What course are you looking to do?

If they are offering an NHS bursary for a mature student, for a number of courses they will also pay your tuition fees too… well they did for my physio degree and my brothers nursing.

ah cool, what would you say as a cheapish one? I’ve seen ranges from a fiver up to 100 odd pounds? I have some rubbish knives that i can practise on which is fine, them getting proper sharp would be a bonus but they don’t really get used anyway.

Have used my dads whetstone when i was a kid to sharpen up my camping knife but it’s been a while. Do you use a knife guide thing or just do it by eye?

if you want some “edgy” pics then the heygate estate at elephant and castle is now derelict, and soon to be demolished (hopefully). Not entirely sure i’d want to go round there at night with camera stuff and a nice bike, but there are security patrols i think. You can wander around in it a fair bit… you might recognise bits from the bill/ harry brown..

Theres also that tunnel full of grafitti just off of the cut at waterloo, thats always quite cool.

Shoreditch / brick lane to get pics of funny moustaches and trendy types. Columbia road flower market up that way on a sunday is always good too. Can also ride out to stratford to the olmpic site fairly easily from there.

You can do all the major spots – southbank, borough market, tower of london, bucky p etc.

I know solo, but i LOOOOVE butter beans (not to mention the trumping) so it’s good to have an excuse to go bean mental. The wife isn’t a huge fan so i don’t get to eat them as much as i’d like…

I shall eat other things too i promise… Is it wrong i’m getting excited about butter bean mash?

i’m gonna give this a bash whilst the wife is off on hols. 3 weeks of beans and the freedom to trump without any raised eyebrows. Yes!

I can recommend the thatched cottage in brock as well. Last time i was there they had just built a pizza oven in the back garden.

mmmmmm pizza

they’re ok for use in the acute phase, but for chronic low back pain they’re not ideal..

4 isn’t enough for a lit review especially on something that has medical guidelines written on the basis of that eveidence.i’m with dr death on this one, i hd a quick squiz and found those too on pub med. Also look through the new CPR guidelines and you’ll pick up loads of refs (US, Aus,and UK have all changed fairly recently)

yep i agree, sounds nervey. Go see your Dr… see if they’ll refer you on

a couple of amazing places…

if you like schnitzel (and who doesn’t?) then Austria on BergmannstraBe is the place to go as the schnitzel is gargantuan and incredibly tasty… its one all manner of awards for the past 10 yrs or so..you might have to book in advance, and if you look a bit german like i do then they won’t believe you’re english and continue to speak german to you (and english to the others at the table)

http://www.tripadvisor.co.uk/Restaurant_Review-g187323-d800825-Reviews-Austria-Berlin.html

Also oranienstraBe has some decent places to go (towards oranienplatz)and theres a row of bars in railway arches heading towards museum island from alexandersplatz, they have a small green out the front of them and are by the railway bridge and tram lines…. really close to the pergammon museum..

Good luck and enjoy – its the best place ever…

sounds as though it could be a small tear either in soleus or of insertion of gastrocs into the achilles.

Internet diagnosis is never any good so get yourself to a physio / GP to have a looksie and they will be best placed to advise you on what to do..

I wouldn’t run or cycle on it until you’ve seen someone (if you can get there in reasonable time), otherwise rest it for a week or two and look into stretching and strengthening exercises – again physio is best to advise.

i stood next to the aussie fella on the tube on friday. He was drinking red bull so he immediately went down in my estimation…. anyone that’s supposed to have good taste and drinks that shite certainly can’t have full function in their taste buds…

I am now rooting for the girl with big eyes

theres a couple of pubs on lambs conduit street (wc1n also – up grays inn rd towards Kings Cross and turn left on guilford street) that are ok if i remember correctly (near great ormond street hospital).

I think theres a pub called the lamb and one called the perseverence i think…. both were pretty ok but can get a bit busy.

knowing a fair few people who research this malarkey (and the whole LBP thing) i’m not really sure anyone knows truly what it is or how to measure it, and even if you can whether it actually works…

If i remember correctly isn’t it all that trans abs, QL, abs, and pelvic floor stuff. Needless to say i’m not musculo-skeletal

d’oh,thats meant to say depends what you’re trying to rehab

we use the airex balance pad at my place, but really depends what you want to use it for….

sometimes cushions / pillows will do as SBZ mentioned,

what you’re rying to rehab..

