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  1. #1
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    Brief Medical History Overview

    Wasting triceps & pectoral, loss of strength

    Hello, I'm new to this forum and really need some guidance with an injury I have. My sports are bodybuilding & swimming, I've been training for about 25 years. This is a new injury for me and I just don't know what to do?

    It all started back in November, I woke up after sleeping awkwardly on my side and found that it was very difficult to extend my left arm. I had a dull throbbing pain between my deltoid and neck. The pain was quite bad and the maximum dose of ibuprofen & paracetamol with anti-inflammatories was required to manage it. After a week the pain subsided but I have been left with weakness in my left side.

    My left triceps and left pectoral muscle are about 50% of the strength of the right hand side. My bench press has been reduced from a regular 160Kg to around 100Kg. Things have improved but only very slightly. My biggest concern is muscle atrophy. My left triceps and left pectoral muscle are visibly smaller, softer and wasting. I visited a chiropractor several times who suggested that I have a prolapsed disc in my neck.

    I’ve started using a Tens EMS , electro stimulator unit on the triceps and pectoral to combat the wastage , but I don’t think it’s made a lot of difference. A guy in my gym had a similar experience after suffering whiplash in a car crash and lost control of his pectoral , but he regained control in about 3 months. I’m not in any pain , my problem is muscle wastage and loss of strength.

    Please can anyone advise me on what I can do to improve this injury?

    Similar Threads:
    Last edited by physiobob; 06-03-2009 at 05:35 PM.

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    Wasting triceps & pectoral, loss of strength

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  3. #26
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    Re: Wasting triceps & pectoral, loss of strength

    Physical Agents In Rehabilitation
    It has been a while since my last post. It sounds that the diagnosis of a viral attack is pretty similar to my diagnosis supposedly stemming from the flu shot.
    Since then i have been making strong steps. I am by no means back to normal, but i am at least getting the strength much closer to the other side. I am hoping by the 1 year anniversary of the initial pain I can be at least 90% back to normal. My pec muscle is still smaller but getting there. The lat is the same way. The tricep is taking a little longer, but coming along.

    The only advice to people is to try and stay positive and keep working, it will come back.


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    Re: Wasting triceps & pectoral, loss of strength

    It's good to hear your making positive progress. I've been making slow steady progress too. I'm not as obsessed with the injury these days and continue to train normally. Bench is creeping up to the 140Kg mark, and I've stopped using the russian stmulator. My anaversary is December. I'll keep you posted.


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    Re: Wasting triceps & pectoral, loss of strength

    I've just come across this topic and wanted to provide details of my experience thus far.

    I have a similar problem to those listed but I think it's definitely cervical C7/8 in origin. Ive been getting neck ache for about 6 months and had a Wikipedia reference-linktorticollis ~6 weeks ago. The neck pain was intermittent and always accompanied by dural pain in the right scapula.

    About a week ago the pain came back and about four days ago I noticed fasciculations of my right triceps and pecs for long periods of the day. I went training later on and realised that my bench press had reduced by ~60% along with triceps strength.

    There was no associated trauma and no paraesthesia.

    There seems to be an improvement in my lower pec which was previously flaccid (there appears to be some flickers of activity) but my triceps strength has not improved.

    I've seen my GP who has referred me to a neurology consultant and am currently taking diclofenac and paracetamol.

    I am also paying regular visits to the traction couch


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    Re: Wasting triceps & pectoral, loss of strength

    Wow, I just read your post after realizing that my left tricep is severely weakened. Pretty scary. I was thinking pinched nerve. But I got a flu shot three weeks ago - one week before I first noticed tricep weakness!

    Time to see the neuro.


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    Re: Wasting triceps & pectoral, loss of strength

    Just a quick update.

    I have a Wikipedia reference-linkMRI scan in 1 week. Currently, I have increased strength in my triceps and over the past 3 days seem to be getting intermittent spasm in the pec, tricep and brachioradialis. My right arm fatigues very quickly too. I still have no paraesthesia. In terms of the pain, this appears to have largely dissipated with the exception of some intermittent pain in the scapula and triceps. Additionally, despite increased activity in the muscles affected, I am unable to maintain contraction.

