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K-Tape For Shoulder Pain? A 'sticky' subject!

183:742286750 (Matthew Ross) — Wed, 28 May 2025 09:00:57 GMT

Can the application of K-tape improve subacromial space?

Source: Lyman, K.J., Gange, K.N., Hanson, T.A. and Mellinger, C.D., 2017. Effects of 3 different elastic therapeutic taping methods on the subacromial joint space. Journal of manipulative and physiological therapeutics , 40 (7), pp.494-500

Kinesiology tape (K-Tape) is a form of therapeutic elastic tape which has been commonly used by various healthcare professions. The developers hypothesise that the tape has similar thickness and elasticity similar to human skin can be used to help offload, stabilise and increase or inhibit muscle contraction based on the way it is applied. However, results of clinical trials have often been either inconclusive or conflicting, highlighting the need for further research.

Shoulder Impingement Syndrome is a common shoulder condition which is theorised to be a narrowing of the subacromial space ultimately affecting the subacromial bursa, supraspinatus tendon or both. However, research is now highlighting that such mechanisms may not be present and the term ' subacromial pain syndrome' is now used more widely.

K-Tape has often been used to help treat people which such shoulder complaints, and previous studies has looked an patient reported outcomes such as pain and disability - however very studies look to examine the physiological change at the shoulder change following the application of tape. A study by Lyman et al (2017) looked to 'evaluate the underlying physiological effects of the elastic therapeutic taping methods on the subacromial joint space in healthy individuals by using musculoskeletal diagnostic ultrasound'

Study Design

48 people were recruited for this study, 24 males and 24 females, with ages ranging from 18-59 years with NO history of shoulder pain in their dominant arm. An ultrasound machine was used on each participant to establish their baseline acromialhumeral distance. The shoulder was then taped in 1 or 3 ways:

1) Taping of supraspinatus from origin to insertion
2) Taping of anterior and posterior deltoid from origin to insertion
3) A combination of both

Following the application of the tape, the participant was instructed to rest for 5 minutes before the acromihumeral distance was measured to note any difference.

Outcome

These more granular results demonstrate that taping of the anterior and posterior deltoids has a statistically significant effect. In contrast, neither taping of the supraspinatus alone nor taping with both techniques increased the measured distance at a statistically significant level. In every case, the measured space increased after taping. The measured effect was larger in women than in men.

My View

This study highlights that taping the deltoid muscle can improve the subacromial space when examined under ultrasound and could be a useful form of adjunctive treatment when helping people with shoulder pain and alongside a comprehensive rehabilitation programme. However, this study was performed in healthy subjects and further research translating this research to those with shoulder pain to examine whether there are similar outcomes and whether pain and disability improves as a result

Give Shoulder Pain The Cold Shoulder!

Wed, 28 May 2025 07:56:25 GMT

What does the research tell us about the management of Frozen Shoulder?

Source:

Akshay Date & Luthfur Rahman (2020) Frozen Shoulder: Overview of Clinical Presentation and Review of the Current Evidence Base for Management Strategies, Future Science OA, 6:10, FSO647, DOI: 10.2144/fsoa-2020-0145

Frozen shoulder is a common condition which occurs in approximately 2-5% of the population with a peak incidence between 40-70 years of age. It is characterised by varying levels of pain and limitation in range which is more common in women and can occur in both shoulders in roughly 20-30% of cases.

While frozen shoulders are normally self limiting, symptoms can continue for a number of years with varying levels of pain and functional limitation and in some instances may never fully resolve.

There are 2 reasons why people can go on to develop frozen shoulder:

· Primary : The most common presentation where pain and limitation are noted however without an underlying cause

· Secondary : Frozen shoulder can occur following trauma, shoulder surgery, prolonged immobilisation, diabetes, thyroid disease or other autoimmune disorders

Pathophysiology and presentation

The reason as to why people develop primary frozen shoulder is still not full understood, however research has shown that the joint capsule that surround the shoulder becomes thickened and tight with evidence of inflammatory cell within the capsule with some suggestion of an autoimmune cause for primary shoulder pain.

It is proposed that there are 4 stages of frozen shoulder that is demonstrated in the table below. Ther onset of symptoms however can be gradual over a period of months with symptoms being poorly locaused and reported as a deep ache, with night pain being an common feature. On examination people usually demonstrate good rotator cuff strength and no specific tenderness on palpation however a marked loss of range of movement, partiucuarly into rotation. As frozen shoulder affects the joint capsule, any form imaging such as an x-ray is normal but can helpful to rull out any other types of pathology.

Management

The main aim of management is to manage symptoms and restore function as a consequence of the freezing portion of the condition. Conservative management is the preferred chocice of treatment with more patients usually improving within 6-18 months and usually comprises of physiotherapy and medication. Surgery is usually considered when shoulder symptoms persistent despite physiotherapy

Physiotherapy: Is the preferred initial treatment of choice, focussing on both stretching and strength maintence. Previous studies evaluating a supervised stretching programme results in a satisfactory outcome for 90% of patients and that mobilisation within tolerable pain was more beneficial than working within pain limits. However, further high quality research is required to assess the benefit of physiotherapy compared to medical therapy alone.

Pharmaceutical Treatments: Paracetamol and NSAID’s are the usual go to treatments for the management of frozen shoulder and has been shown to have more of an effect when combined with physiotherapy. In some steroids, oral steroids have been shown to have a positive benefit however a study examining this did not idtenifyt any additional benefit beyong 6 weeks, concluding that they may be beneficial in the short term however to remain mindful about the long term use of steroids medication

Intra-articular shoulder injections: Studies have shown that steroid injections appear to have greater benefit in the short term for pain relief when compared to steroids. In some studies, a cortisone injection has been shown to reduce pain for up to 8 weeks and himprove passive range of movement in both the short and long term when compared to placebo. Furher studies have identified significant iprovements in pain when an injection is provided between 6 weeks and 4 months compared to placebo and physiotherapy alone, but even higher-level evidence of the combination of cortisone injections and physiotherapy together which the authors of this paper advocate.

Intra-articular sodium hyaluronate injections: Usually performed as an alterative to or in conjuction with steroid injections with some studies highlighting similar benefits to a cortisone injection with less side effects. However, evidence in the literature appears low and further studies are required.