I’d definitely recommend the trek to machu pichu, as otherwise you’ll get there with all of the rest of the fatties, and the walk is amazing, especially the high pass. Only let down is the final night where suddenly there are hundreds of people all at the same campsite – however things may have changed now the limit the amount of walkers..

As ransos mentioned go to colca canyon, it was awesome, especially at cruz del condor.

Other good places were huacachina: a small oasis in the desert with a nice colonial style hotel (but not much else to do)

Manu reserve – pretty nice and unspoilt rain forest,we stayed in the jungle for 6 or 7 days there…. can’t remember the name of the company now.

Nazca / arequipa were amazing

If you can get to the salt flats in bolivia its well well worth it, its pretty surreal, lots of pink, purple and green lakes

if you like to see people taking a dump in lake titicaca i’d heartily recommend puno – thats about all that place was good for… but you can stay on the floating islands on titicaca with a local family which is good fun.

Erm, i can’ remember much more..

i had a very artistic friend who drew on my shirt on the final day at school (some moons ago) a pretend badge on the shirt pocket, which was 3 cocks in a sort of fleur de lis arrangement, with the moto “Live long and Pork”

That was a winner, and i pulled…

Speaking as a physio we tend not to use Grade V manips too much for a number of reasons… they’re a great quick fix to get someone moving properly but should only really be used to enable someone better movement upon which they can do their exercises to improve upon what is the underlying problem. But you can use other mobs to much better effect, there’s a whole range of less glamorous and non clunking mobs to be done which can be even more effective – look up mulligans and the whole nags / snags stuff.

That way you got non dependent clients, that will hopefully go off and do their exercises and look after themselves rather than keep coming back – in turn saving the NHS cash.

And also on the training front – we do 3 or 4 years (depending on country) but also have a higher qualification for manips – the MACP which is an MSc course in itself.

I think the chiro and osteo have some place but should calm down on their over inflated claims on curing all by doing a bit of clicking.

oxford brookes does physio i think (not sure how good it is though…) as everyone else has said couple of days for private and 40 ish quid.

If you were nearer london i could recommend a very good physio, has a PhD in knees and has a nice little practise in dorking (i’m also a PhD physio)

you might want to look at seat position on your bike, if its normal XC height (i.e. as far up as it goes), you end up with a big calf stretch at the end of your down stroke as your heel travels down through (going into excessive dorsiflexion). You might want to lower the seat to reduce this level of stretch.
Also if you are a bit of a stomper you might want to limit the amount of power you’re transmitting through your feet to the pedals in the short term, if you’re chucking a lot of force through the foot, your achilles has to take a fair amount of that strain from the calf muscles. So using a larger ring and higher cadence might ease the strain a little.

These are a couple of tips that might make riding more bearable, but should be done in conjunction with appropriate rest, icing, stretching and strengthening, and definitely under the watchful eye of a physio to try to troubleshoot and reign you in if needs be. The heel raises are a mainstay of treatment, (if they’re painful go up with your good leg and down on both), bow-stringing can be used (a form of friction massage)as well as strappings to offload some of the strain on the achilles.

However, with out having a proper look i can only speculate what might be a good idea, i recommend seeing a sports physio or other sports clinician.

er the usual stuff really (PRICE), so the support may help, altering activities or the way you do them to give it some rest, steroids and other anti inflamms may help, alongside ice (consider contrast bathing too if its been a long time and gets swollen).

Stretches, frictions, possibly ultrasound (depends whether your physio believes in it or not)and a graded strengthening programme should help. But a lot of the treatment will be managing the symptoms and ensuring you rest it appropriately to ensure the injury has the chance to recover. There aren’t really any short term fixes

4,6,7,8,10.

it should be to use a framework to analyse the validity of the research question, the methodology used to assess it, the strength of the results and whether you think they’re useful. It’s not just about flaming an article, but reasoning why you think it is a good or bad piece of work.

