MSKMag OutLoud

Physio Matters
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MSKMag combines cutting edge clinical opinion with light hearted relief from the daily grind! Featuring insights from the finest minds in the MSK industry, MSKMag will keep you up to date with best practice evidence and the best topical memes. mskmag.substack.com

  1. Jul 1

    The Soft Tissue Cost of Testosterone

    This is a free preview of a paid episode. To hear more, visit mskmag.substack.com As testosterone injections become normalised for strength, physique and recovery, emerging research is raising uncomfortable questions about injuries to ligaments, tendons and surgical repairs. Testosterone has had a rebrand. For many people, it no longer seems to sit in the same mental category as ‘performance-enhancing drug’ or ‘anabolic steroid’. It has become wellness-adjacent. Gym-adjacent. Recovery-adjacent. More muscle. Better physique. Faster recovery. More confidence. Back in the gym sooner. Sounds neat. Until the ACL goes. Or the Achilles. Or the biceps tendon. Or the rotator cuff. This is the bit of the testosterone conversation that feels strangely quiet. The online discussion often starts and ends with body composition, energy, libido and performance. But for those of us working in musculoskeletal practice, there is another question worth asking. What is happening to the tissues that have to tolerate all this extra force?

  2. Jul 1

    Is this the writing on the wall for First Contact and Advanced Practitioners in the NHS?

    This is a free preview of a paid episode. To hear more, visit mskmag.substack.com In May 2026, the British Medical Association, the largest doctors’ union in the UK, published the findings of a survey of over 5,000 doctors on the role of Advanced Practitioners (APs), with 81% saying that the way APs currently work poses a risk to patient safety. This was reflected in a new position statement from the Royal College of Physicians, suggesting that replacing doctors with other roles created ‘a real risk of fragmented care and harm to patient safety’. To understand the degree of antipathy against APs, we must go back to the beginning (This is where, in a film, the swirly spiral denotes we are going back in time (you can hum the atmospheric tune yourselves…)). The Origin Story It’s the millennium, and there is a steady but unmistakable shift from a model of care that was in place from the inception of the NHS in the 1940s to when I qualified in the early 2000s. The 1-in-2 on-call rotas are rapidly becoming a thing of the past as Modernising Medical Careers and the European Working Time Directive from 2004 onwards reduced the average number of hours worked by doctors and the old ‘firm’ structures (Consultant, Registrar, SHO, HO etc) made way for newer ways of working. Whilst the number of hours doctors worked decreased, the population continued to age and grow, creating a tidal wave of increasing complexity and acuity, placing services under unprecedented demand. The number of patients registered with NHS GPs in England grew significantly, from roughly 50 million in 2020 to just under 64 million by 2025. To meet this growing demand, the Health Foundation suggests that a further 3,500 GPs will be needed by 2031. But it takes a long time to train a doctor; 10+ years as a minimum for GPs, and the number of full-time equivalent GPs has dropped by 458 since 2015. Step into the breach: non-doctor roles. By the time of the NHS long-term plan in 2019, early pilots of first-contact physiotherapists had shown they could be useful members of the primary care team. In 2020, the National Evaluation of the First Contact Practitioner (FCP) model of primary care evaluated 240 FCPs from 40 services in England and found that FCPs were acceptable to patients, produced positive outcomes, and reduced GP workload [1].

  3. Jul 1

    Physiotherapy Education: Getting Graduates Ready for What Exactly?

    This is a free preview of a paid episode. To hear more, visit mskmag.substack.com Are physiotherapy graduates ready for practice? If you’ve ever asked this question, you’re not alone. The quick answer? No. But they’re not meant to be. The longer answer? Well that starts in 1894… The Start of Physiotherapy Education [Image 1: Almeric Paget Military Massage Corps [8]] Four women drew a line. Stories in the national press were warning the public about ‘unscrupulous’ people offering massage as cover for something else entirely. They set up the Society of Trained Masseuses because the work deserved better. They established a curriculum and examinations. Standards mattered from the very beginning. What followed was a profession that proved itself through necessity. When World War I broke out in 1914, physiotherapists were quickly deployed to military hospitals. They went where the need was greatest. This community instinct, going where people are and working in the places where health matters, was not a policy position. It was simply what the profession did. Recognition followed practice: it always has. So, what does ‘being ready’ really mean for a profession that has always gone where people needed it, and found a different answer every time? Ownership In its earliest years, the physiotherapy classroom and clinic were never far apart. Learning happened close to the work, even without a formal structure. By 1955 that structure arrived in the form of a national syllabus for physiotherapy [1]. Every UK student physiotherapist followed this one pathway - a three-year curriculum taking place in schools attached to a hospital. After an initial six months of training, they spent 1,500 hours or more treating patients under the supervision of qualified physiotherapists, accounting for 10-30 contact hours a week. The final exams were entirely practical, and they assessed and treated patients in the hospital. Assessment papers were sent directly to the professional body to be moderated against a national standard. There was no gap between education and practice because the two had never been separated, everything taking place under one roof. [Image 2: 1955 CSP Syllabus [1]] Interestingly, the syllabus described the preparation of students as “a graduated process of education leading to admission to membership.“ Not admission to a qualification, but admission to a community. To qualify was to join. The professional body set the standards, ran the examinations, and held the membership. Regulation and professional identity were, in practice, the same thing.

