Nick Ilic Physio Clinician

28/08/2025

"Oh NO! What happened?!" asks all of my patients this morning.
(Never fear, I'm not rocking the old placebo-tape for nothing)

👉 Wear it Purple Day (https://www.wearitpurple.org/) is about showing support for LGBTQIA+ youth. It’s a visible stand for inclusion, safety, and acceptance — reminding young people they have every right to be proud of who they are. 💜

Started by students in 2010, the day has grown into a powerful movement where schools, workplaces, and communities wear purple to say: You are seen, you are supported, and you are not alone.

🔹 Wear purple.
🔹 Start conversations.
🔹 Spread the message of pride & acceptance.

Because visibility matters. Because allyship matters. Because every young person deserves to feel safe and celebrated. 🌈💜

Now, I'll get back to my isometric bicep exercise, I've committed to holding this purple dumbbell until close of business today 😆.

25/08/2025

🎾 The Spaghetti Western Grip 🎾

It’s US Open season — which means my feed is full of highlight reels, whacky technique, and unusual grips. I love it.

But whenever these extremes pop up on tour, I can’t help but think: what happens if the average club player tries this at home under Friday Night Lights?

The Spaghetti Western grip sits at the far end of the spectrum:
🔹 Going full western increases the risk of ulnar-sided wrist injuries (ECU tendon, TFCC) when chasing heavy topspin.
🔹 It also adds more rotational torque through the humerus — a risk factor for bony stress injuries, especially in mid-adolescents and young adults.

Not guaranteed injuries — but clear risks worth thinking about.

And even at the elite level, just because someone’s “pro” doesn’t mean they always do the basics well. High performance players also need to make grip changes gradually, under professional guidance, with close monitoring.

👉 So enjoy the highlight reels. But whether you’re a weekend warrior or chasing a ranking, the Spaghetti Western is one to approach with caution.

Full blog here:
https://open.substack.com/pub/nickilicphysio/p/tennis-tips-the-spaghetti-western

11/08/2025

🦵 Patellofemoral Dysplasia – When “Bad Knees” Run in the Family
🔗https://nickilicphysio.substack.com/p/patients-playbook-when-bad-knees

“My dad said everyone’s born with a few s**t bits — in our family, it’s the knees.”

If you’ve had kneecap pain since high school…
If stairs, squats, and sitting too long have always sucked…
If you’ve been told to fix your “maltracking” with:
📢 VMO exercises
😭 ITB foam rolling

Then this one’s for you.

🔹 We cover why your kneecap might never have sat quite right
🔹 Why it’s more of a suction issue than a "maltracking" one
🔹 How to build quads without making your knee angry
🔹 Why dynamometry > guesswork
🔹 And why some patients walk around like peg-leg pirates (yes, really)

This is one of my favourite joints to work with — but it needs the right strategy, the right testing, and a very long fuse. Especially before any talk of surgery.

Read the blog 👇
🔗 https://open.substack.com/pub/nickilicphysio/p/patients-playbook-when-bad-knees

Related Posts from the Patellofemoral Files:

🔹 Ice Skates on the Patellofemoral Dance Floor
https://nickilicphysio.substack.com/p/ice-skates-on-the-patellofemoral-dance-floor-084ac28fb176

🔹 Saving the Unhappy Kneecap Joint
https://nickilicphysio.substack.com/p/saving-the-unhappy-kneecap-joint-2df5f1083d20

🔹 Case Study: Managing Acute Patella Dislocation
https://nickilicphysio.substack.com/p/clinicians-corner-case-study-management

08/08/2025

Had the chance to flex my old Tennis Coach quals over the last couple of days with some players this week.

It's been 10years since I joined the casual coaching roster at

After a long 🌧️y winter it was as brilliant to get out in the ☀️ for a day and get through the small waiting list of intermediate club players (and past patients) to help them develop more consistent and powerful technique.

Much respect to the real 🎾 coaches who are out there in all conditions every day. Canberra Winter 2025 was one of the worst! ❄️

05/08/2025

🦶 “It’s just an ankle sprain…”

Until week 3 rolls around and they’re still limping, swollen, and wondering why it’s not better yet.

📣 New blog for clinicians:
Clinician’s Corner | Managing the Fresh Ankle
https://nickilicphysio.substack.com/p/clinicians-corner-managing-the-fresh

Inside:
🔹 When to boot — and why it matters
🔹 When (and why) to MRI
🔹 Early-stage rehab (before swelling is even gone)
🔹 Mid-to-late stage progressions that go beyond wobble boards
🔹 Return-to-play markers & bracing tips
🔹 Bonus: crossover effect reference + patient education link

🧠 This is the ankle sprain you don’t want to under-manage.

