Dr Paul Kirwan
@pdkirwan
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Physio/Assistant Professor Trinity College Dublin @tcddublin /Head Physio Bohemian FC #Bohs @bfcdublin 🔴⚫/Connolly Hospital/Private Practice/Tendon Nerd
Dublin, Ireland
Joined July 2011
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Possibly the best Christmas present ever - successfully defended my PhD this morning, virtually, that better still count🤔😳. Huge thanks to my supervisors
@helfrench
@DrTrevorDuffy
@RCSI_Irl
@RCSIPhysio
and to
@HansZwerver
and Dr Grace O'Malley for being my examiners. Relief
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After this mornings
#tendinopathy
presentation
#ISCPConf23
some were asking for a copy of my assessment form which I've been using. Please feel free to use/share and would love to hear if its useful. SCREENDEM and think of the ABCs to build
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Well this paper, certainly challenges my bias, excellent study, well designed, impressive list of contributors/authors. Really no surprise steroids outperforming placebo early, but differences at 6/24 months did surprise me, and no adverse reactions!
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Gotta love when two surgeons (with the help of two physios) write an article with the message "put the scalpels down and keep loading those tendons" open access article, my pleasure to work with
@DChalloumas88
@11chrisclifford
and
@TendonGlasgow
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PhD thesis submitted today, online, thanks to Covid. I'm old school so had to print it out. Taking a bit of advice from
@Henrik_Riel
with a special sip to celebrate. I don't think there is a more appropriately named drink for this moment. So many to thank for getting me here🙏
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PhD Graduation day, a virtual ceremony but an occasion to be marked. Too many people to thank, but my sincere thanks to
@helfrench
@DrTrevorDuffy
@RCSIPhysio
for the academic support & guidance, & all the physios in
@HSCPConnolly
so many others helped in so many ways, so grateful
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#WorldPhysiotherapyDay
the theme is arthritis/inflammatory arthritis, so I feel its right to share my
#SCREENDEM
tool which I designed to help me in my efforts not to miss inflammatory arthritis, I still use this daily, if you have used this & found it helpful please RT share
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One word... Chuffed. But I wouldn't have even started this PhD without the help from
@helfrench
who shaped my jumbled ideas into a proposal, then a trial
#sportskongres
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Just over 2 years of recruitment, 114 Achilles screened, 76 midportion Achilles participants recruited and followed for 6 months. Time to enjoy this moment and then move on to analysis and write up. But first, I promised myself one of these later.
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Very Near to PhD thesis submission & I feel it’s only right to thank those who made the process easier by making their PhD available, so a huge & sincere thank you to my supervisor
@helfrench
her hard copy has been invaluable, and to
@Seth0Neill
@Seaniemc89
@rj_devos
v grateful🙏
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A patient seen this week, Diagnosed with AS at 43yo, symptom onset at 26yo. 17yrs of struggling with backpain before referral to rheumatology and commencing treatment - identifying inflammatory backpain isn't easy but we can & should do better
@physiojack
@drjrees
@TendonGlasgow
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i wasted a lot of time years ago trying to 'feel' what others told me i wasn't skilled enough to detect. i dont waste my time any more on this
"Movement in the sacroiliac joint during the single-leg stance is small and almost undetectable by the precise radiostereometric analysis". How many clinicians believe they can assess the SIJ mobility is beyond me!
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This is fantastic, reading the details for the last 10mins. One to share before signing off for Christmas 👌
The Painful Hand! Wish I would’ve thought of making this prior to my first MSK rotation. Super helpful for keeping the various arthritides straight.
#medtwitter
#RadRes
#radiology
#FOAMrad
#MedEd
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Thank you so much to all at
@bfcdublin
The highs and lows that come with football, as well as all the players and staff were such a welcome distraction from PhD demands. Without knowing it, this club helped me so much 🔴⚫👍👌
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A message I reiterate to runners and all those who exercise with OA on a daily basis, however, it's amazing how if one specialist said they should stop running even just once, that seems to stick, while advice to continue and that it is safe to do so can be a harder sell
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Loving
@RodWhiteley
opening session - physios have left S&C and instead started doing 'bullshit' 😂
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Eccentric or Concentric Exercises for the Treatment of Tendinopathies?
