Journal
Notes on pain, movement and recovery
Plain-language explanations of what we see in the clinic every week, what actually helps, what doesn't, and how to keep progress going between sessions.
Self Care4 min readThe Best Sleeping Position for Your Back, Neck, Hip and Shoulder
You spend a third of your life in one position. If pain is waking you or greeting you at dawn, the fix is usually two pillows placed correctly, not a new mattress.
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Neck5 min readCervical Spondylosis: What That Scan Report Actually Means
It is one of the most alarming phrases to find on a scan report, and one of the most ordinary findings in medicine. Most people your age have it and feel nothing.
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Knee4 min readKnock Knees and Bow Legs: When Parents Should Worry
Most children are bow legged at one, knock kneed at three and straight by eight. Knowing that timetable spares families a great deal of worry and a market full of unnecessary corrections.
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Knee4 min readMeniscus Tears: Why Most No Longer Lead to Surgery
There are really two different injuries wearing the same name, and mixing them up is how so many knees end up having surgery that trials show they did not need.
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Self Care4 min readSore Two Days After Exercise: What DOMS Is and Is Not
The workout felt fine. The next morning was fine. Then day two arrived and the stairs became a negotiation. That delay is the signature of DOMS, and it is telling you something useful.
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Self Care4 min readNight Leg Cramps: Why Your Calf Seizes at 3 AM
Few pains are as dramatic per second as a calf locking solid in the middle of the night. Here is what is actually happening, how to end one quickly, and what genuinely reduces them.
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Back & Sciatica4 min readThe Slipped Disc: Nothing Slipped, and It Usually Heals
The name suggests a part has slipped out of position and must be pushed back. Both halves of that idea are wrong, and the truth is considerably more reassuring.
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Posture & Ergonomics4 min readText Neck: What Hours on Your Phone Actually Do
The scare graphic says your head becomes a 27 kilogram weight. The truth is less dramatic and more useful: your neck is not being damaged, it is being under-prepared and over-held.
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Foot & Ankle5 min readAchilles Tendinopathy: Why Rest Makes It Worse
The tendon hurts most in the first steps of the day, loosens as you move, and comes back worse tomorrow. Resting it feels obvious and is the reason it lasts a year.
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Rehabilitation5 min readACL Reconstruction: What the Rehabilitation Year Actually Looks Like
The graft is not the recovery. What decides your outcome is the twelve months afterwards, and returning before you meet the criteria multiplies the risk of doing it again.
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Neurological & Balance5 min readThe Dizziness That Comes On When You Roll Over in Bed
Seconds of violent spinning triggered by a change in head position. It is usually crystals in the wrong part of the inner ear, and it is one of the few things we can genuinely fix in a single appointment.
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Elbow, Wrist & Hand5 min readGolfer's Elbow: Pain on the Inside of the Elbow
The same tendon story as tennis elbow, on the opposite side of the joint. The complication is that a nerve runs right past it, and telling them apart changes the treatment.
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Sports Injury5 min readHamstring Strain: Why It Keeps Happening to the Same Leg
Around one in three hamstring injuries recurs, usually within two months of returning. Almost always because the return was based on how it felt rather than on what it could do.
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Back & Sciatica5 min readPiriformis Syndrome: A Diagnosis That Is Usually Wrong
Deep buttock pain with something running down the leg gets called piriformis syndrome almost automatically. It is a real condition, and it is far rarer than the label suggests.
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Women's Health5 min readPelvic Girdle Pain in Pregnancy Is Not Something to Put Up With
Around one in five pregnancies involves it, and a great many people are told to expect it and wait. It responds well to treatment, and the treatment is not rest.
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Sports Injury5 min readShin Splints: What the Pain Down Your Shin Actually Means
Almost always a training load problem rather than a shin problem. The important job is telling it apart from a stress fracture, which needs very different management.
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Self Care4 min readShould You Stretch Before Exercise?
Almost everyone was taught to touch their toes before sport. The evidence has moved a long way since then, and what replaced it takes about the same amount of time.
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Women's Health5 min readDiastasis Recti: The Gap in Your Abdominals After Birth
Almost every pregnancy produces one. The number people fixate on, the width of the gap, turns out to be the least useful thing to measure.
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Neurological & Balance5 min readFalls Prevention: Balance Is Trainable at Any Age
Balance is not something you either have or lose with age. It is a trainable capacity, and the exercise that improves it is quite specific.
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Neck5 min readHeadaches That Start in Your Neck
If your headache is always on the same side, starts at the base of your skull and is provoked by neck movement, the source may not be your head at all.