  4. 6d ago

    The Beak Is The Breadcrumb: Tarsal Coalition and the Pain That Points the Wrong Way

    A 24-year-old middle distance runner came in with dorsal midfoot pain – just distal to a little lump at the dorsal talonavicular joint. By the time she reached me she’d done the full lap. Foot strengthening. Mobilisations. Expensive custom orthotics. Shockwave. Dry needling. None of it moved the needle. Her running told the same story every time. Fine off the line but pain starting 2 to 3 km into a 5 km run. Every session. She’d already had an MRI from a previous healthcare provider. In a classic case of ‘junk in = junk out’ - there wasn’t much on the report. The referral: ‘ankle pain’, though ideally it would have read ‘dorsal midfoot in runner near palpable prominence at talonavicular joint’. C’mon people…. Radiologists deserve some stories sometimes! Despite an allegedly radiologically-boring midfoot, the report did give away the big clue in the hindfoot: an osseous subtalar tarsal coalition across the sustentaculum tali (without significant stress reaction). Nobody paid it much attention, presumably because nobody was sure what it meant. The beak is a symptom, not a diagnosis A dorsal talar beak is a bony outgrowth on the upper aspect of the talar head, projecting toward the talonavicular joint. It is a traction osteophyte. It forms where the dorsal talonavicular ligament and capsule pull repeatedly on the talus; the foot’s attempt to remodel around mechanics that have gone wrong upstream [1]. The alternative explanation is mechanical: the navicular rides up over the talar head and lifts the periosteum, and bone fills the gap [2]. Either way, the beak is not the villain, it is the breadcrumb. The question worth asking is what is driving it. In a young adult the answer is often a restricted subtalar joint, and the usual culprit is tarsal coalition. What a coalition actually is This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit mskmag.substack.com/subscribe

  5. Jul 1

    Chewy and Jim - Navigating The System

    Chewy and Jim are back - the lads were evaporating during the recording this month as the weather matched their opinions for heat… Chewy and Jim is best watched in full via the video above (so you can watch them melt in real time) or you can listen on the usual podcast players. In this recording, Chewy and Jim cover consultations from good to bad and their experiences sitting on both sides. “You can be as good medically or with your assessment as you want, but if you can’t guide the consultation and keep the patient on board and engaged, they’re going to leave unhappy and not getting what they want out of it.” - Jim It’s a real skill to run an effective consultation and this becomes really challenging in situations of complexity or system restrictions (lack of time). Unfortunately when this skill is lacking or not applied, the whole thing falls apart and people leave disappointed and frustrated. Chewy and Jim describe stark contrasts between well run and poorly run consultations and it makes a huge difference to the experience. “The actual technical aspect of conducting a consultation is a really overlooked skill.” - Jim Chewy and Jim get into a discussion about the variables that go into this particular skill and it is not just experience. Appropriate feedback mechanisms, training, and practice are all of vital importance to develop the ability to run the consultation effectively AND sensitively. Without appropriate challenge for poor practice and ongoing complacency that this is not a skill that requires development, variation in practice widens and can cause significant problems for those people attempting to navigate the health systems they require. “Variation in care standards can be refined. It shouldn’t just be accepted that sometimes you get the biscuit muncher and sometimes you get the brilliant clinician.” - Chewy This is a really difficult skill to improve and we will never master it fully; different components of it require work for individuals, Chewy for example never shuts up and Jim can’t wait to end every conversation as quickly as possible… Embracing your own individuality but holding it to within appropriate professional boundaries is the balance to aim for. Never go full Chew! Jim points out that the likely training method for working on this skill is roleplay and that induces massive cringe responses in most but it is an absolute necessity in order to receive instant peer feedback and implement improvements outside of the clinic room that you can take with you. Embrace it and leave your cringe at the door: improvements in this skillset will help every aspect of the clinical consultation including the outcomes. Chewy and Jim are nothing if not desperate for these rants to be clinically applicable tomorrow… Dos and Don’ts for consultations: * Introduce yourself and explain your role/Don’t leave patients guessing who you are. * Set expectations early. * Guide the conversation without being rude/Don’t interrupt abruptly. * Don’t start the consultation distracted or disengaged. Would Chew Rather speak only in technical jargon or only in complete lay language? The answer will likely surprise you… Let us know your answer. If you have any ‘Would Chew Rather?’ or ‘Who Are Chew?’ questions put them in the comments or email them to us mskmag@physio-matters.com This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit mskmag.substack.com/subscribe

