Your comments: 5 October 2016

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Invitation to take part in a shoulder survey

I am a consultant physiotherapist at Burton Hospitals NHS Trust and am researching physiotherapy management strategies to reduce shoulder pain as part of an internship at Keele University. 
I am interested in suprascapular nerve blocks in the management of shoulder pain. More specifically, I want to find out whether they are being used by physiotherapists, and, if so, where and how. Part of my research involves a survey of physiotherapists, who are involved in the care of patients who have a musculoskeletal disorder. 
Please complete this 10-minute online survey at
Alternatively, you can contact me directly by email at the following address:  
If you contact me, I will send you a direct link to the survey.
This research team includes me, Professor Nadine Foster, Professor Danielle van der Windt and Dr Linda Chesterton at Keele University.
  • Dr Emma Salt, Burton Hospitals NHS Trust

Hip shake-up

Many thanks for the item titled ‘Physios must warn younger hip replacement patients about the risks of further surgery’ (page 9, 21 September).
I wonder if you are aware that, according to the International Hip Dysplasia Institute, the leading cause for early hip osteoarthritis and the necessity for hip replacements in young adults is developmental dysplasia of the hip (DDH)?
Hip dysplasia can often remain ‘hidden’ and symptom free for many years. It is often missed at birth and it can prove difficult for individuals to receive a definitive diagnosis (it can take over 10 years in some cases) when they do start experiencing symptoms in adulthood. However, a timely diagnosis is crucial for treatment options to be available to individuals.
So called ‘hip preservation surgeries’ in the form of osteotomies to reshape the shallow acetabulum of a dysplastic hip can be very successful when performed by surgeons experienced in treating this condition. They often offer an improved quality of life for up to 20 years and thus delay the necessity for total hip replacement. 
Many patients struggle to receive an accurate diagnosis and sometimes the diagnosis is found when osteoarthritis has already begun to develop in the joint. 
This means that hip preservation surgery is less likely to be successful, leaving a replacement as the only option. I wonder if there is a need to improve knowledge and understanding among health practitioners, including physios, particularly in relation to the signs and symptoms of DDH in young adults, the pathophysiology of the condition and when such patients need to be referred on, and to whom. 
  • M-J Sharp, student physio, University of Salford
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