Our Team

 

 Graham Morgan, BSc Physiotherapy, MSc Musculoskeletal Medicine, INDEPENDENt physiotherapist PRESCRIBER, INJECTION THERAPIST, MCSP, HCPC registered

Graham has been working as a Clinical Lead Musculoskeletal Physiotherapist for over a decade now, he is the Clinical Lead for our clinic and acts as a mentor for the majority of the team. He has studied to gain an additional masters degree in Musculoskeletal Medicine alongside his previous physiotherapy degree. His main specialty is management of complex spinal conditions and he continues to work full time in his advanced clinical practice role with the spinal surgeons in the local NHS trust. Graham is a Clinical Lead for the region in management of back pain. Part of his role within the clinic involves planning and implementing high level combined physical and cognitive therapies programs for people with persistent spinal pain, he is trained in cognitive functional therapy. Graham treats patients with longstanding lower back pain with or without leg symptoms, neck pain with or without arm symptoms, post operative spines and patients who may have developed neurological deficits. He is experienced at interpreting spinal imaging as well as recognising when imaging may be required to assist care. Graham is also an independent prescriber and an experienced injection therapist and is used to administering steroid and hyaluronic acid such as synvisc and ostenil to help patients manage chronic conditions.

Niall carter, BSc physiotherapy, msc advanced physiotherapy, independent physiotherapist PRESCRIBER, INJECTION THERAPIST, MCSP, HCPC registered

Nial is one of the most qualified and experienced Physiotherapists in the region. We are very lucky to have him as part of our team. When he is not working at Consortium as one of our Clinical Lead therapists he holds the same role as Graham working as an advanced clinical practicioner in the management of complex spinal conditions within the local spinal surgical team. Nial is also a Clinical Lead within our NHS region in the management of persistent back pain. Part of his role within the clinic involves planning and implementing high level combined physical and cognitive therapies programs for people with persistent spinal pain. Alongside this, he is vastly experienced in managing a wide variety of other musculoskeletal complaints. In addition to his two degrees in Physiotherapy he also an independent physiotherapist prescriber aswell as an injection therapist.

clare haslam bsc physiotherapy, mcsp, pogp, hcpc registereD, MUMMY MOT PRACTICIONER

Clare is a Specialist Women’s Health Physiotherapist within the local NHS trust and has been for over 10 years. She is regional expert in Women’s Health, is a member of the special interest group Pelvic, Obstetric & Gynaecology Physiotherapy (POGP) and is a certified Mummy MOT practitioner. She specialises in treating a variety of women’s health conditions including pelvic floor dysfunction, overactive pelvic floor, pelvic floor weakness, pelvic organ prolapse, bladder and bowel dysfunction such as urinary incontinence, overactive bladder, constipation and faecal incontinence. Alongside this Clare will also treat pregnancy related conditions such as weak pelvic floor, obstetric injuries, rectus diastatis. As a certified Mummy MOT practitioner she offers specialist post natal examinations to help women recover after vaginal or caesarean deliveries (read more about this on our blog). Clares scope of practice also includes Male Health Physiotherapy for pre and post prostatectomy: including assessment, treatment and support with urinary incontinence and errectile dysfunction.

Molly DAVISON MSc Physiotherapy, BSc Sports Science and Physiology, INJECTION THERAPIST, MCSP, HCPC REGISTERED

Molly has a Masters degree in Physiotherapy and is a Clinical Lead Musculosketal Physiotherapist. Alongside her work at the Consortium clinic she also works as a specialist in the local NHS MSK outpatient department aswell as the local emergency department and as an advanced practitioner within some of the local GP practices . After she gained her Masters in Physiotherapy she has continued to train extensively and had gained a qualification in Injection Therapy.

From a young age Molly has always been interested in health and well being, she puts that passion into practice through her physiotherapy work. She is always focused on working with patients to help them achieve their goals. Molly works with Abi in heading up our team of Ossur brace fitters where they frequently fit patients with the Unloader One brace to help with knee osteoarthritis.

Abi Holt Bsc Physiotherapy, INJECTION THERAPIST, MCSP, HCPC registered

Abi has been working as a Clinical Lead Musculoskeletal Physiotherapist for a number of years now. When she is not working at Consortium she is one of the senior staff in the local hospital MSK physiotherapy department while she also works in the local emergency department assessing and managing patients with acute MSK conditions. She has gained extensive post graduate training in all aspects of MSK physiotherapy including Injection Therapy. She also has a special interest in treating spinal pathology, especially patients with chronic lower back pain. Abi works with Molly in heading up our team of Ossur brace fitters where they frequently fit patients with the Unloader One brace to help with knee osteoarthritis.