  6. Jul 1

    The Zebra Farm

    With cases from Dr James Noake In musculoskeletal medicine, we are trained to recognise patterns. Most of the time, the answer sits comfortably within the familiar: overload, strain, tendinopathy. But every so often, something doesn’t quite fit. The story is slightly off, the response to treatment unexpected, or the clinical picture just a little too inconsistent. This is where the ‘Zebra Farm’ comes in. Each time, we explore a trio of real-world cases as written up by Dr James Noake (Consultant in Musculoskeletal, Sport and Exercise Medicine) in his upcoming book ‘Real World Sports Medicine and Musculoskeletal Case Studies : Knee and Lower Leg’. The cases challenge diagnostic instinct; presentations that look routine on the surface but reveal something far less obvious underneath. These are not just rare conditions for rarity’s sake; they are reminders of the cognitive traps we all fall into: anchoring, pattern recognition bias, and premature closure. Because sometimes, when you hear hoofbeats, it isn’t a horse. This is the Zebra Farm. Case 1: The ‘Compartment Syndrome’ That Wasn’t - Myotonia Congenita A runner and footballer in their late 20s had endured a 10-year history of bilateral lower leg pain, described as ‘crampy’ and ‘bursting’. Everything pointed toward chronic exertional compartment syndrome (CECS): * Rapid symptom onset with running * Involvement of multiple compartments (anterior worst) * Stiffness and subjective weakness after activity They had even undergone bilateral fasciotomies with no improvement. Something didn’t add up On reassessment: * Muscles felt ‘woody’ and rigid post-exercise * There was increased muscle tone noted and delayed muscle relaxation * Power improved paradoxically with repeated effort * MRI showed diffuse calf oedema bilaterally, but nothing focal The crucial clue came from EMG: * Myotonic discharges producing a classic ‘dive-bomber’ sound * Further testing showed mild changes in the deltoid too Diagnosis: Myotonia Congenita A non-dystrophic neuromuscular disorder - not a compartment problem at all. Why it fooled everyone * The patient looked ‘muscular’ (due to doing isometrics 24/7 for 10 years…) * Imaging looked ‘consistent’ with exertional pathology * Long history reinforced diagnostic anchoring Key sign ➡️Symptoms didn’t fully settle after stopping exercise and they improved with repetition (warm-up phenomenon). Note though that this warm up phenomenon is short lived! Transition: When ‘muscle pain’ isn’t muscle at all The first case teaches us that abnormal muscle physiology can masquerade as mechanical overload. The next case pushes this even further: when the pain isn’t muscular at all, but vascular. Case 2: The ‘Nerve Entrapment’ That Was a Clot - Peroneal Vein Thrombosis A patient in their 40s presented with 3 months of deep lateral calf aching: * Worse with activity—but now present at rest and at night * Localised toward the lateral calf * Referred as possible superficial peroneal nerve entrapment They also had a significant history: * Prior contralateral DVT * Avascular necrosis of the hip The imaging changed everything MRI neurography revealed: * Marked oedema in the flexor hallucis longus region * Oedema centred around the peroneal vessels This raised suspicion of something non-mechanical. ➡️ Duplex ultrasound confirmed a peroneal vein thrombosis Diagnosis: Deep vein thrombosis mimicking MSK pain Why it fooled clinicians * Localised lateral calf pain suggested nerve pathology * Gradual onset, not acute Key sign ➡️ Pain that progresses from activity-related to constant, especially with night pain, should raise suspicion Bigger picture This case also highlights underlying systemic risk: * With recurrent thrombosis and AVN, consider possible antiphospholipid syndrome / Systemic lupus erythematosus (SLE) Transition: When imaging is subtle - but the symptoms are loud The first case was metabolic.The second was vascular. The third returns to muscle but challenges our understanding of what a ‘muscle injury’ actually looks like. Case 3: The ‘Imminent Tear’ - Soleus Central Tendon Injury A runner presented with: * 3 months of deep mid-calf aching * Described repeatedly as an ‘imminent tear’ sensation following cramping * No single traumatic event * Performance and speed limited and runner has to pull up and stop when symptoms appear Clinical pattern * Low-level activity: manageable * Threshold reached → sudden escalation of pain * No bruising, no classic tear presentation Imaging findings * Ultrasound: Soleus central tendon injury with loss of definition and subtle hypoechoic changes * MRI: central tendon (aponeurotic) disruption within the soleus Diagnosis: Soleus central tendon injury Why it fooled clinicians * No ‘pop’ or obvious tear * Minimal early clinical signs * Ultrasound sensitivity is poor (~27%) * Symptoms felt disproportionate to findings Key sign ➡️ Deep, progressive calf pain with a ‘threshold’ or ‘pre-tear’ sensation - without trauma Closing Reflection: Patterns That Should Make You Pause These three cases highlight a shared clinical truth: When the pattern doesn’t behave like a simple strain, it probably isn’t. Across all three: * Symptoms persisted beyond expected timelines * Pain behaviour was atypical * Initial diagnoses seemed plausible - but incomplete The real challenge isn’t recognising rare diagnoses, it’s recognising when a common diagnosis no longer fits. Practical Takeaways Red flags in ‘routine’ calf pain * Night pain or symptoms at rest * Bilateral or multi-compartment involvement * Long-standing symptoms with failed standard treatment * Disproportionate stiffness or muscle tone * Neurological or systemic history Think beyond muscle when: * Symptoms don’t resolve after rest (≠ CECS pattern) * Pain improves with repetition but only for a short time (→ myotonia) * Symptoms progress despite offloading * Pattern is inconsistent with imaging Always consider alternatives: * Neuromuscular → myotonia, metabolic myopathies * Vascular → DVT, post-thrombotic syndrome * Aponeurotic/tendon → deep muscle architecture injuries Clinical mindset shift * Don’t anchor on the first ‘reasonable’ diagnosis * Reassess when treatment fails * Let pain behaviour, not just imaging, guide your thinking In MSK medicine, the sound of hooves is usually a horse. But in calf pain- it’s just often enough a zebra to matter. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit mskmag.substack.com/subscribe

