James Noake @DrJN_SportsMed Twitter profile

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James Noake

@DrJN_SportsMed

1 year

The most ridiculous thing i’ve ever heard.

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James Noake

@DrJN_SportsMed

3 years

I use MRI in lower back pain 🤭 I also get asked frequently how I manage the scan follow up consults & handle patient Qs So here is a mini-thread which gives a little comms synopsis - some may nod sagely, others may roll their eyes - that’s cool - no right or wrong.

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James Noake

@DrJN_SportsMed

2 months

@LozzaFox This is interesting, because i was sat across from you at lunch today in Les Arc - you spent more time on your phone updating X with pics of you carving up the slopes as ‘Old Bond’ than chatting to your kids - who were also on their phones 🤷‍♂️ #potkettleblack

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James Noake

@DrJN_SportsMed

2 years

1. Unravelling groin pain - a thread I love this area, but it can be confusing & seemingly complex - esp as there is significant overlap between groin pathologies re clinical behaviour & presentation - and often concurrent pain drivers ‘muddying the waters’ further

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James Noake

@DrJN_SportsMed

2 years

Thread alert 🚨🚨🚨 Ankle inversion injuries don't just result in lateral ligament sprains.... ...there are plenty of other injuries to bear in mind when you assess, both acutely & further down the line

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James Noake

@DrJN_SportsMed

1 year

Stress fractures - a detailed thread 🦴🦴🦴 I thought I'd put together an overview & some clinical nuggets from the 'coal-face' First up, I prefer to call them 'bone stress injuries' - majority don't have a # line on imaging & the language can be scary / nocebic for some

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James Noake

@DrJN_SportsMed

2 years

Thread alert 🚨🚨🚨 - Medial knee pain! What else should we be considering beyond OA & MCL sprains? Here are some differentials to consider & their clinical presentation 🧐

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James Noake

@DrJN_SportsMed

3 years

Hip & groin pain in sporty adolescents IS NOT NORMAL! (a thread) Kids aren't 'little adults' - they have different physiology, immature skeleton, growth plates... They're susceptible to unique conditions Yet they are robust - if they're not enjoying sport, pay attention...

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James Noake

@DrJN_SportsMed

1 year

This article is an orthopaedic breath of fresh air “Why build a brick shit house when a wooden one will do?” Love it

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James Noake

@DrJN_SportsMed

2 years

Thread -🚨🚨🚨 Anterior knee pain is super common - understandably, we tend to think of the patellofemoral joint, Hoffa’s fat pad or proximal patella tendon as the main culprits But there are other less common causes that might not necessarily be on your clinical radar….

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James Noake

@DrJN_SportsMed

2 years

Thread alert - posterior ankle & heel pain 🚨🚨🚨 Most cases are ‘common garden’ achilles tendinopathy However, here is a selection of conditions I've seen over time in clinic which can masquerade & are worth considering if the picture is atypical or patient not progressing

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James Noake

@DrJN_SportsMed

2 years

Thread 🚨🚨🚨 Posterolateral knee pain - Outside of acute ligamentous trauma its a bit of a 'No Man's Land' pathoanatomically 🤨 In the same vein as 'anterior knee pain', here are some conditions to bear in mind if your patients symptoms are puzzling you

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James Noake

@DrJN_SportsMed

4 years

A healthy 13yr old boy dies from C19. His parents can’t even be with him as the ventilator is switched off or see him immediately after death. I don’t think there could be anything more motivating for adhering to isolation rules and being social responsibility. Devastating.

