The Hinckley Physiotherapy Clinic Ltd

17/06/2026

Our summer competition is in full swing and we’re supporting England tonight 🏴󠁧󠁢󠁥󠁮󠁧󠁿

⚽️ World Cup 2026 ⚽️

04/06/2026

So true 👏

👀 𝗪𝗵𝘆 𝗘𝗺𝗽𝗮𝘁𝗵𝘆 𝗦𝘁𝗶𝗹𝗹 𝗠𝗮𝘁𝘁𝗲𝗿𝘀 𝗶𝗻 𝗣𝗵𝘆𝘀𝗶𝗼𝘁𝗵𝗲𝗿𝗮𝗽𝘆 (P2)
𝘌𝘷𝘪𝘥𝘦𝘯𝘤𝘦 𝘴𝘶𝘨𝘨𝘦𝘴𝘵𝘴 𝘵𝘩𝘢𝘵 𝘦𝘮𝘱𝘢𝘵𝘩𝘺 𝘪𝘴 𝘮𝘰𝘳𝘦 𝘵𝘩𝘢𝘯 𝘫𝘶𝘴𝘵 𝘣𝘦𝘪𝘯𝘨 𝘬𝘪𝘯𝘥.

👉 In physiotherapy, empathy helps clinicians understand how patients experience their condition, their fears, goals, frustrations, and expectations.

👉 A cross-sectional study published in Musculoskeletal Science and Practice found that physiotherapists with higher levels of perspective-taking and empathic concern tended to build stronger therapeutic alliances with their patients. In contrast, higher levels of personal distress were associated with weaker therapeutic relationships.

👉 This is important because rehabilitation is not simply a process of prescribing exercises. Patients are more likely to engage, adhere, and participate in shared decision-making when they feel understood and supported.

💚Empathy does not replace clinical expertise.
Likewise, expertise alone may not be enough.💚

The most effective physiotherapy care often emerges from the combination of scientific knowledge, clinical reasoning, and genuine human connection.

As healthcare becomes increasingly digital, empathy may become even more valuable—not less.

💚 People do not only remember what treatment they received.
They often remember how their clinician made them feel.

📚 Rodríguez-Nogueira et al. (2022)
The association between empathy and the physiotherapy–patient therapeutic alliance: A cross-sectional study.

31/05/2026

New carpal tunnel syndrome guidelines are out, and it's the first major update in 7 years.

The 2026 APTA Orthopedics clinical practice guidelines bring changes to assessment, outcome measures and intervention, including new recommendations on shockwave therapy, kinesiology taping and psychosocial factors that weren't covered before.

Here we have pulled together the key changes and what they mean for practice. Well worth a read if CTS comes up regularly in your work.

🔗 https://members.physio-pedia.com/members-news/updated-guidance-on-carpal-tunnel-syndrome-what-the-2026-clinical-practice-guidelines-mean-for-your-practice/

18/05/2026

🎗️ Endometriosis & Neuropathic Pain: The Lateral Femoral Cutaneous Nerve Connection
When we think about endometriosis, deep pelvic pain, severe cramping, and GI distress are usually the first symptoms that come to mind. But what happens when endometriosis causes burning, tingling, or numbness down the outside of your thigh?
It might be Meralgia Paresthetica triggered by extra-pelvic or deep infiltrating endometriosis.
🔍 The Anatomy of the Compression
The Lateral Femoral Cutaneous Nerve (LFCN) arises from the L2-L3 nerve roots, courses through the pelvis, runs along the pelvic sidewall under the iliac fascia, and exits into the thigh beneath the inguinal ligament.
Because of this specific anatomical pathway, the LFCN is vulnerable to irritation from endometriosis in a few key ways:
Direct Lesions: Endometriosis implants or chocolate cysts residing on the pelvic sidewall can directly infiltrate or compress the nerve sheath.
Fibrosis & Scarring: Cyclic bleeding from lesions causes localized inflammation, leading to dense adhesions and scar tissue that trap the nerve against rigid structures like the inguinal ligament.
Inflammatory Cascades: Even without direct physical entrapment, the biochemical storm (prostaglandins and cytokines) from nearby pelvic lesions can irritate the nerve fibers, leading to neuropathic symptoms.
⚡ Recognizing the Symptoms
Unlike sciatica or femoral nerve pathology, the LFCN is a purely sensory nerve. This means its compression presents with distinct characteristics:
🔥 Sensation: Burning, tingling ("pins and needles"), hypersensitivity to clothing touch, or complete numbness.
📍 Distribution: Confined strictly to the anterolateral (outer-front) and lateral (outer) aspect of the thigh.
🚫 No Motor Weakness: Because it carries no motor fibers, it does not cause true muscle weakness or foot drop. However, severe pain can sometimes cause a protective limp or altered gait.
🛠️ The Clinical Approach
Managing nerve-related endometriosis requires a multidisciplinary strategy:
Targeted Physical Therapy: Neurodynamics (nerve gliding), myofascial release of the iliopsoas and tensor fasciae latae, and pelvic floor rehab to reduce surrounding muscular tension and improve nerve mobility.
Medical & Surgical Intervention: Specialized laparoscopic excision surgery to remove deep infiltrating lesions along the pelvic sidewall, paired with targeted pain management (like nerve blocks or neuromodulators) if neuropathy persists.
Awareness is key. If you or your patients are experiencing unexplained outer thigh burning alongside a history of pelvic pain, it's time to look closely at the lateral pelvic anatomy.