  7. Jul 1

    An Axolotl at Breakfast - Editorial - MSKMag Issue 31

    This is a free preview of a paid episode. To hear more, visit mskmag.substack.com I recently spent some time with my five-year-old nephew on a family trip. As is often the case when travelling with children, my brain was put to work early. It was 7.30am at breakfast when I was drawn into a round of ‘Guess Which Animal I Am’. “It’s usually a dinosaur,” my sister-in-law had warned me, advising that my first question should be, “Are you extinct?” But no; today my nephew was not extinct. He was an amphibian, native to Mexico, currently endangered, and found in a surprising variety of colours. He was an axolotl. Have you ever come across axolotls? They are extraordinary creatures. Most remarkable of all is their ability to regenerate. Lose a body part and they can regrow bone, nerve and other tissues by reverting specialised cells back into a stem cell-like state. Unlike humans, who of course largely respond to injury by laying down scar tissue, the axolotl can regenerate entire structures. It can even regrow parts of its brain. Listening to my nephew enthusiastically explain the wonders of the axolotl, and then re-reading the five articles that make up July’s MSKMag, I found myself thinking about adaptation and evolution. The story of modern MSK practice may be one of evolution rather than revolution: small changes over time that have fundamentally altered who we are and how we practise. Like the axolotl, our profession has shown a remarkable capacity to adapt and reinvent itself. From the scandals of massage in the nineteenth century leading to the formation of the Society of Trained Masseuses and, ultimately, the CSP; from protocol-led care to complex clinical reasoning and independent practice; and now into advanced practice, first contact roles and business ownership, physiotherapy has continually evolved in response to the environment around it. This month’s articles capture that evolution perfectly: interventions that require us to understand new physiology, radiological findings that challenge our assumptions, complex presentations that remind us to think beyond the obvious, reflections on advanced practice roles, and a history of the literal evolution of the Physiotherapy degree and the changing world that our new graduates are entering. First up, ‘The Zebra Farm’: a new regular delve into James Noake’s upcoming book on those tricky cases that weren’t what they initially seemed. I believe the phrase goes: when you hear hooves, think horses, and when you hear regenerated hooves, think axolotls. Next, take a trip back in time with Tamsin Baird as she describes how we got to the physiotherapy degree as it is today, as well as posing the question about our new grads: ‘Physiotherapy Education: Getting Graduates Ready for What Exactly?’ Nick Ilic guides us as we stick our noses into the talar beak - an imaging finding that might point you in the direction of a tarsal coalition IF you spot it, in ‘The Beak is the Breadcrumb’. Mick Hughes cautions us about the evolution of testosterone from an anabolic steroid to be disparaged, to now sitting within the ‘wellness’ industry as an acceptable adjunct in ‘The Soft Tissue Cost of Testosterone’. Giles Hazan examines the changes happening right now in advanced practice and sets out his ideas for a brighter future in ‘Is This the Writing on the Wall for First and Advanced Practitioners in the NHS?’ And, as well as our usual feature, this month sees the first installment of ‘The Market Read’; a new segment from HMDG that we hope will become your dashboard of how the MSK market is performing. Ever wondered if everyone else is quiet this month or just you? Or why you’re seeing so many running injuries this week? HMDG will give you insights to keep your finger on the pulse. By the end of breakfast I knew far more about axolotls from my nephew than I had ever expected (thanks a lotl). By the end of this issue, I suspect you’ll have the same feeling about the ever-evolving world of MSK practice. If there is a common thread running through these pages, it is that our profession’s greatest strength may be its remarkable capacity to adapt, regenerate and continually reinvent itself.

