Nick Ilic

15/
For more:
Bursitis for Clinicians: nickilicphysio.substack.com/p/clinicians...
Bursitis for Patients:
nickilicphysio.substack.com/p/patient-pl...
The Rotator Cuff Cable:
nickilicphysio.substack.com/p/clinicians...
When is a 'Shoulder' not a Shoulder:
nickilicphysio.substack.com/p/when-is-a-...

Nick Ilic | Physio Clinician | Substack I cut through the noise in musculoskeletal healthcare, offering clear, practical insights for patients & clinicians. Expect deep dives, case studies, and no-nonsense injury management. Subscribe for e...

14/
🎬 Final Boarding Call
The full post (with clinical pathways, imaging criteria, and management pearls) is now live:
👉 nickilicphysio.substack.com
🔒 Paywall at cruising altitude — because that’s where the gold is.
#Physiotherapy #ShoulderPain #RotatorCuff #Rehab

13/
🧾 Scans and Stories
In older shoulders, imaging finds something in almost everyone.
Pain-free rotator cuff tears, “bursitis” in half the population, OA in most.
Use scans to confirm your theory—not to build it.

12/
🌉 The Rotator Cuff Cable
The reason some big tears keep flying while others nosedive.
Think suspension bridge, not shredded fabric.
The load distribution story matters more than the MRI headline.

11/
🎯 The Biceps Canary
When the long head chirps, it’s usually telling you something upstream is wrong.
It’s tender, it’s tired, and it’s tattling on the rest of the team.

10/
🧩 Subscapularis – The Forgotten Anchor
Lose it, and the whole cuff loses its compass.
Rehab here isn’t “more external rotation.”
It’s restoring anterior stability and force balance.

9/
💥 The Bursitis Brouhaha
If every ultrasound says “bursitis,” maybe the machine’s not broken — maybe our reasoning is.
Scans describe structure, not pain.
A good story trumps a grainy screenshot every time.

8/
🧠 Neck First. Always.
If the “shoulder pain” lives between the blades, or the deltoid’s fine but the story’s weird…
Check the neck.
Otherwise, you’ll chase a ghost and call it bursitis.

7/
🧭 Extended Discussion Sections
💡 Young & Wobbly vs Old & Stiff vs Elder Shoulder
You can tell a lot about a shoulder by its passport age.
Different biology.
Different pathology.
Different rules of engagement.

6/
🚨 Emergency Landing: When Rehab Doesn’t Fly
3 months with no improvement = time to divert.
Reassess, rescan, refer.
Sometimes it’s the weather, sometimes it’s the aircraft.
Either way, you need another runway.

5/
🛬 Landing: Return to Function
Touchdown isn’t “pain-free”—it’s recovered enough to live again.
🔹Rebuild strength.
🔹Dial down meds.
🔹Debrief on early warning signs.
🔹Create an early warning action plan for next time.

4/
⚡️ Turbulence: The 6–8 Week Stall
Every journey hits rough air.
Pain flares, progress stalls, and passengers panic.
That’s when you de-activate autopilot and review:
🔹 The neck
🔹 The load
🔹 The story
Stay calm, stay curious, and don’t eject too early.

3/
☁️ Cruising Altitude: The Management Phase
Once you’re airborne, it’s all about steady flight:
🔹 Education that sticks
🔹 Pain relief with purpose (not dependency)
🔹 Movement plans that fit the patient, not the textbook
Comfort is important—but so is the destination.

2/
🛫 Take-off: Pre-Flight Checks
Before you even board the case:
🔹 Traumatic vs Atraumatic
🔹 R/O red flags & urgent referrals
🔹 Check-in all medical baggage
🔹 Know if it’s turbulence (trauma) or tailwind (insidious load change)
Don't fail to perform pre-flight inspection.

1/
✈️💪 New Take-off to Touchdown post: open.substack.com/pub/nickilic...
Chapter II | The Older Shoulder
(aka: Rotator Cuff Pain, Bursitis, & midlife movement mysteries).
For clinicians who want fewer “mystery shoulders” & more clarity from take-off to touchdown. 🧵

Unlike The Mad Katter, I won't punch anyone in the face if they ask ME about my Lebanese heritage.

Settlers from Kfarsghab 100yrs ago helped make 🇦🇺 great through hardwork and grit, many rising up to high community status.

www.kfarsghab.com.au/kfarsghab-hi...

#auspol

Patients Playbook | When ‘Bad Knees’ Run in the Family What is Patellofemoral Dysplasia? What does it mean for you and your family?

🔹 Patellofemoral Dysplasia 🔹
If your knees have always been “a bit off”…

🧠 Born with a different blueprint
🦵 Not just “maltracking”
💪 Quads, suction & load management
🧪 Dynamometry > guesswork

📖 open.substack.com/pub/nickilic...

#Physiotherapy #KneePain #MSK #SportsPhysio #PFJ

Research Review | Pain in the Bum
🔗https://nickilicphysio.substack.com/p/research-review-pain-in-the-bum-gluteal

I discuss Angie Fearon's recent Gluteal Tendinopathy Review (sciencedirect.com/science/arti...):
✅ Bursitis vs GT
✅ SIJ/Lumbar DDX
✅ +LR/-LR test breakdown
✅ Why education > gadgets

I like the idea of this platform.
I don't like the idea of manually duplicating everything I do on that "OTHER" platform just to get it on this platform.
I don't yet want to stop using that other platform.

Solutions people!? 😂 Such a first world problem

I sometimes call Manual Therapies: "Palliative Therapies" (see meaning in pic).

It shifts the focus to short-term benefits: pain relief, reduced inhibition, and improved function so we can commence active rehabilitation, without the baggage of silly, disempowering narratives.

The mere fact that is very difficult and uncomfortable to ask the question I have (without backlash) demonstrates how powerful, extrajudicial, and amplified online dialogue can be. Cognitive dissonance is difficult for everyone, especially if asking themselves "is it at all possible he is innocent?"

I spent a year hating him due to the public dialogue surrounding the DV allegations and listening/seeing the reaction to it, that was wrong of me, legally and congnitively.
It is difficult to separate the cause (DV) from the alleged offender, who has not been found guilty by an Actual Court of Law.

Thanks for assuming I don't know the basics facts and reality of Domestic Violence, the number 1 killer of women in my Country.
This is not a #notallmen laced query.
He could be innocent, and the Court of Public Opinion outside of the legal process could be unnecessarily ruining his life & career.

"You're wrong, do your research, you should argue with that 🤡"

Imagine if there was even some sort of collaborative health organisation worldwide that the US could benefit from, even contribute to?

Humankind has had generations to get used to the notion of disagreeing vehemently, but with love, we have a whole institution for that:

Marriage

🤐

Looks amazing. Will have to make the BIG trip one year

Can I ask, playing devils advocate, what if he IS actually innocent and he's been dragged over the extrajudicial coals unnecessarily?

I feel you summed it up well last year:

We don't know, we won't know, but we should continue to raise awareness of DV and publicly condemn it in all its forms.

Our Australian Physiotherapy Association even has a Dry Needling National Chair.

I was disappointed to see that it wasn't what I thought it was

Prognosis needs trajectory.

In their first visit when patients ask, "When will this be better?" I say it takes 2-3 visits to gauge recovery trends but add, "I wouldn't be surprised if it takes #-# weeks/months."

Patients are usually happy with that.

Reminds me of a good pic from Mr @AdamMeakins.