Hydrodilatation: This technique involves dilation of the joint capsule with either saline or steroid and local anathesic in view of stretching the joint capsule and breaking down adhesions. Some stuids have showed improvement in range of movement following such a procedure but pain and functional scores were compareable. The authors conclude that there is insufficient evidence in the literature to suggestion hydrodilation as superior to other froms of treatment for frozen shoulder

Suprascapular nerve block: The aim of this treatment is to target the nerve that innervates the shoulder, in particular the supraspinatus and infraspinatus. Some studies have shown this may provide some short term relief however the author recommends that more trials are needed.

Surgical Treatment

Manipulation Under Anaestheic (MUA): During this procedure the patient is anthesatised and the shoulder is manioulated to breakdown the scar tissue within the shoulder. It has been shown to have a good benefit in both the short and long term, particularly when combined with physiotherapy. However, care is required that other structures around the shoulder are not affected as a result of the shoulder being manipulated.

Arthroscopic Release: Has been shown to have both good short and long term outcomes in terms of both pain and function. While allowing a controlled released of the capsule, it also allows the surgeon direct visualtion of the shoulder and any other pathology that may need addressing. It also allows physiotherapy to commence early due to patients often having minimal pain. Open surgery is a far less common procedure due to the potential complication as a result

My Conclusion

Frozen shoulder is a common shoulder condition which specifically targets the joint capsule leading to inflammation and thickening of the tissue. This initially results in significant pain and subsequent loss of range of movement and while the prognosis is good it can take a number of months to settle. In the initial stages anti inflammatories and in particular a cortisone injection alongside physiotherapy appears to good evidence behind it while for more chronic conditions that haven’t responded to treatment, surgical treatment by way of a manipulation under anaesthetic or arthroscopic release and physiotherapy following also appears to be favourable.

Not All Leg Pain Associated with Back Pain is 'Sciatica'!

183:742286750 (Matthew Ross) — Tue, 24 Sep 2024 21:09:12 GMT

A new paper by Fourré et al (2023) tries to help differentiate the causes of leg symptoms associated with lower back pain

Lower back pain is incredibly common, and is the leading cause of disability globally. While painful, symptoms are seldom anything to be concerned about and in fact the prognosis for recovery is good - typically 8-12 weeks.

For some, people with lower back pain report symptoms that can be felt into the leg. More often than not, people who experience such symptoms have either been told or report that they have 'sciatica'. However, over the years sciatica has been used as an umbrella terminology to describe ANY pain felt in the leg when actually there are several reasons this may occur, two of these causes are:

Neuropathic Pain: Defined as 'pain caused by a lesion or a disease of the somatosensory nervous system'. In other words, back pain associated with a disc herniation, which causes compression of the nerve leading to symptoms down into the leg
Nociceptive Pain: Defined as ' pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors. Nociceptors are triggered by mechanical, chemical, or thermal stimuli arising from all innervated structures’. In other words, pain that arises from another structure around the lower back but not associated with nerves.

It's important to attempt to identify whether the pain is associated with the nerve of another structure as ultimately the treatment moving forward will vary. So, are there different symptoms that people experience that could help differentiate between neuropathic (nerve) and noiceiptive (other structure) pain? Fourre et al have identified common signs and symptoms which can help (see below)

Based on this image:

Neuropathic Pain: Generally experienced in a certain aspect of the leg (usually the area of the leg supplied by the nerve that has been affected).The most common descriptors used by patients are burning, lancinating, and is accompanied by unusual tingling, crawling, or an electrical shock or shooting in the leg. On examination people may also demonstrate decreased reflexes as well as pain on light touch. Leg pain can occur spontaneously.

Nociceptive Pain: Leg symptoms commonly described as intermittent and can settle quite quickly. Symptoms are usually reported as intermittent and sharp and usually exacerbated by movement. This also means that people can adopt pain relieving positions to settle their leg symptoms, can be brought on again by performing a certain movement.

Hopefully this helps you identify some differences between symptoms however if you are currently experiencing back and leg pain and would like some further advice and guidance, feel free to contact us directly or book your appointment via our 'Instant Booking' function on our website!

Spinal Pain? We've Got Your Back!

Wed, 26 Jul 2023 00:45:54 GMT

Research highlights altered movement patterns as well as conscious / unconscious protection in those with chronic lower back pain.

Chronic lower back pain (CLBP), which is classed as persistent pain that continues for greater than 3 months, is prevalent in 3–4% of adults below 45 years of age and 5–7% of adults over 45 years of age. While a large majority of lower back pain It can have a significant impact on quality of life, function and ability to participate in work and activities, leading to numerous investigations and various referrals to other healthcare professionals.

These two studies attempted to examine movement patterns in people with and without lower back pain, as well as how changing thought patterns around their beliefs can help their pain and function.

Exploring lumbar and lower limb kinematics and kinetics for evidence that lifting techniqueis associated with LBP (Saraceni et al 2021)

People with chronic lower back pain usually report difficulty in bending forward, in particular when attempting to lift anything heavy. This study attempted to review biomechanical movement pattern differences in manual labourers with and without chronic lower back pain (>5 years).

What they identified was that those with lower back pain used a different lifting technique when compared to those without lower back pain. Those with back pain performed more of a slower, 'squat' type lift, with a greater knee bend and straighter lumbar and thoracic spine as well as greater peak knee forces when standing. Those without lower back pain performed the lifting task with a quicker, more stooped like posture with less knee bend.

Their conclusion was that the common assumptions around lower back pain associated with movements and the forces produced during a lifting task were not observed and brings into question the current belief around safe lifting.

From protection to non-protection: A mixed methods study investigating movement, posture and recovery from disabling low back pain (Wernli et al, 2021)

This mixed method study design examined the benefit of Cognitive Functional Therapy (CFT) in people with chronic lower back pain (CLBP). 12 people were interview at the start of the study, identifying their beliefs about their back and the 3 movements and postures that they find most provoking. A course of CFT was delivered over a period of 12 weeks, where participants were interviewed afterwards to review their movements and their perceptions of their symptoms.

At the end of the 12 weeks, 11/12 people had reported significant improvements in their pain and function, enabling them to return to their usual activities and in some instances (7/12 people) not think about their back pain at all. The authors of this study identified two groups for both before and after the intervention which I believe is extremely useful:

Before Intervention

Non-Conscious Protection - A lived experience of being stiff, restricted, tense, locked or seized up
Conscious Protection - Tense, guarded, careful and cautious movements and postures due to belief of structural damage / vulnerability, fear and worry of damage, pain, future +/- diagnostic uncertainty

After Intervention

Conscious Non-Protection - Purposefully relaxed, fluid, free movements and postures that reduce pain and increase function (including integration into valued activities)
Non-Conscious Non-Protection - Automatic, natural, relaxed, fluid, free movements and postures secondary to positive experiences that disconfirm or violate previous beliefs, worries or expectations, and individualised education about their condition and the meaning of pain

Cognitive Functional Therapy (CFT) is the mastermind of australian Physiotherapist Peter O'Sullivan, and now has numerous research papers highlighting the benefit of this intervention in people with Chronic Lower Back Pain. I had the honour of participating in one of his courses last year and have successfully used this intervention in a number of clients.