  8. Jun 1

    Beware Concierge Healthcare

    The following is not a real service. That is important to say upfront, because the uncomfortable truth is that it easily could be. If it were not so off-brand for MSKMag, you would be forgiven for assuming it was legit. And by legit, I mean real rather than credible, because this space is far from credible. Across MSK, private healthcare, wellness, performance, diagnostics and so-called longevity medicine, we are seeing the ingredients of a new commercial model beginning to converge. Advanced screening. Wearables. ‘Optimised’ nutrition. Whole-body imaging. Regenerative injections. Manual therapy. Corrective exercise. Sleep tracking. Supplements. Aesthetic medicine. Concierge-style access. All wrapped in the language of prevention, personalisation and empowerment. Many of these tools have legitimate value in the right context, for the right person, with the right clinical reasoning. That is not the concern. The concern is what happens when they are bundled together into a supposedly premium service for broadly healthy people, where the business model depends on finding things to monitor, treat, correct or optimise. False positives, incidental findings, overdiagnosis, unnecessary treatment, health anxiety and the profitable cultivation of the ‘worried well’ are not fringe concerns. They are predictable consequences when reassurance is replaced by surveillance, and when uncertainty is converted into a monthly management plan. And I most feel for the victims of this fraud: the patients who perceive that they are taking their health seriously by delegating decisions to a combination of tech and supposed professionals. So here is a spoof service brief. It is deliberately exaggerated, but only just. Please read it as satire, but don’t kid yourself that it’s fantasy. Live Safer Live Better Live Longer Introducing Live Health The ultimate personalised care plan combining the latest in medical and therapy technologies to help you feel, look and be the healthiest you can be! Our patented three-step process: * The Screening * The Treatment * The Management The Screening Your dedicated longevity clinician will guide you through a tailored examination and diagnostic pathway that identifies specific issues pertinent to you right now, as well as indicators of which elements of your health require preventative attention. This will include, but not be limited to: * Full genomic sequencing * Full blood panel * Whole-body MRI * Postural screening * Live glucose monitoring * Biomechanical examination * Sleep study * Full orthopaedic testing The Treatment Optimising your health starts with a tailored report grounded in YOUR personal test data. Your screening results will identify areas that warrant treatment and establish their order of priority. Our precise testing sequence, which examines everything from your DNA to your movement patterns, informs stage two perfectly. Treatments include, but are not limited to: * Personalised nutrition plan * Timed eating schedule * Tailored supplement regimen * Meal prep * Rehabilitation * Cryotherapy * Corrective exercises * Posture restoration * Sleep monitoring * Manual therapies * Massage * Manipulation * Acupuncture * Orthotics * Pillow, mattress and bed sheet design * Injection therapies * Stem cells * Collagen * PRP * Botox The Management It is essential that the immediate gains achieved by stages 1 and 2 are maintained to ensure long-term health outcomes. Your dedicated longevity clinician will create a schedule of maintenance care that optimises your health and keeps you on track. Whilst everyone’s management plan will be unique, here is an example from our popular LiveToday tariff: Throughout * Sleep tracker * Glucose monitoring * Meal prep Weekly * Personal training * Massage therapy * Cryotherapy Fortnightly * Manipulation * Acupuncture Monthly * Supplement adjustment * Posture review Quarterly * Corrective exercise programme * PRP, collagen and Botox top-ups * Sleep device review Annual * Blood panel * MRI scan * Stem cell therapy Some things to ponder… What good is weight training if you are burning muscle and not fat due to poorly timed exercise and supplement schedules? What good is cardio if you are further damaging a