    The Cx x-ray showed loss in disc height c5-c7 with OA changes and marginal osteophytes


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    Re: Wasting triceps & pectoral, loss of strength

    I think I have a similar injury. A few months ago I spent a day river rafting and then I woke up in my girlfriends tiny full size bed that night with severe left shoulder pain. The pain progressed to my left elbow and I also experienced peripheral neuropathy with tingling in my fingers. I would say it lasted about 3 weeks and then began to assuage. I have been taking it easy and the pain has gone away, but now I have terrible muscle atrophy in my left tricep. I try to exercise the muscle, but it is difficult to make my tricep contract, I have also noticed when doing tricep kickbacks I can not lock out my arm. My elbow remains bent, and I therefore do not engage the tricep, even with very light weight. Does anyone else have this problem? I also have noticed some problems with my left pec as well, but I am mostly worried about my left arm. I have access to a tens unit, does anyone have a suggestion on how to go about using the unit and at what setting and duration? Any help would be much appreciated, as this is not my area of expertise. Thanks in advance


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    Re: Wasting triceps & pectoral, loss of strength

    sorry to hear bout your situation buddy im insomething similar ive uploaded a video of me trying to walk

    what about blood cirulation to the muscles, i think thts the 2 main reasons for muscle attrophy nerves or blood flow

    is that another avenue worth looking at, it could help narrow it down


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    Re: Wasting triceps & pectoral, loss of strength

    Im in the same boat guys! Ive been lifting weights for 9 yrs and now this. So depressing watching my pec and left tricep dwindle into something child size. My dr found a buldging disc in my c7 area and that is causing the pinched nerve in my left shoulder blade area then radiates down my left arm. Just like most on here, the dr's can't explain my left pec going flat as it has "nothing" to do with my c7 disc. I don't believe that for a second. My pain is mostly gone, my muscles have stopped dropping in size, but the strength has not come back in the slightest bit. I dont think it will either until the problem is fixed. I've heard surgery is the only way to cure a buldging disc. Most of you have had this problem for over a year. what is the outcome for most of you?


  11. #34
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    Re: Wasting triceps & pectoral, loss of strength

    depends on the specifcs

    but i would recommend for the disc,sretching your spine and spine twists see ilates for this kinda stuff, drink lots of water aswell and of course he spine stretching will relieve pressue on the disc




    rearding the nerve this can usualy sort itself out wth te aobve

    regarding your muscle


    make sure you do yourCORE EXERCISES to support it where thits weakend and of course keep training
    ont give up o it you willget there evetually

    regarding surgery i woud avoid as there is no garantte it will work and and if you can riht it naturally its always best that way

    thanks


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    Re: Wasting triceps & pectoral, loss of strength

    Hi All,

    I have had muscle wastage of my left pectoral trapezius and weakness of trapezius and left shoulder for 10 years. Immediately upon noticing the change in physical appearance in 1999, I consulted a neurologist who diognosed a likely C5-C7 root or plexus lesion. Although, the Wikipedia reference-linkMRI and EMG results were normal.

    I continued to train normally (variety of sports) upon advice of the neurologist who said it would likely return to normal even if it took a few years. 10 years later, there have been no measurable improvement despite many visits to the physio and generally taking care.

    Having talked it through, the neurologist and I believe the susepcted nerve damage could have been triggered by a minor neck injury a few months before noticing the wastage, although I cannot recall any particular pain.


    I've largely ignored the watsage, but in the past couple of years I noticed detioriation and began regular gym sessions to build muscle - the pecs and trapezius barely seem to have responded.

    Any suggestions? Having read the forums I can't help thinking the doctors must have missed something. I was 24 when I noticed the wastage - now I'm 34 but still keeping fit, although to lower intensity to avoid further injury.


    Thanks


  13. #36
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    Re: Wasting triceps & pectoral, loss of strength

    firstly u have to pay attention about your diet.And regular exercises as well positive attitude is must.Do u feel numbness particularly at night?


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    Re: Wasting triceps & pectoral, loss of strength

    Occasionally I notice numbness, but not often. Can you elaborate on diet, or point me to a any useful links?