Gary Bradley, BSc Physiotherapy, INJECTION THERAPIST, MCSP, HCPC registered

Gary is a Clinical Lead Musculoskeletal Physiotherapist and Injection Therapist. He supplements his work at Consortium by working in the East Yorkshire NHS services as a Team Lead MSK Physiotherapist. He has a wealth of experience having spent many years working within different facets of musculoskeletal medicine. He is skilled at seeing patients with hyper-acute injuries aswell as managing chronic conditions and long term rehab. Gary has extensive post graduate training, he spends time at the clinic implementing high level combined physical and cognitive therapies programs for people with persistent spinal pain, he is also trained in cognitive functional therapy.

Gary has always been driven to specialise in MSK Physiotherapy he is currently mid way through his Masters degree in advanced Physiotherapy. He is also an experienced injection therapist and is used to administering steroid and hyaluronic acid such as synvisc and ostenil to help patients manage chronic conditions.

His main focus is to empower his patients to be able to understand their condition and to manage it as effectively and independently as possible.

Tom Nozedar MSC physiotherapy, bsc sports rehabilitation, mcsp hcpC registered

Tom is an experienced senior Musculoskeletal Physiotherapist. He works as a Senior MSK Physiotherapist within the NHS and is part of our in house Consortium MSK Physiotherapy mentorship program. Tom is an asset to our team, and can offer our patients a wide range of skills having initially graduated as a Sports Rehabilitator before returning to study and gain his Masters degree in Physiotherapy.

ShAFEEQ younus : BSc Physiotherapy BSc, bsc SPORTS REHABILITATION, LEVEL 3 IN SPORTS MASSAGE THERAPY, hcpc registered

Shafeeq has a BSc degree in both Physiotherapy from Sheffield Hallum University and also a full degree in Sports Rehabilitation.

Aswell as seeing patients for Physiotherapy, Shafeeq also sees lots of patients for soft tissue work and he is often in high demand. His training and experience leaves him really well placed for any advice on pain, injuries and rehabilitation.

Shafeeq is a really valued member of our team having been with us throughout his training period on the Physiotherapy degree. He is now part of our in house Consortium MSK Physiotherapy mentorship program.

debbie robinson : senior rehabilitation therapist, associate member of the chartered society of physiotherapists

Debbie has been working as a Rehabilitaton Therapist for over 25 years. For the last 13 years she has been carrying out community home visits as part of the local NHS Physiotherapy and Occupational Therapy team. Her vast experience in orthopaedic rehab, care of the elderly and with amputees makes her a valuable member of our team who can offer these services to patients in their own home or care facility as required.

MASSAGE TEAM:

bart klimek bsc sports rehabilitation, level 3 in sports massage therapy

Bart is an experienced Sports Rehabilitator and soft tissue therapist having graduated a number of years ago from Hull University. Alongside his work at Consortium, he also works as an associate practitioner for the local East Yorkshire NHS MSK Physiotherapy team. Bart is also training to become a qualified Physiotherapist and is in his final year of his Physiotherapy degree apprenticeship at Sheffield Hallum University.

His sports rehabilitation degree as well as his physiotherapy experience leave him in strong position to manage a wide variety of MSK patients whether it be for soft tissue work, or management of a variety of MSK complaints and sports injuries.

To find out more about the Consortium Sports Massage service please use this link. 

Tissue Regulation

Perhaps the best way to introduce this topic would be to pose the following questions..

Why do some runners demonstrate a poor style with limbs thrown all over the place with no obvious control yet they can continue uninjured?

So how are these lucky individuals able to continue to exercise pain free while many people with better style and form continually run into strings of injuries?

It seems clear therefore that injury does not solely relate to style, biomechanics or perfect alignment.

Each of us has a certain amount of capacity in our tissues to tolerate stresses and loads. Some may have a huge amount of leeway (the sloppy runner who is injury free) and others very little (the perfect runner who is always injured). Some people may be able to suddenly and drastically increase their training loads without injury, while others only have to make the most minimal of changes and they run into trouble. As a general rule of thumb however large changes in activity does seem to be a precursor to injury. The concept of tissue regulation and capabilities of tissues to tolerate load is not something new, in fact it was first described by Scott Dye an American knee surgeon in 2005 (Source).

The model that Scott puts forward should have huge influence in the way we treat patients today. We feel this is a very important concept for the majority of our patients to understand and we have tried to explain it in its most simple terms. 

OPTIMAL LOADING - sensible appropriate loads at the right intensity, speed and position with the correct amount of recovery will in time improve the capability of that tissue to tolerate load. No different from training for a marathon, take it too quick and you run the risk of injury, take it too slow and you waste time. It is a balancing act.

