Shoulders to Shoulder: Need for shared decision making in rotator cuff treatment!   June 18th, 2018
Although evidence on psychosocial factors affecting the prognosis after rotator cuff repairs is scarce, a recent systematic review (Coronado et al., 2018) reported that preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery.
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Psychosocial factors play an important role in the course of shoulder pain   August 31st, 2016
Shoulder complaints are common in physiotherapy practice and consist of pain and functional limitations.
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Dysfunction and treatment implications regarding the pectoralis minor in shoulder impingement syndrome   June 1st, 2016
The scapula plays an important role in the function of the shoulder. During humeral elevation of the arm, a complex scapular movement of upward rotation, posterior tilt and external rotation is needed to create a stable base for the glenohumeral joint.
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Potentiating placebo-analgesia in clinical practice   January 1st, 2015
Manchikanti and colleagues (2011) make in their paper entitled ‘placebo and nocebo in interventional pain management: a friend or a foe – or simply foes?’ an argument for a revaluation of placebo effects in clinical practice. They make the claim that clinicians should not try to avoid the placebo effect, but should try to potentiate it, as this effect isn’t just unethical and mythical but must seen as a very real phenomenon, which can be understood from a vast body of both psychological and neurophysiological research.
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Scapular assessment and its place within clinical reasoning   January 1st, 2015
​Scapular dyskinesia has been widely accepted in the literature as associated with glenohumeral joint pathology. Clinicians who manage patients with shoulder pain need to have the skills to assess static and dynamic scapular positioning. At this point, clinicians can use reliable (and valid) clinical tests for the assessment of both static and dynamic scapular positioning in patients with shoulder pain.
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The balancing exercise of exercise prescription in chronic pain?   January 1st, 2015
​In a very recent review and clinical guideline of Heather Kroll, a nice overview is given about how exercise affects pain. But besides listing possible mechanisms of exercise induced analgesia, she reviews the therapeutic modalities and benefits for a wide variety of chronic pain diagnoses.
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Myofascial trigger points: fact or myth? Let the battle continue   January 1st, 2015
The concept of myofascial trigger points keeps on inspiring researchers and clinicians. With the recent publication of an interesting review article in Rheumatology, the concept is really challenged.
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In the subacromial space or in the brain? Central nervous system sensitization in patients with shoulder pain   January 1st, 2014
Hyperexcitability of the central nervous system, or central sensitization, is considered to be a maladaptive type of neuroplasticity often seen in patients with chronic pain. Central sensitization is frequently seen in patients with osteoarthritis, fibromyalgia, whiplash, neuropathic pain and chronic fatigue syndrome. Up to recently, shoulder pain was considered to be a pure ‘local’ problem. Tissues that are frequently linked to shoulder pain include (rotator cuff) muscles, ligaments, subacromial bursa and joint capsules.
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WILL COMPUTERS REPLACE THERAPISTS? THERAPEUTIC PAIN NEUROSCIENCE EDUCATION VIA E-MAIL   January 1st, 2014
Therapeutic pain neuroscience education (TPNE) is becoming increasingly popular as (part of) the treatment of (chronic) pain and aims at altering the patient’s thoughts and beliefs about pain. Previous research has demonstrated the efficacy of TPNE in the treatment of chronic pain. TPNE is mostly given in one-on-one sessions, which has limitations, as it is time intensive, cost intensive and limited to patients in remote areas. Pain in Motion previously showed that written TPNE does little to alter pain, pain cognitions or illness perceptions in patients with fibromyalgia.
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Tea with discussions about combining manual therapy with pain neuroscience education   January 1st, 2014
Interpreting scientific results in clinical practice can be, to say at least, challenging. Especially when it is somewhat contradictory to what you have heard during all those years of extensive training in both physiotherapy education and other courses. As one of my friends recently put it this way: ‘The more I learn about pain, the less I know and the more confused I get.’
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Treatment Options for Central Sensitization Pain in Clinical Practice   January 1st, 2014
In 2011, Pain in Motion published a paper explaining to clinicians the various options we have for treating the mechanisms involved in central sensitization.
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Exercise therapy for rewriting pain memories? Applying graded exposure in vivo principles during exercise therapy for targeting the brain circuitries orchestrated by the amygdala   January 1st, 2014
Even though nociceptive pathology has often long subsided, the brain of patients with chronic musculoskeletal pain has typically acquired a protective (movement-related) pain memory. Exercise therapy for patients with chronic musculoskeletal pain is often hampered by such pain memories.
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Why does my shoulder hurt?   January 1st, 2014
Dean et al. recently reviewed the neuroanatomical and biochemical basis of shoulder pain. Shoulder pain is often a very challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. As shoulder pain is very common in the physiotherapeutic clinical practice, a vast understanding of pain processing could enlarge the specificity of the patients’ diagnosis and steer treatment.
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Does central sensitization play a role in chronic tendinopathy?   January 1st, 2014
The prevalence of tendinopathies is high both in athletes and in the general population. Despite a wealth of literature, the pain mechanisms of tendinopathies are not well understood. Currently, some studies have described whether, or to which degree, somatosensory changes within the nervous system may contribute to the pain in tendinopathies.
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