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    Re: Wasting triceps & pectoral, loss of strength

    It looks like I fit the profile for this kind of thing. What most of you have described is exactly my situation. I guess there were a few early signs that I should have caught. I have been working out for 13 years, although not as much into the bodybuilding as I used to be. I compete in professional kettlebell lifting (girevoy sport) and occasionally experienced neck pain after high volume. I am also a strength and conditioning coach and own my own gym so this injury is killing me! Along with the neck pain I would get a burning/cramping sensation at the inferior angle and medial border of right scapula. A couple weeks prior to the injury I was running and felt a weird feeling like a cramp at right pec near the arm pit. I thought nothing of it at the time but now it's constant. I was pretty much sedentary in the two days leading up to the injury. I'm sure I was dehydrated and sitting at the computer for long periods of time typing articles (probably with a forward head posture). I felt fine when I went to sleep about 3 weeks ago. I woke up to answer the phone and there I noticed it. It started as nagging and got worse throughout the day. That night I was having muscle spasms in pec minor, right tri, and lat. I tried to do a wall push up and did a face plant. After seeing chiro the spasms went away but still very uncomfortable to drive. After about a week the pain was gone but I was left with no strength in area of muscle spasms. Bench went from 310 to 75. Dumbbell skull crushers 55lbs for 10 on the left and 10lbs for 10 on the right. When trying to activate the affected areas I can contract triceps and lats but to a much lesser degree than left side. With the pec I can only activate lower portion of pec major, minor shows no signs of activation. As I sit and type my right side is fatiguing and feel as though there is a cramp coming on medial to right scapula. Has anyone tried acupuncture? I went for my first session yesterday and dr. seemed to have no doubt of recovery. Said he sees it a lot with athletes and construction workers. I could feel the acupuncture impulses activating areas of muscle that have been dead since injury so it was somewhat reassuring, but I have not made any improvements yet.


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    Re: Wasting triceps & pectoral, loss of strength

    Quote Originally Posted by aeclar1 View Post
    Im in the same boat guys! Ive been lifting weights for 9 yrs and now this. So depressing watching my pec and left tricep dwindle into something child size. My dr found a buldging disc in my c7 area and that is causing the pinched nerve in my left shoulder blade area then radiates down my left arm. Just like most on here, the dr's can't explain my left pec going flat as it has "nothing" to do with my c7 disc. I don't believe that for a second.
    Quote Originally Posted by engl22 View Post
    Hi All,

    I have had muscle wastage of my left pectoral trapezius and weakness of trapezius and left shoulder for 10 years. Immediately upon noticing the change in physical appearance in 1999, I consulted a neurologist who diognosed a likely C5-C7 root or plexus lesion. Although, the MRI and EMG results were normal.
    I both cases the longer you leave it the less likely the nerver will return to full normal function. The best way to test the nerve hypothesis is to so EMG studies which are easier enough to organise through your neurologist. I would want to be certain what is actually causing the impingement and where exactly. Wikipedia reference-linkMRI gives a lot of false positives.

    Pain is NOT a feature of nerve root pressure. Weakness and altered (often reduced) sensation is so pain need not be an indicator of the issue being in the cervical spine.

    For the record this is the innervation of the PEC major. This is an implication for the neck! Innervation: lateral and medial pectoral nerves; clavicular head (C5 and C6), sternoclavicular head (C7, C8, and T1).

    So with weak triceps: Innervation: radial nerve (C6, C7, and C8) you have comm issues with C6 and C7 there. Also a weak triceps will mean you will get some inhibition to contraction of the pec due to the brains perception of possible injury. Hence a secondary route to muscle wasting in that area.

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  17. #40
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    Re: Wasting triceps & pectoral, loss of strength

    I am very glad to have found this page.

    I have been training for around 9 years. Approx 5 years ago I injured my right shoulder doing lying overhead dumbell rows. Aching and griding in the shoulder joint for sometime afterwards. Eventually the pain stopped so I was able to start taining at full strength again but still alot of grinding/popping in the right shoulder. No pain.

    Within the last year or so, I started to lose the 'pump' in my right pec. I could feel it at first, (lack of blood flow to pec) but soon after, right pec atrophy became very noticable. Particular imbalance through tricep push/pull downs, and any chest exercise. Even lat pull downs, dips and chins it becomes very apparent!! Also experiencing loss of right pec control. What a nuicance! Nerve damage? Would that be serratus anteroir?

    Particular imbalance issues after waking up or lying for long peroids of time as well, suggesting blood flow issues to right pec perhaps?

    Any advice would be appreciated.


  18. #41
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    Red face Re: Wasting triceps & pectoral, loss of strength

    It was great to find this thread. I have the exact story many of you have told. Terrible pain in the right back/shoulder that went away in a week and then a rapid loss of strength in the right tricep, lat and pec. Bench press went from 300lbs. ten reps to 120lbs. 3 reps. Could no longer do any dips, but full strength in both arms with curls.

