John Drummond (@GatesPhysio) header
John Drummond (@GatesPhysio) profile picture

Mostly off twitter 2025 onward. Advanced Practice MSK Physiotherapist @NHSGGC

Nottingham
Joined December 2011
Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)Photo by John Drummond (@GatesPhysio)
🤕🤦‍♂️Headache Thread🤦‍♀️🤕 I will try to cover common DDx in 1ry & 2ry Headache, Red Flag/screening Qs, resources/links etc I may add to it over time so consider bookmarking / sharing if useful. Aimed towards MSK clinicians, FCP/ACPs, Primary Care non-medics for now
5
64
3
252
70,658
So Twitter please do your stuff. I’m desperate to find a GP successor for my great wee rural practice in Shetland. I’m retiring in April. We have advertised with no success so far. Please share widely
6
442
10
337
30,386
-differential diagnosis includes serious pathology / esp if can progress rapidly -known risk of serious complications. -The age/comorbidity increased risk complications. Key reflections again to be even more precise and on documentation bjgp.org/content/59/568/872
1
2
184
Long but facinating commentary on CES with key points regarding clinilinical signs vs symptoms, CES "early"/incomplete, MRI urgency+threshold, documentation, safetynetting, hospital guidelines and bladder scans.
Jarman v Brighton and Sussex University Hospitals NHS Trust [2021] EWHC 323 (QB) - new judgment on cauda equina - alleged delay in MRI and decompression surgery - C unsuccessful bailii.org/ew/cases/EWHC/QB/…
9
7
3
25
Key paper discussed @SpinesNuh Venkatesan et al. Spine (2019) pubmed.ncbi.nlm.nih.gov/3147…
3
7
Exploring the lived experiences of UK physiotherapists involved in CES litigation cases -Clinical decision support tool -Emergency and urgent referral proformas -Video resources on litigation @ManMetUni @thecsp Gill J, Finucane L, Mercer C, Yeowell G, & Greenhalgh S, 2025
12
Exploring the lived experiences of UK physiotherapists involved in CES litigation cases -Clinical decision support tool -Emergency and urgent referral proformas -Video resources on litigation @ManMetUni @thecsp Gill J, Finucane L, Mercer C, Yeowell G, & Greenhalgh S, 2025
1
1
245
Five GIRFT HVLC pathways for orthopaedic surgery now updated linkedin.com/pulse/five-girf… Hot off the press - published last week
1
188
GIRFT marks Migraine Awareness Week with launch of national online pathway for headache care Sept 2026 girft-interactivepathways.or…
5
GIRFT marks Migraine Awareness Week with launch of national online pathway for headache care Sept 2026 girft-interactivepathways.or…
🤕🤦‍♂️Headache Thread🤦‍♀️🤕 I will try to cover common DDx in 1ry & 2ry Headache, Red Flag/screening Qs, resources/links etc I may add to it over time so consider bookmarking / sharing if useful. Aimed towards MSK clinicians, FCP/ACPs, Primary Care non-medics for now
2
284
John Drummond retweeted
Advanced clinical practitioners are facing a ‘growing supervision gap’, as their roles become more pressured while the support available to them remains inconsistent, according to a new study. rcni.com/nursing-standard/ne…
14
6
9
14
72,284
John Drummond retweeted
Fact: since the 1970s physiotherapists in the UK are regulated to act as autonomous clinicians. They don’t need a doctor to refer to them, assess a patient for them or direct treatment. They are trained and regulated on that basis. More
16
4
9
26
77,005
In 1990 a rheumatologist led the team that defined fibromyalgia by counting tender points. Seven years later he published a paper taking his own criteria apart. It's one of the more honest things in modern medicine, and it still shapes what you should do in clinic.
2
6
32
6,433
John Drummond retweeted
Delighted to present our #MSK Community Appointment Day work at today’s @northwestcsp Network event. By asking “What matters to you?” we bring support around the patient, reduce unnecessary appointments & referrals, improve personalised care, & help tackle health inequalities 😊
3
6
303
John Drummond retweeted
Two weeks without mobile internet restored sustained attention to levels typical of someone ten years younger. A recent preregistered randomized controlled trial published in PNAS Nexus demonstrates that simply disabling mobile internet access on smartphones—while retaining calls, texts, and computer-based browsing—can yield substantial psychological benefits in as little as two weeks. Participants who blocked mobile data showed marked enhancements in sustained attention (with objective test performance improving to levels comparable to reversing a decade of typical age-related decline), mental health (including reductions in depression and anxiety symptoms exceeding those often seen with antidepressants), and subjective well-being (higher life satisfaction and positive affect). Notably, 91% of participants improved in at least one of these domains. The key insight is that the intervention targets the unique "always-available" connectivity of smartphones, which drives constant interruptions and fragmented focus. Without this mobile tether, individuals reported reallocating time toward in-person socializing, exercise, and nature—activities that mediated much of the gains. Although not all cognitive functions were affected equally, and full compliance varied, even partial adherence produced meaningful benefits. This evidence underscores how pervasive mobile connectivity may quietly erode mental clarity and mood, making targeted digital breaks a practical strategy for reclaiming focus in a hyper-connected era. [Castelo, N., & Kushlev, K. (2025). Blocking mobile internet on smartphones improves sustained attention, mental health, and subjective well-being. PNAS Nexus, 4(2), pgaf017]
