Wednesday, April 22, 2020

Reggie In Today's Straits Times

Reggie (left in the picture) in today's Straits Times on online/ video consultations during the circuit breaker period.

It's under the Sports section on page B21. Go take a look.

Call us if you need any advice/ suggestions regarding your condition.

Monday, April 20, 2020

Physiotherapy In The Forum Page

Forum page B10, Straits Times 200420
Physiotherapy services was initially on the 'essential' list but subsequently taken off the list.

The President of the Singapore Physiotherapy Association wrote in to the forum page of today's Straits Times on page B10.

Since many countries are similarly on restricted movement orders or lock downs, you can read from this article that physiotherapy is on the 'essential' list in Australia.

We definitely do understand that the government is trying to bring the number of transmissions down. Our clinics are still here for you for online/ video consultations.

Stay safe everyone and stay at home.

Monday, March 9, 2020

ST 090320 No More Heading For Children Under 12

We wrote about how heading the ball in young children may damage their nerve cells in February 2020. Now The Football Association of Singapore has adopted similar guidelines for children under twelve.

It's on the last page of the Straits times today under the sports section on page B18. Go take a look.

You saw it here first.

Friday, February 28, 2020

Heading In Football Damages Nerve Cells In The Brain?

If your child is playing football (or soccer), please be aware that too much heading may be detrimental. This news headline caught my eye as my boys go to football training on most Tuesdays.

The British Football Association has just recommended a few days ago that children 11 and under in England, Scotland and Northern Island will not be allowed to head soccer balls training. Limits for older children will also be put in place.They will however be able to head the ball in matches/ games.

The new guidelines came about after a study found that ex professional football players in Scotland were 3.5 times more likely to die from degenerative brain diseases (e.g. Alzheimer's) and 5 times more likely to die from Parkinson's disease when compared to members of the public.

This ban on heading is already put in place in America  by the United States Soccer Federation back in 2017 for children 10 and under. They also limited heading for children aged 11 to 13 to not more than 30 minutes a week.

Although there is still no strong evidence to suggest that heading the ball is to blame, these new guidelines will be introduced to lessen any potential risks ensuring that football remains as safe as possible.

A single header or two is unlikely to cause any significant damage, but repeated headers over an extended period may lead to problems.

There needs to be much more research to understand fully all factors that can contribute to the increased risk of degenerative brain disease in footballers. Until then it is wise to reduce exposure to the current recognized risk.


Mackay DF, Russell ER et al (2019). Neurodegenerative Disease Mortality Among Former Professional Soccer Players. NEJM. 381: 1801-1808. DOI: 10.1056/NEJMoa1908483.

Wednesday, November 27, 2019

Reggie's Going to the 2019 SEA Games

ST 271119
Reggie has been helping out with Team Singapore's rugby teams since 2015 when the SEA Games was held in Singapore.

At the last SEA Games in 2017, he travelled with the Seven's Team to Kuala Lumpur and the team came back with the silver medal.

Reggie 2nd from the left back row
Let's hope they come back with the gold medal this time.

You can read about Reggie being quoted in today's Straits Times on page C9 under the Sports section.

Saturday, September 28, 2019

Our Turn At Fans Of The Hip

Finally our turn at this course. I've been looking forward to going for this since last year when Reggie and Gino attended it last February. Even though they have shared and taught us what they had learnt, nothing beats learning from Michael.

We always want to become better physiotherapists, so we get better at treating our patients.

Some thoughts on the tilting of the pelvis.

Here's a really fascinating picture of the fascia and intermuscular septum in our legs.

Back to work in the clinic next week for Rachel and I while the boys go for the next course.

Sunday, August 18, 2019

Only One Painful Shoulder, But MRI For Both Shoulders Abnormal?

Neck/ nerves can cause shoulder pain
A patient recently came to our clinic complaining of right shoulder pain. She had just gone to see an orthopaedic surgeon who after a short chat suggested getting a MRI scan for both shoulders for comparison purposes. The surgeon did not even bother assessing her first before suggesting she go for the scans.

I was initially surprised that the surgeon suggested imaging both shoulders especially when there was no physical assessment done on her painful right shoulder or her neck. But what she told me subsequently surprised me further.

Both right and left shoulder MRI scans were abnormal! She had tears in both her right and left supraspinatus muscles (right side possibly from swimming and badminton)! There was no pain at all in her left shoulder.
See the position of Supraspinatus under the acromion
Then Gino told me an article he'd seen where researchers found abnormal MRI findings in both shoulders (Barreto et al, 2019).

These subjects had self reported pain in one shoulder only. They had no history of previous upper arm fractures, frozen shoulder, significant range of motion deficits, no repeated dislocations and no neck related pain.

MRI's were done on both shoulders and randomly interpreted by an orthopaedic surgeon and a radiologist specializing in musculoskeletal conditions.

The conclusion was that abnormal MRI findings were very common in both shoulders! Only full thickness tears in the supraspinatus tendon and shoulder osteoarthritis were higher by 10 percent. Otherwise many patients had similar abnormal tears/ injuries in both shoulders. Yes, even in the non painful shoulder.

Please bear this mind if your surgeon sends you for a MRI scan without even assessing you thoroughly. So many problems can be caused by this and a lack of understanding of context especially if no physical assessment is done.


Barretto RPG, Braman JP et al (2019). Bilateral Magnetic Resonance Imaging Findings In Individuals With Unilateral Shoulder Pain. J Sh Elbow Surg. S1058-2746(19)30234-4. DOI: 10.1016/j.jse.2019.04.001