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James Noake

@DrJN_SportsMed

11 months

Lateral ankle US assessment - nice schematic of sequential ligament assessment ⁦ @TendonImaging ⁩

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James Noake

@DrJN_SportsMed

19 days

First I'd want two X-ray views to confirm the dislocation Then consider kinesiotape (pink, not black) Failing that, PRP +/- a sprinkling of stem cells

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James Noake

@DrJN_SportsMed

2 years

I get asked about the utility of hip & groin tests all the time The short answer is there's a big overlap across clinical tests & key pain drivers - no test is particularly specific; some are sensitive This is my take based on clinical experience - opinions welcome

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James Noake

@DrJN_SportsMed

1 year

🚨🚨 groin pain cheat table🚨🚨 Groin injury clinical tests lack specificity with a large overlap across conditions.... This makes the history, pain pattern / behaviour & mechanism of injury even more crucial Hopefully this table I've put together will help you navigate ⬇️

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James Noake

@DrJN_SportsMed

1 year

Consent ✅ Frozen shoulder ➡️ ultrasound video hydrodilatation Pre inj video - max 70-80deg active abduction - apprehensive Immediately post inj video - 130deg active range pain free

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James Noake

@DrJN_SportsMed

6 months

Consent ✅ Previous high grade lateral ligament tears Presenting with achilles and peroneal tendinopathy / overload pain now Video - positive sulcus sign on posterior glide with calc fixed Can be done with knee flexed and foot planted on bed as well.

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James Noake

@DrJN_SportsMed

3 years

In July last year, my sister lost her baby at 39 weeks. Today she gave birth to Sadie. It’s a good day! ♥️

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James Noake

@DrJN_SportsMed

3 months

@BadInfl69003077 @Dr_BellaR Spot the man who was furloughed.

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James Noake

@DrJN_SportsMed

3 years

13. Hope this is helpful. Would love to hear how others approach this and communication pearls.

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James Noake

@DrJN_SportsMed

7 months

Documented consent for images & data ✅ Thread 🧵 'Deep gluteal syndrome' or piriformis syndrome - a patient's journey Over-diagnosed & a diagnosis of exclusion really... the neurogenic thoracic outlet syndrome of the pelvis? 🧐 It does exist though

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James Noake

@DrJN_SportsMed

2 years

Wow 👀 Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return

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James Noake

@DrJN_SportsMed

1 year

Don’t want to be a neigh sayer, but this is unlikely to be effective.

Rocktape

@rocktapeuk

1 year

Always cool seeing our equine instructor going about her business #equine #equineosteo 👍👌🙌 @SusannahMoney

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James Noake

@DrJN_SportsMed

3 years

I once called an ortho consultant at 2am for help re a post op acute compartment syndrome - she drove in, assessed, coordinated the surgical team. Then said on way out having done the fasciotomies “ I’m not actually the on-call consultant this week, but don’t worry”. Legend.

Tessa Davis

@TessaRDavis

3 years

If you've ever been a trainee, you will have felt that horrible anxiety when phoning the consultant in the middle of the night. Guilt. Self-doubt. Trepidation. Thanks to the med twitter community - here are the top 5 tips on making that call. Day 14/30 #ship30for30

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James Noake

@DrJN_SportsMed

3 years

“How bad are the dermatomes?”- this blog is a must read for those who struggle with the discrepancies between radicular pain and text book dermatomal teaching. Spinal cord Neuroinflammation theory is particularly interesting.

How bad are the dermatomes?

Thanks for reading the 21st edition of my sciatica newsletter. This newsletter tracks my research as I write a book about lumbar radicular pain! Today let’s talk about dermatomes. Dermatomes are a...

tomjesson.substack.com

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James Noake

@DrJN_SportsMed

3 years

Deteriorating groin or proximal thigh pain in a female (& sometimes male) endurance runner is a femoral stress fracture until proven otherwise. If you are treating it as a hip flexor ‘strain’ or tightness then you probably have the wrong diagnosis.

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James Noake

@DrJN_SportsMed

1 year

This MRI report has made my day My work is done 😂😂 #INTHF

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James Noake

@DrJN_SportsMed

3 years

Just had a patient who’s had 19 sessions of chiropractic treatment (actually paid for by Bupa!) and been told he has a 14mm leg length discrepancy. He’s not better obviously Can we stop with this now. I’m tired of unravelling this BS in clinic, especially on friday afternoon.

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James Noake

@DrJN_SportsMed

3 years

Stop fusing young, active patients’ lumbar spines. It doesn’t work. That is all.

