success Series I was joined on the podcast by Caroline White, current Football Association Women’s Phase Lead Physiotherapist.

Prior to working in football at the FA, Caroline has worked in top flight Rugby Union with both the Northampton Saints and Gloucester, in the NHS, within University sport, with the Great Britain handball team and in a host of other roles.

What is not measured is not managed.

This is 100% true.

But I’m not talking here about your patients assessments but actually your OWN assessment as a therapist.

Knowing where to start with a patients rehab programme may sometimes seem hard.

What exercises do you pick?

How many reps or sets should your patient do?

Hip pain can be tough to get a grip a hold of.

I’m sure you have seen those patients that seem to get better, sometimes quickly, but then just as quickly, they regress…

The patella sweep test is a simple knee special test but…

It is the simple tests that are often the best tests!

This test can give you some important information about your patient’s knee injury…

One of the most common lower limb misdiagnoses made by new grad’s involves ankle syndesmosis injuries.

Often these injuries are mistaken for lateral ankle injuries like an ATFL or CFL ligament injury…

Neck pain patients with positive red flag symptoms, like pins and needles and weakness, used to get my head in a spin as a New Grad.

I used to worry that I would make this kind of patient worse…

Think about going to see your doctor.

And before you even get chance to explain what is going on…

The doctor just gives you some pills and shows you the door.

Whilst every patient you see will be different…

They will have different injuries…

Different past medical histories…

If you sometimes find yourself getting stuck with your patients…

And wonder what treatment technique or rehab exercise to use once you have finished your patient assessments…

Then this podcast episode is for you!

Impingement is NOT a diagnosis.

I hold my hands up and admit that I used to think it was…

And worse still, I admit I gave it this diagnosis to 100’s of patients and the athletes that I worked with.

Have you noticed that most injuries you see are not quite as simple or clear cut as you were told at University.

Those textbook shoulder, knee or lower back pain patients never walk in to your clinic…

When it comes to the shoulder and special testing, the biggest mistake that I see New Grad’s make, is doing too many tests…

And worse than this…

Why is it that shoulders are so difficult to treat and especially, tricky to diagnose?

The reason…

In this special episode I spoke to Jade Danes, a sports therapy graduate currently working in both professional sport and private practice.

Just in the last 12 months Jade has progressed from being turned down for jobs in both clinics and at professional sports clubs in favour of other sports therapists and physio’s…

Stop wasting your time and efforts on the wrong rehab exercises and treatments and halt your frustration…

So you can treat even tricky ankle patients!

He had depression and I didn’t know.

We were 4 months in to a 9 month rehab programme and he had been struggling for the last 3 months…

I graduated in the Summer of 2010 and was straight to work in my first job as the Assistant First Team Physiotherapist at the Leeds Rhinos.

I have learnt a lot over the last 10 years…

You use your red flag questions to make sure you don’t miss any serious pathology and treat something you shouldn’t.

But despite what many therapists believe…

Anterior hip pain can often be tricky to get a hold of as it can be irritated by simple movements and positions, like squatting or lunging…

Or even sedentary activities like sitting or driving, so it often doesn’t take much to irritate symptoms…

Many treatment techniques offer only short lived improvements for patients with lower back pain.

I’m sure you found yourself treating the same muscles, improving patient symptoms, only to see their symptoms quickly return as quickly as they went away…

A vertebral artery problem is a medical emergency!

You are not going to see many of these cases but you need to know what patient signs and symptoms might make you suspect this injury…

There is a big difference in opinion about the best way to squat and in particular…

…should you let the knees come over the toes?

Many therapists think that letting your knees come over your toes is bad for your knees.

If you have ever found yourself stuck for what treatments to use for a patient with shoulder pain…

…or sometimes find your current techniques don’t get the results you want…

How do you best manage an acute ankle injury?

Beyond your usual application of ice, compression and elevation etc, one big decision is you need to make is should you protect the ankle?

Have you been overlooked in the past for a role because you are NOT a physio?

Maybe you experienced this as a student…

…when you were not been given the same opportunities on placements and…

Picking your first job as a New Grad is a BIG decision.

How do you know a job is right for you?

In this special episode I am joined by New Grad Physio Dave Fahey as we discuss his rapid rise from student to his role now working full-time with Leeds United Football Club.

Learn how he was able to transition from University…

Have you ever wondered why some therapists struggle to create opportunities whilst other New Grad’s seem to transition effortlessly from University and into the real world…

…and fly up the career ladder faster than anyone ever thought possible?

Do you sometimes fear that you might do more harm than good with the patients you see with lower back pain?

