Physielle - physiotherapy tips

Surgery left him SHAKING? 🫪

But don't worry, this is a normal part of recovery after an injury.

This muscle twitching is also called myoclonus, and after surgery/injury it can be due to:
1) residual effects of trauma to tissues
2) your brain trying to protect the area from being used too much

With some time and rehab, my patient is expected to make a full recovery.

HOWEVER:

⚠️ If you have this type of twitching for no apparent reason, consider seeing a physio or doctor because it could be early signs of neurological disease (e.g. multiple sclerosis, nerve damage, NMD/ALS etc.)

Rest ≠ Recovery❗

How the tendinopathy pain cycle usually goes:

Injury occurs → Your tendon is triggered (normally with overuse, e.g. running too much/too long/too intense).

Rest phase → Your pain decreases because initial inflammation settles, but your tendon remains weak, deconditioned, and under stimulated.

False confidence → You assume you're "healed" and try resuming your activity.

Progressive limitation → You try lighter activities (jogging), because you're scare you'll retrigger your tendon. But the pain inevitably returns.

Repeated rest → You rest again and pain reduces again, but your tendon gets more deconditioned with each rest period.

Downward spiral → Eventually even normal walking becomes painful because your tissue capacity deteriorated while your symptoms went away temporarily.

The solution is to USE the tendon to STIMULATE new growth factors so it can ADAPT to what you want it to do.

🔪 Surgery is NOT the surgeon's decision...

It's YOUR decision.

These 3 questions will help you get the conversation started with your medical team to find the best management for you.

Sometimes it's surgery, sometimes it's not.

Of course, there are many other things to be discussed like:
- your lifestyle and activity needs
- the degree of your current disability
- how much pain you're in
- the extent of the current damage
- what you've tried previously
etc.

These are conversations to be had with your doctor, physio, coaches/trainers (if you're an athlete), and other trusted medical and health professionals.

Unless your body is severely compromised, most orthopaedic surgeries are ELECTIVE so don't rush into a decision.

Key things to know about HIGH ANKLE SPRAINS (syndesmosis injuries) 🦶🏻:

Common MECHANISM of injury - (forced) weight bearing eversion in dorsiflexion.

Commonly injured tissues:
Anterior Inferior Tibiofibular Ligament (AITFL)
Posterior Inferior Tibiofibular Ligament (PITFL)
interosseous membrane
These can be in combination with other tissues, like the ATFL, deltoid ligament, talar dome etc.

SURGICAL procedures - tightrope or screw fixation to bring the tibia and fibula together distally.

Xavier Savage injury video from

Also best of luck to Endo Wataru on his rehab! Hope to see you back at Anfield soon or at the world cup ⚽

This lady has electric shock IMMUNITY ⁉️

For simplicity's sake, nerves have 2 functions:

1) To FEEL; sensory pathway

2) To MOVE; motor pathway

If either/both of these aren't functioning (like in a spinal cord injury), you might not be affected by a taser/electrical instrument.

My thanks to for letting me stitch your video!

Don't know if you have mum thumb? TEST YOURSELF 👍🏻

1) Down & spread (WHAT)
- hand with palm down
- bend wrist towards palm side
- open thumb (away from pinky)

2) Wrap thumb & hammer down (Eichhoff's)
- pinky facing towards your thigh
- wrap your thumb with your fingers
- wrist down like you're hammering a nail

If you have pain on the tendons on the thumb side of your wrist, you likely have De Quervain's.

These tests are, of course, preliminary checks and not an official diagnosis. Please consult with a healthcare or medical professional!