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James Noake

@DrJN_SportsMed

1 year

First patient of the day with raging cervical radiculopathy - “I’ve tried all the normal stuff - laser, cupping, theragun - it’s just not going away” Ah, that cheered me up on a cold friday morning.

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James Noake

@DrJN_SportsMed

11 months

@RevRichardColes If you’ve got excruciating hip / groin pain then it’s likely to be hip osteoarthritis- or less likely a more serious condition eg avascular necrosis, insufficiency fractureZ Or referred pain into your hip. you should be seeing either a Physiotherapist or your GP / orthopaedic

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James Noake

@DrJN_SportsMed

3 years

55yo female runner, 5 & 10k for years, with no prior knee pain attends A&E with a likely degen meniscal tear Doc tells them “you shouldn’t be running at your age anyway...” Why does this ignorant, ill informed message still get air-time? So harmful & upsetting for the patient

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James Noake

@DrJN_SportsMed

16 days

Saw patient with ? ACL tear at 2 pm MRI at 2:20pm MRI reviewed with patient at 2:50pm - ACL & medial meniscus injuries confirmed Discussed with ortho colleague - appt in 4-6 weeks booked Prehab physio booked for tomorrow Good service / turn around i think!

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James Noake

@DrJN_SportsMed

1 year

🚨🚨groin pain cheat table - updated! 🚨🚨 Groin injury clinical tests lack specificity with a large overlap across conditions... This makes the history, pain pattern, behaviour & mechanism of injury even more crucial Hopefully this table I've made will help you navigate��️

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James Noake

@DrJN_SportsMed

1 year

Consent ✅ Pt with 6 months bilateral arm pain, hand parasthesiae & clumsiness What are we seeing in lower limbs? Cause?

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James Noake

@DrJN_SportsMed

10 months

Rehab clinicians - Please don't get over enthusiastic give patients rehab programmes stuffed with loads of exercises - they just can't manage them with busy schedules & typically confess to me they lose motivation & stop doing them. It might look like the best rehab plan in

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James Noake

@DrJN_SportsMed

5 months

Letters like this make X / Twitter worth it…. 🥰 Wherever you are, Neil (Irish Physio) thanks so much for taking the time to write to me!

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James Noake

@DrJN_SportsMed

2 years

Patient today with lower ab, groin & perineal pain- “Could my car seats be aggravating it?” “Possibly - but only if,say, you drive a Lamborghini with carbon fibre bucket seats” “I do drive a Lamborghini with carbon fibre seats” Well that solves that then #stronghistorytaking

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James Noake

@DrJN_SportsMed

2 years

Reverse patella sign

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James Noake

@DrJN_SportsMed

2 years

A reminder that not all lumbar radiculopathy is ‘sciatic’ Although much less common, femoral nerve root from high lumbar disc bulge (here L2/3) can cause flank, hip and anterior thigh pain Misdiagnosed as hip joint and gluteal tendinopathy

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James Noake

@DrJN_SportsMed

1 year

Popliteus is an under-rated source of posterolateral knee pain, particularly post arthroscopy It is intra-articular and doesn't like an effusion, change in joint biomechanics post ACL recon & rapid push with high end rehab progressions eg plyos Bear it in mind if plateauing

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James Noake

@DrJN_SportsMed

9 months

@SAS_gas_Thomas it’s actually this chap who encapsulates the understandable current attitude amongst NHS clinicians - preoccupied by the stress of the job, unimpressed by Tory virtue signalling, disenchanted …..

