Kyle Gosse
1090 Topsail Road A1N 3K2 Mount Pearl, NL, Canada

Running Shoes! . This one from @adammeakins Is near and dear to my heart as I believe that running shoes has become one of the most over complicated and over marketed topics in physical therapy professions second only to pillows. .... Many people are still being advised to buy running shoes based on their foot shape Yet there is a large body of evidence spanning more than a decade that shows this method of shoe selection does NOT reduce the risk of injury As I mentioned in my other post foot shape is not a strong risk factor for running related injuries And so selecting shoes to correct or control foot posture is also not a strong factor in reducing running injury The best way to select a running shoe is simply to pick one that feels comfortable. #Physio #physiotherapist #physiotherapy #physicaltherapy #sportsphysio #sportsphysiotherapy #trainer #personaltrainer #coach #strengthcoach #osteopath #osteopathy #chiropractic #chiropractor #sportstherapy #sportstherapist #rehab #therapy #myotherapy #kinesiotherapy #exercisephysiology #exercisephysiologist #dptstudent #shouldercomplex #cantgowronggettingstrong

@hannahmoves is definitely right. Your flare ups are not a regression sometimes they are just simply apart of the rehab process. . . . Share this with someone who needs to see this.... Flare ups can be quite discouraging. But remember, you’re still on the right path. If anything this is a reminder of why you’re working to change your circumstances in the first place! I first heard this from @sanderder84, because my followers are the smartest. Don’t sit still. Make moves! Nick Hannah, PT Registered Physiotherapist #hannahmoves #hmrehabmoves #osteopathy #stjohns #newfoundland #physicaltherapy

Leg Length Discrepancy! Thank you! @michael_barbellmedicine one of the hardest pills many of the people who come to see have to swallow is the realization that their perceived leg length discrepancy is probably not playing a huge role on why they are in pain. A common assessment taught in rehab based schools. ... LLD (a.k.a. anisomelia) defined as a measurable difference between the length of the lower extremities, and often blamed for numerous issues related to pain or dysfunction due to the asymmetry. Flawed premise: a structural observation = a problem resulting in symptoms necessitating intervention. Recall: Pain is a complex experience that cannot be reduced to simple anatomical observations that might superficially seem problematic. Measuring LLD: Many folks perform assessments for LLD in clinics/gyms via visual assessment, palpation, tape measures, or blocks (pelvis leveling). Overall, the available research evidence demonstrates such approaches ineffective. A more accurate assessment would be done via imaging, X-ray or CT scanogram. But recall, just because we can observe and measure doesn’t mean problem. How readily identifiable are LLDs in the general population? Gordon and Davis set out to answer this question in their 2019 article - Leg Length Discrepancy: The Natural History (And What Do We Really Know) Finding: Approximately 90% of the population has an LLD. On average, a 5.2 mm difference has been observed. Looking at Knutson 2005 - 10% of the population has equal lower limb lengths,~50% has a 4 mm LLD or less, and ~90% has a 10 mm LLD or less. Does a particular LLD tend to matter more regarding pain and dysfunction? Not necessarily. Gordon and Davis argue for a potential threshold of clinical relevance at 3 cm. The likely scenarios in which we may be curious about LLD are acquired contexts such as post-traumas (e.g. fractures) or joint replacement. The often touted functional LLDs lack evidential support and are often argued for based on fallacious reasoning in attempts to validate an intervention. We also do not have supportive evidence to screen folks universally for LLDs. Finally - shimming and/or shoe inserts are not typically necessary in this context generally speaking. Turns out we are adaptable and capable of coping with various observable asymmetries. Hopefully this provides some clarity

Always love guys like @dr.surdykapt taking a no nonsense approach to stuff like this. Stop bandaging foot pain with orthotics and figure out why it is there in the first place. Modify loads, improve workload tolerance, and neurological cues and watch your pain go down. PLANTAR FASCIITIS Understanding a condition is integral to successful rehabilitation.... For example, plantar fasciitis is better referred to as plantar heel pain or plantar fasciopathy because inflammation is not the primary driving factor. Additionally, it is not possible to break up scar tissue or adhesions, nor is it necessary to try. Finally, heel spurs on imaging do not correlate with a worse long-term prognosis. If you didn’t know these things, you might try to rest, ice, roll, and take anti-inflammatories until your symptoms improve. Or you might think that surgically removing the heel spur is the only option. I’m not saying that these things can’t help you or haven’t helped you. That’s very possible. However, many people have tried the purely passive approach without much success. Instead, I recommend a more active approach. Modify/reduce aggravating activities (walking, running, sports, etc.) and gradually build up your tolerance/capacity over time. There are no short cuts - just consistency and time. Scroll back to November 30, 2020 to see the two most popular/researched exercises and a description of how to implement them. There’s also two YouTube videos on the @e3rehab channel and a massive blog at https://e3rehab.com/blog/plantarfasciitis See more