So, if you are experiencing long term lower back pain, speak with me today on either enquiries@mattrossphysiotherapy.co.uk or 07814 717577 to see how I can help.

I look forward to hearing from you!

Matt Ross

COVID-19 Update 28th Feb 2022

Mon, 28 Feb 2022 01:01:29 GMT

Recently. the UK Government announced changes to their guidance and laws on how to manage the COVID-19 Pandemic. According to the recently published 'Living with COVID-19', regular asymptomatic testing and required self isolation should you test positive has been removed. However, the UK government still recommend:

Wearing a face covering in crowded and enclosed spaces
Testing if you do develop symptoms (the NHS still suggest that a temperature, loss of sense of taste or smell and a new continuous cough are the most common signs)
Stay at home if you are unwell
Regular hand washing

The current recommendations the Public Health England Infection Protection and Control Teams is that PPE shall continue within a healthcare setting until advised otherwise. Therefore Matt Ross Physiotherapy shall continue with:

The wearing of full PPE
Strict cleaning procedures both before, after and inbetween patient appointment times
Sufficent gaps in between patients to ensure adequate social distancing

While facemasks have not been mandatory for a while now, the clinic has a broad range of clients from different ages and diffent medical conditions and I have a duty to ensure everyones safety during this time. I therefore kindly request that all clients continue to wear a face covering whilst on the premises (unless medically exempt or for any other valid reason).

If you feel unwell, please do not attend your appointment and notify me so we can arrange at your earlies convenience

This guidance will be reviewed on the 1st April 2022. Many thanks for your continued support.

New Opening Hours!

183:742286750 (Matthew Ross) — Sat, 21 Aug 2021 22:29:04 GMT

Evidenced Based Physiotherapy More Accessible Than Ever Before.

Matt Ross Physiotherapy has been established for almost 3 years and throughout this time I have had the pleasure of helping hundreds of clients with various conditions. Since the very start I have always aimed to provide professional, evidence based physiotherapy ensuring people receive interventions based on the recent scientific evidence and I am delighted to receive positive feedback as well as recent awards from Global Health and Pharma.

As a result of increased demand I am delighted that the clinic has changed it's opening times to enable more people to receive the very best physiotherapy in Chelmsford. The clinic times are as follows:

Monday to Wednesday: Closed
Thursday to Saturday: 8.30am to 6pm
Sunday: 10am to 4pm.
Emergency appointments may be available at request - please contact directly.

Booking appointments has never been easier and can be done by clicking the 'instant booking' located at the footer of the webpage. This is the very first step in developing the services and availability of the clinic and I am looking forward to many more exciting developments in the next to distance future!

Kind regards

Matt Ross

COVID-19 Update 19th July 2021

183:742286750 (Matthew Ross) — Sun, 18 Jul 2021 11:21:56 GMT

Important information in relation to the upcoming easing of restrictions.

From Monday 19th July 2021, Boris Johnson and the UK government announced plans to lift all remaining COVID restrictions which includes social distancing the the use of face masks. While this a great step in our return to normality based on the amazing efforts of the UK public and the vaccine rollout, it's clear that the number of UK infections are continuing to rise sharply.

Your health, safety, and well being are of huge importance to me at the clinic and I will continue with:

The wearing of full PPE
Thorough cleaning between customers
Gaps between appointment times to ensure that you do not come into contact with other customers.
Personal lateral flow testing 2 times per week.

While during our consultation I try to maintain social distancing as much as possible, the nature of our profession means that in order to perform an objective assessment may require close contact. In light of this, and for the safety of both you and I, I would be grateful of you would continue wearing a face covering throughout your time in the clinic. If you are mask exempt then please let me know prior or at the start of your consultation.

If you require physiotherapy and are still concerned about attending a face to face clinic then don't forget that I still offer home visits and virtual consultations.

Thank you for your continued support and understanding and please stay safe.

Kind regards

Matt

GHP Private Healthcare Awards Winner 2021: Best Emerging Physiotherapy Clinic - Essex

183:742286750 (Matthew Ross) — Sun, 07 Feb 2021 16:32:13 GMT

I am absolutely delighted to announce that Matt Ross Physiotherapy has won the 'Best Emerging Physiotherapy Clinic in Essex' accolade following nomination in the 2021 GHP Private Healthcare Awards.

These annual Healthcare & Pharmaceutical Awards, organised by Global Health and Pharma, recognises the tireless work undertaken by companies, individuals and initiatives that contribute towards promoting the physical and mental welfare of those in need of support and I am delighted to be acknowledge by the GHP judging panel.

Since the opening of the clinic back in 2018, I have always ensured that those who required physiotherapy treatment received the very best, evidence based and holistic interventions, making sure that people fully understand their condition and how to work together to aid their rehabilitation and I'm confident that over the coming years the clinic will continue to go from strength to strength.

Lastly, thanks to all my friends and family for your continued support throughout this journey and to all my clients, old and new, for your kinds words and trust over these last few years.

Matt

Appointments Available Throughout the New Lockdown.

183:742286750 (Matthew Ross) — Tue, 05 Jan 2021 16:40:41 GMT

Dear all,

On Monday 4th January 2021, Boris Johnson and his government announced a new national lockdown in an attempt to reduce the high rates of transmission and infection that is circulating throughout the UK. This new lockdown is similar to that of March 2020, however I am delighted that the government has decided that Physiotherapy services are 'essential' and in accordance with advice from the Chartered Society of Physiotherapy, services will remain open.

Matt Ross Physiotherapy will continue to follow strict and thorough cleaning protocols to ensure the health and safety of everyone. This includes:

Temperature check and hand sanitiser on arrival
With one clinic room this ensures that you will not come into contact with anyone else other than the clinician
Full PPE worn throughout the consultation
Following the 1 meter+ rule where able
Lengthened time between appointments to enable through cleaning of the clinic

I understand that some people may require physiotherapy services and are unable to attend as they are concerned about the current situation or currently shielding. You'll be pleased to know that there are a number of different options available:

Telephone and Video consultations
Ask the Expert Q&A section
FREE lockdown exercises

These next few months will no doubt be difficult for everyone but with the current vaccine programme accelerating there appears to be light at the tunnel. However should you have any physiotherapy needs during this time or have any questions please feel free to let me know.

