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@physio_strengthI help people build durable health and performance through evidence-based biology, psychology, and behaviour change Program link in bio ๐
London, England
Joined August 2016
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Healthcare professionals
You do not diagnose OA from an XR
thanks, from everyone not stuck in 1950
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I disagree. Listening and good communication skills are the most important. Exercise "prescription" doesn't happen without them.
Exercise prescription: Physiotherapy's most important and least standardized skill
pubmed.ncbi.nlm.nih.gov/4256โฆ
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Coffee may be doing far more than delivering caffeine.
Recent research suggests even decaf can influence inflammation, mood, stress biology, and the gut microbiome.
For people carrying chronic invisible load, that's a useful reminder:
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Nope. Running actually helps preserve your joints.
If you donโt like to run donโt runโฆ but donโt say worthless nonsense like this.
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All these budding exercise physiologists and strength coaches. ๐คฆโโ๏ธ๐คฆโโ๏ธ
This is made up slop. Walk all you want. None of your muscles are working hard when youโre walking and your adductors are firing too.
Is walking enough? No. You need strength and power training too.
And no. This is not how knee OA arises.
Why donโt these guys keep developing apps and posting their incomes in their bio ๐คฃ
The healthiest habit in America is quietly destroying millions of knees.
Walking 15,000+ steps a day builds your heart, your lungs, your endurance. It also loads the same five muscle groups in the same direction, 5.5 million repetitions per year, while the muscles responsible for keeping your knees from collapsing inward barely fire at all.
Your body moves in three planes. Sagittal (forward and back), frontal (side to side), and transverse (rotation). Walking is almost entirely sagittal. Quads, hamstrings, glutes, calves: all getting hammered. Your adductors, the five muscles along your inner thigh, work in the frontal plane. They stabilize the pelvis, keep the knees tracking straight, and prevent the femur from drifting into varus alignment under load. During level walking, they activate at a fraction of their capacity. Along for the ride.
Run that imbalance for a decade. The outer thigh gets progressively stronger. The inner thigh stays the same or atrophies. The knee joint, caught between two muscle groups pulling in opposite directions, starts absorbing asymmetric force with every single step. Cartilage wears unevenly. The medial compartment takes the hit first.
This is how knee osteoarthritis develops. Knee OA now affects roughly 23% of the global adult population. In the US alone, surgeons perform nearly 800,000 total knee replacements per year at $30,000 to $50,000 each. That number is projected to hit 3.5 million annually by 2030.
Patients with knee OA show 8 to 24% weaker hip abductor and adductor muscles compared to healthy controls. A longitudinal cohort study found that weaker hip muscles predicted faster OA progression. When the NHL gave players with weak adductors a 6-week strengthening program, injury rates dropped from 3.2 to 0.71 per 1,000 game exposures. 78% reduction from targeting one muscle group.
The doctor telling this personโs dad to walk less is treating the symptom. The imbalance is the disease. Copenhagen planks, lateral lunges, side-lying adductions. Fifteen minutes, twice a week. Thatโs the difference between a $40,000 surgery and a body that can actually handle its own mileage.
Readers added context they thought people might want to know
This exaggerates any risk from walking, which is shown by multiple independent studies to be excellent exercise, and does not cause osteoarthritis in knees.
x.com/hjluks/status/โฆ
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If your orthopaedic surgeon is arrogant enough to say to you โyou donโt need physiotherapy after your operationโ, then you should run a million miles for
them
๐คฌ๐ก
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MEDICINE DUJOUR: There is NO such thing as a magic pill.
ALL cardiometabolic markers revert after one stops Weight Management Medications.
Results appear to be robust.
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This paper did not say or demonstrate that long term degeneration was prevented. They just said the fragment could be fixed back.
๐ฅ VJSM Patellofemoral Special Issue:
Surgical management of osteochondral fractures following first-time patellar dislocation. Early fixation restores articular congruity and prevents long-term degeneration.
ow.ly/VA7k50XkBGP
#VJSM #Patellofemoral
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I have just done a Grok AI review of a question regarding the false positive rate for US imaging of painful tendinopathy. In general it is between 10 and 40%. This is an issue, but the real problem is the lack of a credible reference or criterion standard against which to estimate diagnostic accuracy of tests (including imaging). In general, the main criterion standards are surgical opinion & findings, and MRI.
The real clinical question is not whether imaging (US included) or surgical findings reveal pathology, but whether, the pathology revealed is actually *symptomatic*. Pathology DOES NOT equal the cause of pain in MSK conditions. It is fallacious circular reasoning to claim that US imaging has a certain diagnostic accuracy when the reference standard against which it is measured, is another imaging modality for example. Surgica finding are just another form of imaging btw.
Research and a different approach is required. I am looking into that.
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A true honour & a very proud moment. Letโs go reds โค๏ธ
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Please consider donating to help @Valjones2305Val a good friend and colleague of mine, and one of the kindest, cleverest and wittiest physios I know!
Val suffered a horrific accident recently that has left her paralysed just after recently kicking breast cancers head in!
More details with this link here gofundme.com/f/val-jones-jouโฆ
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NEW PAPER: Infections can trigger dormant cancer cells. Cancer survivors are advised to consider vaccinations. @Nature
Hidden in the lungs of some breast cancer survivors are tumor cells that can remain dormant for decades โ until they one day trigger a relapse.
Now, a study shows these rogue cells can be roused from their slumber by viruses such as COVID-19 or the flu.
nature.com/articles/d41586-0โฆ
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Yet again another trial shows high intensity strengthening exercise AND low intensity home based exercise helps reduce sub acromial shoulder painโฆ
However, only one is gonna turn you into a yoked out beast with boulders for shoulders! ๐ #ChooseStrength
bmcmusculoskeletdisord.biomeโฆ
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Replying to @AdamMeakins
True, but pain management is only a speck of dust in the overall exercise picture. We also want to improve health, strength, conditioning, bone density, neural drive, and many other things that are optimized with higher intensity.
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The average caloric intake in the USA is 3540 kcal/day (FAO Data)
The average physical activity in the USA is less than 20 minutes per day
The average person is overweight/obese
But you think seed oils explain the health crisis?
You need to get your head examined
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Nope, you donโt know the best six exercise to fix XYZ.
Nope you havenโt found the best way to release fascia and negative emotions.
Nope your stupid exercise isnโt essential for โopening my hips.
You are spouting bull ๐ฉ for clicks and likes.
Now go away off my time line.
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Replying to @exfatloss @BioLayne
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This will be great for millions of people in chronic pain if @hubermanlab and @PeteOSullivanPT do get to talk! ๐ฅ
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Trying to inform patients about the lack of effectiveness and risks of many non-evidence-based โfeel goodโ treatments is often difficult, awkward, time consuming, and not well rewarded!
Many patients donโt care and in some cases make complaints or write negative reviews about how you didnt โtreatโ them!
Its incredibly hard to be an evidence based physio whilst also trying to develop a good reputation and earn a reasonable living.
My utmost respect and support to all of you still trying! ๐ซก


