📎 For your patients: https://nickilicphysio.substack.com/p/whats-the-right-call-when-your-ankle-is-big-fat-sore-1ab68167423d
👉 What to do when your ankle is big, fat & sore

05/08/2025

📍 New Blog: Shared Decision Making in Modern Musculoskeletal Healthcare
https://open.substack.com/pub/nickilicphysio/p/clinicians-compass-shared-decision

Surgery or Rehab First?
We’re in a new era of decision-making — and it’s about time.

Over the past 5 years, successful non-surgical management has risen for:

✅ Rotator cuff tears
✅ Meniscus injuries
✅ Hip labral tears
✅ Achilles ruptures
✅ And some ACL injuries too

But this isn’t anti-surgery.
It’s about evidence, outcomes, and informed choices.

🔸 Achilles:
Re-rupture = 2% surgical vs 5% non-surgical.
3% difference — but no scar, no anaesthetic, fewer complications.

🔸 Rotator Cuff:
Tear size ≠ outcome.
Beliefs, goals & good rehab matter most.

🔸 ACL:
With right rehab protocols (e.g. BLEX), healing rates can hit 80%.
And even when surgery is needed, rehab shows you why and when.

👨‍⚕️ Good rehab isn’t guesswork:
🔹 Use dynamometry
🔹 Follow criteria, not just timelines
🔹 Know when to hold, escalate, or refer

You can always operate later.
You can’t un-operate.

📖 Read the blog:
https://open.substack.com/pub/nickilicphysio/p/clinicians-compass-shared-decision

03/08/2025

🎯 Patient Playbook | Not All Tendons Are Created Equal
📖 Read it here: https://nickilicphysio.substack.com/p/patient-playbook-tendinopathy-not
(🔗 Link in bio on Instagram)

"I’ve tried massage, injections, rest… why is my tendon still sore?"

You’re not broken.
You just haven’t been given the right plan—yet.

Here’s what most people don’t realise:

⚡ Not all tendons are the same
🔩 Some get sore from load, some from awkward positions
🌀 Some are affected by things like menopause, diabetes, stress or poor sleep
🚫 Most people I see have already tried:
— Shockwave
— PRP
— Cortisone
— Rest
— “Stretch it out” advice
… and still aren’t better.

If that’s you—this one’s written for you.

Let’s help you understand:
✔ What kind of tendon you have
✔ Why it’s still sore
✔ What your rehab plan should look like

No gimmicks. No fluff.
Just honest answers.

30/07/2025

🎾 Tennis Physios & Coaches — this one’s for you!

There’s a brand new Learn.Physio Practical on tennis injuries now live, covering:

✅ Common swing errors & how they link to injuries
✅ Technique tweaks that protect joints and boost performance
✅ How to assess tennis-specific injuries clinically
✅ Smart return-to-play strategies for players of all levels

🎓 Check it out here (less than a ☕/month):
👉 https://www.learn.physio/p/learn-physio-practicals

—

🧠 I cover all this and more, drawing on years as a former:
🎾 Tennis Australia–contracted tournament physio
🎾 Tennis Australia–qualified coach
🎾 iTPA Certified Tennis Performance Specialist

A while ago I was TheTennisPhysio(dot com) — doing butt-rubbin’ gigs and play/no-play decisions on the pro and international juniors circuit.

These days, I focus on specialist serve and stroke analysis, helping injured players and coaches solve pain + performance puzzles.

And yep, I still play — a lot.

I also run Canberra Heavy Hitters, a league for advanced club players and performance juniors — focused on development, not just social hits.

I live, breathe, and talk tennis all day, every day. 🎾

—

📝 Want more? Here’s a growing list of tennis-specific injury blogs & clinical deep dives:

📚 ECU Tendon Injuries: https://nickilicphysio.substack.com/p/ecu-tendon-injuries-in-tennis-49573d88dbb
📚 Spondylolysis in Teens: https://nickilicphysio.substack.com/p/the-sporting-lumbar-spondylolysis-75ed41ed27e
📚 Padel Tennis Risks: https://nickilicphysio.substack.com/p/padel-tennis-gameplay-and-injuries-a194c3318f79
📚 High-Load Case Study: https://nickilicphysio.substack.com/p/the-brief-autobiography-of-a-high-loader-an-n-1-accidental-experiment-in-load-management-fa06605d86e5
📚 Tennis Elbow vs Real Tennis Injuries: https://nickilicphysio.substack.com/p/management-of-tennis-elbow-vs-actual-tennis-elbow-de508bfbd803
📚 Server’s Shoulder: https://nickilicphysio.substack.com/p/clinicians-corner-servers-shoulder
📚 Court Surface Mechanics: https://nickilicphysio.substack.com/p/tennis-tips-the-court-surface-beneath

—

💬 Got a tennis injury or performance topic you want covered? Let me know.

