Rheumatology.Physio Podcast

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,In 2025 I recorded a Bone Health Module for my online course. It wasn’t something I particularly planned on but a series of events meant that the material was all but written and it seemed a sensible move. Fast forward to now and it has rather smashed it to be honest, I have had some really great feedback so I thought I would share with you the intoductory part of the module. For my paid subscribers, scroll down and you will find a second part entitled “Factors Affecting Bone Mass”.If anyone would like to enroll in the full module it is HERE. Available as a standalone option or as an add-on to the full Rheumatology.Physio online course which is the best value in my opinion :)Also check out this webinar we have coming up with the legend that is Adam Dobson:

Welcome Back Rheumatology Fans,Recently we explored high-intensity exercise in Rheumatological Diseases with insights from Jean-Pascal Grenier. The conversation challenged a belief that has lingered in rheumatology forever That people with inflammatory arthritis should exercise gently.Moderate exercise? Yes. Gentle strengthening? Of course. Hydrotherapy? Yes Please!But high intensity? Long duration? Pushing physiological limits? This has been where clinicians have become nervous. It is natural of course, an assumption that utilising inflamed joints will cause that inflammation to increase or an acceleration of joint damage leads to caution. Especially if there is also an associated increase in pain levels.Which is why it is worth talking about Natalie Dau - Follow her Instagram here.Natalie is an ultrarunner who holds the Guinness World Record for crossing Peninsular Malaysia on foot. In the process she ran roughly 700 km in just over eight days as part of a 1,000 km endurance project from Thailand to Singapore. (I once got a train from London to Edinburgh and thats 630km and I was absolutely exhausted).Natalie Dau has Rheumatoid Arthritis.For many clinicians trained even 10–15 years ago, that combination of facts would have sounded contradictory. RA was traditionally framed through the lens of protection: protect the joints, protect the energy envelope, protect against flare.And yet here we have someone running the equivalent of two marathons a day.Now, before anyone concludes that this is a prescription rather than an observation, it’s worth being clear: Natalie’s story is not an argument that everyone with RA should become an ultramarathon runner. But her story is useful because it forces us to interrogate our assumptions.One of the themes Jean-Pascal raised was that the human body – even with inflammatory disease – is often far more adaptable than we think. With appropriate training progression, recovery, and load management, people can tolerate much higher intensities than traditional guidance might imply.Graded individualised exposure, consistency, individualised adaptation and a good amount of reassurance. This can enable people to achieve a lot more than they thought they might be able to.I used to run a version of this for people newly diagnosed with RA in the NHS, they were offered to attend an exercise group and we started every session with static bike. The person had control, I gave them the instruction to bike at a 5-6/10 on an effort scale. The difference between session 1 and session 2 was STAGGERING. I tracked their settings in super none-vigorous manner and they increased their settings a lot more than you would anticipate. So to conclude, no you can’t exercise “too much” with Rheumatoid Arthritis, the amount you SHOULD exercise is variably individual but a good starting point is to aim for 150 minutes of moderate intensity per week. Some is better than none, more is usually better and enjoying it is probably the most important ingredient. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,You can get access to this article but upgrading your subscription, enrolling in my online course or becoming a member of Physio Matters Advanced PracticeWe got ANOTHER media request, I am starting to wonder who is giving out my email address, if it is you then can you tell them I would like paying next time… haaaaaa.Ok, so back to being serious, this request was advice for returning to tennis or squash when arthritis had stopped the person from playing. This was actually a new one for me so here we are with an expansion on my responses. You can get access to this article but upgrading your subscription, enrolling in my online course or becoming a member of Physio Matters Advanced Practice