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James Noake

@DrJN_SportsMed

2 years

I don’t have my own website yet - but thinking if I get it up and running, maybe i could continue interesting cases with educational offshoot there as regular updates 🤷🧐

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James Noake

@DrJN_SportsMed

2 years

If you’re comfortable with the concept of forming a diagnosis 😮🤭😲🤭based on a thorough history & focused examination, then you might find this blog useful

Unravelling Groin Pain - Physio Network

Groin pain can be a clinical mystery. Check out this blog which unravels groin pain and is guaranteed to help your assessment and clinical reasoning skills.

www.physio-network.com

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James Noake

@DrJN_SportsMed

2 years

MRI should not be requested by clinicians who are not capable of putting it in context - clinically and with respect to general population findings. It’s a powerful, positive tool in the right hands, and a crap one in the wrong hands. It’s not a difficult concept

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James Noake

@DrJN_SportsMed

1 year

Consent ✅ Doctor with years of pain - shown on their body map below Affecting ward rounds, unable to swim, jog Been told psychosomatic after LSp MRI normal Guided hip joint LA injection removed all symptoms today including leg - able to run! Hip joint isn't just groin!

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James Noake

@DrJN_SportsMed

3 years

Id strongly recommend listening to @adamdobson123 and @Retlouping podcasts on imaging in back pain & do discs slip - amazing insight

‎The Back Pain Podcast: Do I Need an MRI for My Back Pain? on Apple Podcasts

‎Show The Back Pain Podcast, Ep Do I Need an MRI for My Back Pain? - 19 Nov 2020

podcasts.apple.com

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James Noake

@DrJN_SportsMed

2 years

Young pt with 1/12 focal R LBP -no radicular signs / Sx- “My GP has told me it’s likely I have nerve damage so i’m scared to go back in to the gym - she sent me to physio” “Ok - what did the physio say” “That I need an MRI” We still have a long way to go in primary care MSk

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James Noake

@DrJN_SportsMed

2 years

With consent Runner, Cross fit Plantar midfoot pain on higher impact exercise, jumping Tender on palpation deep medial arch & pain on FHL testing Treated as plantar fasciitis to date MRI - ‘intersection syndrome’ (tenosynovitis at Knot of Henry where FHL & FDL cross over)

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James Noake

@DrJN_SportsMed

3 years

With consent Elite male runner 20s 6/52 ⬆️ L groin pain ➡️ to thigh initially warms up now stops him, night pain Rx as hip flexor strain 🙄 Video ➡️ Hop test R vs L +ve FADIR US - periosteal reaction femoral neck ? stress # hip flexor in an endurance runner?think again

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James Noake

@DrJN_SportsMed

1 year

i’ve tried hard to crystallise experience to date; groin pain exam complexities / pitfalls / pearls; sign post to the most useful contemporary research & consensus here in one article blog. 🤯 Hope it’s useful.

Football Medicine & Performance Practitioners

@FMPA_Official

1 year

Unravelling Hip & Groin Pain Dr James Noake ( @DrJN_SportsMed ) discusses acute and chronic hip and groin injuries.

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James Noake

@DrJN_SportsMed

2 years

12 MSK pearls of Christmas! A festive thread Partridge in a pear tree - Patients with proximal weakness (myopathy)? Think medical eg Cushing’s syndrome - centripetal obesity (pear shaped), purple skin striae, moon face…. Blood work up & MRI brain

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James Noake

@DrJN_SportsMed

1 year

Musing - How many Deep Gluteal Syndromes / Piriformis Syndromes are non MSK eg endometriosis? Have seen 5 pts, all female between 30-40, with stubborn gluteal pain that’s radiates into leg and pelvis - also element lower back pain Normal / non dysplastic hips One pt so far

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James Noake

@DrJN_SportsMed

1 year

Me listening to the 45yr old patient telling me their knee OA is bone on bone and that the surgeon told them they’d need the other knee doing soon as well.

Fuck You I Quit

@fuckyouiquit

1 year

Me enjoying the last 8 minutes of my break while the rest of the understaffed office is struggling

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James Noake

@DrJN_SportsMed

1 year

Consent ✅ Patient is Irish Also has hand joint pain & diabetic Diagnosis?

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James Noake

@DrJN_SportsMed

3 years

i only started using twitter properly 2 years ago - 10k is weird I genuinely enjoy sharing Msk information & education content - i get excited with every new case that pops up Thanks to everyone who contributes to each thread to make it a holistic resource

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James Noake

@DrJN_SportsMed

1 year

I'm only half way through my clinic today and I've already had 3 people say "hope its not twins!" when I get the US out. Give me strength.