Stay safe.

Matt

Matt Ross Physiotherapy Service Continue During Tier 4 Restrictions.

183:742286750 (Matthew Ross) — Tue, 22 Dec 2020 21:39:07 GMT

Dear all,

As you are no doubt aware, Boris Johnson and the government announced further restrictions and implemented tier 4 in an attempt to reduce the rate of transmission of the virus. This sadly means the closure of non-essential retail and services.

After further investigation and consultations with our governing body I have been informed that physiotherapy are deemed an essential service and therefore, according to government guidelines, face to face appointments are available as usual.

Your health and safety during this time has always been of high importance and I will continue to maintain the high standards of cleanliness that I have done throughout the whole year which includes significant gaps between appointments to allow thorough cleaning, full PPE and temperature check on arrival.

I understand in light of current circumstances you may have concerns about attending a face to face appointment and in this instance I am pleased to be able to offer telephone / video consultations. Please let me know if you would prefer this type of appointment. Also, please take a look at the FREE lockdown exercises that I have created that will help keep you fit and healthy during this time.

Many thanks for your continued support. And while it will certainly be different this year, I want to wish you a very Merry Christmas, no matter how you celebrate it, and a happy and healthy New Year.

Matt

COVID-19 Update

183:742286750 (Matthew Ross) — Sun, 01 Nov 2020 17:24:34 GMT

Services will remain open throughout November 2020.

Last night Boris Johnson announced a new 4 week national lockdown will be implemented in an attempt to reduce the spread and number of infections. Therefore, from Thursday 5th November 2020 all non essential services will be asked to close and a stay at home advisory announced. People should only leave their home for:

Education
For work, if you cannot work from home
For exercise and recreation outdoors
For medical reasons, appointments and to escape injury of harm
To shop for food and essentials
To provide care for a vulnerable person.

The Chartered Society of Physiotherapy seek to reassure people who are seeking physiotherapy services that these shall be available to them no matter what the level of lockdown. More information can be found here at https://www.csp.org.uk/news/2020-10-28-physiotherapy-services-remain-open-across-uk?fbclid=IwAR2UohT...

Therefore, Matt Ross Physiotherapy will continue to provide appointments throughout the proposed 4 week lockdown. Your safety is and always will be of absolute importance to me and I will continue to provide the same high level of hygiene and cleanliness that has been witnessed over these last few months. These include:

The provision of face masks and hand sanitiser
Significant gaps in between patients to allow thorough cleanliness
Full PPE worn by me throughout the whole consultation.
Temperature taken on arrival
Independent clinic means that you will not come into contact with another patient.

During this continued time of uncertainty I am delighted to be able to help those in need. Should you have any questions or concerns then please feel free to contact me.

Continue to stay safe and look after one another.

Matt

Matt Ross Physiotherapy and South Woodham Runners

183:742286750 (Matthew Ross) — Tue, 29 Sep 2020 21:43:29 GMT

Professional and evidenced based physiotherapy for members of South Woodham's most popular running club

Matt Ross Physiotherapy is delighted to announce that South Woodham Runners, the most popular running club in the area, recommends us as their physiotherapy practice of choice.

Running has always been a popular hobby in our local community, and South Woodham Runners provides an opportunity for likeminded people to come together on a weekly basis to participate in social runs and in local competitions. Their members understand that whether they are a social or seasoned professional they need to make sure that they look after their bodies, understand the nature of any aches or niggles and have this addressed as soon as possible so they can get back to their running sooner.

As part of this collaboration, members of South Woodham Ferrers are entitled to special offers and monthly newsletters to keep up to date with the latest evidence and key exercises that they could incorporate into their exercise plan.

I am looking forward to a close working relationship in the future with all the members of South Woodham Runners, and if you are interested in joining please check out their Facebook page by clicking the following link:

https://www.facebook.com/woodhamrunners

Returning to Activity Post Lockdown

Mon, 27 Jul 2020 18:05:49 GMT

This is a subtitle for your new post

Never has it been more important to look after our health and wellbeing. The government lockdown that was implemented at the end of March 2020 turned our lives upside down, affecting millions of people in multiple different ways. Some people sought to increase their activity levels, finding ways of keeping fit by taking up activities such as jogging, running, brisk walking and cycling, while those of a certain age or with underlying health conditions were encouraged to isolate to reduce the risk of transmission.

Thankfully, almost 4 months on, restrictions are slowly starting to lift as the reduction in transmission continues. People who have been shielding will soon be able to go out and facilities continue to open. As we start to emerge into this ‘new normal’, reports suggests that during the period of lockdown period has had an impact on our health in a multitude of different ways. There are incidences where people report pain after rapidly increasing their activity as a way of keeping fit, while others while those who have been advised to shield may have encountered deconditioning as well as potential psychological effects such as anxiety and depression which can play a large role in pain perception in a whole host of musculoskeletal conditions.

What Can I Do?

Movement and exercise is important for our physical and psychological wellbeing. However we need to be mindful in the ways we approach our chosen activity to prevent overuse injuries such as tendinopathies.

Research is continuing to examine the multidimensional impacts of COVID-19. A study by University College London report a sudden spike in reported exercise at the beginning of lockdown, with 4 in 5 people report performing regular physical activity which has remained constant since. This also correlates with a more recent study from the University of Brighton that highlights a rise of musculoskeletal injuries associated with leisure activities from 15% to 28%.

There a number of useful tips and strategies that can help reduce your risk of injury as we start to emerge from lockdown. Should you wish to engage in more exercise, it is always worth consulting with a health care professional first should you have any concerns.

For those wanting to start an activity as a means to keep fit, ensure that you gradually increase your activity over the coming weeks. An example of an excellent graded exercise programme is the ‘couch to 5k’ for runners or the ‘couch to 30 miles’ for cyclists, many of which can be found online. Gradually increasing your exercise and activity appropriately stimulates cells within various tissues, encouraging adaptations which in turn help your body become stronger as well as improving your cardiovascular system.