    Had PT for 5 weeks that helped alot. Wikipedia reference-linkMRI, EMG, Orth exam and neurologist. Slight bulge in C7. Had a ful shot two week before initial symptoms.

    Problem began in January and it is 6 months since then. Still have atrophy in right pec, long tricep and right lat, but strength is returning. No reaccurance of pain. I no longer do any behind the neck excersies and haven't done any bench press in the last 6 months (Too embarassing at the gym). I do dumbell work out instead.

    Been lifting for the last 34 years, so I wasn't going to stop now. Never a sick day in my life and no injuries. (Been very fortunate) In the gym 5 days a week. It is frustrating as the right side is still weaker, but I am seeing slow improvements. I use Creatine Monohydrate and that seems to help (I see a difference if I stop using it for more than three days).

    I really believe I will get my full strength back and the atrophy is diminishing, but I am realistic and believe this is probably a two year journey.

    My doctor agreed that its probably a combination of C7 and possibly Parsonage Turner Syndrome. He stated that he is seeing alot more of this type of problem over the last 18 months. If I had to bet...it was the flu shot. Next year I choose the flu instead of the shot.

    One good note...my Doctor put me on Predisone for two weeks at the beginning when the pain started. It turns out that studies show that if you introduce Predisone at the first signs of Parsonage Turner Syndrome it lessens the severity of strength loss and atrophy and time it takes to recover is reduced...I hope that is the case with me.

    Just thought I write in and give encouragement. It seems to happen to alot of people and if persistent it will get better.


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    Re: Wasting triceps & pectoral, loss of strength

    I am glad I found this forum. I have a similar problem and it is getting me soooo frustrated. I suffered an upper back injury while doing a rowing exercise...it felt like a short pinch / crunch on my left rhomboid. What followed was an intense pain that went from the injured area down to my left forearm. That was then followed by a tingling sensation across my left arm and down to my index finger. This lasted for about 3 months during which I never went to the doctor mostly because, aside from the pain, I didn't notice any loss of strength (and yes...being stubborn I never listed to my wife's advice to visit a doctor : ) Then I got a back massage and that is when the real problems started. The day after the massage my upper back (left side), left shoulder, and left forearm started aching and, although the pain lasted for no more than a couple of days, I started experiencing a substantial loss in strength (more or less 40% loss) in my left tricep and left pectoral muscle (upper part). Four months after the day of the injury I still feel rather weak (...still not listening to my wife...I refuse to go to the doctor...poor wife : ) Now all pain is mostly gone with the exception of a tingling sensation I still experience on my index finger every now and then. I am 36 and about 220 and still exercising regularly. I hope to recover soon from this, but I will definitively change the way I train from now on...less weight, more reps. As a general advise, what would you recommend to facilitate the healing of the neurological system? Someone before said vitamin B (B12, B complex, other?). Anything else? Also, do you have any experience with electro-stimulation therapy (EST)? I have been thinking about buying an EST device for a long time (Compex seems to be a good brand). Any other supplement you would recommend? Thanks in advance for your help. Good luck everyone!


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    Re: Wasting triceps & pectoral, loss of strength

    Quote Originally Posted by blinko View Post
    sorry to hear bout your situation buddy im insomething similar ive uploaded a video of me trying to walk

    what about blood cirulation to the muscles, i think thts the 2 main reasons for muscle attrophy nerves or blood flow

    is that another avenue worth looking at, it could help narrow it down

    Nerve is more likely, as with blood flow changes you would likely experience a non dermatomal/myotomal/peripheral nerve distribution of symtoms in addition to one extremity being cooler or cyanotic when compared to its counter part. The majority of the symptoms on the board appear to be involving neurological structures, particular when there is neck pain involved. Some of these cases are due to lower cervical radiculopathies.