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James Noake

@DrJN_SportsMed

2 months

@jamahariya It's also been said - 'A fool speaks, a hypocrite judges and a wise man observes'.

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James Noake

@DrJN_SportsMed

8 months

Consent✅ Red flag conditions will pop up in MSK clinic every now and again - be vigilant This pt fell with subsequent ‘minor’ abrasions over patella - some subcutaneous swelling but minimal pain 5 days later was doing hip flexor (🤣) stretches in HIIT class rubbing the

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James Noake

@DrJN_SportsMed

10 months

I get not all chiropractors operate in the same way & have variable skill sets - and there are good & bad clinicians in all spaces. But it makes my blood boil when I hear this from pt (almost verbatim)- "The chiro booked me in for 3 adjustments a week for the next few months -

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James Noake

@DrJN_SportsMed

2 years

Musing - Why do we call ankle injuries ‘inversion’ & ‘eversion’? The dynamic mechanism is hardly ever uniplanar, rather a combination - so they should be ‘supination’ & pronation’ injuries 🤔 This is why there is a whole host of structures are at risk

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James Noake

@DrJN_SportsMed

2 months

People, can we stop doing x-rays to look for ‘heel spurs’ to “diagnose”plantar fasciitis 🤬

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James Noake

@DrJN_SportsMed

2 years

I should have been a physio Vet who is terrified of bending & squats because of LBP flares 2 /year Told him the spine is strong, its designed to bend, its safe Got him to repeat x 5 until touched his toes no MRI - finish off the progress in the cons with a LSp physio then S&C

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James Noake

@DrJN_SportsMed

1 year

Consent✅ Subacromial injections are not always straight forward Even with high res US guidance, it can require finesse / manipulation of the the needle to tip to pick up & accurately infiltrate the bursa Can you do this with the same precision land-mark guided ('blind')?

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James Noake

@DrJN_SportsMed

1 year

consent ✅ 60s, tennis, referred as ? bilateral carpal tunnel syndrome mild bilateral parasthesiae hands, no pain or power loss MRI CSp - marked multilevel foraminal stenosis Again we see structure doesn’t always marry up with symptom severity

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James Noake

@DrJN_SportsMed

5 months

Consent✅ Always amazes me how well some people cope with osteoarthritis This chap works in furniture removal - came to me concerned by some mild R knee medial aching.... Otherwise happily getting on with his job, walking his dog Degree of varus impressive, has a fixed

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James Noake

@DrJN_SportsMed

3 years

Summary 1. Kids don't get muscle or tendon injuries - think apophyses 2. Image early - X-ray 👍 3. Red flags, childhood conditions 4. Engage parents & observe their influence 5. Kids love their sport - its socially defining - if they are unhappy, there's a significant problem

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James Noake

@DrJN_SportsMed

5 months

@DrPJJB @TonyDtheDoctor Sorry - ‘repaying the nation’? 😂😂😂What is a graduate medical student repaying the nation for? I hadn’t realised ‘the nation’ pays med school tuition fees, covers student loans etc. How generous of them. You’re an absolute plum.

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James Noake

@DrJN_SportsMed

2 years

Message via PA from pt “My time is very precious, so i don’t want to waste it seeing Dr Noake if he can’t guarantee he will do an MRI. Also it would be helpful if he can rearrange his lunch break to accommodate me” See you later 👋👋

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James Noake

@DrJN_SportsMed

3 years

female, 60, runner - inversion injury 6 months ago. X-ray in ED ‘normal’. Persistent pain anterolateral midfoot, can’t load. Non union intra-articular ant calcaneal process #. Lesson - palpate all key bony landmarks in acute ankle sprain AND get correct xray views.