Welcome Back Rheumatology Fans!Swimming is often recommended for people with arthritis, but is it actually better than other types of exercise? The short answer: it depends on the individual.Swimming and water-based exercise can be helpful because the buoyancy of water reduces the amount of weight going through the joints. For example, when standing in water up to belly-button depth, the body is only bearing around 40% of its usual weight . This reduction in joint loading can allow people with painful hips, knees, or feet to move more comfortably and exercise for longer.Water immersion also provides a cardiovascular benefit. The pressure of the water increases venous return — meaning more blood is pushed back to the heart — which makes the heart work slightly harder and therefore provides a cardiovascular training effect . In addition, buoyancy can make it easier to move stiff joints and take them through their range of motion.However, swimming is not without downsides. Many barriers are logistical: travelling to the pool, changing clothes, slippery surfaces, cold environments, and cost. Some people also accidentally overdo activity in the water because the reduced joint loading masks normal pain signals.Ultimately, swimming is a good exercise option for arthritis, but it is rarely the only or “best” option. The most effective exercise is usually the one a person can do consistently and safely.* Water reduces joint loadingBuoyancy can significantly decrease the weight passing through painful joints, making movement easier.* Swimming provides cardiovascular benefitsWater pressure increases venous return, which places a mild training demand on the heart.* Movement can be easier in waterBuoyancy can help people move joints and the spine through their range of motion with less discomfort.* Logistics often limit swimming as exerciseTravel, changing facilities, cost, and cold environments can be significant barriers.* Exercise choice should be individualisedSwimming is helpful for some people with arthritis, but it is not inherently superior to other forms of exercise.Check out our new CPD from PMAP! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome Back Rheumatology Fans,I had the ABSOLUTE pleasure to talk to Jean-Pascal Grenier who published this great review on high-intensity exercise and Rheumatic Diseases.You can find Jean-Pascal on LinkedIn or Research Gate or InstagramFull Article Link: https://pubmed.ncbi.nlm.nih.gov/41566885/Clinical Takeaways From The Podcast• High-intensity exercise is not harmful for people with rheumatic disease according to current evidence.• Outcomes such as pain, disability, and function are at least as good with high-intensity exercise as with lower-intensity approaches.• Some functional outcomes (e.g., activities of daily living tests) may actually improve more with higher-intensity interventions.• Persistent clinical caution around intensity may reflect historical beliefs rather than current evidence.• Exercise prescription should still be individualised, considering disease activity, patient confidence, and training tolerance rather than relying on blanket intensity restrictions.Podcast SummaryIn this episode of The Rheumatology Physio Podcast, Jack is joined by researcher Jean-Pascal Grenier (JP) to explore a long-standing clinical question: Is high-intensity exercise harmful for people with rheumatic disease? The short answer, according to JP’s recent review, is no.The conversation unpacks evidence examining high-intensity exercise interventions across conditions such as rheumatoid arthritis and other rheumatic diseases. High intensity was broadly defined in the literature as exercise performed at ≥70% of maximum heart rate, including aerobic training, resistance training, and interval-based protocols.Across the studies reviewed, high-intensity exercise was found to be at least as effective as low- or moderate-intensity approaches for key outcomes such as pain, function, and disability. In several secondary outcomes—including activities of daily living and functional capacity tests—high-intensity exercise even showed superior improvements in some patient groups.JP explains that the motivation for the review came from a persistent culture of caution around exercise for inflammatory disease. Patients are often advised to “take it easy” or avoid heavy exertion due to concerns about joint damage or disease flares. However, the evidence does not support the idea that higher exercise intensities are harmful.Instead, the discussion highlights a mismatch between clinical messaging and available evidence. While exercise is widely recommended in rheumatology guidelines, caveats around intensity often remain despite limited supporting data.Ultimately, the episode reframes the conversation around exercise prescription in rheumatology. Rather than defaulting to conservative, low-intensity programmes, clinicians may be able to confidently consider higher-intensity training when appropriate, recognising that patient preference, tolerance, and individual context still matter.If you subscribe to Physio Matters Advanced Practice you immediately gain full access to my Online Course, paid posts on substack and 2 EBooks! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome Back Rheumatology Fans!What on earth does a Rheumatologist do? What ingredients make up the secret sauce? Watch the video to find out and I have sorted a little summary below if you are strapped for time. Video SummaryWhat actually happens after you refer someone to rheumatology with suspected psoriatic arthritis (PsA)? It’s a question many clinicians ask — particularly because PsA doesn’t come with a neat, definitive diagnostic test.This episode walks through what really goes on behind the clinic door.Psoriatic arthritis is a clinical diagnosis. While investigations can support it, they are often inconclusive. Around 90% of patients will have a negative rheumatoid factor. HLA-B27 is negative in roughly half of cases (higher in axial presentations), and inflammatory markers such as ESR and CRP are only elevated about 50% of the time. Imaging isn’t foolproof either — ultrasound and MRI may show inflammatory changes, but only if the right structures are scanned at the right time.So what are rheumatologists doing differently?Primarily, they are applying highly developed clinical reasoning. The initial consultation looks remarkably similar to a skilled MSK assessment: detailed history, joint examination, skin assessment, pattern recognition. The difference lies in the depth of exposure to inflammatory disease and the synthesis of information across multiple domains.Broadly, three scenarios tend to emerge:* Clinical suspicion + supportive investigations → straightforward diagnosis and initiation of DMARD therapy such as methotrexate.* Strong clinical suspicion but negative tests → cautious treatment trial (NSAIDs, steroid injection) with close follow-up.* Uncertain clinical picture + negative tests → further differentials considered, or a watch-and-wait strategy with review over time.Importantly, there is no “magic blood test.” The real expertise lies in pattern recognition, probabilistic thinking, and appropriately managing uncertainty.For physiotherapists, understanding this process helps refine referrals, manage patient expectations, and appreciate why a definitive answer isn’t always immediate. Rheumatology isn’t about hidden investigations — it’s about high-level clinical reasoning applied consistently and responsibly. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,Fatigue! The overlooked, underappreciated, oft ignored symptom associated with Arthritis. In this video I go into some detail about why it occurs and why it is so hard to manage, then explain the parameters we can use to actually make improvements!Ideally watch the video but I have put a summary for you below.Fatigue: The Most Under-Appreciated Problem In Inflammatory RheumatologyIn this episode, Jack explores what he believes is one of the most under-recognised and poorly managed problems facing people with inflammatory rheumatological conditions: fatigue. While joint pain, stiffness, and function quite rightly receive clinical attention, fatigue is often sidelined—despite being one of the most debilitating symptoms patients report and one of the hardest to treat medically.Jack focuses specifically on auto-inflammatory rheumatological conditions such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, Sjögren’s syndrome, and polymyalgia rheumatica, rather than osteoarthritis or gout. He argues that fatigue in these conditions sits firmly within the therapist’s remit—not just physiotherapists, but all MSK professionals—because medication alone often fails to meaningfully improve it.The episode breaks fatigue down into several key contributing factors. First is a literal sleep deficit. Many inflammatory conditions disrupt sleep, often waking patients in the early hours of the morning due to pain and stiffness. Over years, this creates a chronic lack of restorative sleep, often in people who are still working, raising families, and unable to flex their schedules.Second is immune-driven fatigue. An overactive immune system requires energy and actively promotes tiredness as a protective mechanism—much like the exhaustion felt during flu or infection. In inflammatory disease, this process is switched on constantly, leading to a persistent, unrefreshing fatigue that is largely resistant to disease-modifying drugs.Finally, Jack highlights muscle loss and deconditioning. Chronic inflammation can reduce muscle bulk, activity levels often fall after diagnosis, and even when disease control improves, muscle mass rarely returns fully to baseline. This means everyday tasks require more effort, accelerating fatigue.At around the nine-minute mark, Jack emphasises a key clinical reality: fatigue is multifactorial, chronic, and difficult to “fix.” Patients cannot consciously control their immune system, and pacing strategies—while useful for some—are often impractical, particularly for younger patients with busy lives.

