Entries by Bodine Ledden


A very important but overlooked skill… Feedback is what I am referring to. I believe that both giving and receiving feedback is a skill, and that skill takes practice. The word itself might increase anxiety levels when someone says  “let me give you some feedback”, it might automatically put you on the defensive. However, the implications […]

Case study time..

Let’s tickle your dendrites, fire up your axons because this case study will get you more excited than an action potential. What comes to mind for you? Does your mind go completely blank? Do you panic? Or do you get a rush of possible differential diagnosis rushing to your head?  It might be easy to point the […]

How much is enough?

I always get asked the question, “How much is enough?” What I mean by this is treatment dosage.How long should you mobilise a joint for? What grade mobilisation should I use? How long should I leave a needle in for? How much stimulation should I use? How many repetitions should I prescribe? How many times should I […]

Are you staying up to date?

As clinicians it is important that we are always staying up to date with evidence based practices and terminology. One very commonly used label is “Sciatica” This diagnostic label dates back to Hippocrates who was allegedly, the first physician to use the term ‘sciatica’, deriving from the Greek ischios, hip. Many years later Galen treated sciatica by blood letting, […]

Stop Blaming Me!

So often in clinicians and patients blame an individual muscle or structure as the cause of pain.  How often do you hear (or even say) that it’s the Piriformis, Supraspinatus or the QL… Yes, I am sure if someone presents with pain in the buttock, shoulder or low back, these muscles may be tender to press on. […]

Reconceptualising pain with a plastic brain

Can your brain change? Have you every changed your mind, or changed your opinion? Even when you believed something so strongly, but you were still able to change. What about that bad habit that you were able to shake? Have you ever tried to learn to play an instrument, learn a new language or take […]

Leadership – personal perspective

Firstly, let me start out by saying I am no expert in leadership, nor do I think I am a great leader. But over the years I have had some great leaders and some not-so-great leaders. I am lucky enough to currently be led by one of the best, so I am learning as I […]

You have a bad posture..

Does pointing out postural discrepancies help or harm? I, like many of you were taught to assess a patient’s posture, and was taught that if someone had an anterior pelvic tilt, then it must mean their hip flexors are short and tight and their glutes are long and weak, or if their shoulders were internally […]

I think, therefore I am

Often there is a lot of attention directed towards the ‘condition’ or the ‘pathology’ in chronic pain, and while this is a component, we need to zoom out and look at the whole person. It is common to think and believe that the pain is the cause of the negative impact on a patient’s life. What if we look at it […]

Stress, pain and resilience

We all talk about stress, But what is stress? The World Health Organisation defines stress as any type of change that causes physical, emotional or psychological strain. But is all stress bad? Stress is a common and normal physiological response. Stress that is applied appropriately can be positive – this is eustress, which can be beneficial effect […]

What kind of a plant is painful?

A faceplant.. Ok that’s enough jokes… But it does link in with today’s topic so I couldn’t resist. Our bodies and our aches, pains, injuries and overall wellbeing can be a bit like a garden. You put good stuff in, you get good stuff out. You plant nothing, then you get nothing out. Sometimes, a plant in […]

The Trigger Point

A trigger point is something that you will deal with in everyday clinical practice when treating patients with musculoskeletal pain presentations. Unfortunately, the myofascial trigger point is often an overlooked contributor to chronic myofascial pain and central sensitisation.  So what is a trigger point? As defined by Travel & Simons a trigger point is a “A […]

A perspective of change

Definitions in the world of science continuously change. Just as our skin ages and changes so do our brains. The ideas and beliefs that we held to be true when we first learned about manual therapy in our undergraduate studies should also change and evolve as the understanding improves. When our understanding fails to evolve, […]

6 Myths about sacroiliac joint pain

Myth #1 The SIJ can become unstable The SIJ functions to provide stability and the transmission and dissipation of load from the trunk to the lower extremities. (Thawrani, 2019) The SIJ is an inherently stable structure with only a small 6 degrees of movement available during normal activity.  (Palsson et al. 2019) During development the SIJ changes structure, it […]

Hip and Groin pain

Anterior hip and groin pain could be due to a number of different reasons. But let’s talk about intraarticular hip pain. ▶️ Intra-articular hip pathology refers to pain and pathology within the hip joint▶️ It typically presents as deep pain in the anterior hip and groin region and can also present as buttock pain▶️ Common […]

The importance of patient expectations

Patients’ beliefs and expectations need to be better understood by clinicians to improve management. Asking the question, What is your understanding of your pain? Do you believe that it is just a physical / mechanical problem? Spending the time to really hear your patient’s story and understand what they expect from this treatment regarding their pain and […]

Managing lateral hip pain

Following on from last week’s email about the Lateral hip pain. This week we will take a look at the management. One of the key components to successful management is education. Educating our patients about potential contributors to their pain is key. AS discussed last week the gluteal tendons are vulnerable to compression at the insertion […]

Lateral hip pain

Lateral hip pain is very common and debilitating source of pain. There are multiple pathologies associated with anatomical structures of the lateral hip including: 👉 Gluteal tendinopathy👉 Proximal ITB syndrome👉 External snapping hip syndrome👉 Gluteal tears👉 Gluteal bursitis Pain in this region has been termed Greater Trochanteric Pain Syndrome (GTPS) which is an umbrella term. […]

Referred Pain

What is it? Referred pain can be confusing and often misunderstood. Patients regularly present to us in clinical practice with referred pain symptoms. But what is it? Where does it come from? and why can it be so different?   Firstly let’s start out by stating that referred pain is different to neuropathic pain. Referred […]

I have Sciatica…

What does that even mean?! Sciatica is a symptom that may be originating from a plethora of pathophysiological causes. Firstly, we should consider that the layman may understand sciatica as ANY pain that is referred into the leg, and Dr Google will often (unfortunately) confirm their suspicion of this… When a patient presents to your […]

Shoulder pain: The influence of imaging and diagnostic labels

How often does a patient present to you in clinic with an imaging report ordered by a GP, (or other practitioner) But the practitioner has not taken the time to go through the report and educate the patient on what it means using normalising / unthreatening terminology. There is often terminology like “partial thickness tear” […]