    SPPAWA


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    Re: Wasting triceps & pectoral, loss of strength

    hey everyone.
    this tread is very interesting. ive been battling with loss off control and atrophy in my right pec for over a year now. i have the same symptoms that many off you have described, atrophy of and loss of control of rigt pec, but i also have lost shoulder stabilization and my right side, and have a winging scapula on my right side. i know that the serratus anterior muscle holds the scapula in place, this musche is innervated at c5-c7 as are many of the shoulder stabilizing muscles, and i think the pec is innervated from c6-c8. i thought there must be impingement sumwhere there, cervical Wikipedia reference-linkmri showed up nothing. i have seen neuros, orthos,chiros and no one seems to know what is going on. 1 neuro told me that i have brachial neuritis but couldnt be sure as i did not have any severe pain 1-2 weeks proior to the atrophy. i have been out off the gym for 1 yr now to see if it would help things, but things have gotten worse. does anyon else have these syptoms with a winging scapula?
    has anyone fully recovered?

    i have had cervical spine mris which show no im


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    Re: Wasting triceps & pectoral, loss of strength

    Hi all,

    So glad I found this site. Has anyone out there been cured of their atrophy & weakness?

    Here's my story: I have almost this exact problem on the left side--four months ago I went to a chiropractor & felt a twinge in my upper back & pec, but I didn't have any pain. I soon discovered I had zero strength in my left pectoral and left tricep & thought he had pulled some muscles during the adjustmenet (a neck twist--I had gone to him before with success in relieving neck/thoracic pain).

    Two months later I first noticed severe atrophy in the middle of my left pec & went to a doc who ordered a neck Wikipedia reference-linkMRI & nerve tests (EMG). Nerve tests showed moderate acute & chronic left C7 Wikipedia reference-linkradiculopathy and significant denervation of the left pec & pronator, milder denervation of the triceps. Multiple docs said nerve damage takes ~6 weeks to show up on EMG, so it's not surprising a first nerve study doesn't show anything. So in my case (and in many of yours) it seems nerve damage is quite clear, and it's at C7 and more. The neurosurgeon I just saw this morning told me what several have said--the pec wouldn't be affected by C7 impingement--but the nerve doc said everyone's wired a little differently. It's clear to me that there *is* damage at C7 for some of us--it shows up in MRI & EMG. It's only the textbooks that say the pec wouldn't be compromised; the real evidence says otherwise.

    I also have chronic Wikipedia reference-linkdegenerative disc disease (DDD) at C4-C5, C5-C6, and C6-C7 (MRI & x-ray). My other symptoms are hand tiredness/weakness (unable to write with a pen for more than a few words before hand cramps) that started around 11 years ago (after a wicked concussion) and a rapidly declining bench press since 5 years ago (possibly after a hard face-plant skiing)--from about 275 to 200 lbs. The bad chiro visit made my bench go from 200 to 65 overnight. I'm now back up to 115 for 10 reps...very weak.

    I've seen two surgeons in the past week: one recommended a 3-level ACDF, the other said no way because I'm too young & not in debilitating pain. Dr. #2 suggested a cervical laminectomy/foraminatomy, which is much less invasive and has far fewer long-term consequences. He said he's done thousands. The doctors (5) have all told me that pain & numbness means go with conservative treatment (PT, exercise, traction, ESI), but atrophy & weakness are clear indications of nerve damage that can only be surely addressed with surgery, and it must be done reasonably soon to prevent the nerve damage from becoming permanent (if it isn't already too late). This matches my research too.

    However, they all tell me I could just live with it too, if I can deal with permanent damage and the weakness that comes with it. The condition probably won't get any worse, at least in the short term.

    So I'm leaning toward surgery with the doc who's done thousands of foraminotomies. However, he tells me he's NEVER seen chest atrophy like mine. Hmm. It's comforting to know there are others that do have atrophy & cervical symptoms, so I think (and hope) he's wrong. I'll come back & post if it works or not (if I do it).


  23. #46
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    Re: Wasting triceps & pectoral, loss of strength

    Yeah! I got a name and an idea of my condition.

    My story is about the exact same.

    Got a flew shot in left arm.
    A week later I wake up with severe pain behind the left shoulder blade area. Numbness in left arm, mainly around elbow, numbness in fingers. mainly my pinky finger, and ring finger. I also loss coordination of pinky and ring finger. Could close fingers, but had a hard time opening. Could not type with them.

    Pain lasted about 3 weeks. Doctor put me on anti inflamatory and pain meds. thinking that an inflamed muscle was pinching a nerve in my back/shoulder.

    I have extreme loss of strength in tricep and pec. muscles. Muscles wasting away. Can barely do push ups, dips, tricep kick backs, etc.