47
198
18
823
61,633
John Drummond retweeted
We've written to the Secretary of State and NHS England CEO calling for urgent action to address unsafe doctor substitution by employers. The letter comes in the wake of our survey report revealing doctors' serious concerns over patient safety. 🔗 cdn.intelligencebank.com/eu/…
26
210
8
415
31,535
Long-term risk of knee replacement after ACL reconstruction using the contralateral knee as an internal control: a National Hospital Episode Statistics database study of 135 881 patients 👇👇👇 bjsm.bmj.com/content/early/2…
28
2
124
7,404
John Drummond retweeted
Neurogenic Claudication Territories in Lumbar Spinal Stenosis. 📚 Young JJ et al. Digital pain diagrams to identify common lumbar spinal stenosis pain distribution patterns: a cross-sectional latent class analysis. European Spine Journal. 2025. researchgate.net/publication… Preliminary investigation. More atypical & heterogeneous than you might think Authors used digital pain diagrams in 2,379 patients with LSS. 6 clinically recognisable pain distribution classes rather than one classic “textbook” presentation. 📊 Pain distribution classes: ⭕️ Class 1 (11.4%) → Bilateral posterior leg pain ⭕️ Class 2 (8.7%) → Bilateral posterior + anterior leg pain ⭕️ Class 3 (26.1%) → Unilateral posterior leg pain ⭕️ Class 4 (21.0%) → Unilateral posterior leg pain + low back pain ⭕️ Class 5 (22.9%) → Unilateral anterior + posterior leg pain ⭕️ Class 6 (9.9%) → Multisite pain Clinical take aways👇 ⚠️ The “classic” bilateral posterior leg pattern was less common. ⚠️ Unilateral presentations were more common than bilateral ones. ⚠️ Anterior thigh/leg symptoms were common, challenging the idea that LSS is predominantly a posterior calf/buttock condition. ⚠️ Low back pain severity was relatively similar across groups, questioning how diagnostically useful back pain itself may be. ⚠️ Multisite pain presentations existed So not so neat, entirely fits my biases and observations. ⚠️ Drawbacks: cross-sectional study only, preliminary data, secondary care sample, based on clinical coding rather than imaging-confirmed standards, no symptom-quality mapping or imaging correlation, several common co-morbidities/masqueraders excluded.
3
28
2
109
8,265
Just published 🔥 𝗔𝗻 𝗶𝗻𝗱𝗲𝗽𝗲𝗻𝗱𝗲𝗻𝘁 𝘃𝗮𝗹𝗶𝗱𝗮𝘁𝗶𝗼𝗻 𝗼𝗳 𝗮 𝗰𝗹𝗶𝗻𝗶𝗰𝗮𝗹 𝗽𝗿𝗲𝗱𝗶𝗰𝘁𝗶𝗼𝗻 𝗿𝘂𝗹𝗲 𝗳𝗼𝗿 𝘁𝗵𝗲 𝗱𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀 𝗼𝗳 𝗰𝗲𝗿𝘃𝗶𝗰𝗮𝗹 𝗿𝗮𝗱𝗶𝗰𝘂𝗹𝗼𝗽𝗮𝘁𝗵𝘆 𝘄𝗶𝘁𝗵 𝗿𝗮𝗱𝗶𝗰𝘂𝗹𝗮𝗿 𝗽𝗮𝗶𝗻 pubmed.ncbi.nlm.nih.gov/4207…
1
69
2
323
19,586
John Drummond retweeted
An independent validation of a clinical prediction rule for the diagnosis of painful cervical radiculopathy. 2026. Highlights: New 3-test cluster showed stronger diagnostic utility than original clinical prediction rule. New cluster includes Spurling, Shoulder Abduction test, ≥2 positive ULNTs. Positive cluster (3/3) rules in CR with 100 % post-test probability. Negative (0/3) cluster rules out painful cervical radiculopathy diagnosis. Modified Shoulder Abduction test showed higher post-test probability. sciencedirect.com/science/ar…
1
11
55
8,102
John Drummond retweeted
.@Retlouping's recent posts on Centralisation and Peripherilsation in Radiculopathy reminded me of my recent use of the Puddle metaphor in Radicular Pain - which has been received well by Sciatica patients. Sometimes with progress I don't see a pattern of centralisation or peripheralisation... just a "drying up" of radicular pain. I present to you: Puddlisation. Comes with the added metaphorical benefits of using "rainy days" to explain an exacerbation, and the use of seasons "summer is around the corner" for drying up (majority of Australians get it).
Just for clarity: McKenzie discovered centralisation, peripheralisation occurred without his discovery in every patient on the planet with somatic referred pain, radiculopathy and or radicular pain. It’s not a McKenzie discovery. Peripheralisation is not the opposite.
2
3
30
2,630
19/Now move beyond mneumonics! Remember, brachial plexus splits & recombines like jumping jacks w/a very palindromic 5-3-6-3-5 pattern The names tell you if they are splitting or combining (Trunk=Together, Division=Divide, Cord=Combine, Branch=break)
1
3
17
3,169
John Drummond retweeted
Defensive medicine and uncertainty teapawt.net/LaurafinucaneB/status/…
Defensive medicine:A symptom of uncertainty? A defensive medicine approach should be avoided when confronted with uncertainty @sue_greenhalgh @mercephysio1 & James Selfe 👇👇👇👇 authors.elsevier.com/a/1eqh7…
1
1
4