This worry is common but results in many therapists applying a very conservative rehab plan, sometimes even prescribing ‘rest’…

Are you confident in your assessments to differentiate between a hamstring muscle, tendon or nerve injury?

Would you know how to manage each of these different issues?

Neck injuries often bring an added worry and apprehension for therapists.

Maybe sometimes you…

The knee itself is a relatively simple joint.

It’s a hinge joint, it flexes and extends (it also internally and externally rotates) but lets’ keep it simple…

The shoulder can be challenging to deal with.

It is a complex joint, with many structures.

It is well evidenced that many shoulder special tests have poor sensitivity…

Whilst the world is on a ‘go-slow’ at the moment and the therapy profession as we know it has almost driven to a halt, you may think that now is not the time to focus in on your career path…

Private clinics are shut, sport as we know is has stopped and almost everything other than front line care in the NHS has been cancelled.

When rehab doesn’t go well it is frustrating for your patient and for you as their therapist.

A common time to encounter rehab problems is when patients go back to higher-level activities like running, the gym, back to work or return to sport.

Do you sometimes wonder whether you have prescribed the right exercise for your patient or not?

Do you worry how you patient will respond and how they will turn up at their next appointment?

If you have qualified, you will know exactly what I mean when I say…

That what patients say and how they present is hugely different to what we were told at University.

The result…

Patients with knee pain, generally do very well, until…

They go back to higher-level activities like the gym, running or sport.

Once activity levels are increased their pain often returns, leaving the patient and the you…

Whilst in recent years therapists generally have become better at assessing ankle injuries, many syndesmosis (high ankle) injuries still get missed, often misdiagnosed as a lateral ankle injury.

This present a BIG problem as these injuries are managed in the same way as a lateral ankle injury…

Whilst these unprecedented circumstances present us with many challenges, you can use lock-down to your advantage.
Most therapists are finding they have more time on their hands and as such, it is a great opportunity to develop your skills and spend more dedicated and uninterrupted time on your CPD…

Knowing when to allow your patients to return to higher level activities, like the gym, running and sport can be a difficult decision.

I’m sure you’ve been asked those questions from your patient like…

As therapists we ALL do the same 3 things…

We assess our patients…

Just because a patient has knee pain it does NOT mean they have a knee problem…

If you can get your head around this important concept it will make your management of problems like ‘anterior knee pain,’ ‘shoulder impingement’ and other overuse injuries much easier…

The shoulder often proves problematic for both patients and therapists.

Pain can persist, with patients struggling to return to normal function, particularly more active patients, resulting in BIG frustration as a therapist, when despite your best efforts, your patients shoulder pain continues…

Ever get to the end of your patient assessment and are NOT sure what might be going on with your patient?

At the end of the assessment, (ideally at the end of the subjective assessment), you should be able to able to diagnosis what your patient’s problem is – or so you were told at University…

Is making mistakes as a New Grad Physio a good or bad thing?

It is generally thought that making mistakes is generally a good thing as a New Grad; as you are said to learn from these experiences and as a result get better…

Overuse injuries like Achilles or patella tendinopathies can often be tricky to manage.

Patients and athletes alike have often had these problems for long periods, have tried and failed rehab previously and some have even been told they ‘may have to live with their problem,’ or even worse, ‘give up’ their activity or sport…

Do you sometimes feel like you end up just treating the patients MRI report or the referral letter that has been sent from another practitioner, like a GP?

Even if they present very differently in your clinic room…

If you have ever had a patient go away and NOT complete their rehab, you will know not only how frustrating it is as a therapist.

Maybe you label these patients as ‘lazy’ or think ‘they’re not really that bothered about getting better.’

Often quick changes can be made in patient symptoms but often these effects only last for a short period of time.

Patients then don’t progress and as a therapist you may sometimes find yourself trying various treatment techniques and rehab exercises to try get on top of their symptoms…

As a therapist you know doubt ask those important red flag questions during your subjective assessment, but do you really understand WHAT a positive answer is telling you and more importantly, are you clear what to do next?

Some patients need urgent onward referral, but many, just need our help in the form of hands-on treatment and rehab…

Knee injuries are common and your ability to diagnose injuries like an ACL, MCL, LCL or PCL are vitally important,

Failure to do this and you risk putting your patients or athletes at further risk of injury and also, without a definitive diagnosis, it makes it difficult for you to manage their injury in the best possible way, resulting in poor treatment outcomes…

So many New Grad Physio’s start the year with big aspirations about what they want to achieve over the next 12 months.

This might be to spend more time on CPD, learn a particular skill-set, gain better working hours and more responsibility, gain that next…

How was a rugby player with a posteriorly dislocated shoulder, that required a general anaesthetic to relocate and a high severity of damage to his shoulder as a result, able to get back to play in just 7 days?