13/05/2026

Please join us ( and Skelly ), in wishing one of our physio colleagues , Vikki, a very Happy Birthday.
Have a great day love
Sarah , Ruth , Reece and Ann
🎂🎈xx

07/05/2026

𝗔 𝗣𝗮𝗿𝗮𝗱𝗶𝗴𝗺 𝗦𝗵𝗶𝗳𝘁 𝗶𝗻 𝗟𝗼𝘄 𝗕𝗮𝗰𝗸 𝗣𝗮𝗶𝗻 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁: 𝗪𝗵𝘆 𝗠𝗼𝘃𝗲𝗺𝗲𝗻𝘁 𝗕𝗲𝗮𝘁𝘀 𝗣𝗶𝗹𝗹𝘀 𝗮𝗻𝗱 𝗦𝘂𝗿𝗴𝗲𝗿𝘆

⬛ Low back pain (LBP) has been the leading cause of global disability since 1990, yet our approach to treating it is often outdated, ineffective, and unnecessarily invasive.

⬛ A landmark 2026 review by Saragiotto and colleagues synthesized the highest-quality LBP research published between 2020 and 2025, breaking down contemporary LBP management into five key themes.

⬛ The overarching message is clear: LBP care is most effective when it is active, person-centered, and psychologically informed, while medications and surgeries carry high risks with little to no meaningful benefit.

🟦 𝗣𝗿𝗲𝘃𝗲𝗻𝘁𝗶𝗼𝗻: 𝗦𝗶𝗺𝗽𝗹𝗲, 𝗦𝗰𝗮𝗹𝗮𝗯𝗹𝗲, 𝗮𝗻𝗱 𝗔𝗰𝘁𝗶𝘃𝗲

⬛ The evidence is consistent: exercise-based programs, especially when combined with education, can reduce the likelihood of a new LBP episode by 25% to 45%.

⬛ We don't need complex, expensive regimens to see results.

⬛ For example, a recent trial showed that an individualized walking program combined with brief education reduced the risk of an LBP recurrence by 20% and reduced LBP recurrences that required healthcare seeking by a staggering 43%.

⬛ When prevention efforts are focused on simple, scalable physical activity approaches, patients build resilience and reduce the long-term impact of pain.

🧠 𝗡𝗼𝗻-𝗣𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝗶𝗰𝗮𝗹 𝗖𝗮𝗿𝗲: 𝗠𝗶𝗻𝗱 𝗮𝗻𝗱 𝗕𝗼𝗱𝘆 𝗖𝗼𝗻𝗻𝗲𝗰𝘁𝗲𝗱

⬛ Non-pharmacological care should be the first line of defense, but not all therapies are created equal.

⬛ Exercise is Key, But Type Doesn't Matter: There is no single "magic" exercise for chronic LBP.

⬛ Whether it's Pilates, walking, or functional restoration, the best exercise is the one the patient enjoys and will do consistently.

⬛ Motivation and adherence are far more important than the specific biomechanics of the movement.

⬛ Psychologically Informed Care: The greatest gains in managing persistent LBP come from approaches that blend physical movement with psychological support.

⬛ Cognitive Functional Therapy (CFT), which builds movement confidence and addresses unhelpful beliefs, has been shown to produce large, sustained improvements in pain and disability for up to 3 years, saving over AU$5,000 per person in healthcare and societal costs.

⬛ Adjuncts, Not Fixes: Manual therapy and acupuncture can provide small, short-term relief, but they should only be used as add-ons to active rehabilitation, not as standalone "cures".

💊 𝗧𝗵𝗲 𝗗𝗼𝘄𝗻𝗳𝗮𝗹𝗹 𝗼𝗳 𝗣𝗵𝗮𝗿𝗺𝗮𝗰𝗼𝗹𝗼𝗴𝗶𝗰𝗮𝗹 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁

⬛ For decades, pills were the default answer to a bad back.

⬛ The latest evidence strongly contradicts this approach, showing that medicines offer minimal benefits and pose meaningful risks.

⬛ Paracetamol: High-certainty evidence shows paracetamol is no more effective than a placebo for acute LBP, and long-term use for chronic pain risks gastrointestinal bleeding and elevated blood pressure.

⬛ NSAIDs (e.g., Ibuprofen): These provide very little pain relief and increase the risk of gastrointestinal and cardiovascular harms.

⬛ Opioids: Opioids provide no benefit for acute LBP and very uncertain benefit for chronic LBP.

⬛ Shockingly, even short-term use of controlled-release opioids for acute pain can double a patient's risk of opioid misuse a year later.