For those who have had a significant reduction in their weekly activities, for example those have been required to shield or those who were highly active pre-lockdown, their tissues would have gone through a period of deconditioning. A paper by Bogdanis in 2012 highlighted that this reduction in activity and adoption of a more sedentary lifestyle has a significant impact on both muscle strength and mass, particularly in the larger anti-gravity muscles such as the gluteal and quadriceps . This is reinforced in a paper by Narici et al (2020) who notes the beginning of significant muscle atrophy within 5 days, with approximately a 10% loss at 30 days and 15% loss at 60 days. Therefore it is important to understand that as restrictions start to ease, your body will find it difficult to immediately return to the sort of intensity that you capable of pre-lockdown. Start off slowly, with shorter distances or lighter weights, and continue to develop over the coming weeks.

If you are aware that a task that will require significant effort, then you can break this activity down through a process called ‘pacing’. Set yourself a time limit and have a short rest in between the activity to allow the tissues time to recover and avoid the acute overload of tissues.

However some injuries, niggle, aches and pains are unavoidable in your attempt to get fit and physiotherapy can help you get back on the right track. By helping identify the problem, providing education and management strategies as well as a specific and tailored exercise programme to help facilitate your recovery, I can help you get back to the activities you enjoy sooner, pain free, and with the confidence and knowledge to help reduce your risk in the future.

Reopening Monday 8th June 2020!

Sun, 31 May 2020 20:02:47 GMT

I am delighted to announce that in light of the recent guidelines from the UK Government and advice from both the Chartered Society of Physiotherapy and Acupuncture Association of Chartered Physiotherapists that the clinic shall be open once more from Monday 8th June 2020.

There will be a number of changes from what you would normally expect from a physiotherapy appointment, however this has been implanted to ensure that both I and patients remain safe and minimise the risk of transmission.

Why Matt Ross Physiotherapy?

Being a small family run business, there is only one clinic room meaning that you will not be amongst other people awaiting treatment. 45 minutes shall be left between appointments to ensure that the clinic can be deep cleaned and made safe for the next patient. When you attend your appointment you can be assured that everything has been performed to help maintain your safety.

What can I expect from my appointment?

Prior to your arrival you will be sent a new patient information sheet and consent form which will contain COVID related information which you must read and sign and bring to your first appointment.

Please thoroughly was hands before attending.

The therapist will be wearing a mask throughout the duration of the session. Gloves will be donned when performing any hands on / physical assessment and disposed of immediately afterwards.

Bed covers have been removed to allow easy cleaning and paper towel shall be used instead. Washable plastic pillow covers shall be used to ensure these can be safely cleaned after each patient

On arrival, a table will be present which provides hand sanitised and your own face mask. Before entering the clinic it is important that these are addressed. Once the mask is in situ, your temperature shall be taken with a contactless digital thermometer. If you have a temperature in excess of 37.5 degrees then unfortunately your session will not go ahead.

If your temperature is within normal limits then you can enter the clinic and your appointment will continue as normal, however you MUST wear your mask until you leave the building.

You can still expect the same level of professionalism, evidence based practice and personalised exercise programme.

However, you MUST NOT visit the clinic if:

You are displaying the symptoms of coronavirus which includes and not limited to a high temperature, new persistent cough and / or a loss of taste or sense of smell
You have recently come into contact with someone who has has coronavirus symptoms
You have been instructed by NHS111 of the NHS Track and Trace team to self isolate.
You have recently visited a foreign country and have not quarantined for the required 14 days

As physiotherapy is a hands on profession it is impossible to maintain the 2m rule and please expect close contact however with the above stipulations the risk of transmission should be low. Online and telephone appointments are still available should you wish to have a consultation via this avenue.

Appointments must be booked in advanced so please contact me through our contact us section.

Please continue to play your part in reducing the spread of the virus and stay alert, control the virus and save lives.

I cannot wait to welcome you back to the clinic

Kind regards

Matt

Acupuncture Course

183:742286750 (Matthew Ross) — Tue, 20 Nov 2018 21:19:53 GMT

First Weekend Experience of Learning Acupunture with the AACP.

Ever since I heard about the improvements made my friends and family have made by receiving acupuncture for various injuries, I have always been interested in learning how it works and thought it would be great to offer this service to my clients.

So, on the weekend of the 17th and 18th November 2018 I had my first weekend organised by the Acupuncture Associate of Chartered Physiotherapists (AACP) to learn the logic behind it and the skillset to be able to administer it. Over the course of the weekend I learnt about the origins, contemporary practice, meridians, key points and techniques. We jumped straight in and began to administer needles in view of treating various conditions.

It was a thoroughly enjoyable and informative day, and following the next weekend (early December) I should be in the position to offer acupuncture within the clinic to form case studies, and then be able to offer the service properly in the new year.

So keep your eyes peeled on both the website and social media for news and updates about when this service will be launched. I cant wait!

Placement Experiences as a Physiotherapy Student

183:742286750 (Matthew Ross) — Tue, 20 Nov 2018 19:10:10 GMT

Tips and Advice for Physiotherapy Students

Welcome to my next blog in the ‘So you want to be a physiotherapist…?’ series. In part 3 we introduced year 1 and I provided some key tips that will help you begin your physiotherapy studies.

This month I will be looking at placements, and the important role that they play not in only reaffirming your knowledge gained throughout your studies, but also will provide a great insight into clinical working and what you can expect as a qualified physiotherapist.

Although I have only discussed year 1 so far in my blog pieces, this blog will discuss your placements across your whole degree (years 1 – 3) and how the marking and expectations of you change over this time.

Placement Format

Universities will differ on when placements are allocated over the course of your 3 years. For me at King’s College I had 2 half day observational days in year one followed up one 6 week placement at the end, two 5 week placements in year 2 and then 3 five week placements in year 3.

However, no matter how your placements are organised, in the UK you have to complete a minimum of 1000 hours of clinical placements over the course of your 3 years to be able to complete your degree and apply to the HCPC. Most universities schedule over and above this (i.e 1056 hours) to account for any sick days or bank holidays.

Placements can be provided in a whole host of different areas, ranging from inpatients to outpatients, from critical care to community, but universities will attempt to make sure you have experience in all three fields of physiotherapy; musculoskeletal, neurology and cardiorespiratory.

Receiving Your Placement

You will be informed of your placement well in advance of when it is scheduled for. We received email notification informing us of our placement location, speciality, typical working pattern and who your clinical educator will be.

It is important that when you first receive your notification that you email your clinical educator to find out a little more about the placement. For example, what area of cardiorespiratory will you be working in? What is a typical working day? Do they have any pre-reading they recommend? Make sure that the email reads well and is professional throughout. Remember this is the first contact they make with you and you never get a second chance to make a good first impression.