Welcome Back Rheumatology Fans,You have Gout to be joking that I am discussing Gout again! Seriously, fascinating.Article Link: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2844321Watch the video → check out the article!Or below is a summary:People with gout are at significantly higher risk of cardiovascular disease, and this risk should be central to how we assess and manage them in clinical practice. In this episode, the focus shifts beyond gout as an episodic inflammatory arthritis and instead frames it as a condition with important long-term systemic consequences—particularly for cardiovascular health.Evidence consistently shows that individuals diagnosed with gout have an elevated five-year risk of major cardiovascular events such as myocardial infarction and stroke. This increased risk is driven by two main factors. First, gout is a chronic inflammatory condition, and systemic inflammation is a well-established contributor to cardiovascular disease. Second, many of the risk factors associated with gout—such as obesity, hypertension, metabolic syndrome, smoking, and alcohol consumption—overlap with those seen in people at high cardiovascular risk. The combination of these mechanisms means that gout should prompt clinicians to think well beyond joint symptoms alone.A large, robust study involving over 100,000 patients explored whether achieving effective urate control could influence cardiovascular outcomes. Participants with gout were treated with urate-lowering therapy, commonly allopurinol, and outcomes were compared between those who achieved a serum urate level below 6 mg/dL and those who did not. This “treat-to-target” approach resulted in a meaningful reduction in cardiovascular disease risk over five years when compared with usual care.Importantly, the benefits were not limited to cardiovascular outcomes. Patients who achieved the target serum urate level also experienced fewer gout flares, reinforcing that this biochemical target is clinically meaningful and reflective of effective disease control. In addition, subgroup analysis showed that patients who already had a higher baseline cardiovascular risk—such as those with hypertension or a family history of cardiovascular disease—derived the greatest relative benefit. In other words, the people who stand to lose the most from cardiovascular events may also gain the most from optimal gout management.For clinicians working in rheumatology and musculoskeletal care, the implications are clear. A diagnosis of gout should act as a trigger for broader cardiovascular risk assessment. This includes monitoring serum urate levels and aiming for a target below 6 mg/dL, but also addressing modifiable lifestyle factors. Reducing alcohol intake, managing body weight (particularly abdominal adiposity), smoking cessation, and supporting physical activity are all key components of comprehensive care. Pharmacological urate-lowering therapy and lifestyle interventions should be viewed as complementary rather than competing strategies.Physiotherapists and other allied health professionals have an important role to play in recognising cardiovascular risk factors, reinforcing health behaviour change, and ensuring that concerns are escalated appropriately to medical colleagues when needed. Even when cardiovascular management falls outside our direct scope, identifying and flagging risk can make a meaningful difference.Ultimately, treating gout effectively is not just about preventing flares—it is about improving long-term health outcomes. By adopting a treat-to-target approach and integrating cardiovascular risk reduction into routine care, we can significantly improve both joint health and overall wellbeing for people living with gout.Further Resources https://rheumatologyphysio.substack.com/p/investigating-gout This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome Back Rheumatology Fans,Every once in a while, I get really excited. This is one of those once in a whiles…This Study (please go and download it etc so it counts for the authors stats and such) aimed to develop and initially validate a scoring system to aid us clinicians decision making for referral to Rheumatology in young people with possible Juvenile Idiopathic Arthritis (JIA).THANK YOU to the authors, I don’t know if I always say that enough.The StudyVery briefly because the study design is not the crux of this post.The authors had 342 patients 61 (18%) of which had already been diagnosed with JIA. These were all under 16 and were presenting with joint pains being the primary reason for attendance.Their exclusion criteria included presence of fever (which is a primary symptom of systemic JIA and is a very important separate factor).They collected data from the patients at initial assessment, the patients were diagnosed or not with a specialist with JIA and then the authors did some clever statistical calculations to generate the scoring system.So basically, they gathered information, then the patients were diagnosed and then the authors worked out which were the most useful questions and assigned a scoring system to them based on statistical analysis. The Scoring CriteriaThe important part for MSK Clinicians, GPs, and anyone else seeing under 16s with joint pains.The authors recommend a score of 3+ providing a sensitivity of 95% bearing in mind this was an initial validation study as they were developing the score. If you use the score you MUST consider your own clinical reasoning and if you are ensure at all, seek advice. This score is still in relatively early in its validation and should not be relied upon too heavily.I have replicated this from the article material as I cannot currently find a downloadable/printable version. Useage Of The ToolPractically this tool is for use when your presenting patients primary complaint is joint pain WITHOUT fever. Of course we would also have considered other relevant pathology and mechanisms of injury.A score of 3+ on the tool supports referral to Rheumatology for further consideration the person has developed Juvenile Idiopathic Arthritis. I cannot stress enough that if you are not sure - get some advice!Further information on Juvenile Idiopathic Arthritis This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome Back Rheumatology Fans,2026… The year of the GLP-1 Agonist?Video SummaryIn this video, Jack, The Rheumatology Physio, discusses the rapidly growing interest in GLP-1 agonists (such as Ozempic) and their potential role in rheumatology and inflammatory arthritis. I reflect on the increasing public and clinical attention these medications are receiving, particularly as many people report improvements in chronic inflammatory and autoimmune conditions alongside significant weight loss.GLP-1 agonists mimic the body’s natural GLP-1 hormone, helping regulate blood sugar, suppress appetite, and promote weight loss. The key rheumatology question, however, is why some people with conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and osteoarthritis are reporting symptom improvements while taking them.There are two likely mechanisms. First, excess abdominal fat is immunologically active and raises the body’s baseline level of inflammation, which worsens arthritis symptoms and disease activity. By reducing this fat, GLP-1 drugs may lower systemic inflammation, creating an anti-inflammatory shift. Second, emerging evidence suggests these drugs may also directly interact with inflammatory and immune pathways involved in autoimmune disease — meaning their benefits may go beyond weight loss alone.However, at present, GLP-1 agonists are not formally prescribed specifically to treat arthritis. They are currently used for weight management, with any improvement in arthritis considered a secondary benefit. His practical advice is for people with inflammatory arthritis and excess body fat to discuss GLP-1 therapy with their GP or rheumatologist as part of a broader medical plan. He predicts that dedicated rheumatology use of GLP-1 drugs is likely to arrive in the near future as evidence grows. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome Back Rheumatology Fans,I have previously commented that “weight loss for Osteoarthritis is the best bang-for-buck treatment we have currently”:This slide occasionally gets me in hot water with other Physio’s and MSK Professionals but that doesn’t matter to me really, I stand by it and if anything I am becoming more wedded to this stance.Anyway… Ben Steele-Turner is an unstoppable force of Osteoarthritis information and dietary advice. I have shameless updated much of my teaching based on his answers to my questions.NOW HE IS PUBLISHING AS PART OF HIS PhD. His first article is open access HERE.I have written a short summary below but please click on the link and read the article in full.Physiotherapist-Led Weight Management for People with OsteoarthritisThis scoping review provides the most comprehensive overview to date of how weight management (WM) is currently understood, implemented, and perceived within physiotherapist-led care for people with osteoarthritis (OA). With 79 records included across 22 countries, the review highlights substantial variability in practice, persistent uncertainty around scope of practice, and a widespread need for improved training and confidence among physiotherapists.Why Weight Management Matters in OAThe evidence linking excess bodyweight to OA (particularly knee OA) is robust. Weight loss of as little as 7% can reduce pain, while more significant reductions can slow structural progression and reduce joint replacement risk. Despite strong guideline recommendations, weight management remains underprovided in OA care. Physiotherapists, who frequently work with people with OA and often have longer consultation times, may be well placed to address this gap.Current Practice: Highly Variable and Often MinimalAcross studies, the proportion of physiotherapists who reported including weight management ranged from very high (over 80% in some survey responses) to extremely low when actual practice was audited. For example, only 12% of individuals with knee OA in one prospective study reported receiving any weight management support during physiotherapy, and note audits showed weight management discussions documented in only about 10% of encounters. People with OA also consistently reported that weight management was either not addressed or addressed only superficially.Scope of PracticePhysiotherapists and people with OA expressed mixed views about whether weight management should fall within physiotherapy’s remit. Many clinicians felt it sat outside traditional physiotherapy roles, often preferring referral to dietitians (admittedly I do this!). However, people with OA who participated in a physiotherapist-led diet-plus-exercise trial reported positive perceptions, especially when physiotherapists had received additional training. This suggests that scope-of-practice concerns may be alleviated when physiotherapists feel more adequately prepared.Confidence and SkillsA recurring theme across the literature is discomfort discussing weight. Physiotherapists commonly feared damaging rapport, felt unsure how to raise weight sensitively, or believed that effective weight management strategies were outside their expertise. Many reported feeling untrained in nutrition or behavioural counselling, and physiotherapy students also identified weight management as a major skill gap.These concerns were echoed by people with OA, who sensed that physiotherapists had limited time and limited practical advice to offer. When weight management was addressed, it was often brief, generic, and lacking actionable support.Education Changes PracticePromisingly, trials of targeted weight management education, such as e-learning modules or structured upskilling programmes, showed clear improvements in physiotherapists’ confidence, knowledge, and attitudes. One physiotherapist-led intervention combining exercise with a structured very low-energy diet yielded clinically significant weight loss and symptom improvements, demonstrating feasibility and safety when clinicians are appropriately trained.Further Resources This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,I recently spoke at Clockwork Medical’s Event - Power Up To Play | Lower Limb Symposium on Rheumatological Contributors In Lower Limb Tendinopathies. This reminded me of a particular case I worked with successfully a few years back. I introduce a case focused on managing an insertional Achilles tendon problem in a young rugby player with psoriatic arthritis (PsA). For full access upgrade or enroll in my online course

