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Consent ✅ Runner Lateral knee pain longer runs & with multi-direction movements in football MRI - marked ITB inflammation - but zero response from diagnsotic injection after extensive rehabilitation Re-assessment today on POCUS shows popliteus tendinopathy evaluating the lateral joint line & hiatus Pain on resisted knee flexion from...

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James Noake

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10,660 views • 1 year ago •via X (Twitter)

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Consent ✅ Female Cross fitter with bilateral quite focal anterior knee pain superolateral to patella Onset after ramp up in training volume & weight esp squats, cleans Function inhibiting catching symptoms at predictable knee flexion angle POCUS - thickened lateral quadriceps fat pad seen to impinge under quads expansion & over trochlea on active knee flexion ➡️ extension - correlates with palpable painful click felt under probe US guided injection today removed click & pain on squat testing
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Consent ✅ Female Cross fitter with bilateral quite focal anterior knee pain superolateral to patella Onset after ramp up in training volume & weight esp squats, cleans Function inhibiting catching symptoms at predictable knee flexion angle POCUS - thickened lateral quadriceps fat pad seen to impinge under quads expansion & over trochlea on active knee flexion ➡️ extension - correlates with palpable painful click felt under probe US guided injection today removed click & pain on squat testing

James Noake

30,448 views • 3 years ago

Consent ✅ L anterior elbow pain in bodybuilder POCUS - shows distal biceps tendinopathy & paratendinitis with fluid in sheath US guided injection - seems there is an occult intra-substance tear that is only visualised with the injectate in-situ Lateral to medial approach to avoid vessels medial to tendon - also be wary of radial nerve / branches bottom right of screen Injection can also be done in cobra position - here paratendinitis an easy target so injection undertaken proximally
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Consent ✅ L anterior elbow pain in bodybuilder POCUS - shows distal biceps tendinopathy & paratendinitis with fluid in sheath US guided injection - seems there is an occult intra-substance tear that is only visualised with the injectate in-situ Lateral to medial approach to avoid vessels medial to tendon - also be wary of radial nerve / branches bottom right of screen Injection can also be done in cobra position - here paratendinitis an easy target so injection undertaken proximally

James Noake

10,656 views • 2 years ago

Consent ✅ The thing I enjoy most in my job is collaboration with expert physiotherapists on complex cases, especially in elite sportsmen & women It’s a symbiotic relationship – there is mutual learning & professional growth - and the patient gets the best of both worlds I had the privilege of assessing a professional ballet dancer who flew in from Budapest alongside the amazing Liz Bayley recently I thought I’d summarise our joint knee assessment for those interested (get a cup of tea! 😆) 2 months ago, sharp pain in the medial knee after sitting with legs crossed for 30 minutes ‘Instability’ during Swan Lake rehearsals, with pinching pain and fear of knee buckling – had one fall on stage during a performance One episode woke up one morning with local swelling, ‘pressure’ in the joint, and diffuse anteromedial knee pain - unable to walk or fully extend / flex the knee Currently experiencing sensation of pain, ‘swelling’ & fullness, particularly anteromedial patella - burning, prickly sensation Warms up with activity – latent post exercise pain Aggs - Grand plie in first position, squatting, bridges with hip adduction, transferring weight in turned-out position, down stairs Reviewed MRI in Hungary – Normal menisci, Hoffa's fat pad & articular cartilage – but report missed adductor magnus distal tendinopathy! (see sagittal image) – always check the images yourself Exam- Hip joint & lumbar spine clear Full squat sore especially with R leg bias Tender medial aspect of the knee, particularly in the region of the pes anserinus Fat pad compression test negative Mild awareness PFJ compression Knee flexion pain at end range but other meniscal tests negative Adductor loading / stretch tests (including adductor magnus bias) negative Prone knee bend neural tension test with saphenous nerve bias – minimally provocative DDs: · Patellofemoral pain – ‘common things are common’ · Pes anserine bursitis with associated infrapatella branch of saphenous nerve irritation? · Distal adductor magnus tendinopathy with associated saphenous nerve irritation? (AM forms floor of Hunter’s canal) POCUS in clinic – Great for tracing saphenous nerve & distal branches reliably; no nerve pathology seen or pain reproduction on systematic Tinel’s test using probe. Adductor magnus tendinopathy confirmed – but on further review of MRI, the inflamed adductor magnus tendon seems some distance from saphenous nerve (see axial image), so symptoms less convincing related to secondary nerve irritation However, pes anserine fluid noted vs contralateral side & correlates with her typical pain US guided local anaesthetic injection (video) significantly improves symptoms on comprehensive testing in gym & pilates studio P - Liz Bayley refined a Ballet specific rehabilitation plan now we have more diagnostic confidence - so cool watching her piece this together! Observe how symptoms respond over 6-8 weeks If no improvement, consider definitive injections to pes & / or PFJ – but need to exercise caution especially around tendons that are placed under huge athletic demand
0:12