🙌 Huge thanks to Mick Hughes & the Learn.PhysioLearn.Physio crew — this was the most fun I’ve had on a workday.

And great work Owen Peemoeller from On The Line Tennis at Melba Tennis Club for his contribution.

Practicals offer an immersive hands-on experience through classes presented in a point-of-view format, providing an authentic feel as if you're in the room with the presenter.

29/07/2025

🧠 Clinician’s Corner | Tendinopathy Isn’t a Template
📖 Read it here: https://nickilicphysio.substack.com/p/clinicians-corner-tendinopathy-isnt
(🔗 Link in bio on Instagram)

"All tendons respond to loading, right?"
Not quite.

We’ve been treating them all the same for too long.

⚡ Some are Springs (Achilles, Patellar)
⚓ Some are Anchors (Gluteal insertion, Prox Hamstring)
🎯 Some are Placers (Wrist extensors, Rotator cuff)
🔀 Some are Hybrids (Glute med, Adductors)

Each one:
✔ behaves differently
✔ flares differently
✔ recovers differently

🧩 Tendon pain isn’t just about load.
🧠 It’s also about compression, position, adjacent muscles, and metabolic context (think menopause, diabetes, systemic inflammation).

🚩 If your go-to is still “just load it”—or if you’ve had a patient flare with a Theraband—this one’s for you.

27/07/2025

🎓 New Research Review:
Pain in the Bum – Gluteal Tendinopathy & Lateral Hip Pain
🔗 https://nickilicphysio.substack.com/p/research-review-pain-in-the-bum-gluteal

Angie Fearon’s recent topical review on Gluteal Tendinopathy (Journal of Physiotherapy, 2024) is a timely update on one of the most misdiagnosed and mismanaged causes of lateral hip pain.

In this blog, I discuss her review and expand on key points from a clinical lens:
🔸 Bursitis vs GT—who actually gets each
🔸 Differentiating GT from SIJ and lumbar spine
🔸 +LR/-LR of common tests
🔸 Why education and load management still trump gadgets and injections

📄 Her paper: https://www.sciencedirect.com/science/article/pii/S1836955325000177

If you treat lateral hip pain, it’s worth a read (or two).
Let me know how it fits with your own practice.

26/06/2025

New Clinician’s Corner Case Study:

🦴 A CT Lumbar Spine Walks In, an X-ray Hip Walks Out
🧭 Sometimes we diagnose the continent, not the country.

She came in with leg pain. A back CT already done.
But the pain wasn’t posterior.
There was no true “back pain.”
And she was limping.

Within five minutes of assessment, it was clear — this wasn’t a lumbar issue.
This was classic hip joint referred pain.

This blog breaks down:
✅ The step-by-step assessment (from the waiting room to dynamometry)
✅ Why we need to stop equating “leg pain” with “sciatica”
✅ When hips pretend to be the spine
✅ How to pivot away from unnecessary imaging and toward the right path

The patient gave full consent to share her story and x-ray — because she wants it to help others avoid the same delays.

📖 Read the full case:
🔗 https://nickilicphysio.substack.com/p/clinicians-corner-case-study-a-ct
📬 And subscribe to the full Substack archive:
https://nickilicphysio.substack.com

23/06/2025

🧠💬 Ever wondered how a physio uses AI in real life?

I finally wrote the full breakdown:
👨‍⚕️ How I use ChatGPT (but not like a robot)
📱 Why Lyrebird helps when I need to really listen
🎙️ When Rev saves me from writing 5 follow-up emails
🤖 And why AI will never replace a good clinician

Oh—and there’s a cartoon woodland creature doing admin in the woods. Naturally.

📖 No paywall. Just real tools, honest thoughts, and a bit of fun:
👉 https://nickilicphysio.substack.com/p/clinicians-compass-how-i-use-ai-in

📬 Want more of this?
Subscribe here: https://nickilicphysio.substack.com/subscribe