Pre-Reading

Once you have been told what clinical area and speciality you will be working in for your placement, I strongly suggest that you go over your notes, examination techniques and further reading to bring that topic to the forefront. In my second blog I offered some resources that helped me over the three years and recommend you take a look at this, but there are lots out there that can help. Perhaps book a room with some colleagues and go over some practical examination techniques / role play etc.

Guidelines for Your Organisation / Governing Body

As physiotherapists in the UK we are required to adhere to both the HCPC Standards of Proficiency as well as Code of Members Professional Values and Behaviours.

As autonomous health care professionals, we are meant to be accountable for our actions and these guidelines provide a framework for how we should work. As you will be on placement in a clinical setting it is highly advisable that you go over these to refresh yourself.

Weighted Marking

Whilst placements are vitally important to obtain an insight into clinical working, it is also important to remember that you are being assessed against pre-set criteria. During my placements, I was marked on the following areas:

Interpersonal Skills
Professionalism
Treatment / Management
Clinical Reasoning

On my first placement, each criteria was equally weighted towards the final overall mark. However, over the course of the next two years the weighting changed so the clinical reasoning and treatment aspects are more heavily weighted. While the other two topics are still important, clinical reasoning is a vital component as you move towards the latter years and for when you finally graduate and start working.

Your First Few Days

It is absolutely fine to be nervous when you first start your placement, everyone does, particularly on your first one but after the first few days you will start to feel more settled.

Typically, on your first day you will meet up with your clinical educator and you will go through health and safety information, log ins for any IT software plus a guide of where you will be working. Usually you will shadow your clinical educator over the first few days to gain an insight into how they work, document information and liaise with members of the team.

Learning Contract

Every placement we were given a ‘placement pack’. Within this pack were feedback sheets from clinicians / patients plus a booklet where your goals and feedback are recorded.

It’s important that, before you start, you have a think about what your goals are for this placement – don’t make them too complicated and think of approximately 5. Goals that often encompass communication, documentation, exercise prescription and progression etc. are often ones to consider.

During the first few days of your placement, you will go through these goals goals with your clinical educator and make any alterations to them if necessary. Once agreed, these become your main goals over the duration and will be revisited at the end.

It is also worth discussing the grade that you wish to achieve on this placement. Of course, everyone wants to achieve the highest grade possible, but as you will come to learn different clinical educators will have different expectations in order for you to achieve this, so open and honest dialogue between the two is key. It is worth making a note of the key points mentioned in this discussion and refer to it occasionally to see whether or not you are achieving these tasks.

During your placement.

As already discussed, initially you will shadow your clinical educator to gain an insight into their assessment and treatment techniques as well as how a typical day operates and the systems they use. Over time your clinical educator will gradually let you take the lead with patients and in some instances, should they feel confident with your progress, will let you see patients by yourself to then discuss with them after about how you felt it went.

Your placement may also include running and participating in classes, working with other members of the multidisciplinary team, discharge planning and attending meetings to name a few. Some situations may put you out of your comfort zone but don’t worry, the more you do it the better you become and if there are things you are unsure of, ask your clinical educator, that’s what they are there for.

Reflective Practice

Physiotherapists are autonomous professionals and we are therefore held to account for any intervention we offer our patients. It is important that, throughout your placements and indeed the rest of your physiotherapy career that you continually reflect on your practice. There are some good reflective practice sheets available, one of which is offer by the CSP and can be found here. Not only will this highlight to your clinical educator that you are being proactive in your own learning, but these can also contribute towards your CPD folder. Try to aim for a couple of reflections minimum a week. As well as written reflections, discuss with your educator after a patient. What went well? What didn’t? What would you have done differently in that situation?

As physiotherapists, we are also responsible for keeping up to date with the latest evidence base. Your clinical educator will be impressed if you can explain an intervention that you performed based on the most recent NICE guidelines or systematic review, for example.

Half Way and Final Way

Half way during your placement you will sit down with your clinical educator and discuss your performance so far. You will revisit the initial goals that you set out and agreed at the beginning of the placement as well as going through the marking criteria. You should be given an idea at what level you are performing at for each criteria, and given advice about where you should improve on. Take note of this and ensure that you address these points in the second half of your placement.

On the other hand, don’t be afraid to address points that you feel you have accomplished but your clinical educator feels as though you haven’t, and give examples if you can.

At the end of your placement you will do the same, however this time you will be given your final mark and then, with your clinical educator, compile a list of action points to address on subsequent placements.

Ask Questions!

Do not be afraid to ask questions. This is SO important, as with so much going on, in an area that you are not particularly sure of, you are going to be unsure on several things. I was once told that, as a clinical educator, they would worry far more about someone who did not ask questions than someone who did. Talk to your clinical educator, other physiotherapists and members of the MDT, they are there to help you and not long ago they were in your shoes too!

I was also assigned a ‘link tutor’ from university, a member of staff who I could contact if I had any questions or concerns. Again, don’t be afraid to make contact should you need to.

In Summary

Placements are a fantastic and essential way to transfer the theory learnt at university to actual patients who have a real pathology. Yes, you will be assessed and yes, your mark will count towards your degree, but do not lose sight of the real reason you are there and it’s to gain a small insight into the clinical working of a physiotherapist and to develop the skill of learning from your own practice.

You will not know everything, and you will be asking lots of questions. Physiotherapy is a lifelong learning process Whilst I was on placements I encountered numerous band 5 physiotherapists who were continually asking colleagues questions.

I hope you have found this blog useful and hopefully it will provide some preparation for your upcoming placements. Most importantly, enjoy yourself! Physiotherapy is a great profession and it’s good to gain an insight in the important role they play within the MDT.

Next month, we will continue our journey through the academic aspect of your degree and take a look at year 2. See you next time!

2018 EULAR Recommendations for Physical Activity in People with Inflammatory Arthritis and Osteoarthritis

183:742286750 (Matthew Ross) — Thu, 08 Nov 2018 10:10:00 GMT

Physical Activity Deemed Safe and Feasible.

There are approximately 100 different types of known arthritis, with the two most well-known being osteoarthritis (OA) and rheumatoid arthritis (RA).

OA is the most common form of arthritis which, although can be affect people of any age, sees a steady increase in prevalence with age. OA typically involves inflammation and structural changes of the joint, causing pain, functional disability and reduced quality of life (Cross et al, 2014). Arthritis Research UK (2014) highlight that approximately 8.75 million people have sought treatment for OA with just over half having knee OA.