Thanks for sharing
@rwilly2003
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Really flattered to win best clinical poster at
@ISTS_2016
thanks to
@helfrench
@DrTrevorDuffy
#tendons2016
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A beautifully written piece on uncertainty in medicine read & share
@Seth0Neill
@fizziowizzio
@AdamMeakins
@tomgoom
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#EULAR2016
My mnemonic for screening for inflammatory arthritis from this mornings "Time is Joint' session
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Soleus is a beast, the days of 'Gastroc is the power muscle of the calf and soleus is the postural muscle' are hopefully done.
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First time going to
@sportskongres
and really flattered to have been selected for the oral presentation competition. Looking forward to this🙏 thank you. Flying the
#tendongeek
flag and the 🇮🇪🇮🇪👍
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corticosteroids do worse than wait and see from 12 weeks on - something worth telling patients who want a steroid injection.
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Great paper on how tendons adapt to load - via mechanical, material & morphological adaptations. Aim for >12 weeks
http://t.co/XnRUoXiIXO
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If we don't get good at Load/S&C - give up & just run a spa. Great presentation by
@RodWhiteley
#opload
. Stirring and Thought provoking
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So I finally get to go
@sportskongres
well, let's hope ...just submitted my PhD results, years of work summarised in 250 words
Last chance to submit your abstract for
@sportskongres
2020: Senior editors from top sports medicine journals will rate and judge.
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'Thank you for making my life painfree' ... What a fantastic message from a patient today, who struggled with severe lateral hip pain for 2 yrs, saw GP, Physios, massage therapists multiple time. Has RA so everyone put it down to that. 1/12 after starting rehab, much improved,
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Great slide from
@tendonresearch
flagging the diff in Tendinopathy population. Athletes load, sedentary individuals metabolic
#tendons2016
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With bilateral shoulder pain (and or pelvic girdle pain) in over 50s also worth also considering Polymyalgia Rheumatica. Check ESR and CRP, absence of RA antibodies, EMS and if pelvic girdle involved and no other joint involvement
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@bfcdublin
Thank you all at
@bfcdublin
for this. Mam grew up around the corner from Dalymount and loved the fact I work for the club that her Dad supported. She would appreciate this🙏
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i am looking forward to this. thanks to
@janecamco
and
@AutEvenHospital
for the invite to speak on managing tendinopathy. A few spaces are still left i believe. Tough acts to follow as previous 2 years they had
@philglasgow
and
@AdamMeakins
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A quick glimpse into what it's like to be a tendon researcher. On the left everyone sees a bunch of cables, I see organized collagen(top right) and disorganized collagen(bottom right) 😕😟😥 a sure sign it's time for me to take a break. Merry Christmas
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Do you suffer from Achilles pain? Do you live in/near Dublin? If interested in taking part in a clinical trial for the management of your Achilles pain, contact details here!
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Just read in detail, huge work. This will be typed, laminated & set atop of our ESWT. Research informing practice
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Thanks Karim. Not so much a nail in the coffin but a call to be patient and stick with loading beyond the usual 12 weeks. Rehabilitation of tendinopathy takes time. Collaboration with 2 surgeons & 2 Physios on this important finding
@DChalloumas88
@TendonGlasgow
@11chrisclifford
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If you have not discovered podcasts as a way of learning- can't recommend these highly enough. 👌
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@tendonpain
i have found this v useful since the ISTS/Oxford conference - is this model/suggestion still in favour?
http://t.co/KSsEcCyzds
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interesting paper, i'll need a few more reads, but check out Soleus work loops Vs Gastroc
@tomgoom
@Seth0Neill
must target Soleus in rehab
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Brilliant ad dramatically demonstrating the impact of social distancing, share and RT
@Seth0Neill
@fizziowizzio
@tomgoom
@thekneeresource
@AdamMeakins
@JarrodAntflick
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Protecting the title is of paramount importance please retweet and share
@tomgoom
@AdamMeakins
@Seth0Neill
@Peter_Gettings
@stevenawoor
Calling for international support for implementation of original government decision to protect Physiotherapy title
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Word of advice, if you get the chance to listen to
@McCreesh_Karen
talk about shoulders, then go & pay full attention. Fantastic talk, lots of great info and my new favourite slide for exercise prescription, see below, physios doing DJ with exercise prescription.