Welcome Back Rheumatology Fans,Exercise (which I like) and Rheumatology (which I also like) make excellent bedfellows but are often misunderstood and misapplied. I listened to a really great podcast on the topic and encourage you to as well. Full PodcastThank you to The British Society For Rheumatology for publishing.A few takeaways for you below for you to apply in practice, lots more information and specifics for manageing Rheumatological Diseases on my online course, click below to enroll!1. Exercise in Rheumatology is most effective when it’s personalised, contextualised, and initiated early.A recurring theme throughout the conversation is that “exercise” as a general recommendation is too blunt to be meaningful. Patients often hear the phrase “you should do more exercise” without any guidance about what type, when, how often, or how it fits their symptoms or values. As MSK clinicians, this is where our practice becomes pivotal. Patients take exercise advice most seriously when it comes from a trusted professional — and rheumatology health-care providers consistently rank highly as motivators.The clinical message for physiotherapists is that exercise advice is not a single event but a dialogue. Starting early matters: patients newly diagnosed with inflammatory disease often wait months for physiotherapy input, yet those same months are when they have the most to gain from movement-based reassurance. Even a brief “2-minute conversation” at the end of a medical consult — offering a starting point, normalising safe activity, suggesting step-count increases or simple balance work — can materially shift behaviour.The nuance comes from tailoring. The needs of an 85-year-old trying to maintain independence differ profoundly from a 20-year-old gym-goer. The role of the physio here is functional problem-solving: what matters to the patient? What are they already doing? How can behaviour be shaped using the smallest effective change? And crucially, how can we frame physical activity not as an intimidating prescription but as a spectrum — from daily activities to structured exercise — where all movement confers benefit?2. All major exercise modalities can help rheumatic disease One of the clearest messages from the podcast is that we do not yet have a single “optimal” exercise type for any rheumatic disease. Aerobic training, strengthening work, flexibility, balance, aquatic exercise, yoga, tai chi — across the major rheumatic conditions, they all show benefit for pain, fatigue, function, sleep, and mood. The data are too heterogeneous to crown a winner, and forcing patients into a pre-chosen modality risks disengagement.For physiotherapists, this reinforces the importance of pragmatic exercise design. Loading principles still matter: tendons respond best to progressive load, bones respond to impact, and cardiovascular systems respond to sustained intensity. But instead of privileging one type of exercise, we should think of the four pillars — aerobic, strength, flexibility, balance/core — as tools we combine based on deficits, goals, and tolerance.The clinical takeaway is that our role is less about choosing the “right” modality and more about identifying the entry point that the patient can and will engage with. Exercise adherence depends more on enjoyment, identity, symptom confidence, and perceived safety than on the physiological superiority of any single training type. As research grows — including forthcoming EULAR guidelines — we may gain sharper distinctions between exercise formats. But right now, for the patient in front of us, the most effective exercise is the one they are willing and able to perform consistently.3. Sports & Exercise Medicine complements, not replaces, rheumatologyThe podcast also offers a insight into when referrals to Sport & Exercise Medicine (SEM) can add real value. Three domains stand out:a) MSK pain that doesn’t map cleanly onto inflammatory activityPatients whose rheumatic disease is well-controlled but remain symptomatic often sit in a diagnostic grey zone: biomechanical overload, postural contributors, muscle imbalance, central sensitisation, enthesopathy, coexisting tendon pathology. SEM clinicians can provide extended MSK assessments, diagnostic ultrasound, functional testing, and targeted loading programmes that help physiotherapists refine management.b) Primary tendon pathologyTendons form a significant proportion of SEM workloads. Differentiating tendinopathy from inflammatory enthesopathy is clinically challenging yet critical, particularly around the Achilles, patellar, gluteal, and rotator cuff complexes. SEM assessment can clarify pathology, assist with load-modulation planning, and consider adjunct therapies (e.g., shockwave, injections) when rehabilitation alone is insufficient. This collaboration aligns seamlessly with physio-led progressive loading principles.c) Interventional optionsFor suitable cases, SEM can offer ultrasound-guided interventions including corticosteroid, high-volume injections, nerve blocks, PRP, or shockwave — typically when conservative management has reached its ceiling. For physios working with rheumatology conditions, understanding these options improves referral quality and helps set patient expectations.The broader takeaway is that SEM and rheumatology are highly complementary disciplines that thrive when working in tandem with physiotherapy. The physio is central to longitudinal rehabilitation, behaviour change, and functional recovery; SEM can provide diagnostic clarity and intervention options; rheumatology manages systemic disease. When these three align, patients with complex MSK pain — particularly those with mixed mechanical and inflammatory presentations — tend to do significantly better.Further Resources This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,We are going fully deep dive on a specific topic this week on one of my favourite soap boxes because this suits my bias in a lovely way.Here is a link to the full article PDF or Site LinkThe Johnston County Osteoarthritis Project (JoCoOA) offers a rare, longitudinal look at the burden of hip symptoms, radiographic hip osteoarthritis (rHOA), severe rHOA, and symptomatic radiographic hip OA (sxHOA) over nearly three decades. Across five time points from 1991 to 2018, this large, population-based cohort of adults aged ≥45 revealed a consistent and rising prevalence of structural hip changes. The most striking finding is the substantial increase in rHOA: from 28% at baseline to 53% by 2017–2018. Severe rHOA also rose from 2.5% to 9%, and symptomatic rHOA increased from 10% to 15%. By contrast, hip symptoms alone remained relatively stable over time, hovering around the low-to-mid 30% range.For more analysis and my Clinical Takeawways upgrade your subscription or enroll in my online course!If you are an upgraded substack member and want access to my full course, let me know and we can work it out.

