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Every runner considers injuries to be their nemesis. These can vary from minor niggles to fractures and can side line runners from their practice, performance and passion for days, weeks or sometimes even months leading to them requiring rehabilitation and graded return to running.  

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Poor rehabilitation adherence may lead to sub-optimal treatment outcomes, reduced clinic efficiency and increased cost of care. But despite this knowledge, research indicates that attendance at physiotherapy departments is within 54%-94% and can be as low as 40%. Several studies confirm that adherence to a clinic-based exercise protocol is often around the 50% mark and may be particularly poor for unsupervised home exercise programs.

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Within musculoskeletal physiotherapy, adherence to exercise programs is a challenge and generally adherence has been reported to be in the range of 50% and can be even lower for unsupervised home exercise programs. If you don't take your medicine, its likely not to have its desired effect. Similarly, if you do not adhere to the prescribed exercise program, it is likely that effect of exercise program will be sub-optimal. 

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Low back pain is a major health problem around the world which accounts for considerable socioeconomic and healthcare burden. The life time incidence of LBP has been reported between 60-80% (Twomey 2000; O’Sullivan 2005) and out of these incidents in about 80-90% cases pain subsides within first 2-3 months and rest of the patients (around 10-20%) develop chronic pain syndromes (Carey et al 2000). Chronic low back pain (CLBP) patients comprises 73-77% of all the patients with lower back pain disorders. In about 85% of these patients the exact cause and diagnosis is still elusive (Main and Watson 1999) and classified as non specific chronic lower back pain (NSCLBP) (Waddell 2004).

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Introduction: Shoulder pain along with subsequent restriction of movement is a common clinical presentation in both the sporting and general populations.Compromised shoulder movement due to pain, stiffness or weakness can cause substantial disability and affect a person’s ability to carry out daily activities and work.One year prevalence of shoulder pain has been reported between 5% and 47% . Conditions that can contribute to the clinical picture of a painful stiff shoulder (PSS) include calcific tendinitis (acute & chronic), non calcific tendinitis of the rotator cuff (acute & chronic), bicipital tenosynovitis, arthrosis of the glenohumeral or the acromioclavicular joint, tear of the rotator cuff, sprain of rotator cuff & synovitis .

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Rehabilitation adherence is an outcome of a complex interaction of physical, social, therapeutic and psychological elements. This second article, based on the findings of my doctoral research, highlights the role of social support and other social influences as a determinant of rehabilitation adherence.

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Introduction – Musculoskeletal physiotherapy is a specialist area of professional physiotherapy practice concerned with the assessment, diagnosis and management of the musculoskeletal pain and dysfunction. The main aims of musculoskeletal physiotherapy are to reduce pain, maintain/regain joint movement, and maximize function and health-related quality of life without adverse effects, enabling people to cope better with ill health.

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The Mulligan Concept is one of the commonly used manual therapy techniques in management of musculoskeletal conditions. Pioneered by Brian Mulligan in the 1970's, it is based on Kaltenborn's concept of restoring the accessory component of physiological joint movement. Its been over 12 years since I underwent training in Mulligan Concept. In this article, I first review the basic principles of the concept and then later look at some of the literature around the effectiveness of Mulligan Concept. 

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