#isers
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Tragic news. Part of the fabric of Dalymount and Bohs. Always busy, always helpful, always smiling and always there. RIP Mono ❤️🖤
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Experience helps so much Paula, started my MSc at 35, finished at 37, started my PhD at 42, finishing at 48. I can't imagine doing either straight out of University. I got much more out of both as I could relate amm my learning to clinical experience. Best of luck
Never thought I'd be saying this but I'm actually looking forward to sitting down this afternoon and writing up my research proposal.
I may be one of the oldest students on my ACP course but now is exactly the right time in my career/life for me to be undertaking this MSc 🤓📚
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After 3 x 12hr days work in the hospital, helping our Snr Resp Physio in Covid ICU in any way I can,and admittedly feeling a bit useless and sometimes in the way. I reckon it is earned. Hope you're well Jonny
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Key pts from this, high intensity,long duration(>12 weeks) best for tendon adaptation.Ecc vs Conc seems insignificant
http://t.co/hkgOwrYKkh
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@Retlouping
Jaysus 🤦♂️🤮🤬, I wasted hours, days and weeks in the 90s trying to figure out upslip, downslip, torsion, nutation, right on right blah blah blah, and was told I'm not skillful/experienced enough to appreciate subtle changes. Now I know it's just a load of crap. Move on
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great free resource here with a section on Rheumatology, info on inflammation, OA to name a few, for anyone interested
The Nature Reviews Key Advances in Medicine eBook is now online and Free to download! . 44 articles written by international experts summarizing the key clinical and biomedical breakthroughs published in 2017 and highlighting trends to watch out for in 2018
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Do you have Achilles pain? Do you live in or near Dublin? Interested in being part of a trial? There are just over 10 spots left for this trial. Please retweet and share. Thanks
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2 very interesting articles from
@JOSPT
if you see lateral hip pain/GTPS well worth a read
@function2fitnes
@Seth0Neill
@11chrisclifford
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Huge thanks to
@JackAChew
@physiojack
@TPMPodcast
for the opportunity to chat about rheumatology/tendinopathy this morning. For those looking for the SCREENDEM tool. I've attached below, thanks to
@thekneeresource
for designing this graphic 👊
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Just home from my first
#sportskongres
and hopefully not my last. Incredible conference, lots learned, old friends, new friends, new ideas and what a party 🇩🇰👊👌
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@2505JC
@DerekGriffin86
@kieranosull
@PeteOSullivanPT
@AdamMeakins
@tomgoom
for improving ease of Dx and clinical utility, for me it has to be this by
@alisongrimaldi
et al ... i use these tests almost daily
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So this sold out which is Really flattering. For anyone hoping to attend and can't make it to Kilkenny, I will be hosting the same course in Dublin later in the year. Date TBC
#tendons
#tendinopathy
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More evidence against CSI in tendon pain, LET. Check the Number needed to harm 😬
Comparison of corticosteroid, autologous blood or sclerosant injections for chronic
#tenniselbow
-
@SMACEO
#SportMed
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If anyone has a PDF of this article I would really appreciate a copy. Thanks🙏
The anatomy of tendons & ligaments:
a> tendon structure at the bone insertion
b> tendon structure at tissue & molecular levels
c> anatomy of ligaments (intervertebral disc)
#tendon
#ligament
#arthritis
#anatomy
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this gem on gluteal tendinopathy by
@alisongrimaldi
@Bill_Vicenzino
i use to ed staff away from 'troch bursitis'
Reflection time! Most influential Sport & Exercise Medicine/Physio paper of 2016 in your eyes? Send in links+reason using
#BJSMreflects
*SG
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@JackAChew
After 25 yrs as a clinician, i am now part time clinician, part time academic. It's a lovely balance and a privilege, but once my PhD gets submitted, I will be back full time clinical. As no clinical academic roles. Very sad
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Progression from bilat to unilateral exercises to Nordic
@davidopar
giving a nod to excellent work by
@JackHickey89
#opload
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And symptoms of GTPS can be on par with end stage hip OA. You can get a THR to bring your hip jt pain to an end but you can't get a new set of hip muscles and tendons
Symptomatic hip OA prevalence rates around 4.2 % versus 4.2% for GTPS - Yet grant/fellowship reviewers tell us GTPS is not a problem in the NHS!
