Physiotherapist
Joined September 2014
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ChrisMatsias retweeted
Why screening tests to predict injury do not work—and probably never will…: a critical review
bjsm.bmj.com/content/50/13/7…
ChrisMatsias retweeted
Are we prescribing exercises by name rather than by load? 👀 Rethinking exercise prescription for tendinopathy in our latest BJSM blog.
Read more 👇
🔗 bit.ly/4844Nsz #BJSMblog
ChrisMatsias retweeted
🏋🏽♂️ The guidelines on resistance training have changed. Here's a summary of the latest position stand from the American College of Sports Medicine (ACSM). See the full paper for details, it's open access [PMID: 41843416]
ChrisMatsias retweeted
🎯 The Aspetar Hamstring Injury Rehabilitation Pathway – “The Aspetar Way”
📥 Download your FREE copy
A structured, milestone-based framework designed to guide athletes from injury through rehabilitation and back to performance.
The pathway features six progressive phases, adapting to each athlete’s needs while supporting clinical decision-making throughout the rehabilitation journey.
It provides a practical reference for clinicians working in clinical or elite-team environments, across different sports and athlete populations—particularly when rehabilitation is complex, slower than expected, or affected by persistent symptoms or recurrent injury.
📥 Download your free copy and discover The Aspetar Way.
➡️ aspetar.com/hamstring-rehabi…
ChrisMatsias retweeted
People keep saying Trump term II is the most corrupt administration ever, so I built a model to find out if it was true.
I took the UN's definition of corruption, turned it into eight criteria and 100 points, and scored the leaders history remembers for looting their countries: Marcos, Suharto, Mobutu, Abacha, Obiang, Putin.
Then I put every president since Eisenhower on the same scale, both parties, with every exoneration counted right alongside the convictions.
Nixon scored 41 and no other American President scored over a 25.
Trump's second term scored a 91, which ties him with Suharto and Mobutu and puts him above Marcos and Abacha.
So he is not only the most corrupt president in American history. At this pace he finishes his term level with the most corrupt rulers of the last hundred years.
PSA: don't come in my comments arguing about the results if you haven't read the full article, because ignorance is a choice.
Full article is up now on my Substack (link in bio) and it's free.
ChrisMatsias retweeted
🦴 2026 ACR Osteoarthritis guideline update - key takeaways
1️⃣ Exercise remains a cornerstone
Strong recommendation for knee & hip OA
Hand exercise: conditional recommendation
2️⃣ Weight loss is strongly recommended
For knee/hip OA with overweight or obesity
GLP-1 receptor agonists are now conditionally recommended in knee OA with obesity, alongside diet + exercise 🆕
3️⃣ Topical NSAIDs are strongly recommended
For knee and hand OA
When appropriate, topical NSAIDs are conditionally preferred over oral NSAIDs
4️⃣ Oral NSAIDs remain strongly recommended
For knee, hip and hand OA
Individual contraindications and adverse-effect risks should be considered
5️⃣ Intra-articular glucocorticoids remain recommended
Strong recommendation for knee & hip OA
Ultrasound guidance is strongly recommended for hip injections
6️⃣ Methotrexate has a new role in erosive hand OA
Conditionally recommended for erosive hand OA
This represents a change in recommendation direction since 2019
Still conditionally recommended against knee & hip OA
7️⃣ PRP & stem-cell injections are recommended against
❌ PRP — strongly against for knee/hip OA
❌ Stem-cell injections — strongly against
8️⃣ Several commonly used treatments are recommended against
Strongly against:
❌ Hydroxychloroquine
❌ Bisphosphonates
❌ Glucosamine
❌ Chondroitin
9️⃣ Biologics are not recommended for OA
❌ TNF-α inhibitors — strongly against
❌ IL-1 inhibition — against, with recommendation strength depending on the joint
🔟 OA management should be multimodal
Education + self-management + exercise + weight management + physical/occupational therapy + appropriate pharmacologic treatment
Treatment should be personalized through shared decision-making, considering symptoms, comorbidities, contraindications, adverse-effect risks, patient preferences and access.
#RheumattDoc #MedTwitter #RheumTwitter #Medicine #rheumatology @docakx @IhabFathiSulima @CelestinoGutirr @DurgaPrasannaM1
ChrisMatsias retweeted
“Sciatica” can hide very different pain mechanisms. 🧠 This commentary buff.ly/W8mAqOv turns the IASP framework into practical guidance for distinguishing radiculopathy, radicular pain & referred pain, supporting clearer diagnosis and more tailored #PhysicalTherapy care.
ChrisMatsias retweeted
🚨 2026 ACR OA guideline update: 5 quick take-home points
• Exercise remains strongly recommended for knee & hip OA
• Weight loss is strongly recommended in knee/hip OA with overweight or obesity
• NSAIDs remain core therapy
• Intra-articular steroids remain important for knee & hip OA
• GLP-1 receptor agonists are a new conditional option in knee OA with obesity
• PRP and stem-cell injections are strongly recommended against
One notable change: methotrexate is conditionally recommended for erosive hand OA, but conditionally recommended against for knee/hip OA.
Source: American College of Rheumatology. 2026 Update of the ACR Recommendations for Management of Osteoarthritis of the Knee, Hip, and Hand.
#Rheumatology #Osteoarthritis #ACR #MedTwitter @IhabFathiSulima @docakx
📰 Breaking: The ACR Releases 2026 Osteoarthritis Guideline Summary
New evidence-based recommendations emphasize exercise, self-management, appropriate weight loss, and shared decision-making; introduce conditional recommendations for GLP-1 receptor agonists in knee osteoarthritis and methotrexate in erosive hand osteoarthritis.