RA is an autoimmune inflammatory arthritis that, like OA, has a significant impact on the ability to perform daily activities, health-related quality of life due to structural changes that occur as a result (Singh et al, 2016).

The World Health Organisation (WHO), in conjunction with the American College of Sports Medicine (ACSM) (Garber et al, 2011) provided recommendations for physical activity levels in health adults which has been widely recognised and promoted. Part of these recommendations is that:

‘’Healthy adults aged 18-65 years should participate in moderate intensity aerobic physical activity for a minimum of 30 minutes 5 days per week or vigorous intensity aerobic activity for a minimum of 20 minutes 3 days per week’’

While evidence, such as the systematic review by Fransen et al (2015), highlights the positive impact of physical activity, people with rheumatic and musculoskeletal diseases are generally less active compared to healthy controls while type and dosage of exercise still remain unclear.

To address this, a EULAR task force was created to:

1. Evaluate if the physical activity recommendations are applicable to inflammatory arthritis and OA

2. Develop evidence based recommendations on physical activity promotion and delivery in the management of people with inflammatory arthritis and OA.

3. Formulate an educational and research agenda.

In this paper, inflammatory arthritis encompasses RA and Spondyloarthritis while OA encompasses hip and knee OA.

22 European experts formed the multidisciplinary task force ranging from medical doctors to human movement scientists plus 3 patient representatives. Two systematic literature reviews were performed; one to investigate the effectiveness, safety and feasibility of physical activity while the other investigated facilitators and barriers towards physical activity.

The results from the systematic literature review were presented during the second meeting of the task force, allowing the experts to draft 10 recommendations through discussion and consensus. After the second meeting, the recommendations were sent to members of the task force via email to allow them to rate the level of agreement for each.

Results

The literature search resulted in 96 papers from which 4 overarching principles and 10 recommendations for physical activity based on these results and expert opinion were produced. The recommendations are as follows:

1. Promoting physical activity consistent with public health physical activity recommendations should be an integral part of standard of care throughout the course of disease.

2. All health care providers should take responsibility for promoting physical activity and making necessary referrals to make sure the receive the appropriate physical activity interventions.

3. Physical activity should be delivered by health care providers component in their delivery.

4. Health care providers should evaluate peoples current physical activity levels to identify which areas require improvement.

5. General and disease-specific contraindications for physical activity should be identified and taken into account in the promotion of physical activity

6. Physical activity interventions should have clear personalised aims that should be evaluated by the use of subjective and objective measures.

7. General and disease specific barriers and facilitators related to performing physical activity should be identified and addressed.

8. Where individual adaptations to general physical activity recommendations are needed, these should be based on comprehensive assessment of physical, social and psychological factors including fatigue, pain, depression and disease activity.

9. Health care providers should plan and deliver physical activity interventions that include behavioural change techniques.

10. Healthcare providers should consider different modes of delivery of physical activity in line with people’s preferences.

In Conclusion

The results from this task force correlates with previous research that exercise is beneficial to those with both inflammatory and osteoarthrosis. However, the paper does highlight that physical activity promotion is a behavioural intervention and should therefore form a key part in physical activity interventions.

Although a literature review formed a key part in the formation of the recommendations, there was only one reviewer of the abstracts with a second person involved in screening unclear abstracts which doesn’t comply with the standard procedures for producing systematic literature reviews.

Also, while the paper addresses the most prevalent inflammatory and osteoarthritic conditions, large heterogeneity between conditions may limit the precision of the recommendations and sub conditions, such as juvenile arthritis, were not considered.

Exercise continues to demonstrate its usefulness in improving the outcomes and quality of life in a large majority of conditions. However, as physiotherapists we need to understand the individual barriers that a person may hold against physical activity, address them empathically, utilise behavioural change techniques such as education and work collaboratively with our patients to implement a graded programme to achieve the public health physical activity guidelines on physical activity.

Original Article

Osthoff, A.K.R., Niedermann, K., Braun, J., Adams, J., Brodin, N., Dagfinrud, H., Duruoz, T., Esbensen, B.A., Günther, K.P., Hurkmans, E. and Juhl, C.B. (2018). 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Annals of the rheumatic diseases , 77 (9), pp.1251-1260.

References

· Arthritis Research UK (2014). Arthritis in the UK – Facts and Statistics. Available at: https://www.arthritisresearchuk.org/~/media/Files/Arthritis-information/Arthritis%20key%20facts.ashx arthritis research UK facts and figures [Accessed 3rd November 2018].

· Cross, M., Smith, E., Hoy, D., Nolte, S., Ackerman, I., Fransen, M., Bridgett, L., Williams, S., Guillemin, F., Hill, C.L. and Laslett, L.L. (2014). The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Annals of the rheumatic diseases , 73 (7), pp.1323-1330.

· Fransen, M., McConnell, S., Harmer, A.R., Van der Esch, M., Simic, M. and Bennell, K.L. (2015). Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med , pp.bjsports-2015.

· Garber, C.E., Blissmer, B., Deschenes, M.R., Franklin, B.A., Lamonte, M.J., Lee, I.M., Nieman, D.C. and Swain, D.P. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine & Science in Sports & Exercise , 43 (7), pp.1334-1359.

· Singh, J.A., Saag, K.G., Bridges Jr, S.L., Akl, E.A., Bannuru, R.R., Sullivan, M.C., Vaysbrot, E., McNaughton, C., Osani, M., Shmerling, R.H. and Curtis, J.R. (2016). 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis & rheumatology , 68 (1), pp.1-26.

Simply Health Insurance

183:742286750 (Matthew Ross) — Thu, 01 Nov 2018 10:48:14 GMT

Matt Ross Physiotherapy now a recognised provider!

I am delighted to announce that Matt Ross Physiotherapy is now a recognised health care provider for Simply Health!

Simply Health has been supporting their customers with their health care needs for over 140 years by providing a range of services from physiotherapy to dental care.

I am looking forward to working closely with Simply Health in the future, and providing a professional and effective service for their customers.

Patellofemoral Pain

183:742286750 (Matthew Ross) — Thu, 04 Oct 2018 16:52:37 GMT

2018 Consensus Statement on Exercise Therapy and Physical Interventions

Patellofemoral Pain (PFP) is an umbrella term that describes peripatella or retropatella pain in the absence of other pathologies. Other descriptions for PFP include patellofemoral pain syndrome, anterior knee pain and chondromalacia patellae (Brukner et al, 2017) and is common in loading activities such as squatting, running and stair ambulation (Crossley et al, 2016).