⬛ Other Drugs: Muscle relaxants, gabapentinoids, and glucocorticoids show little to no meaningful benefit and are not routinely recommended.

⚠️ 𝗔𝘃𝗼𝗶𝗱𝗶𝗻𝗴 𝗜𝗻𝘃𝗮𝘀𝗶𝘃𝗲 𝗮𝗻𝗱 𝗦𝘂𝗿𝗴𝗶𝗰𝗮𝗹 𝗜𝗻𝘁𝗲𝗿𝘃𝗲𝗻𝘁𝗶𝗼𝗻𝘀

⬛ The 2026 review paints a stark picture of invasive treatments.

⬛ Lumbar fusion, spinal injections, radiofrequency denervation, and spinal cord stimulators offer little to no long-term benefit for most chronic LBP patients.

⬛ Worse, these procedures expose patients to high costs and substantial complications like infections or revision surgeries.

⬛ Unless a patient has a highly specific condition—like clear nerve root compression or serious underlying pathology—invasive interventions should be avoided.

🌍 𝗛𝗲𝗮𝗹𝘁𝗵 𝗘𝗾𝘂𝗶𝘁𝘆 𝗮𝗻𝗱 𝗦𝗽𝗲𝗰𝗶𝗮𝗹 𝗣𝗼𝗽𝘂𝗹𝗮𝘁𝗶𝗼𝗻𝘀

⬛ Clinical trials often ignore the populations most impacted by LBP, leading to care that doesn't fit their unique needs.

⬛ Older Adults: Despite bearing the highest LBP burden, older adults are often excluded from research and are at a higher risk of receiving unnecessary imaging, opioids, and surgery.

⬛ Care must be tailored to their functional capacity, prioritizing group exercise and acupuncture over medications.

⬛ Children and Adolescents: LBP in youth is a strong predictor of chronic pain in adulthood.

⬛ The focus must be on reassurance, staying active in school and social lives, and supporting psychological well-being.

⬛ Indigenous and Underserved Communities: These populations experience disproportionately high rates of LBP but face immense structural barriers to receiving guideline-concordant care.

⬛ Addressing this requires moving beyond a purely biomedical framework and actively dismantling structural racism, implementing cultural humility training, and investing in community-led, equity-oriented care models.

✅ 𝗧𝗵𝗲 𝗕𝗼𝘁𝘁𝗼𝗺 𝗟𝗶𝗻𝗲

⬛ The evidence is unequivocal: we must shift away from low-value care like opioids and invasive procedures.

⬛ By prioritizing patient education, personalized exercise, psychologically informed therapies, and culturally safe care models, we can reduce the global burden of low back pain and improve lives across all communities.

19/04/2026

The old idea that autistic children are somehow less sensitive to pain is not supported. A better understanding is that pain may be felt strongly, but expressed differently. That difference in expression can mean pain is missed, misunderstood, or wrongly attributed to autism itself.

The old idea that autistic children are somehow less sensitive to pain is not supported. The better understanding is that pain may be felt strongly, but expressed differently. That difference in expression can mean pain is missed, misunderstood, or wrongly attributed to autism itself.

What this review highlights

Autistic children appear to have a higher risk of both acute and chronic pain, not a lower one. The review points to several possible reasons for this, including sensory processing differences, co occurring health conditions, genetic influences, and possible brain, gut, microbiome links. It also shows that pain communication is often complex. A child may not describe pain in expected ways, may show distress through actions rather than words, or may appear calm while still experiencing significant discomfort.

Why this matters

If professionals assume reduced pain sensitivity, there is a real risk of delayed diagnosis, missed health needs, unnecessary investigations, or responses that focus on behaviour rather than the underlying cause. In practice, that can be dangerous and distressing for the child and family.

The strongest clinical message is this, different expression does not mean less pain

Implications for assessment

Pain assessment in autistic children needs to be more thoughtful, more relational, and more individualised. Standard pain tools may not always capture the child’s lived experience well. Professionals need to attend to baseline sensory patterns, communication style, body signals, changes in participation, sleep, eating, movement, posture, and regulation. Parents and carers are essential here because they often notice subtle changes others may miss.

Implications for support

Pain management should not be one size fits all. It needs:
- parent and carer involvement
- multidisciplinary coordination
- attention to sensory processing and the environment
- adaptation of communication and assessment methods
Autistic children do feel pain. Often, they may feel it intensely. The challenge is not whether pain exists, but whether adults around them know how to notice, interpret, and respond to it in ways that fit that particular child.

From a sensory integration perspective, this fits with the wider point that the nervous system shapes how sensation is registered, interpreted, and responded to. Pain is not just a simple input. It is an embodied experience influenced by sensory modulation, interoception, past experiences, predictability, and context.

15/04/2026

03/04/2026

Wishing all our friends , family and patients a very happy Easter weekend 🐣🌼🐰

Well done to all who took part in our Easter competition 😁👏 …. Winner will be notified..

And a special thank you to Phil for our fabulous wooden Easter gifts 🐰🐭🐣

Sarah, Ruth, Reece and Vikki