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Happy New Year to all.

Fully booked next week, I will update if anything changes.

Also doing an Olympic Test Event next week (Gymnastics - I don't only treat Cyclists!) so reduced capacity generally but back to normal with availability from the 17th.

PM queries as normal.

I am back in the pain zone, have been since xmas ... sucks badly. was sleeping on a yoga mat for a couple of nights because the bed hurt so much.
Went to a physio (the only one I could find that was open) who managed to help me exactly nill, just slapped some deep heat stuff on and showed me how to do a cobra the first time, the second visit me managed to put a heat package on then pissed off next door to treat another patient. Left being in even more pain, but totally got the sense that the guy loved the idea of repeat visits. What a crop of shit.

The only time I feel OK is after a combo of a couple of beers, two paracetamol and some deep heat creme that my mother in law has given me.

That's poor form from the physio - sounds like a practitioner who relies on extended bouts of passive treatments. Anyone double treating without good reason should arouse suspicion. PM me if your next appointment is equally "effective" and client-centred.

Merry Christmas to all patients and fellow forum members. Best wishes for 2012.

That elusive slot is available again this week.

4pm on Thursday.

It's always the last to go.

You know the number by now.

Just found out I've also been selected to work at the Velodrome for the Olympics :-)

4pm is available again tomorrow.

0207 482 3875.

I have one appointment available this week at 4pm on Thursday.

Call 0207 482 3875 to book.

www.cyclephysio.co.uk

@mcrebbin / @CyclePhysio

4pm new slot available this Thursday if anyone needs an appt. Closed next Tuesday to attend Cyclefit Symposium.

The main risk associated with not having / delaying surgery is the possibility of early onset degenerative changes as a result of abnormal loading stresses within the knee. Good proprioceptive rehab and functional strength are essential whether you undergo surgery or not but sadly a lot of people don't rehab to a high enough level.

Clinics Tue & Thur inside LA Fitness in Kentish Town.

www.cyclephysio.co.uk
www.complete-physio.co.uk

Patients awaiting Royal Free & Whittington are sometimes with me for up to 12 wks while on waiting lists. The majority recover within this time.

45min new slots are £45, 30min follow-ups are £35.

Feel free to PM any queries.

Michael.

Mike, you should go see bluerip (michael) cycle specific physio, recommended.

Cheers Zed.

And a lot cheaper than £60 per session. That must have been in the city.

I have had a cancellation this Thursday and am now free between 4 and 5pm if anyone needs a follow-up / new assessment / bike fit.

Call us on 0207 482 3875 to book if this is convenient for you.

95% of back pain resolves within 6-12 weeks so for the majority of cases a 'wait and see' approach is employed by GP's with symptom management (pain killers for pain for example) implemented. However during this time there can be significant fear avoidance and functional loss which can be minimised with the help of Physio / Osteo / Chiro.

TS - throbbing in your joints would be an uncommon side-effect but a plausable one. Hopefully your bloods are clear for rheumatological / inflammatory markers. The fact that you've stopped nsaids and your symptoms are actually improving is positive.

Good luck with your results.

Full now until 11th October. PM questions.

www.cyclephysio.co.uk

2 slots available tomorrow: Tuesday: 5 and 5:45pm.

Call us on 0207 482 3875 to book, still some available on Thursday too. I'll be away next week and busy the week after.

Thread resurrection.

After my ride down to Monte Carlo (http://www.lfgss.com/thread71741.html) I have numbness in both hands. Over the first seven days, I just had a numb finger tip on the middle finger of my right hand. On the eigth day, two alpine descents during which I clawed at my brakes for dear life left my hand numb. The feeling has not returned over a week later. I have had two massages in that time, focusing on my shoulders. These were tense and I thought that that tension might account for the numbness. No improvement.

Any suggestions for anything I should do other than simply rest?

Prevention is better than cure Clive:
In other words: You should have taken me with you ;-)

You've described radial and median nerve distribution rather than classic ulnar nerve patterns. Would be worth stretching your wrist flexors and extensors but may also have some central irritation if your symptoms are bilateral - in which case may need to loosen your neck / shoulder and pectorals.

Let me know if nothing has changed after a week. Neuropraxia can take several weeks to settle even with good management.

Few PM requests:

New Patient Appointments available this week:

Tuesday (tomorrow) 5:30pm
Thurs 4:15 and 6:15pm

Otherwise full.

Call us on 0207 482 3875 to book.

PM queries as allways,

Michael.

You can't beat a thumbs up from Norris!

Still quiet from 3.30-5.30 but otherwise full now on Thursday.

I have a few slots next week on Thursday. Tuesday is currently full.

Thanks for your 'word-of-mouth' referrals (you know who you are). Some clients are travelling great disctanes for appointments so I'll try to keep up the good work.

You must now consider that part of the knees' internal structure is missing so I would recommend that you optimise your lower limb biomechanics and alignment. When they recommend 'cycling' they are not referring to skid breaking or pulling away from lights / grinding hills with a 48:16.

Graded loading would be ideal (gears) but this may not be a possibility. There would be few risks associated with cycling sensibly but you may want to check how aggressive you can be with your Ortho consultant / physio. Knees adapt well but sometimes respond adversely to quick loading - try to avoid causing swelling or other inflammatory signs as this may time to resolve if you irritate sub-chondral tissue.

I finally have a 'quiet' day with some availability between 4pm and 6pm or after 7pm this Thursday. PM or contact the clinic direct to book.

Michael

Your GP should be suspicious of your scaphoid bone and other carpal bones to exclude fracture or instability. CTS is generally easy to diagnose and differentiate from other causes of median nerve irritation but as pointed out above your symptoms may be referred (generally from the cervical spine) or the result of what is known as a 'double crush' syndrome which predisposes the nerve to hypersensitivity.

TRUE CTS patients usually respond well to combinations of the following: splinting, carpal bone mobilisations, acupuncture, myofascial release; stretching; neural mobilisations and activity modification. Failing this then steroid injections offers an effective anti-inflammatory solution. Options then elevate to nerve conduction testing in severe cases and surgical decompression but I would exhaust conservative options (and ensure it is true CTS) before seeking surgical management unless symptoms are severe and atrophy has occured.

Good luck with your GP - They will most likely to refer you to Physiotherapy (depending on your area and service availability) but CTS is often overly wrongly diagnosed without thorough examination.

PM if you have any queries.

Michael.
Forum Physio.

I am now able to confirm hours from 12th July:

Tue: 5 - 8pm (happy to extend later by special arrangement)
Thur: 3.30 - 8pm (again happy to extend)

The gym in which the clinic is located is open until 10pm on each day.

4.45 - 8.00. I can extend later by prior arrangement but 4.45 is the earliest start time available. I'm offline from tonight until Monday but you can call our admin team 0207 482 3875 if you want something confirmed before then.