Although numerous intra and extra articulating structures could be responsible for the production of PFP, the actual cause is not entirely understood (Collado and Fredericson, 2010). One consideration is that PFP is a result of an increased loading through the knee, causing peripatella synovitis or damaging the articulating patellofemoral cartilage which, although avascular and aneural could result in an inflammatory cascade that produces synovial irritation (Brukner et al, 2017).

PFP has shown to affect adolescents, young adults, elite athletes as well as members of the general population with incidence rates varying between 15%-45% and is considered one of the most common types of knee pain (Smith et al, 2018).

Previous systematic reviews like the one produced by van der Heijden et al (2015) suggested that there was very low but consistent evidence highlighting the positive impact of exercise on PFP, and that exercises focusing on both the hip and the knee reported better outcomes than exercise focusing solely on the knee.

Another systematic review by Smith et al (2015) looking at knee orthoses found very low evidence that using a knee orthosis did not improve reported pain levels or improved function in the short term (3 months) for adults who were also undergoing an exercise programme.

In both instances, the authors concluded that further high quality research was required to identify the appropriate dosage and modality to treat those suffering with PFP.

2018 Consensus Statement for Patellofemoral Pain.

To address this, a 2018 Consensus statement on exercise therapy and physical interventions was produced by Collins et al (2018). 51 Scientists and clinicians from across the world attended the International Patellofemoral Research Retreat in Australia for their biannual meeting to discuss the latest PFP research developments, discuss literature to formulate consensus statements and to develop future research agenda.

Part of this two day meet was to analyse systematic reviews and randomized controlled trials since their 2016 consensus statement on the same topic to identify whether clinical practice needs to be changed in light of new evidence.

A literature search was performed and studies were classified under the headings:

Exercise therapy
Combined interventions
Foot orthoses
Patella taping and bracing
Other adjunctive therapy.

Papers were reviewed by three people and graded in relation to their quality by using the Assessment of Multiple Systematic Reviews ( AMSTAR ) tool and the PEDro score for methodological quality of randomized controlled trials. Findings from new trials was presented to a panel of 41 attendees which made up the expert panel and consisted of active researchers and clinicians. This panel would vote on whether alterations to current recommendations were in order, or whether new statements should be included in the consensus.

Results

Discussions within the expert panel manly focused on new literature that considered adjunct therapies such as acupuncture, dry needling, manual soft tissue techniques, blood flow restriction training and gait training. However, there was uncertainty regarding the quality of this evidence and therefore the recommendations from the 2016 consensus remained unchanged. These include:

Exercise therapy is recommended to reduce pain in the short, medium and long term with an improvement in function in the medium and long term.
A combination of both knee and hip exercises is recommended to reduce pain and improve function in the short, medium and long term and is recommended over knee exercises alone.
Combined interventions are recommended to reduce pain in adults with PFP in the short and medium term. This means exercise therapy and either foot orthoses, patella taping or manual therapy.
Foot orthoses are recommended to reduce pain in the short term.
Patellofemoral, knee and lumbar mobilisations not recommended in isolation.
Electrophysiological agents are not recommended.

However.…

Some caution should be required when interpreting the results from this paper. Firstly, members of the panel who voted were a combination of active researchers and clinicians. Insight from their own research and experiences around the treatment of PFP may have biased the way they voted towards the statements.

Secondly, and as noted within the paper itself, the idea of the meeting was to share new ideas and knowledge around the treatment of PFP. Discussions that took place over these two days may have biased the statements that were produced to the expert panel.

In conclusion

Since the 2016 consensus statement surrounding the management of PFP, there has been insufficient high quality evidence to suggest any alterations in the recommendations are required. Exercise remains the modality of choice, particularly focusing on the hip and knee which correlates with previous literature such as the Cochrane review previously mentioned and therefore the clinical management of PFP should not change. While these statements provide a guide for clinicians and practitioners alike in the treatment of PFP, the multifactorial aspects that could contribute to the production of pain means that thorough investigation and clinical reasoning should be utilized to offer a personalized and appropriate intervention for your patients.

References

Brukner, P., Carlsen, B., Cook, J., Cools, A., Crossley, K., Hutchinson, M., McCory, P., Bahn, R. and Khan, K. (2017). Clinical Sports Medicine. 5th Edition. McGraw-Hill Education. Australia.
Collado, H. and Fredericson, M. (2010). Patellofemoral pain syndrome. Clinics in sports medicine, 29(3), pp.379-398.
Collins, N.J., Barton, C.J., van Middelkoop, M., Callaghan, M.J., Rathleff, M.S., Vicenzino, B.T., Davis, I.S., Powers, C.M., Macri, E.M., Hart, H.F. and de Oliveira Silva, D. (2018). 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med, pp.bjsports-2018.
Crossley, K.M., van Middelkoop, M., Callaghan, M.J., Collins, N.J., Rathleff, M.S. and Barton, C.J. (2016). 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med, 50(14), pp.844-852.
Smith, B.E., Selfe, J., Thacker, D., Hendrick, P., Bateman, M., Moffatt, F., Rathleff, M.S., Smith, T.O. and Logan, P. (2018). Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PloS one, 13(1), p.e0190892.
Smith, T.O., Drew, B.T., Meek, T.H. and Clark, A.B. (2015). Knee orthoses for treating patellofemoral pain syndrome. Cochrane Database of Systematic Reviews, 2015.
van der Heijden, R., Lankhorst, N., van Linschoten, R., Bierma-Zeinstra, S. and van Middelkoop, M. (2015). Exercise for treating patellofemoral pain syndrome. Cochrane Database of Systematic Reviews, 2017(6).

Welcome to Matt Ross Physiotherapy!

183:742286750 (Matthew Ross) — Thu, 04 Oct 2018 13:22:46 GMT

A dream come true...

I am delighted to be able to write my first blog on my new website, Matt Ross Physiotherapy. After years of hard work to be able to finally get to this position, I am thrilled that I am now able to work in a profession I love and help people from all walks of life.

The website is now launched, and I hope it provides you with a wealth of information about not just what I do here in the clinic, but also tips and advice shared from the worlds leading experts, so please make sure to follow my social media accounts!

The clinic is starting to look great and except for a few items that we are still waiting for, you will provide you a relaxing and comforting experience to begin your rehabilitation journey with me.

Please feel free to browse the site and please do send me any feedback as it will be helpful in making the user experience more friendly. Don't hesitate in emailing me should you have any questions.

I look forward to working with you in the future and welcoming you to the clinic.

Matt Ross