There are lots of tools out there to help, the nhs recommend the CASP tool.

marp (currently writing up PhD and pulling out the remainder of my hair!)

nearly Dr Marp, PhD applied biomedical research (physiotherapy). Writing up as we speak

to OP:
Has nobody mentioned positioning yet? FLEXED position, pain inhibition due to abdominal incision, poor basal expansion, been ventilated and anaesthetised in supine – collection of secretions etc, is analgesia correctly controlled? Immediate treatment approach would be get into a decent position to improve expansion, check fluid balance, chat with docs, saline nebs, flirt with nurses, eat chocolates, acbt with supported cough etc etc… re-auscultate, check to see if sats are improving,etc. If they’re really crappy you can try the bird. Then liaise with docs again re: problems and get them to sort out fluid balance and any other issues.

Manips can offer you short term benefit, but the long term efficacy of them is not proven. Also the problem with them is they tend not to get to the root of the problem. They offer temporary relief but you should in that window of pain free movement use exercises / stretches to help strengthen up whichever muscles are weak and to stretch those that are shortened.
.

In the short term pain relief, keeping moving, gentle pilates / yoga stretches (cat,lumbar rolling, rotations)swimming and a heat pack should provide some relief .
In the long term you're just as well off doing any form of exercise for non specific low back pain.

It's so easy for a simple and little change to knock things off and cause annoying (and painful) injuries. Could be a combination of things all ganging up on you to make it more aggravated.

It typically takes 6-8 weeks to recover from these depending on age and severity, and also on whether you rest it sufficiently. Inflammatory problems like this need a good rest from strenuous activity to allow them to settle before returning to full blown exercise.

You might want to have a look at this,
http://www.clinicalsportsmedicine.com/chapters/28d.htm

it's one of the bibles of sports medicine and worked a treat for me in outpatients.

Also, did you have your seat raised for a while? Did your physio mention if you had tight hams? (i take it you have as you're a biker), do you have a good cyclists walk – tight calves and walk slightly more on the front of the foot?

how long has it been knocking around?
Treatment is rest and ice initially, but you'll want to start eccentrically loading it fairly soon. Can also try bowstringing which can be really nice in reducing discomfort in the area.

Eccentric loading – stand on a step with your heels hanging off the edge. Push up onto tip toes using only your non painful leg, then slowly lower both of your heels until they are hanging off the step and you'll feel a nice stretch in your calves. Do about 10 reps (but let pain be your guide)When this becomes pain free progress to pushing up with good leg and coming down on the injured leg.

Bowstringing – bend your ankle up (dorsiflex) so that you can feel a stretch on the achilles. Place one thumb over the other on the medial (inside) edge of the achilles tendon itself, above the insertion onto the heel. Slowly and rhythmically with a constant pressure move the tendon towards the outside of the ankle (i.e. move it in the lateral direction).
Do this for ~ 30 sec at frequency of 1 / sec.

Also will want to work on some soleus and gastroc stretches

Hope that helps, and hope it gets better soon

build up of wax occurs generally when you clean your ears with cotton buds etc and that stops the natural flow of gubbins out of the ear to where you can get it with a finger.
Also, never let an indian man stick things in your ear, i work in with a lot of audiologists and they always go on about the amount of ear drum perferations due to poking sticks in ears to get wax out etc.

Could be either your calves or hamstrings. Depends where the pain is. If its more in the middle at the back its more likely your gastrocs/soleus (calf) than hams. Would fit with fell walking if there was a lot of up hill and down dale type action. The calves generate a lot of power in pushing you up onto your toes.

Quick muscle check – does it hurt to push up on to tip toes and hold on to tip toes on the sore leg? (do this on the sore leg only)

Does it hurt to hang the heel on the sore leg down off of a step (try to push the heel down to stretch the calf)?

If either of these are sore then calf is most likely.

Does it hurt to pull your heel up to your bottom? (ie bend your knee?) What if someone resists this movement? (Try at different angles of knee flexion)

If this is so more likely hams…

They're a couple of quick checks but best to get and see a physio face to face and let them have a proper look.