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Ankle injuries are among the most common musculoskeletal complaints, with inversion sprains leading the way. These occur when the foot twists inward, often due to a misstep or awkward landing, causing damage to the soft tissues of the ankle. Interestingly, studies show that for every fracture caused by an inversion sprain, there are about eight cases of soft-tissue injuries (Boyce & Quigley, 2004). While acute injuries may heal with time, 30% of individuals experience lingering symptoms, including pain, stiffness, and recurring instability (Van Rijin et al., 2008). Without proper rehabilitation, these issues can evolve into chronic ankle dysfunction, which can severely impact mobility and quality of life.

This blog will explore the importance of exercise in ankle pain management, particularly following an inversion sprain, and how a well-rounded rehabilitation plan can help restore function and prevent long-term complications.

The Role of Immobilization vs. Exercise

In the past, imm...

I wish someone had told me this 20 years ago.

‘IT STILL HURTS’ – is an occasional greeting from our follow-up clients.

We love to hang our hat on the week’s success stories, of which there are usually many but when someone doesn’t get better are you to blame as the therapist?

Have you ever thought one or all the following?

1: My diagnosis must be wrong.

2: If I had an MSc Phd then all my patients would be pain free.

3: My treatment skills are not good enough.

4: If only I was a specialist, they cure all pain.

 …I have!

Then I discovered something. Initially from reading the late Pain Pioneer and Physio Louis Giffords book ‘Aches and Pains’ and then from my own experience of tracking the long-term care pathways of my patients in conjunction with their doctors, and finally through my own research for my recent book on Exercise for Pain Relief.

Here is the truth – as short and simple as I could make it for this blog.

Many patients with common musculoskeletal pain may not exp...

Manual Therapy for Sciatica: Can it Help?

Evidence-based recommendations for the use of manual therapy for sciatica.

 Key points include:

 Sciatica is a common condition caused by irritation of the sciatic nerve, typically due to a disc bulge BUT can there be other causes too?

 Positive outcomes are more likely with a positive outlook and reduced secondary problems like pain and stiffness.

 Manual therapy approaches like mobilization, soft tissue techniques, and taping can address these secondary issues and promote healing.

 Nerve mobilization techniques may be helpful for some patients, but caution is advised due to potential for worsening symptoms.

 Medications for sciatica generally have limited effectiveness and side effects.

Take a course on this subject: https://lawrenceacademy.mykajabi.com

Visit the YouTube Channel: https://www.youtube.com/@ThePhysioChannel

Hip Impingement Treatment: Key Modifications for Pain Relief

In this guide, we cover Activity Modifications to help manage hip impingement pain. Full name = Femoroacetabular Impingement (FAI) 

1. Sitting: Avoid Hip-Closing Positions

To minimize symptoms while sitting:

• Adjust Seat Height: Raise your seat to keep hips open.
• Avoid Crossing Legs: Keep feet flat to reduce hip pressure.

2. Modify Aggravating Movements

Repetitive hip flexion movements can worsen symptoms.

• Lunge Instead of Squat: Use a lunge to get low, keeping the symptomatic hip straight.

3. Shoe Fit Adjustments

Simple adjustments can ease hip pain:

• Loosen Laces and Use a Shoe Horn to avoid deep bending when putting on shoes.

4. Exercise Modifications

Proper form in exercises is key to avoiding impingement.

• Deadlifts: Use larger plates to reduce hip flexion and widen your stance.
• Squats: Try half squats and use a wider stance to reduce impingement.
• Cycling: Ensure the saddle is high enough to
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The three most important strategies to help manage Osgood-Schlatter's and reduce knee pain.

Strategy #1: Reduce the painful activities by 50%. If training twice a week, cut it down to once a week. This will allow time for recovery and pain reduction. This approach is much better than what many doctors often prescribe, which is total rest for several weeks—a difficult and frustrating option for young athletes.

Strategy #2: Prioritize the important training and events. Don’t try to do everything. If playing for your school, your local village team, and another team, prioritize the key events and practices that matter most. This will also allow for some recovery time and pain relief.

Strategy #3: Switch to alternative activities that are lower impact. If running and jumping are aggravating the pain, switch to activities like swimming, walking, rowing, or cycling.

If the knee pain doesn’t improve after following these strategies, activity levels may need to reduce further. 

Learn ...

The research studies collectively support the use of cervical traction as an effective intervention for neck pain, particularly when combined with exercises and manual therapy.

• Raney et al. (2009) developed a clinical prediction rule to identify patients with neck pain and radiculopathy who would benefit from cervical traction and exercise, showing positive outcomes when both are applied together.
• Joghataei et al. (2004) compared intermittent cervical traction with exercise therapy and found that traction significantly reduces chronic neck pain when part of a broader treatment plan.
• Cleland et al. (2005) demonstrated short-term improvements in neck and arm pain when cervical traction is combined with thoracic thrust manipulation.
• Kumar et al. (2014) reviewed multiple studies, concluding that cervical traction is particularly beneficial for cases involving nerve compression.
• Young et al. (2009) compared cervical traction with a placebo in patients with cervical radiculopathy and
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