Consent ✅ The thing I enjoy most in my job is collaboration with expert physiotherapists on complex cases, especially in elite sportsmen & women It’s a symbiotic relationship – there is mutual learning & professional growth - and the patient gets the best of both worlds I had the privilege of assessing a professional ballet dancer who flew in from Budapest alongside the amazing Liz Bayley recently I thought I’d summarise our joint knee assessment for those interested (get a cup of tea! 😆) 2 months ago, sharp pain in the medial knee after sitting with legs crossed for 30 minutes ‘Instability’ during Swan Lake rehearsals, with pinching pain and fear of knee buckling – had one fall on stage during a performance One episode woke up one morning with local swelling, ‘pressure’ in the joint, and diffuse anteromedial knee pain - unable to walk or fully extend / flex the knee Currently experiencing sensation of pain, ‘swelling’ & fullness, particularly anteromedial patella - burning, prickly sensation Warms up with activity – latent post exercise pain Aggs - Grand plie in first position, squatting, bridges with hip adduction, transferring weight in turned-out position, down stairs Reviewed MRI in Hungary – Normal menisci, Hoffa's fat pad & articular cartilage – but report missed adductor magnus distal tendinopathy! (see sagittal image) – always check the images yourself Exam- Hip joint & lumbar spine clear Full squat sore especially with R leg bias Tender medial aspect of the knee, particularly in the region of the pes anserinus Fat pad compression test negative Mild awareness PFJ compression Knee flexion pain at end range but other meniscal tests negative Adductor loading / stretch tests (including adductor magnus bias) negative Prone knee bend neural tension test with saphenous nerve bias – minimally provocative DDs: · Patellofemoral pain – ‘common things are common’ · Pes anserine bursitis with associated infrapatella branch of saphenous nerve irritation? · Distal adductor magnus tendinopathy with associated saphenous nerve irritation? (AM forms floor of Hunter’s canal) POCUS in clinic – Great for tracing saphenous nerve & distal branches reliably; no nerve pathology seen or pain reproduction on systematic Tinel’s test using probe. Adductor magnus tendinopathy confirmed – but on further review of MRI, the inflamed adductor magnus tendon seems some distance from saphenous nerve (see axial image), so symptoms less convincing related to secondary nerve irritation However, pes anserine fluid noted vs contralateral side & correlates with her typical pain US guided local anaesthetic injection (video) significantly improves symptoms on comprehensive testing in gym & pilates studio P - Liz Bayley refined a Ballet specific rehabilitation plan now we have more diagnostic confidence - so cool watching her piece this together! Observe how symptoms respond over 6-8 weeks If no improvement, consider definitive injections to pes & / or PFJ – but need to exercise caution especially around tendons that are placed under huge athletic demand

James Noake

21,470 views • 1 year ago

CORE TRAINING with emphasis on lateral flexion/extension loading at length and holding isometrically. Low back issues are rampant with the populations I train so building some durability. Half Kneeling Lateral Bend Hip Drops from a Bench Lateral Bridge with Row Suitcase Carries
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CORE TRAINING with emphasis on lateral flexion/extension loading at length and holding isometrically. Low back issues are rampant with the populations I train so building some durability. Half Kneeling Lateral Bend Hip Drops from a Bench Lateral Bridge with Row Suitcase Carries