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Knee5 min readKnee Osteoarthritis: Why 'Wear and Tear' Is the Wrong Way to Think About It
The phrase 'wear and tear' suggests a joint being used up, and it leads people to do exactly the wrong thing. Knee osteoarthritis responds to load, not to protection.
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Women's Health5 min readReturning to Running After Having a Baby
Being told you are 'cleared for exercise' at six weeks is not the same as being ready to run. Here is what readiness actually looks like, and how to build to it.
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Neurological & Balance5 min readStroke Rehabilitation at Home: What Actually Drives Recovery
The nervous system relearns through specific, repeated practice. That means most of the recovery happens between appointments, not during them.
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Elbow, Wrist & Hand5 min readTennis Elbow: Why It Hurts to Grip, and What Actually Fixes It
Most people with tennis elbow have never played tennis. The pain is a tendon problem at the outside of the elbow, and the thing that resolves it is the thing most people avoid.
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Posture & Ergonomics4 min readDesk Ergonomics: How to Set Up a Workstation That Does Not Hurt
Most workstation advice is a list of angles nobody remembers. Here is the short version that actually reduces symptoms, in the order that matters.
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Posture & Ergonomics3 min readDoes Bad Posture Actually Cause Back Pain?
The link between posture and pain is much weaker than most people assume. Here is what the research actually shows, and what to focus on instead.
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Back & Sciatica2 min readLower Back Pain: What Actually Helps in the First Two Weeks
Most lower back pain settles on its own, but what you do in the first fortnight decides how quickly, and whether it comes back.
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Foot & Ankle4 min readFlat Feet: When They Matter and When They Do Not
Having flat feet is not a diagnosis and usually needs no treatment at all. What matters is whether the foot is flexible, and whether it actually hurts.
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Rehabilitation4 min readPost Surgery Physiotherapy: What Recovery Actually Looks Like
Surgery repairs the structure. Rehabilitation is what turns that repair into a working joint. Here is what to expect after the common operations, joint by joint.
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Back & Sciatica4 min readQuadratus Lumborum Pain: The Deep Muscle Behind Many Sore Backs
A deep, one sided ache just above the hip that hurts to stand and to cough. The quadratus lumborum is often involved, though rarely the whole story.
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Coxa Vara and Coxa Valga: What Your Hip Angle Means
Two terms that sound alarming on a radiology report. Here is what the hip angle actually is, when it matters clinically, and when it is simply a measurement.
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Neck3 min readNeck Pain from Desk Work: Why It Happens and How to Stop It
Aching between the shoulder blades by mid-afternoon is one of the most common complaints we see. Here is what is actually going on, and the changes that make a measurable difference.
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Back & Sciatica3 min readSciatica: What It Actually Is, and What Genuinely Helps
Sciatica is a symptom, not a diagnosis. Understanding which structure is irritating the nerve is what decides the right treatment, and the timeline.
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Shoulder3 min readFrozen Shoulder: The Three Stages and How Long Recovery Takes
Frozen shoulder follows a predictable pattern. Knowing which stage you are in changes what treatment should be doing, and prevents a great deal of wasted effort.
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Foot & Ankle3 min readHeel Pain First Thing in the Morning: Plantar Fasciitis Explained
That sharp stab on your first steps out of bed has a specific cause, and a specific fix. Stretching alone is why most people stay stuck for months.
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Knee3 min readKnee Pain on Stairs: What It Means and What to Do About It
Pain going down stairs and pain going up point to different problems. The direction that hurts is one of the most useful clues you can bring to an assessment.
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Elbow, Wrist & Hand3 min readWrist and Hand Pain from Typing: Is It Carpal Tunnel?
Waking at night to shake your hand out is the giveaway symptom. Here is how to tell carpal tunnel from the other things that cause hand pain, and why a night splint is the first thing to try.
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Shoulder4 min readShoulder Impingement and Rotator Cuff Pain When You Lift Your Arm
Pain in a specific arc of movement, worse reaching overhead and at night, this is the most common shoulder problem we see, and the evidence on how to treat it has changed a lot.
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Foot & Ankle3 min readRolled Your Ankle? What to Do in the First 72 Hours
Ankle sprains are treated casually and re-sprained constantly. What you do in the first three days, and the balance work you do six weeks later, decides which group you end up in.
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Hip4 min readHip Bursitis and Pain on the Outside of Your Hip at Night
If lying on one side wakes you up, the problem is usually tendon compression rather than 'bursitis', and the fix starts with how you position yourself in bed.
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Self Care3 min readHeat or Ice? A Simple Guide to Getting It Right
The most common question we get asked, and the honest answer is less rigid than most advice suggests. Here is a practical rule for choosing, and the safety points that matter more than the choice itself.
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