slipped disc? What good is a monthly massage without a cryotherapy flush to release the scar toxins? For too long, the healthcare of individuals has been based on data collected from groups. The most important person in your health is YOU. Take charge of your health today by instructing us to personalise your care. Express your interest here to be the first to be contacted when appointments go live in our new Wimbledon, Kensington and Alderley Edge clinics. The uncomfortable part of this spoof is not that any single component is necessarily absurd. Blood tests, imaging, exercise, nutrition, sleep work, rehabilitation, manual therapy and selected interventions can all be clinically useful when there is a clear indication. The problem is the logic of the package: screen first, find something, treat everything, then maintain indefinitely. Each of these has evidence-based utility in specific circumstances, but not in combination and not regardless of demographic: * Full genomic sequencing * Full blood panel * Whole-body MRI * Postural screening * Live glucose monitoring * Biomechanical examination * Full orthopaedic testing The following ‘treatments’ do not specifically treat anything that the aforementioned screening tests would reveal. This is also not being suggested as a list of options from which one or two things will be selected. Instead, it is presented as ‘holistic’ care that includes each of these categories and implies that all can be meaningfully tailored. * Personalised nutrition plan * Timed eating schedule * Tailored supplement regimen * Meal prep * Rehabilitation * Cryotherapy * Corrective exercises * Posture restoration * Sleep monitoring * Manual therapies * Massage * Manipulation * Acupuncture * Orthotics * Pillow, mattress and bed sheet design * Injection therapies * Stem cells * Collagen * PRP * Botox This example schedule is over-treatment on every level of analysis, with no basis in evidence. There is also emerging evidence that such close scrutiny may contribute to health anxiety. Interestingly, personal training, meal prep and sleep advice are likely to improve the health of many patients, with the risk that any progress would then be attributed to the numerous other interventions. In that model, ‘personalised care’ can become a seductive justification for abandoning proportionality. Incidental findings become opportunities. Normal variation becomes pathology. Ageing becomes a defect. Prevention becomes provocation. The patient does not leave with a clearer sense of what matters; they leave with a longer list of vulnerabilities and a subscription to manage them. This matters for MSK because our sector is especially vulnerable to this drift. We already work in a world where posture, movement, scans, asymmetries, degeneration and pain are too easily over-interpreted. Add longevity branding, consumer diagnostics and high-end concierge packaging, and the risk is obvious: we could end up selling certainty where none exists, treatment where none is needed, and dependency under the banner of optimisation. The challenge is not to reject prevention, technology or personalised care. It is to ask harder questions before we package them. Who is this for? What problem are we solving? What is the likelihood of benefit? What is the risk of harm? What happens when we find something? And are we helping people live more freely, or teaching them to monitor themselves more fearfully? Because the future of healthcare does not only depend on what we can measure. It depends on whether we have the restraint, composure and fundamental ethics not to treat every measurement as meaningful. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit mskmag.substack.com/subscribe

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MSKMag combines cutting edge clinical opinion with light hearted relief from the daily grind! Featuring insights from the finest minds in the MSK industry, MSKMag will keep you up to date with best practice evidence and the best topical memes. mskmag.substack.com

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  • Creator
    Physio Matters
  • Years Active
    2024 - 2026
  • Episodes
    71
  • Rating
    Clean
  • Copyright
    © Physio Matters
  • Show Website
    MSKMag OutLoud