Nick Ilic
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nickilicphysio.bsky.social
Nick Ilic
@nickilicphysio.bsky.social
180 followers 56 following 34 posts
Musculoskeletal Clinician and Rehabilitation Physio I ✍️ real-world, evidence-informed blogs about musculoskeletal healthcare — helping clinicians bridge the gap between textbooks and the messy reality of clinical practice. 📬 nickilicphysio.substack.com
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Unlike The Mad Katter, I won't punch anyone in the face if they ask ME about my Lebanese heritage.

Settlers from Kfarsghab 100yrs ago helped make 🇦🇺 great through hardwork and grit, many rising up to high community status.

www.kfarsghab.com.au/kfarsghab-hi...

#auspol
🔹 Patellofemoral Dysplasia 🔹
If your knees have always been “a bit off”…

🧠 Born with a different blueprint
🦵 Not just “maltracking”
💪 Quads, suction & load management
🧪 Dynamometry > guesswork

📖 open.substack.com/pub/nickilic...

#Physiotherapy #KneePain #MSK #SportsPhysio #PFJ
Patients Playbook | When ‘Bad Knees’ Run in the Family
What is Patellofemoral Dysplasia? What does it mean for you and your family?
open.substack.com
Research Review | Pain in the Bum
🔗https://nickilicphysio.substack.com/p/research-review-pain-in-the-bum-gluteal

I discuss Angie Fearon's recent Gluteal Tendinopathy Review (sciencedirect.com/science/arti...):
✅ Bursitis vs GT
✅ SIJ/Lumbar DDX
✅ +LR/-LR test breakdown
✅ Why education > gadgets
I like the idea of this platform.
I don't like the idea of manually duplicating everything I do on that "OTHER" platform just to get it on this platform.
I don't yet want to stop using that other platform.

Solutions people!? 😂 Such a first world problem
I sometimes call Manual Therapies: "Palliative Therapies" (see meaning in pic).

It shifts the focus to short-term benefits: pain relief, reduced inhibition, and improved function so we can commence active rehabilitation, without the baggage of silly, disempowering narratives.
The mere fact that is very difficult and uncomfortable to ask the question I have (without backlash) demonstrates how powerful, extrajudicial, and amplified online dialogue can be. Cognitive dissonance is difficult for everyone, especially if asking themselves "is it at all possible he is innocent?"
I spent a year hating him due to the public dialogue surrounding the DV allegations and listening/seeing the reaction to it, that was wrong of me, legally and congnitively.
It is difficult to separate the cause (DV) from the alleged offender, who has not been found guilty by an Actual Court of Law.
Thanks for assuming I don't know the basics facts and reality of Domestic Violence, the number 1 killer of women in my Country.
This is not a #notallmen laced query.
He could be innocent, and the Court of Public Opinion outside of the legal process could be unnecessarily ruining his life & career.
"You're wrong, do your research, you should argue with that 🤡"
Imagine if there was even some sort of collaborative health organisation worldwide that the US could benefit from, even contribute to?
Humankind has had generations to get used to the notion of disagreeing vehemently, but with love, we have a whole institution for that:

Marriage

🤐
Looks amazing. Will have to make the BIG trip one year
Can I ask, playing devils advocate, what if he IS actually innocent and he's been dragged over the extrajudicial coals unnecessarily?

I feel you summed it up well last year:

We don't know, we won't know, but we should continue to raise awareness of DV and publicly condemn it in all its forms.
Our Australian Physiotherapy Association even has a Dry Needling National Chair.

I was disappointed to see that it wasn't what I thought it was
Prognosis needs trajectory.

In their first visit when patients ask, "When will this be better?" I say it takes 2-3 visits to gauge recovery trends but add, "I wouldn't be surprised if it takes #-# weeks/months."

Patients are usually happy with that.

Reminds me of a good pic from Mr @AdamMeakins.
You could have just pretended you were a young cool-kid who knew internet slang letters.... but you just gave it away.

v

;)
a man is smiling and saying `` very cool '' .
ALT: a man is smiling and saying `` very cool '' .
media.tenor.com
turns out I was wrong, it's both a title and their throne.
It's amazing.
Patients don't really want it, they never ask for it if they've never had it before.

I haven't offered dry needling in years, noone has asked since. The local GPs are super relieved to hear we don't do it. Yet the APA has a "Dry Needling Chair" (a title, not a poky chair)
Reposted by Nick Ilic
The BMJ @bmj.com · Nov 23
Psoriatic arthritis is an immune mediated inflammatory musculoskeletal disease affecting around 30% of patients with psoriasis.

This review summarises the clinical features and comorbidities characteristic of psoriatic arthritis
www.bmj.com/content/387/...
For more of my thoughts on the management of #PatellofemoralPain here’s my big guide on managing PFP for Clinicians:
📖 physioclinician.medium.com/saving-the-u...
And a smaller blog on troubleshooting tough cases involving dysplasia or osteochondral injuries:
🎯 medium.com/@physioclini... /end
5️⃣Limit use of outdated and nocebic narratives/concepts:
🚫Patella maltracking
🚫Chondromalacia (“soft cartilage”)
🚫VMO or ITB focused rehab
For the vast majority of PFP patients they're not useful, it's impossible to 'lengthen' ITB, or isolate VMO (just get quads going) /10
a man in a pink hoodie is talking about poor choice of words
ALT: a man in a pink hoodie is talking about poor choice of words
media.tenor.com
4⃣When Rehab isn't going well.
Rule out via MRI:
🔍PF joint dysplasia
🔍Chondral damage +/- bony oedema
🔍OC lesions
Extend expected timeframes for these patients (6-12 months). Skipping this step is common in second opinions I’ve seen, more here:
medium.com/@physioclini... /9
Knee extension exercises must be individualised- it's often different between patients.
Find what targets the quads/thigh more than the kneecap - get those quads "cooking".
Use slow tempo (2s each way), with a 1s pause at ends. Aim for 3x8-12RM (1min rest) 2-3x/week.
/8
3️⃣How Strong Should They Be?
We're usually trying to get the injury caught up to the unaffected side (within 10-20% in most cases).
But I also look at %BodyWeight (%BW) of knee extension peak isometric force on dynamometry.
🎯Sedentary cohort ~45%BW
🎯Athletic cohort ~55%BW
/7
2️⃣Education: Specifics Matter
Patients need clear, actionable advice:
✔️Continue with loads that load PFJ less
✖️Limit loads that load PFJ more
It’s part of calming things down. Education often gets lip service, but it’s crucial. More on this here
physioclinician.medium.com/are-we-payin... /6