In episode #20 you will find out how, as I detail what we did at each and every step…

Despite the advances in sports medicine, the vast amount of research conducted and the efforts to prevent hamstring injuries, their prevalence and re-injury rates have remained relatively similar over the last 20 years.

So, what are we missing?

Ankle injuries are highly prevalent, and we see them frequently in our clinics within the NHS, private practice and sport.

When managed well, patients and athletes can return to full activity quickly, having accelerated through their treatment plan…

I hold my own hands up and admit I gave ‘sciatica’ as a diagnosis commonly as a New Grad Physio.

Problem is, it isn’t even a diagnosis and more importantly than that, giving ‘sciatica’ as a diagnosis may be causing you to focus on the wrong problems, leading to poor treatment effects and ineffective patient outcomes…

In episode #16 of the New Grad Physio Podcast I will discuss the lack of awareness New Grad’s have about what life as a graduate therapist is REALLY like and why this results in overwhelm, frustration and a lack of progress during those early years after graduating.

We will cover why you need continued support when you graduate if you want to make continued improvements in your clinical practice and your ability to help your patients in a way you feel they deserve…

The ability to deliver a clear, concise clinical message to your patient is key to ensure your patient fully understands the problems they have, their prognosis and how their proposed treatment plan will progress.

Regardless of how great your patient assessment, hands-on treatment techniques and treatment plan might be, all this great work can be undone if you cannot get your…

Episode #14 of the New Grad Physio Podcast will discuss the controversial topic of manual therapy.

Regardless of your current thoughts regarding manual therapy you need to listen to this podcast episode because you will discover WHY manual therapy gets a bad name…

In episode #13 of the New Grad Physio Podcast you will learn why some New Grad’s are able to fly up the career ladder faster than anyone thought possible whereas some therapists get left behind.

In the podcast you will discover…

In episode #12 of the New Grad Physio Podcast you will find out HOW to get patients to give you the RESPECT and RECOGNITION you deserve as a New Grad Physio.

Those early years are tough enough without having to overcome patient resistance to your advice and interventions just because they perceive you as being…

In this episode of the New Grad Physio Podcast you will discover the REAL REASON patients leave your clinic and DON’T do their home exercise programmes.

Most therapists WRONGLY accuse these patients of being ‘lazy’ or ‘not caring’ about their health…

In episode #10 of The New Grad Physio Podcast you will discover exactly WHY Your Patient DOESN’T Need A Diagnosis…

So much WASTED time and attention is given to a patient’s diagnosis, but in doing so, so many New Grad Physio’s are missing the BIG point about what…

In this latest episode of The New Grad Physio Podcast you will discover exactly WHY You Need To Step Out Of Your ‘Comfort Zone.’

I will talk through a BIG ‘A-HA’ moment I had as a New Grad Physio that made me realise the skill-sets that I needed improve, which helped me fast-track my learning and development in these specific areas…

In this episode of The New Grad Physio Podcast you will discover exactly WHAT you need to know to fly up the promotion ladder faster than you ever thought possible!

Maybe you don’t want to follow the ‘traditional’ NHS rotation route and have a clear idea about where you want your career to go…

In this episode of The New Grad Physio Podcast you will discover exactly WHAT is the REAL REASON patients come to see you (BIG HINT – It is NOT Pain).

Once you know this Real Reason you can really start to understand how..

In this episode of The New Grad Physio Podcast you will discover exactly WHY some of the BEST therapists are actually pretty AVERAGE at certain parts of their clinical practice, but, are still able to get great patient results…

In this episode of The New Grad Physio Podcast you will discover exactly WHY you need a mentor to help you accelerate your learning and climb the promotion ladder faster than you ever thought possible…

In this episode of The New Grad Physio Podcast I will show you exactly WHY your next career move could be the MAKING or BREAKING of your therapy CAREER…

In this episode of The New Grad Physio Podcast I detail how a recent night I spent in A & E can teach us all a valuable lesson about communication, specifically, how poor communication can quickly ruin your patients experience of your care…

In this episode of The New Grad Physio Podcast I will show you exactly why a COMPETENCY underpins EVERYTHING you do as a New Grad Physio and why it might be the #1 reason you are NOT getting consistent positive patient results…

In my very first episode of The New Grad Physio Podcast I will show you exactly WHY you are NOT able to do as much consistent CPD as you need to do and why this is stopping you enjoying a SUCCESSFUL start to your life as a New Grad Physio, Sports Therapists or Sports Rehabilitator…