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Case Study: pathology doesn't always = pain!

Meet Josh

About Josh’s injury…

Josh first came to see Saltfleet Clinic physiotherapist Fraser in early August after injuring his knee during indoor cricket a week prior. Josh had already had an MRI scan of his knee through a doctor, which revealed some meniscal (cartilage) and ligament damage on the inner part of his knee. With finals fast approaching, Josh was keen to get back into cricket as soon as possible, but wasn’t sure if he was able to, based on his scan results.

How we got Josh moving:

Despite the MRI findings, it was obvious Josh was moving really well! His knee pain was minimal, and his functional testing and strength both exceeded expectations. It was obvious Josh was in a position to take on more in his rehab, earlier on, and under the guidance of physio Fraser, Josh was doing relatively advanced strengthening and plyometric exercises from the start – with an aim to get back to indoor cricket as soon as possible.

A great result!

Josh progressed quickly and was able to make it back to playing indoor cricket finals by early September, without holding back or experiencing any pain. His application to active rehab was great, which made his faster than normal return-to-sport possible. Good work Josh

So, what can we learn from Josh’s recovery?

Firstly, medical imaging in the form of X-ray, ultrasound, CT and MRI can be a useful diagnostic tool at times, but it’s important to remember that findings of a certain pathology doesn’t necessarily mean we will have to have issues with pain and/or function. Ultimately scan results don’t show the amount of pain we feel, or our future pain levels – and is Josh’s case, his ability to play sport.

In fact, one recent study followed over 600 people who had early MRI’s for their injury, and 2400 who didn’t. Those who had early scans actually ended up having less-favourable outcomes than those that did, with the same injury. The study concluded that “there is no correlation of scan findings with pain, disability, or ability to work”, and therefore findings shouldn’t always guide or limit our approach to recovery.

This leads us on to another key take-away; it’s important to remember that everyone is different (no two knees are the same!) which is why you should have your own individual injury assessed by one of our experienced physiotherapists. There’s no “one-size-fits-all” approach to treatment, even if the injury appears similar. It’s important that you receive tailored advice and exercises that are relevant to your particular presentation, so that you can recover as quickly as you can – allowing you to get back to doing the things you love, sooner (like Josh)!

To get assessment, treatment and advice that’s tailored specifically to you, with one of our experienced physiotherapists, either book-online at or call us on 8186 1963 today.


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