Bite Sized Physio: 3 Articles That Will Make You a Better Physio This Month
- Natalie Pearce
- Jul 3
- 4 min read
July 2025
DASH PHYSIOTHERAPY
Even though I have been a physiotherapist for a number of years now, I have always found it hard to find the time to keep up with the latest research. So in part, to force myself to keep up with this ever-changing profession as well as trying to make the process easier for all busy physiotherapists, I aim to summarise three recently published articles each month. Hopefully through this, we can keep learning and developing our physiotherapy practice together.
Scapular Stabilisation for Shoulder Pain: Putting the Cart Before the Horse?
International Journal of Sports Physiotherapy
This article identifies a great flaw in a physiotherapists objective examination by only identifying possible causes of injury by what movement impairments they can see. During a shoulder injury examination our first port of call is to check ROM while looking at scapular mechanics concurrently. Problems like winging and ill-timing of scapula movement are easily observed and quickly identified however movements of the glenohumeral joint can be almost impossible to see and just as likely to be the cause of pain.
This study highlights potential contributory movement faults within the glenohumeral joint and how these contribute to scapulothoracic motion.
What we learnt?
Patients that present with shoulder pain often exhibit varying levels of elevation, upward rotation, internal rotation and anterior tilt of the scapula
Inability to glide the humeral head inferiorly places it superiorly to the glenoid fossa, to maintain joint congruency the scapula moves superiorly as a result. Joint mobilisations of the humerus within the glenoid fossa have been shown to improve superior scap movement almost to that of the unaffected side
If the patient has anterior instability - and the humeral head is placed anteriorly in the glenoid fossa the scapula may compensate by internal rotating and anteriorly tilting to keep the humeral head centered within the joint
Scapular stabilisation exercises have been shown to improve shoulder pain however not scapular mechanics. Exercises prescribed (Y’s and T’s) often have high levels of glenohumeral load and are hypothesised to be stimulating the need for glenohumeral joint stability and in turn improving scapular mechanics
Further research to distinguish the effectiveness of reducing shoulder pain between scapular stabilisation exercises and glenohumeral joint exercises is needed
Improved Hip and Gluteal Flexibility Following a Daily Lunge and Reach Stretching Intervention
International Journal of Sports Physiotherapy
Brent A. Ehresman, PT, DPT, B.J. Lehecka, PT, DPT, PhD, Damien Hiser, PT, DPT, Levi Koster, PT, DPT, Jessica Wietharn, PT, DPT
The kneeling hip stretch is an exercise I give to almost every patient, but how effective is it actually lengthening our hip flexors? More specifically, does it improve our glute power, strength or endurance? And should we be tailoring this stretch more heavily for certain athletes?
What we learnt?
Recent studies have shown that a reduction in hip flexor length can lead to a lesser gluteus maximus activation. This is theorised to be due to a greater activation of the hamstrings if hip extension cannot be reached
This was a very limited study with small testing groups and poorly controlled testing conditions themselves as they did not completely isolate the gluteus maximus muscle, however the results were still interesting. It is relieving to know that persistent use of the hip flexor stretch daily did in fact increase passive hip flexor length. The only measure that was significantly increased was gluteal power with no improvements in gluteal strength or endurance.
The reasoning behind this is that, unlike many other muscle groups, the hip flexors have a closer anatomical and functional relationship with the lumbar spine. Although stretching the hip flexors may reduce hip flexor strength itself, it can improve the positioning of their antagonists—the hip extensors. With better hip alignment, the gluteal muscles may be able to store and utilise more elastic energy, enhancing their performance.
Investigating the effects of closed kinetic chain exercises on joint position sense, functionality, range of motion, and pain in individuals with distal radius fracture: a randomised controlled trial
Biomed Central
Distal radius fractures (DRF) are among the most common orthopaedic injuries. However, many patients do not attend physiotherapy after cast removal, often under the misconception that rehabilitation is complete. This study explores the effectiveness of different exercises so that in future physiotherapy practice we can educate and rehabilitate with confidence.
What we learnt?
Six weeks of consistent closed kinetic chain (CKC) rehabilitation exercises for a DRF shows clinically significant improvement compared to a regular exercise rehabilitation program in pain, joint position stability, range of motion and upper extremity functionality.
It has to be noted that the CKC exercises were introduced after 3 weeks out of the cast, post 2 weeks of regular rehabilitation to reduce possible pain response
The wrist has a complex bone structure compared to other joints and relies heavily on proprioception to maintain stability. The co-contraction required in CKC exercises may stimulate these proprioceptors
Article Links
Stay tuned for Bite Sized Physio: August 2025 edition
Comments