Vernon Griffith, CSCS*D

55,752 views • 1 year ago

THREAD ALERT 🚨🚨 Seen loads of interesting & 'left-field' foot & ankle cases over the last week so I thought I'd post them 🦶👣 1. Footballer Anterior ankle pain on powerful kick, sprint & inclines When very irritable, gets an uncomfortable 'flicking' sensation Pain reproduced on dynamic lunge & resisted dorsiflexion Tender over tibialis anterior & into anterior joint recess MRI shows inflammation anterior ankle joint line POCUS video - large dorsal talar ostophyte irritating TA tendon on active DF / PF So, 2 problems - 'footballers ankle' plus compression of TA tendon under load & through ROM US guided injection to anterior ankle impingement zone, podiatry & physio input before RTP
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THREAD ALERT 🚨🚨 Seen loads of interesting & 'left-field' foot & ankle cases over the last week so I thought I'd post them 🦶👣 1. Footballer Anterior ankle pain on powerful kick, sprint & inclines When very irritable, gets an uncomfortable 'flicking' sensation Pain reproduced on dynamic lunge & resisted dorsiflexion Tender over tibialis anterior & into anterior joint recess MRI shows inflammation anterior ankle joint line POCUS video - large dorsal talar ostophyte irritating TA tendon on active DF / PF So, 2 problems - 'footballers ankle' plus compression of TA tendon under load & through ROM US guided injection to anterior ankle impingement zone, podiatry & physio input before RTP

James Noake

14,233 views • 1 year ago

Auston Matthews is down after a knee on knee from Radko Gudas. He left the ice in pain and went back to the dressing room. Gudas received a match penalty and was ejected from the game. sdpn
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Auston Matthews is down after a knee on knee from Radko Gudas. He left the ice in pain and went back to the dressing room. Gudas received a match penalty and was ejected from the game. sdpn

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Don't have knee pain Let's keep it that way! 😍 The brace provides optimal support and stability for those with knee pain, sprains, and strains, including ACL/MCL injuries, inflammation, soreness, and tendinitis. 🛒

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Ultrasound quiz Level: Basic Chronic knee pain with recurrent effusions and secondary osteoarthritis of the knee 10 years after partial meniscectomy What can you see on this video?

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"Jordyn Tyson is injury prone" Let's line you up in the slot and have a safety torpedo your knee from behind and see what happens

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Spurred on by Dr Robbie Erskine ‘s influence in ambulatory spinals: Total Knee Arthroplasty by Raghbir Singh Khakha No tourniquet Intrathecal Prilocaine All the Block It Like It’s Hot Podcast Blocks (Jeff Gadsden) On arrival in recovery… pain 0/10 I am now convinced! With patient consent ✅
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Spurred on by Dr Robbie Erskine ‘s influence in ambulatory spinals: Total Knee Arthroplasty by Raghbir Singh Khakha No tourniquet Intrathecal Prilocaine All the Block It Like It’s Hot Podcast Blocks (Jeff Gadsden) On arrival in recovery… pain 0/10 I am now convinced! With patient consent ✅

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I love rhyming when it comes to beating knee pain! Do these every day and your knee pain will 100% disappear!
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I love rhyming when it comes to beating knee pain! Do these every day and your knee pain will 100% disappear!

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JSN screaming in pain holding his right knee after a hospital ball from Sam Darnold this Sunday
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JSN screaming in pain holding his right knee after a hospital ball from Sam Darnold this Sunday

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Knee Pain Relief in Seconds! Did you know that massaging the middle finger bone on the same same side as your painful knee can help ease discomfort? 💯 This simple yet effective technique supports energy flow & may bring quick relief 💯 Try it now👇👇👇
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Knee Pain Relief in Seconds! Did you know that massaging the middle finger bone on the same same side as your painful knee can help ease discomfort? 💯 This simple yet effective technique supports energy flow & may bring quick relief 💯 Try it now👇👇👇

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KNEE PAIN ? ☝🏼 Doing these exercises consistently, will reduce pressure on the knees, less discomfort.. and help you move pain free again.

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CORE TRAINING - Some recent movements we have done the past two weeks with emphasis on flexion, extension and anti-rotation. - Kettlebell Saws - Medicine Ball Partner Passes - Medicine Ball V-Ups - Medicine Ball Hollow Rocks
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CORE TRAINING - Some recent movements we have done the past two weeks with emphasis on flexion, extension and anti-rotation. - Kettlebell Saws - Medicine Ball Partner Passes - Medicine Ball V-Ups - Medicine Ball Hollow Rocks

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After having “knee” added to “hamstring” on the injury report yesterday, Bills TE Dalton Kincaid was practicing in a regular blue jersey today, but was wearing a knee brace, as well.
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After having “knee” added to “hamstring” on the injury report yesterday, Bills TE Dalton Kincaid was practicing in a regular blue jersey today, but was wearing a knee brace, as well.

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If you have moderate to light knee pain… This simple drill can help to reduce it. It looks funny, but it works. Why this works? It strengthens your quads in a way you normally don’t get from regular squats.
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If you have moderate to light knee pain… This simple drill can help to reduce it. It looks funny, but it works. Why this works? It strengthens your quads in a way you normally don’t get from regular squats.

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