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James Noake

@DrJN_SportsMed

1 month

Consent ✅ & specifically requested by patient to spread awareness Important learning update on this case - many people have enquired about this This lady had some improvement in pain post deep gluteal space sciatic nerve decompression But at review, her lower limb control

James Noake

@DrJN_SportsMed

7 months

Documented consent for images & data ✅ Thread 🧵 'Deep gluteal syndrome' or piriformis syndrome - a patient's journey Over-diagnosed & a diagnosis of exclusion really... the neurogenic thoracic outlet syndrome of the pelvis? 🧐 It does exist though

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James Noake

@DrJN_SportsMed

4 months

Classic.

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James Noake

@DrJN_SportsMed

2 years

A blog for those wanting a succinct review of adolescent hip & groin pain - why it’s important not to underestimate it, key causes to be vigilant for, clinical presentation, case studies, parental influence.

Clinical Pearls for Diagnosing Hip and Groin Pain in Adolescents - Physio Network

Hip and groin pain in sporty adolescents is not normal. We can be a bit more relaxed in adults and allow them some aches and...

www.physio-network.com

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James Noake

@DrJN_SportsMed

1 year

Clinicians thoughts on the lever (or Lelli’s) test for ACL tear? Vs Lachman’s etc I’ve had 2 patients out of 10 in last 3 months with a false negative test and ACL disruption confirmed on subsequent MRI

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James Noake

@DrJN_SportsMed

1 year

Left L5/S1 extraforaminal disc bulge Severe left sided radicular pain & antalgic gait 5 days of prednisolone 40mg and diclofenac SR - symptoms completely gone

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James Noake

@DrJN_SportsMed

3 years

an updated LSp MRI blog after Twitter feedback! How to Communicate Lumbar Spine MRI Results to Patients - Physio Network

How to Communicate Lumbar Spine MRI Results to Patients - Physio Network

Learn a reassuring and effective approach for communicating lumbar spine MRI results to patients, for a variety of low back conditions, in this thorough blog.

www.physio-network.com

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James Noake

@DrJN_SportsMed

2 years

Bupa - please don’t tell patients who have 6 x MSK issues (plantar fasciitis, LBP, MTSS, PFP, ankle sprain, FAI, neck pain) that it’s appropriate to have al of this safely & adequately assessed in one 30 min initial appt! #manageexpectations

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James Noake

@DrJN_SportsMed

4 years

@IamGrandpa1 @TinFoilAwards @DerickLakes ‘Smash glass for baby’

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James Noake

@DrJN_SportsMed

1 month

Consent ✅ With respect to lower lumbar & gluteal pain, there are numerous potential pain drivers - disc, facet, SIJ, myofascial.... Cluneal nerve irritation is way down the list, but see it occasionally Dental hygienist - diffuse upper gluteal aching / burning, provoked by

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James Noake

@DrJN_SportsMed

5 months

Consent✅ Female 30s Neck pain radiating into occiput, (cervicogenic) headaches - pain referring into upper traps symmetrically..... a super common pain pattern presentation MRI typically unhelpful 🤷‍♂️- although occasionally we find changes that are relevant & can be a target

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James Noake

@DrJN_SportsMed

1 year

Why does everyone 💩 themselves when we talk about giving oral prednisolone for 5 days - Yet we are content to prescribe & accept opioids, tramadol, NSAIDs etc which have higher side effect risk profile Never had a complication with prednisolone course in 10 years

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James Noake

@DrJN_SportsMed

3 years

Going to step back from Twitter for an extended period; have decided that the -ives (certain individuals in the main) outweigh the +ives. Sorry to those who feel they gain something from my educational posts - i enjoy teaching. Contact me on my Pure email.

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James Noake

@DrJN_SportsMed

1 year

@VATskills “hello Mrs S - Im your surgeon for today - before we go through your consent form, may i ask if your appendix is on the left or right?”

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James Noake

@DrJN_SportsMed

3 years

3 lumbar prostate cancer mets and an iliac breast cancer met this week.... in a sports medicine clinic. This is why i always MRI scan spinal & pelvic pain patients with a malignancy history.