Welcome Back Rheumatology Fans,Another week, another podcast, another new subject to learn all about and this time it is SUPER relevant to us as Physiotherapists and MSK Therapists seeing patients with Lupus.You can listen to the podcast here, it is 12 mins long but I struggled a little with the accents of the guests, there is a full transcript to download (which I did) which solved that very minor issue. Be aware, it is heavily medical, I had to look up quite a few terms!I have sorted some takeaways below which you all seem to be finding useful! For tons of info on Lupus and Connective Tissue Disorders (as well as all the other Rheum disorder) enroll in my online course. Just FYI changes are coming to this in 2026 but currently if you enroll you get lifetime access so do it NOW.Preload deficiency may explain fatigue and exercise intolerance in SLE - even when disease is controlledClinicians at Johns Hopkins observed a subset of SLE patients whose lupus was well controlled yet who continued to report profound fatigue, dyspnea, heat intolerance, and markedly reduced exercise capacity. These symptoms were not due to active inflammation, cardiac structural abnormalities, or pulmonary disease. Careful haemodynamic testing - including exercise right-heart catheterisation - revealed that these patients failed to generate adequate preload during exertion, limiting cardiac output. This is “functional dehydration” phenomenon and reframes persistent fatigue in SLE.Exercise intolerance in these patients is posture-dependent and quantifiablePatients described a distinctive pattern: they tolerated exercise better lying flat than standing, and they exhibited elevated baseline heart rates. Cardiopulmonary exercise testing (CPET) confirmed objectively reduced exercise capacity despite structurally normal hearts on CT, echocardiography with strain imaging, and MRI. This demonstrates that the limitation is physiologic rather than subjective, separating preload deficiency from nonspecific fatigue. Recognising this pattern - orthostatic worsening, normal imaging, elevated resting HR - can guide clinicians toward targeted evaluation rather than attributing symptoms to deconditioning or psychological causes. Undetectable NT-proBNP levels help rule out other causes and support the diagnosisAcross the cohort, NT-proBNP levels were low or undetectable. While not diagnostic of preload deficiency by itself, an undetectable NT-proBNP carries a ~99% negative predictive value for structural heart disease associated with heart failure. This biomarker therefore helps eliminate common cardiac explanations for exercise intolerance. In the appropriate clinical context - controlled SLE, normal structural imaging, reduced exercise tolerance - very low BNP levels increase confidence that the issue is inadequate cardiac filling rather than pressure overload.Treatment focuses on restoring functional blood volume and controlling heart rateMany patients demonstrated “functional dehydration,” meaning that despite drinking normally, they could not retain enough intravascular volume to support preload during exertion. Treatment therefore parallels POTS (postural orthostatic tachycardia syndrome) management: high fluid intake (1–3 gallons/day) and increased sodium consumption (up to 5 g/day). Some patients benefited from electrolyte solutions like Gatorade or Liquid IV to maintain volume. DO NOT DO THIS WITHOUT MEDICAL SUPPORTThe pathophysiology remains unknownThough preload deficiency has now been documented, its underlying mechanism is unclear. Dysautonomia was suspected, but formal autonomic testing did not reach diagnostic thresholds. The next steps include determining prevalence, defining risk factors, and pursuing mechanistic studies to identify the affected biological pathways. Further Resources This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,Polymyalgia Rheumatica is a fascinating condition which for a long long (loooooong) time has been treated with steroids and the crossing of fingers. We are now seeing progress however with biologics on the horizon. This publication HERE (I have put think link rather than the doc so they can use tracking) brings us good information on targets for Physios (and other MSK Professionals) in PMR and I see this as a big step forward. Thinking about what I teach on my courses there isn’t anything new in here from my point of view, it is essentially how I teach management of PMR BUT I have been extrapolating from other conditions - mostly RA. Now we can lean on this more specifically and that makes the little nerd inside me very happy.Below I go into more detail on the specifics, you can upgrade your substack membership or enroll in my online course which will give you access as well

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,This webinar I delivered for the Physio Matters Masterclass and I have provided access here. A free preview is available to watch, upgrade to unlock the full 45 mins.Upgraded subscribers see below for:* slide deck* webinar summary

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,I am really enjoying these case study videos and this one is the first submission from good pal Nick Ilic! We talk about an overlapping “mechanical” and “inflammatory” presentation that certainly caused Nick some challenges and interest!If you are a free subscriber then you can access the first few minutes - upgrade to get full access. If you would prefer to get access included in your online course subscription then go here and follow the instructions.