    Went to Orthapedic Surgeon. Got an Wikipedia reference-linkMRI and X-Rays which were inconclusive. Surgeon thinks I have brachial plexus nerve damage. Sent me to get nerve study.

    Went to nerve study. Test shows there is nerve damage.

    Dr. says nerves heal at a rate of at best 1mm a day. Dr. thinks that I will recover in about 2 years based on the amount of damage that I have.

    He said to not drink alcohol, because nerves do not grow well when you drink alcohol.

    It has been 8 months since initial pain. I am recovering very slowly.

    I have been working out regularly and am up to about 20 push ups, and I can bench about 150 lbs.

    I use to bench about 275 and could do 60 push ups pretty easily.

    So in about another year or so I am hoping to be near 90%.


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    Re: Wasting triceps & pectoral, loss of strength

    Well it has been just about 2 years since my first answer to what was going on. I am pretty much back to full strength. Needless to say I have never had another flu shot! The only thing I can say is keep up hope. I continued to work out during the weak times and did not cause any damage. Before getting any surgery I would definitely explore the possibility of the flu shot being the cause of anyones issues. Let me know if I can help with anything.


  25. #48
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    Help !!!!!!! What do i ask the neurologist?

    Just found this thread. Thank Google.

    8th jan this year , intense pain back of neck - shoulder. Tingling/numb fingers. Initially a lot of skin surface muscle flicking on pectoral and back of shoulder.

    Immediately went physio and have done weekly and bi weekly ever since and doctor (Gabapentin) and will be seeing Neurologist on the 28th of this month.

    On rhs Weak triceps, totally Wikipedia reference-linkwinged scapula and just noticed for first time this morning, that pectoralis major not working. Also right forarm becoming sore. All scalenes tight. Seem to be going down hill. This is confirmed by my physio recording reflexes on triceps, biceps etc.

    My background is building work and a lot of rock climbing. Presently not driving, working, climbing and not walking a long way either.

    I need to get the most out of this consultant appointment and am not sure how to handle it. I'm just a bit overwhelmed.

    Any help appreciated. thanks in advance.


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    Re: Wasting triceps & pectoral, loss of strength

    Hi ccln55 - There are many reasons why you might lose "pump" in the pec...nerve is the primary one in this case...But what is causing the nerve to affected - is it pinched, irritated, damaged? Is it from the enck joints or caught on its way to your pec?

    As for lying down, it may not be bloodflow but actually compression/stretching of your neck etc which can cause the imbalances...

    Have you checked it out with a physio?

    Hi idcaton,

    1. I suspect it is the neck - ask the consultant about nerve damage from the neck
    2. Ask for Wikipedia reference-linkMRI to confirm the extent of any involvement of the neck and nerves
    3. You may need nerve conduction studies to assess the damage to the nerves (if any)
    4. Ask him what he thinks is wrong and ensure he lays out the options of what to do for each of the tests he will no doubt get you to do.

    CHeers

    Cheers

    Last edited by alophysio; 21-03-2011 at 11:26 AM. Reason: didn't look at 2nd page!
    [B]Antony Lo
    The Physio Detective
    APA Musculoskeletal Physiotherapist
    Teaching Fellow at the University of Western Australia[/B]
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    _____________
    If you would like me to comment on your thread, please send me a message me with a copy of the link to it.
    _____________
    [B]My Philosophy:[/B]
    The goal of physiotherapy is to restore optimum function - that is to move freely and maintain positions without causing damage either now or in the future. This requires the assessment and restoration of efficient load transfer throughout the whole body.
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    The entry above constitutes general advice only and does not take the place of a proper assessment, diagnosis and treatment. Opinions expressed are solely the opinions of Antony Lo.

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    Moving on from the neurologist.

    Aircast Airselect Short Boot
    Thanks for reply alophysio.

    Neurologist says "Brachial plexus neoropathy". An Wikipedia reference-linkMRI scan and nerve conduction tests by "the electrician" will confirm.

    He says keep going to physio, they will analyse what you can and can't do, help etc. "From the diagnosis they will know what to do".

    I'm concerned that i won't find a physio that knows what to do.

    The possibility of this condition has been discussed between myself and my physio(s), but the conversation has never gone "If this turns out to be the case, we will do ...", hence my concern.

    What should i be hearing from the right physio, what should i be doing with the right physio, what should i be asking, how will i know i've got myself a really great physio?

    Thanks in advance

    ian.



 
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