Chronic jaw pain and your bite plate is not giving you relief? . TMJ discomfort is one of the most common pains I have been treating people for the last little while. It can be stubborn and extremely debilitating in some situations. Very often with TMJ pain as with many other conditions it is not just as simple as rubbing "tight" tissues on the jaw. The pain itself can be very multi factorial including but not limited too. - Stress ... - Anxiety/Depression - Sleep quality - Cranial nerve irritation at the base of the skull - Etc. . In this next little segment for you guys I will show some of the common interventions we begin to use to work with individuals experiencing chronic jaw pain. #osteopathy #physicaltherapy #stjohns #Newfoundland See more

@hannahmoves always providing the tough pills to swallow. . Top four reasons people can improve health related problems, regardless of any intervention: NATURAL HISTORY... Commonly (but not always), health related complaints will improve with time irrespective of any treatment. REGRESSION TO THE MEAN This is the statistical phenomenon that if a variable (i.e. a health complaint) is extreme on its first measurement, it will tend to be closer to the average (i.e ‘better’) on its second measurement, or vice versa. Since most people seek medical care when their symptoms are worse than average, subsequent measures MAY be closer to the average, and therefore ‘better’. THE ‘ALL HANDS ON DECK’ EFFECT The motivation to seek out professional care may inspire other healthy behaviours (i.e. more sleep, physical activity, better diet, improved stress etc.). MEANING RESPONSES Nonspecific, positive treatment effects created by contextual factors, verbal and non-verbal factors, expectations etc. outside of any particular intervention given. They are difficult to measure but most certainly contribute positive health outcomes in small ways. So there you have it. Sometimes you get ‘better’ without our ‘interventions' doing anything. Don’t sit still. Make moves! Nick Hannah, PT Registered Physiotherapist #hannahmoves #hmrehabmoves #osteopathy #physicaltherapy #stjohns #newfoundland

No disc has ever "slipped"...ever. But when we use that word with clients and they think something like this is possible it definitely impacts them negatively. Thanks @paincloud1! Quote by Lorimer Moseley #trustme #keeplearning... #fysioterapia #fysioterapi #fysioterapie #physiotherapy_world #physioterapy #physioterapist #physiotherapists #physiolife #fisioterapeutas #physicaltherapy #physicaltherapist #physicaltherapystudent #physiotherapie #physiostudent #fysiotherapie #trustmeimaphysiotherapist #musculoskeletal #musculoskeletalphysiotherapy #kinésithérapie #kiné #fizyoterapi #fisioterapia #osteopathy See more

Thanks @hannahmoves for this great breakdown [MULTIDISCIPLINARY CARE APPROACHES] . . .... I think many would agree that having a multi-disciplinary management strategy for a client dealing with a complex health situation should yield the most optimal health outcomes. Each professional brings a unique skillset as defined by their scope of practice. . However, having multiple professionals working with the same person is only as helpful as their ability to collaborate. . COLLABORATIVE Equal understanding of the clients goals. A shared narrative (Language, messaging, empowerment tactics etc.). A common & modern understanding of body symptoms & pain. Agreement as to the dispositions involved in the client’s condition/pain. A team effort to prioritize the most relevant factors. . SILO-BASED Some professionals as interactors others as operators A mixed narrative (i.e. Mixed messaging, language etc.) Disagreement about explanations for symptoms & pain. Disagreement about dispositions involved in the client’s condition/pain. Professional bias that my lane of care is most important. . Silo-based care is dangerous as it can lead to increased confusion, anxiety and distrust of the healthcare system. It may only serve to perpetuate a health related problem and spawn a learned helplessness regarding their health and life. . Having many professionals working with a client doesn’t automatically make matters better. . In fact, in many cases it probably makes matters worse. . #osteopathy #physicaltherapy #stjohns#newfoundland See more