Welcome Back Rheumatology Fans,An attempt to clear up some myths and misconceptions about the Hypermobility screening tools in this webinar. I cover the Beighton Score, Brighton Criteria and 2017 EDS Criteria2017 EDS Criteria Checklist sheetUpgrade your substack for full access to much more learning, alternate weeks include subscriber only content! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans, A review of Juvenile Idiopathic Arthritis was published in NEJM https://www.nejm.org/doi/full/10.1056/NEJMra2402073 and it is SO DETAILED.I have used it to update some of my JIA slides and put them into an update video.The first 6 minutes are unlocked and the rest is subscriber content. Upgrade for access. Alternatively upgrade to the recorded course.

Welcome Back Rheumatology Fans,Many of you will remember Mike from “Rheum Mates” which was a podcast series that we did a few years back. It is never boring chatting with him and so we discussed his PhD of all things which is on the sometimes spicy topic Hypermobility!2017 hEDS Criteria: https://onlinelibrary.wiley.com/doi/10.1002/ajmg.c.31552 For case studies, webinars and a whole lot more - upgrade to the paid substack or enroll in my online course HEREBelow is an AI Summary Of The PodcastMikes PhD Focus & Research Direction* Original Aim: Investigate evidence for conservative (non-surgical, non-pharmacological) management of HSD/hEDS in adults.* Shifted Focus: Now looking at pediatric cohorts due to a lack of robust adult RCTs.* Adult studies are often low-quality, opinion-based, or use flawed inclusion criteria (e.g. only Beighton score).* Pediatric studies have more rigorous RCTs with better sample sizes and clearer outcomes.📚 Key Learnings from the Literature* Hypermobility ≠ HSD or hEDS:Many people are hypermobile (e.g., "double-jointed") but are asymptomatic and don’t meet diagnostic criteria.* Beighton Score Alone Is Inadequate:It doesn’t account for widespread pain or systemic symptoms—should not be used in isolation to diagnose HSD/hEDS.* Proper Criteria Needed:Diagnosis should be based on the Brighton criteria or 2017 hEDS criteria, not just joint flexibility.👶 Pediatrics & Early Diagnosis* Delay in Diagnosis Is Common:Many are misdiagnosed or ignored—sometimes taking up to 15 years to get a correct diagnosis.* Symptoms Often Multi-Systemic:Includes joint pain, dislocations, stretchy skin, fatigue, GI issues, POTS, anxiety, etc.* Early Diagnosis Matters:Leads to better patient outcomes, validation of their symptoms, and appropriate support.🧠 Clinical Challenges* Heterogeneity:Two people with hypermobility can present very differently—one may function as an elite athlete, the other may be disabled.* Unclear Why Some Develop HSD/hEDS:Genetics don’t yet explain it fully. Severity of hypermobility does not predict chronic pain or dysfunction.🏃 Management & Treatment* Exercise & Education Are Key:Strong evidence shows structured exercise improves pain and function.* Two RCTs (Kemp et al. & PACL) showed general exercise programs work just as well as targeted ones in children with hEDS.* Surgery & Medication Less Effective:Lack of evidence supporting these as primary treatment options.* Athletes May Self-Manage by Staying Active:Gymnasts and dancers often remain asymptomatic due to regular strength and mobility training.✅ Clinical Tips to Avoid Missing Diagnoses* Distinguish Hypermobile Joints from HSD/hEDS:Most hypermobile individuals are healthy—don’t over-diagnose.* Use Full Diagnostic Criteria:Don’t rely on the Baten score alone; use Brighton or 2017 hEDS criteria.* Educate & Empower Patients:Reassure them that appropriate exercise and education can improve quality of life.* Recognize Impact of Delay:Long-term mismanagement leads to worsening symptoms, mental health issues, and loss of function. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome back Rheumatology Fans,In this video, we take an in-depth look at inflammatory back pain, its key characteristics, and its connection to rheumatological conditions like ankylosing spondylitis. We discuss common symptoms, including morning stiffness, pain improvement with activity, and chronic nature, as well as how to differentiate it from other…

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,📢 Exciting new research alert! In this video, we dive into a recent study published in the Journal of Rheumatology (Feb 2025) that examines changes in the presentation of early rheumatoid arthritis (RA) over the past 24 years.🔍 What’s in the video?✔️ A breakdown of the study: Changes at Presentation in Patients with Earl…

Welcome back Rheumatology Fans,I thought a little change of pace was called for and so I decided to have a look at some famous people who reportedly have Rheumatological conditions!Let me know if you know any others!Further Resources This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comFull Publication LinkWelcome back Rheumatology fans,In this video I discuss screening for Osteoporosis, can we put specifics to who we should screen and what that means in practice. For full in-depth Bone Health content then you can access my course HEREI go into some specifics about the following categories:* Females over 65* Females under 65* Males over 65F…

This is a free preview of a paid episode. To hear more, visit rheumatologyphysio.substack.comWelcome Back Rheumatology Fans,Something a bit different this week as I prepare for 2025 and try to adapt, grow and improve. A Vlog of sorts.So can we prevent Rheumatoid Arthritis? It is early days in this research but it is starting to look positive. I discuss this as well as some tips for implementation to clinical practice.Further Resources

