Hi Brian,

Ok, i have reread this thread and i have a few questions (if you don't mind!)

1. How long are your physio sessions. I run at 15mins for a short standard consultation and i can get through all the spinal joints on both sides in that time. Is your physio only doing T10-T12??

2. Has anyone really tried to treat your L/S (lumbar spine)?? By that i mean mobilisations or manipulation - it will feel like rhythmic "bouncing" or "pushing" on your back just off centre? I don't think massage will be relevant here but let us know what all your therapists have done with their hands (manual therapy)

3. Checking alignment is one thing but has anyone done a "stork test" or "active straight leg raise test (ASLR)"?? Stork is standing on one leg and feeling from behind what happens in the pelvis/low back. ASLR is where you lift up one striaght leg when lying on your back - we look at what your pelvis/L/S and T/S does (rolling, lifting, tilting, etc)

4. Shin soreness could be an indicator that your lower limb biomechanics (a fancy way of saying how your body moves down there!) is not efficient.

5. You are a big lad - 95kg before but now 108kg. How tall are you? Is it muscle or fat?

6. Thoracic dysfunction is not just breathing. It can be seen in how you do activities, one arm might feel "heavier" to lift compared to another, etc. Twisting may be limited. The Thorax is a VERY poorly taught and understood area of the body. The pelvis is difficult enough for physios to comprehend but a typical thoracic "ring" or two ribs, two vertebrae to a sternum has 13 joints! Also, there are 12 ribs so it is like having 12 little pelves sitting on top of each other - i would not be suprised if you don't find someone who can treat this area well. Most people (like me) are taught just to poke and prod and "crack" the back...pretty unsophisticated stuff. Had to learn after uni what to do properly. One of my mentors is researching the thorax - pity for you she is Canadian (in Canada) - she does teach in the UK periodically!

7. You mention that activity in itself is not painful but rather it is afterwards that is the problem. Have you tried to vary the length of time during activity and whether the time has an effect on your symptoms?

8. Some simple questions from a standard history - can you please list all:
a. aggravating activities
b. easing activities
c. What happens when you wake up, during the day, how you feel before bed and what happens at night.
d. ALL the treatment you have had from various people looking at various bits of your body.
e. What you think is wrong with yourself - what does your gut tell you? From what you have read and listened to and felt, what seems to be the most effective way to treat this problem? I have found that while a lot of people get the theory wrong, they tell me enough information from their limited uderstanding to help me get them over the line.

9. Lastly, if you are able, can you post a short video of 2 or 3 mins (if you are able to) of you riding (your bike on rollers should be perfect) and the view from behind?? A big ask i know but we physios prefer to see and feel rather than use words!

Thanks. I hope i haven't been too imposing on you!