DO NOT AUTOMATICALLY ASSUME THAT YOU HAVE DONE SOMETHING WRONG OR THAT SOMETHING IS DAMAGED . When you begin to experience pain the number one variable you have at your disposal is modifying the amount of load you are performing on a weekly basis. In this context, the word load can mean something different to many different people. For some, it means reducing the amount of exercise they are doing for others it can mean decreasing how active they are at work or in the garden. ...In any of these instances, the solution very rarely is to stop the activity altogether. In many situations, this can make things worse, not better. However, many of you would be astonished about what a difference simply reducing the total volume activity can make towards the way you are feeling and the pain you are experiencing. . Helping you to modify your lifestyle and begin to instruct you on how to reintroduce the activities you want to be performing is one of our main responsibilities as clinicians! However, we can't promise you will beat the Lakers... #osteopathy #stabilityosteopathy #physicaltherapy #nbaplayoffs #stjohns #newfoundland

So true from @encompass.health I am always preaching to my clients to do the little things right before focusing on more grandiose rehab ideas. Pain more times than not is extremely multifactorial and involves more than just dealing with the biomechanics of why you might be uncomfortable. #osteopathy #physicaltherapy #painscience #stjohns #newfoundland

How do do you pick a service? As a person in pain it can be incredibly overwhelming when looking for help to choose between chiropractors, manual osteopaths, physiotherapists, athletic therapists, RMT’s, etc. Then you also have to factor in the noise from your friends and family who are aways happy to share their personal experiences on the topic. . So amongst all of this how do you pick which category is best for you? The simple answer is YOU DON’T. When you are choosing a ...clinician you are not picking their sub category of field you are picking THEM! There are many professions trained to handle a wide range of issues such as non specific low back pain, acute injuries, nerve compression, etc. When you are picking a clinician to help you, focus less of your attention on comparing the various sub categories and more attention to: - do you trust what the person is saying or do you feel as thought they are hiding behind jargon? - Do their practices seem current? - Are they empathetic? - Is there experience working with people who have similar symptoms to you? - Do they seem committed to your success as a client? - Do you feel as though you have stepped into into a follow up appointment factory with once weekly maintenance check ups? Or does the outlined timeline seem reasonable? - Have you been given exercise, lifestyle, and day to day modifications or are all the interventions passive (being done to you)? . When you focus on critical questions like this versus what subcategory of rehabilitation a clinician works in you are far more likely to find someone to help you. Also, don’t be afraid to speak to the person before booking an appointment. It is normal to want reassurances. #physicaltherapy #stjohns #osteopathy #newfoundland #rehabilitation

When watching the PGA championship this weekend I became extremely frustrated when one of the sports elite Brooks Kopeka was seen regularly receiving joint mobilizations on the ground throughout his round. The announcers would then without knowledge on the subject perpetuate the need for nonsense like this condoning it as some sort of miraculous idea. When in reality this was most likely one part of an extremely dynamic treatment model that encompassed many things such as loa...ded exercise, and swing modifications for weeks leading into the event (or at least I hope so, if not I hope he seeks new council) The fact that he was receiving these mobilizations during play would leave me to confidently speculate that he was most likely not completely rehabilitated and if it was a less important event and not a major like the PGA championship he probably would have skipped it altogether. . There is a place for interventions like this in the spectrum of treatment. Joint mobilizations can be extremely useful for managing discomfort in the short term in order to make the beginnings of long term adaptation easier. Unfortunately when this kind of thing is seen on TV average people and amateur athletes alike see it and instantly think that this is where they should be investing their rehabilitation time and dollars when in reality they don’t see that manual therapy is one tiny facet of what that professional athlete is most likely undergoing. . Popularization of things like this continuously sets back evidence based physical therapy and encourages practitioners to adopt simpler less encompassing models of treatment because the public has become so interested quick fixes. I can vividly remember seeing the same trend when Michael Phelps started showing up to the olympics covered in cupping marks. It suddenly became the thing that athletes should be doing even though the research on the subject overwhelmingly points to placebo. #physicaltherapy #stjohns #pga #osteopathy See more

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