Hello there Rheumatology Fans,My first podcast for a while, I have been busy with other projects and they have slipped off the priority list but I couldn’t leave this topic uncovered.I discuss barriers and facilitators to First Contact Physiotherapists identifying Axial Spondyloarthritis with Carissa Jones whose MSc dissertation was on this exact subject. It is obviously a topic close to my interest as it is a big audience I teach to!Tons of useful information in this one and I am very grateful to Carissa for giving up her time and expertise to record with me!LISTEN ON APPLELISTEN ON SPOTIFYFurther Resources This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Dr Katherine Jones joins the chaps for this episode. Dr Jones explains the interactions between inflammatory bowel diseases and exercise, does it help? Spoiler... There are a lot of unanswered questions! The conversation steers from benefits to barriers, via hernias and finally to advice. Tim lends his experience of the struggles he has had returning to exercise and Rob discusses his return to Iron Man (the absolute nutter). You can email us now so get in touch! [email protected] Crohn's Disease and Ulcerative Colitis are conditions that are termed Inflammatory Bowel Diseases. These are auto-inflammatory conditions meaning they are caused by the bodies own immune system mistakenly affecting its own tissues. Rob Beaven - https://dyerstclinic.com/ Jack March - https://rheumatology.physio Tim Colledge - https://open.substack.com/pub/timcolledge05Also available in all podcast players:SPOTIFYAPPLE PODCASTSYOUTUBEPrevious Episodes…Ep1 - The Diagnostic JourneyPrelude - Who Are We And Why Are We Here? This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Dr Mike McFarlane joins the chaps in this episode. He lends his considerable expertise as a Consultant Gastroenterologist as we cover a huge lot of ground from initial symptoms, diagnostic testing, different pathways, what happens after diagnosis and more...!! Crohn's Disease and Ulcerative Colitis are conditions that are termed Inflammatory Bowel Diseases. These are auto-inflammatory conditions meaning they are caused by the bodies own immune system mistakenly affecting its own tissues. Rob Beaven - https://dyerstclinic.com/ Jack March - https://rheumatology.physio Tim Colledge - https://open.substack.com/pub/timcolledge05Also available in all podcast players:SPOTIFYAPPLE PODCASTS This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Jack, Rob, and Tim explain who they are, why they are here, and what this podcast is going to all be about. Crohn's Disease and Ulcerative Colitis are conditions that are termed Inflammatory Bowel Diseases. These are auto-inflammatory conditions meaning they are caused by the body’s own immune system mistakenly affecting its own tissues. Rob Beaven - https://dyerstclinic.com/ Jack March - https://rheumatology.physio Tim Colledge - https://open.substack.com/pub/timcolledge05Also available in all podcast players:SPOTIFYAPPLE PODCASTS This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Jim was just a little excited to indulge in one of his favourite topics for a full podcast - Osteoarthritis. Ossur produce a wide range of limb products, of particular interest are their medial offloader braces for knee osteoarthritis. These provide a very real option as part of a management program for this tricky condition and Jim wanted to delve deep into how and why they might work. A lot of ground covered as he discusses with Giles the construction of the braces, how they work and who they might work for, improving compliance/tolerance and the cost implications.⁠You can find out more about Ossur here⁠You can also contact them for more information by email [email protected] or phone 03450 065 065Don't forget to like and subscribe to the podcast, if you have 10 seconds why not leave a review! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Jack March am a big fan of NASS, this isnt news really. What is news though is they have innovated again in the patient self-management and support world. YourSpAce is a sensational resource to signpost patients to. Zoe Clark - Senior Self-management Programme Officer NASS and Allied Health Professional is here to discuss the project. Your SpAce LinkOrder free promo packs (postcards and A4 posters)Your SpAce has been supported by funding from Novartis. Novartis had no editorial input.With thanks to Ben Marlow from Ben&Jack Studio for recording and editing https://benandjackstudio.com This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

We are finishing up this AxSpA series with a bang! I finally managed to get Dr James Noake behind the microphone to talk about AxSpA in Sport and Exercise Medicine. We discuss the patients that attend his clinic, some of his tips, the challenges that this cohort present and the role of SEM Consultants in assessment/managementFind James on twitter HEREPlease provide feedback on this podcast HEREThank you to Novartis for sponsoring this Series of 5 podcasts For more resources CLICK HERE This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Psoriasis as we know is a big risk for developing Psoriatic Arthritis. Clinically reasoning who we send to Rheumatology is a little bit of a challenge however. Do you refer a person with Psoriasis and tendon pain? Or do you need more of an inflammatory picture first? We don't want to delay diagnosis but we also don't want to over investigate or over medicalise. I discussed one way in a blog about nails. In this video I discuss a paper that looks at Psoriasis, MSK Pain and Ultrasound. We take some useful ideas from it to help with clinical reasoning. Unfortunately the paper is not open access but you can find it here.  Please consider heading to rheumatology.physio/shop to find more resources and supporting me to continue this hairbrained project!   As usual, feedback is greatly appreciated and for any further reading for me please send it my way!  PLEASE REMEMBER – THIS BLOG IS NOT A REPLACEMENT FOR CLINICAL REASONING, IF YOU ARE UNSURE GET ADVICE This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Full Paper open access herePlease visit the website for more CPD This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

The people who have conditions are the voices we need in healthcare to understand not only the effects of the disease but also the processes involved in navigating healthcare systems. Bethany Dawson has had Axial Spondyloarthritis for a number of years and has experienced the good and the bad of these systems. Dale Webb is the CEO of the National Axial Spondyloarthritis Society who work tirelessly to bridge the divide between patients and healthcare.The information and experience in this podcast are vital if we as MSK Therapists are to understand our place in this landscape. I learned so much from this conversation and you will too.Find NASS HEREPlease provide feedback on this podcast HEREThank you to Novartis for sponsoring this Series of 5 podcasts For more resources CLICK HERE This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

I didnt think saying "not everyone with joint pain needs an xray" was going to be my controversial opinion when I think Tea is the worst drink ever invented but here we are...The NICE guidance says "Our guideline on osteoarthritis recommends that adults aged 45 or over should be diagnosed with osteoarthritis clinically without investigations if they have activity-related joint pain and either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes" This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Axial Spondyloarthritis affects "people of childbearing age" which means we need to know the affect it has on pregnancy, birth and symptoms. Unfortunately until recently this information has been quite sparce. Enter Dr Sinead Maguire who is changing this in a hugely positive manner.In this podcast we cover a lot of ground, the what, why and how does AxSpA affect women during and after pregnancy. Then we go on to talk about effects on the baby as well. A must for anyone seeing women with AxSpA!Thank you to Novartis for sponsoring this Series of 5 podcastsFor more resources CLICK HEREPlease provide feedback on this podcast HEREMentioned Systematic Review HEREDr Maguire Recent Article HERE This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome back Rheumatology fans, I booked in another sneaky podcast record and its a really great look at Hypermobility with the awesome Mike Makher. We discuss what hypermobility is, what physios can do and when we should refer out. Don't forget to like and subscribe to the channel or head to my website Rheumatology.physio for podcast links, blogs and more Rheumatology info  Comment on your experiences or any topics you want me to cover This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