What's going on? poor selling on our part? reviewers not reading sufficiently?
.
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As a physio who is in year 28 of clinical practice, this 👇👇 is so true. Trying to figure out the balance and options is still a challenge to me
@TimIrelandPT
Plan on what’s next in your career. Seeing patients 35h/week is not possible over 30 years
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This is an important message, thanks for the chance to spread this
Inflammatory arthritis could be responsible for ur patients tendon pain. How can u screen for inflammatory arthritis involvement? Webinar w
@pdkirwan
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#sscsportsmed17
music to my ears from
@MikeReiman
importance of a good thorough subjective history 👏👊
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Some very interesting Achilles cases lately, 1. AT with Gout, AT symptoms x 2-3yrs, no change with load/Tx, pt saw lots of physios/docs, nobody asked about InfArth, pt never offered forth his Gout Dx, symptoms nearly resolved 2/12 post allopurinol/colchicine, take a thorough Hx
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Thank you
@TendonGlasgow
I Still can't believe that this
#SCREENDEM
tool that I made to help me in my clinical setting has become so popular with Physios, Medics and others. Hopefully some patients with Inf arthritis have been identified as a result & got the right Tx earlier🤞🙏
@pdkirwan
@lindsaycrowe91
@pdkirwan
… thanks a million …especially for allowing us to use SCREEND’EM … such a valuable resource in the clinic …. Always great fun working with you so thanks 🙏 again 👍🏻
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Next session will be very interesting ... No tweeting from me for the next hour, too busy listening Michael Kjaer, Stephanie Dakin and Neal Millar
@TendonGlasgow
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I have been dipping in and out of this excellent
#tendinopathy
article lately by
@TendonGlasgow
@ProfGMurrell
trying to tackle one section at a time, lots and lots to get my simple head around
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nice advice from
@McCreesh_Karen
when referring to physio, can our GP/Medical colleagues simply say “I am going to refer you to physio, I am confident this is what you need” don’t let physio be considered a source of amusement while awaiting an ortho appointment
#isers
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3 different functions of the tendon, nicely visualised by M Azizi at
#QM_tendon
http://t.co/WFoBaPrbgv
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Really interesting to see Achilles tendon ruptures per year, and the drop during Covid and then a spike afterwards. Nice work from Annette Jones and
@Seth0Neill
and Co
#ISTS2023
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V well designed RCT shows Heavy Slow Resistance and Eccentrics both yield good clinical results in Achilles Tpathy
http://t.co/S2f3Id1Dmy
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They are my slides. Thanks for asking/seeking credit 👍 but one typo in the HSR slide, it is by Beyer 2015 AJSM,
This slide provides a nice overview of different treatment strategies for achilles tendinopathies.
Can someone point us to the creator of this slide for credits?
Papers included (next tweet):
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Thanks to
@DrPeteMalliaras
for making Dublin part of his busy Mastering Lower Limb Tendinopathy tour. A day packed with tendon learning👌. Thanks to all who came along too. Next stop Glasgow with
@11chrisclifford
and
@TendonGlasgow
safe travels Pete
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Great slide
#tendons2016
and paper by
@Seaniemc89
gets another nod and a reccomendation to read
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To all physio bloggers please read and comment
@AdamMeakins
@tomgoom
can you imagine - fired for your blog
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So a penguin can do a box jump to roughly it's shoulder height...much respect, but I'm feeling pretty pathetic now🤦♂️😢
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I hope this gets traction and spreads. And ultimately leads to the panel system being scrapped 🙏 panel system is a ridiculous method to recruit IMO. Please share
@RuaidhriOConno1
@_ISCP_
The PSI HSCP Panel Recruitment Survey is now available here - . PSI & our HSCP colleagues are calling on the HSE & Government to commit to an urgent review and reform of this system without delay
#panelnotfit
#MyPSI
@IACP_ie
@IASW_IRL
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Incredible leap 😳👀💪
Not sure how to explain this..
Years of studying biomechanics & all I have is ‘poetry’
Science is art for some
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