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James Noake

@DrJN_SportsMed

4 years

30yr old woman with 5 years finger tip pain at rest and ++ filing nails / manicure, temp sensitivity - pain occurs radiates proximally into finger. Normal NCSs and MRI CSp (but told maybe “nerve damage” 🙄 by neurologist). 5 sec exam today gave her the answer - pics show?

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James Noake

@DrJN_SportsMed

6 months

Parental and patient consent ✅ Further on (osteo)chondral injury - 14yo, sudden onset lateral retropatella pain after awkward single leg landing with hyperextension & valgus POCUS video - well defined lateral trochlear groove acute chondral defect MRI - loose body in

James Noake

@DrJN_SportsMed

6 months

Consent ✅ Body builder - severe retropatella pain squatting / leg press X-rays can provide a lot of useful information & a good first line investigation But this image shows the potential limitation in assessing chondropathy vs MRI

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James Noake

@DrJN_SportsMed

2 years

If you have an injury it’s generally better to see a sports doc first to be assessed & decide if you need imaging, & if so, what modality. Just self paying for an MRI scan, esp without someone to put it in context, can be pointless (sometimes harmful) & frequently a waste of $$

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James Noake

@DrJN_SportsMed

10 months

Fallen out of love with rugby My London Irish dissolved despite being the best they’ve been for 10 years English rugby dire

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James Noake

@DrJN_SportsMed

1 year

With consent sudden onset pain R mid hamstring sprinting for drop shot in tennis Bruising pattern pre-dominantly medial thigh - but on POCUS injury is lateral (arrow - biceps femoris MT junction) Bruising isn’t a reliable indicator of injury site

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James Noake

@DrJN_SportsMed

3 years

Another must read from Tom Jesson - DGS and Piriformis syndrome

Piriformis syndrome

A glute cause analysis, Part 1

tomjesson.substack.com

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James Noake

@DrJN_SportsMed

4 years

@toxicologist12 OBGYN - Gwyneth Paltrow

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James Noake

@DrJN_SportsMed

1 year

Consent ✅ Young dancer Diffuse crampy calf & ankle pain & early fatigue - foot parasthesiae - with repetitive jumping & plantarflexion activity LSp / MRI / NCS clear Single leg plantarflexion test - foot & ankle pallor, ⬆️ P&N Likely Popliteal Artery Entrapment Syndrome

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James Noake

@DrJN_SportsMed

3 years

High gd proximal femoral shaft stress # in female runner. Unusual vs neck of femur. Symptoms vague - mild ache in thigh; ‘weakness & loss of propulsion’. All clinical tests normal except ‘shut down’ on hop test. Pain pattern in BSIs can be unreliable so loss of function should 🚩

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James Noake

@DrJN_SportsMed

3 months

So yesterday i had my cardiology NHS appointment (3:45pm) By 3:45pm i had had ECG, Echo, BP etc The consultant (Dr Tevik Ismail) - an incredible, empathetic, super bright human being - spent 45 mins plus with me The NHS is on its knees generally, but it still rises to the

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James Noake

@DrJN_SportsMed

1 year

Nope.

Jesse Morse, MD

@DrJesseMorse

1 year

Back pain explained! Herniated disk? Sciatica? I try to simplify these common topics for you, as if you were standing in front of me as one of my patients. Watch & share!

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James Noake

@DrJN_SportsMed

8 months

It’s funny how things come to a head and you just have that epiphany - ‘a snap of fingers’ moment - time to leave something behind, move on & focus on more important things in life. i feel i’ve done my educational bit. Can catch up with me via james.noake @puresportsmed .com if

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James Noake

@DrJN_SportsMed

3 years

Fantastic piece for those wanting to understand MRI basics better. Perfect detail and accessible. 👏👏 Beginners Guide to Musculoskeletal MRI -

A Beginners Guide to Musculoskeletal MRI - BJSM blog - social media's leading SEM voice

Muscle injury is the most common type of injury in athletes, especially in football players (Ekstrand (2011), Elliott (2011)). For this pathology, magnetic resonance imaging (MRI) is included in the...

blogs.bmj.com

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