In this, the second of a series of five podcasts concentrating on Axial Spondyloarthritis for healthcare clinicians, Jack March - The Rheumatology Physio speaks to Dr. Louise Warburton a GP with Special Interest in Rheumatology all about AxSpA in Primary Care. They go into specific detail about the challenges of Primary Care, which investigations to order and what the results of these investigations mean and referral pathways. Vital information for anyone working in Primary Care and referring roles.Thank you to Novartis for sponsoring this series of podcasts. Please fill in this feedback survey regarding the podcast to help inform and improve the delivery of CPD materials.https://pcrmm.org.uk/ https://Spadetool.co.uk/ This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome back Rheumatology fans, trying something new this week as I created my first "Top Tips" video. This weeks video comes from a recent batch of courses I presented, the question was asked a couple of times. How do you differentiate a gout flare from an osteoarthritis flare? After all the symptom profiles and patient demographics are rather similar. The "Top Tips" series is born, you can watch the video below (10 mins) or I have popped the slides below as well which contain the information. Let me know what you think of this format please!The Rheum 101 hybrid event in Person and Virtual tickets are available and being snapped up FAST. Grab yours HERE if you want to hear from some amazing speakers all about Rheumatology (including Chris!). It will be unmissable!! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome back Rheumatology fans, we are all about imaging and Psoriatic Arthritis this week following a heads up from the wonderful Chris Martey on twitter about a paper tha discusses this in fantastic detail. I have pulled out what I believe to be the salient points for this blog.The Rheum 101 hybrid event in Person and Virtual tickets are available and being snapped up FAST. Grab yours HERE if you want to hear from some amazing speakers all about Rheumatology (including Chris!). It will be unmissable!!FULL PAPER (open access) This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

In this, the first of a series of five podcasts concentrating on Axial Spondyloarthritis for healthcare clinicians, Jack March - The Rheumatology Physio speaks to 3 members of AStretch about Physiotherapy provision for AxSpA. They cover a broad range of topics from the benefits of in-person and virtual appointments, transferrable skills that MSK Therapists already have, and personalising treatments. Susi, Heather, and Hannah are hugely experienced clinicians working with people with AxSpA and the information they provide is top class and of immediate use in the clinical environment.Thank you to Novartis for sponsoring this series of podcasts.  This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Would you like these blogs directly to your email inbox? I now have a weekly newsletter! SUBSCRIBE HEREHappy New Year Rheumatology Fans, we are starting 2022 with a BANG as there is a great consensus document that has been published about none radiographic AxSpA. It only came to my attention in the last 24 hours so I havent had time to fully get to grips with it yet but a couple of things drew my attention which I wanted to get started with in this blog for you. In other news we have courses up both in-person and virtual, check them out HERE there are limited tickets so grab them before they disappear and you miss out. Also the updated, upgraded, and all-around better recorded course is live too so check that out for a ton of learning.Please consider heading to the shop to find more resources and supporting me to continue this hair-brained project! Or you can Buy A CoffeeYou can also listen to all of my blogs as podcasts subscribe to your preferred channel HERE You can also find my podcast on Apple & Spotify & GoogleAs usual, feedback is greatly appreciated and for any further reading for me please send it my way!PLEASE REMEMBER – THIS BLOG IS NOT A REPLACEMENT FOR CLINICAL REASONING, IF YOU ARE UNSURE GET ADVICE This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome back and after a bit of a break I was back on Chewing It Over! I opened it up as an Ask Me Anything and a few questions came in for me to discuss. We first talked about assessing for Enthesitis, then moved on to psoriasis and nails before finishing up on Hypermobility. It was good fun and I will certainly look at running some more in the new year.If you have any questions for me then do get in touch, I always try to answer them or use them as a basis for a blog. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome back to the blog! Psoriatic Arthritis (Big Sigh). This is not easy, today I had a paper brought to my attention by Martin Thomas on Twitter which is open access LINK and is an interesting read for certain. It speaks to a lot of the challenges we face when trying to pick out Psoriatic Arthritis conditions in the sea of MSK presentations. I have tried to create some learning pointers in this blog.Please consider heading to the shop to find more resources and supporting me to continue this hairbrained project! Or you can Buy A CoffeeYou can also listen to all of my blogs as podcasts subscribe to your preferred channel HERE You can also find my podcast on Apple & Spotify & GoogleAs usual feedback is greatly appreciated and any further reading for me please send it my way! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome back to the blog! Catchy title alert, clickbait? Maybe. This is a topic I have been wanting to talk about for a while and I have a really good little article in the blog to demonstrate why. I have put my thoughts in and I hope they get your brain ticking over. I have also put the audio on my podcast feed :) This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

RheumMates is back and oh wow do we cover some ground in this podcast. Faye is a Physio and has Ankylosing Spondylitis.We cover topics like acceptance of the diagnosis, how her management has varied over time and what happened during her pregnancies. So much to learn in this podcast and I hope it is of use to therapists and women with Axial Spondylitis alike!Don't forget to subscribe, rate and review if you can and find loads more information on my websiteLike what you heard? Why not support the show by Buying A Coffee This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Thank you to Psoriasis Association for inviting me to speak alongside Karina Jackson to their members about exercise. It was very enjoyable with an excellent Q&A section.Dont forget to subscribe to the channel and if you fancy leaving a review that would be epic! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe

Welcome back to the blog! Osteoarthritis has been a bit of a passion project of mine over the last few months, learning and absorbing, finally attempting to disseminate what I believe to be the most up to date understandings around how the condition develops. I ran a webinar with BASRaT entitled "Osteoarthritis - Beyond Wear and Tear" and I have taken some of the questions from it and answered them. For an in-depth read about Osteoarthritis you can get my "Osteoarthritis - Clinician Edition" as an EBook or PrintedPlease consider heading to the shop to find more resources and supporting me to continue this hairbrained project! Or you can Buy A Coffee This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit rheumatologyphysio.substack.com/subscribe