READ MORE → acr.tw/4ruyE6J
ChrisMatsias retweeted
Stretching before exercise does not prevent injuries. A 2014 meta-analysis of 26,610 participants in the British Journal of Sports Medicine found that stretching had no effect on injury rates at all. Strength training cut injuries by a third.
The study was led by Jeppe Bo Lauersen at the University of Copenhagen. His team pooled every randomised trial that tested whether exercise-based programmes could prevent sports injuries, and compared the results by type: stretching, strength training, balance work, and combinations. Stretching reduced nothing. Strength training reduced injuries by 33 percent and cut overuse injuries, the ones that build up slowly over weeks, by nearly half.
The reason stretching fails is that it addresses the wrong problem. A muscle tear happens when a muscle is asked to produce more force than it can handle. Making a muscle longer does not make it stronger. Strength training does, and it also thickens tendons and stiffens the connective tissue around joints, all of which protect against the sudden loads that cause tears and sprains.
The finding goes against what every gym teacher, track coach, and physical therapist has said for fifty years. But the data is not close. Across every trial, every sport, and every injury type, stretching before exercise had zero detectable effect on whether the person got hurt.
This does not mean flexibility has no value. It means the five-minute hamstring stretch before a run is doing nothing for injury prevention, and replacing it with five minutes of bodyweight squats and lunges would be measurably better. The body does not need to be looser before it works. It needs to be ready to handle load, and that is a strength problem, not a flexibility problem. pubmed.ncbi.nlm.nih.gov/2410…
ChrisMatsias retweeted
Which objective marker gives you the most confidence that a hamstring strain is ready for full NFL practice, and why?
From: @JonHernandezDPT, Mohamed Almubiadin, @Connor_Whicker, @BGragston, @alighaisarnia8, Alyssa Lee
Supported by @VALDPerformance | Read the full article here ➡️ sportsmith.co/articles/which…
ChrisMatsias retweeted
100% and in some immediate may be too late?
Motor Recovery Depends on Timing of Surgery in Patients With Lumbar Disk Herniation
ovid.com/jnls/neurosurgery/a…
“Immediate diagnosis, imaging, and referral should be aimed for to allow disk surgery within 3 days in patients with severe and moderate radicular weakness.”
ChrisMatsias retweeted
Physio, chiropractor, osteopath and all in primary care
When someone presents with weakness and a disc prolapse - don’t sit on these with conservative management for months and then ask a spinal surgeon what can be done when it hasn’t improved
Refer immediately for an MRI and surgical opinion - if the patient elects to have surgery this is best done early and may be worthless late
ChrisMatsias retweeted
⚠️ Graft type is not associated with revision ACL reconstruction in football players ⚽️ #ACL
NEW nationwide cohort analysis of subsequent ACL reconstructions 📄
#OpenAccess ➡️ bit.ly/3UCDr9D
ChrisMatsias retweeted
bmj.com/content/394/bmj-2026…
Good paper and guide on OA hip
Easily relevant and applicable in “the real world” unless of course it doesn’t suit your anecdotes, cherry picked cases and bias
Aligns with @NICEComms and probably something we should all consider
ChrisMatsias retweeted
🤯 It is September already and this month's #editorschoice is the first in our #OA Fundamental Series
Read all about OA #diagnosis and #assessment in this free-to-read article by Lauren King and Abhishek - oarsijournal.com/article/S10…
ChrisMatsias retweeted
Ortho using the physical exam as the discriminatory test to identify the structural issue and proceed yes / no in the context of ? meniscal tear....sounds like a cop out
I don't know any surgeon who's surgical threshold when considering tibiofemoral compartment pathology would rely on a McMurrays test etc - mainly because these tests are painful, non specific and crap generally
On MRI, there could be lots going on (in which case you use the history and exam as part of the hypothetico-deductive reasoning process to decide what to focus in on before you view the scan, and what to ignore - including, respectfully, the report which mandates everything is described regardless of relevance)
... Or there may be nothing except a meniscal tear (especially in younger patients), in which case, it's the meniscal tear... 'preserve the meniscus'
What does the MRI tell us (once you have a high index of suspicion that a meniscal tear is the pain driver & bearing in mind POCUS can tell us some of this as well in the right hands)
1. Is there an insufficiency fracture alongside the meniscal tear?
2. What's the configuration of the tear-
root?
Is there a bucket-handle segment which is locking and reparable?
Red zone?
Is there a flipped fragment eg in medial gutter with synovitis and tibial oedema (these response really well injection / scope)
Is there extrusion?
3. Is there meniscocapsular synovitis? (a target for a joint line injection)
4. What's the extent of co-existing compartmental chondropathy which may influence surgical / treatment choices
Are the cruciate intact?
5. Could an osteotomy be a reasonable interim option?
6. Is there a loose body responsible for the mechanical symptoms mimicking a meniscal tear?
7. Is there a medial / lateral femoral condylar OCD / flap mimicking a meniscal tear?
I could go on for ages.
A good history plus MRI trumps meniscal cluster tests every day of the week
ChrisMatsias retweeted
What Happens During a Football Player’s Medical Examination?
🔗thefootballphysio.co.uk/what…
ChrisMatsias retweeted
⚽🤕High Ankle Sprain (Syndesmosis Injury) in Football Players
🔗thefootballphysio.co.uk/high…