UNDERLOADING/SUBOPTIMAL - e.g complete rest! This will create the reverse effect and decrease the tissues capability to deal with load, as it would when you take time out injured. This can result in malnourishment, pain and pathology. The same principle applies with overloading. This is why we will try to avoid at all costs and will very rarely prevent you from having to stop participating in your activity.

How do you know if your exercises are pitched into the right zone for you?

If you can tolerate your current exercises/training load or activity in a pain free manner, with no flare up of pain on the second day after exercise then you are likely to be working within a capable zone for that tissue.  Be careful though as it is common for tissues to flare up 24 hours later. This can often be due to a latent production of an inflammatory chemical called cytokines.

No pain, no gain in the majority of cases is therefore not applicable what so ever!

What is the ideal?

Theoretically it is best to remain working at the upper limit of your optimal zone. Loading OPTIMALLY and allowing correct progression and recovery time will increase the capability of that tissue to deal with a task in a healthy manner.

What to do if I'm injured?

You will need to work in a lesser zone and then slowly build back up again. Even injured joints can function very well with certain activities. Examples of this can be using swimming and cycling where there is less direct impact yet you can still maintain strength and movement without continuing to overload and worsen your injury.

In summary, your tissues don't take well to sudden changes. Changes such as increases in training need careful grading. Think of your tissues like employees, if you drastically change someone's job role overnight without prior warning, you will have outrage and backlash on your hands. If you make small changes and are appropriately prepared it will make for a smoother transition. This is an especially important principle when dealing with patients chronic pain, they may well need to take much smaller steps and take them over a much longer period of time.

Exercise prescription is therefore something that should be taken extremely seriously. It is not just a case of picking exercises, giving them a go and quickly abandoning them if they don't give you the results you want. Exercises and training regimes must consist of OPTIMAL loads and need to be sensibly and accurately applied. The volume and intensity of your exercises needs to be monitored in order to be able to progress and regress them appropriately. The principles we have discussed here about regulating tissues must be applied in order to ensure successful recovery.

Thanks for reading 

Are you a victim of misleading medical imaging?

It is only natural if you have a problem to want to resort to some form of imaging to try to identify a cause. From a patients perspective this is understandable, for patients, it makes logical sense. Unfortunately, as with most things there is far more to consider here as we will go on to explain... Patients are misled by imaging so frequently that we feel it is very important to cover this topic early on. 

ARE SCANS USEFUL? 
Absolutely this is a yes, they are key to many things. This is not a one sided argument about the problems we encounter with misleading images however. Obviously scans are essential for surgical planning, identifying major/serious pathology, fractures, lesions and dislocations etc. 

Will my scan ACCURATELY identify my problem? 
It is very common for scans to show abnormalities that do not relate to a person's symptoms. These findings are often purely radiological incidental findings! Our clinicians interpret images in daily surgical clinics and constantly encounter these issues when analysing the hundreds of MRI and Ultrasound scans we come across a year. We find ourselves often explaining to patients why it is that their MRI scan shows a huge disc prolapse clearly compressing a nerve on the right side but yet their symptoms are only on the left! 

FACTS AND FIGURES

SPINAL MRIS
48% of 20-22 year olds with absolutely no back pain or any issues had at least one degenerative disc seen on their scan, at least 25% had a disc bulge showing. (Source)

40% of individuals under the age of 30 and 90% of people over the age of 50 have disc degeneration, yet they are pain free. (Source)

One study found 98% of men and women with no neck pain had degenerative changes seen on their MRI scan. (Source)

SHOULDER ULTRASOUND SCANS
20% of pain free adults had a partial rotator cuff tear on MRI scan with 15% showing a major full thickness tear! For those people over 60, at least half have a rotator cuff tear they never even knew about. (Source)

KNEE XRAYS
If you x-ray a normal population of adults with no actual knee pain, at least 85% of the x-rays taken will show arthritis. (Source)

In one study, 48% of professional basketball players were shown to have cartilage damage on their knee MRI scans, none had any pain. (Source)
 

WHAT DO WE TAKE FROM THIS? 
Degenerative changes are simply normal. What we see on our scans, often does not represent reality. There is no need to worry if your scan shows certain changes, they are not necessarily associated with pain. If you allow your images to mislead you, theoretically you could end up in higher amounts of pain for longer amounts of time.

Don't get us wrong, as previously mentioned, where appropriate, imaging is an important part of a patients care. Our clinicians at consortium rely upon images to make surgical decisions in conjunction with the surgeons we work with. What is essential is that a patients symptoms directly correlate with the symptoms that they present with. Both us, and patients need to make sure we do not get side tracked with purely incidental findings. Next time you somebody tells you that your discs are worn out or your shoulder is torn then I hope you can see there is no reason to immediately panic! It is absolutely feasible for patients with worn out joints to function at high levels with no symptoms. 

Thanks
The Consortium Team