Nick Ilic Physio Clinician

Nick Ilic Physio Clinician Patient-centred injury management with a focus on utilising the latest evidence-based guidelines.

Working closely as a team with patients and their other healthcare providers to get the best outcomes possible with a no-nonsense and honest approach.

Finally, after many month, it's here:✈️ Take-off to Touchdown | Chapter II | Management of The Older Shoulder 🔗 Read her...
04/11/2025

Finally, after many month, it's here:
✈️ Take-off to Touchdown | Chapter II | Management of The Older Shoulder
🔗 Read here: https://nickilicphysio.substack.com/p/take-off-to-touchdown-chapter-ii

🦁 Cuffs and 🐯 Bursas and 🐻 Tears, Oh My!!

This chapter in the Take-off to Touchdown series covers what to do when management of the older shoulder (40+) isn’t going to plan — when progress stalls, imaging gets confusing, or the patient’s “rotator cuff” pain turns out to be something else entirely.

It’s easy to take off, cruise, and land — but are you still in control when there’s turbulence? What about when you need to make an emergency landing?

Inside, we go through:
🧭 The Clinician’s Checklist for the older shoulder
🦒 Why you should always, always rule out the neck
💥 GOOSe vs FLASH — the slow waddle vs the sudden crash
🩻 Which imaging matters (and when)
🎯 Subscapularis – the true anterior anchor
🧲 Long Head of Biceps – the canary in the coal mine
💤 Bursitis – and why it’s far less often the real villain
…and did I mention ruling out* the neck?
(*how much is it contributing to the symptoms)

This series is a structured guide for clinicians — how to triage, manage turbulence, and keep your patients safely in the air when things don’t go by the book.

✈️ Catch up on the series:
🗺️ Prologue | Flight Plans for Musculoskeletal Clinicians
👉 https://nickilicphysio.substack.com/p/take-off-to-touchdown-prologue-flight

🛫 Chapter I | Neck and Low Back Pain
👉 https://nickilicphysio.substack.com/p/take-off-to-touchdown-a-pilots-checklist-for-the-clinician-on-the-management-of-neck-and-low-back-c3243b493be4

📖 Want to read this one for free? Subscribe now and get a free preview: https://nickilicphysio.substack.com/

🧒🎾 “He’s only 13 – I didn’t think it could be anything serious… just tightness that needs stretching.”🧠 New Parent’s Pla...
21/10/2025

🧒🎾 “He’s only 13 – I didn’t think it could be anything serious… just tightness that needs stretching.”

🧠 New Parent’s Playbook blog:
Kids Should Not Get Persistent Back Pain
📍 https://nickilicphysio.substack.com/p/kids-should-not-get-persistent-back

Yes, most back pain in kids settles quickly.
But when it lingers past 2 weeks… or keeps flaring despite “just a week off” between matches or comps?
🚩 That’s not tightness. That’s a red flag.

In this blog I cover:
🔹 Why adolescent bone stress injuries are on the rise
🔹 How screen time & posture are often wrongly blamed
🔹 Who to see first: GP or MSK Physio
🔹 Why not all providers are trained for growing bodies
🔹 MRI referral tips for clinicians (specific sequences that matter)

✅ Free preview = key advice for parents & coaches
🔓 Paid tier = practical pathways, clinical pearls, and what to do next
🧠 Start your 7-day free trial and unlock it all

New free Blog: 👉 Patient Playbook | BPC-157: The Miracle Molecule That Isn’thttps://open.substack.com/pub/nickilicphysi...
13/10/2025

New free Blog:
👉 Patient Playbook | BPC-157: The Miracle Molecule That Isn’t
https://open.substack.com/pub/nickilicphysio/p/patient-playbook-bpc-157-the-miracle
.now pepped up with a 🚀 Roger Ramjet Proton Pill reference (just to show my age).

🥕 🥛 💊 Nutrition is important for tissue repair. Physios sometimes have to delve into diet, nutrition, and supplements when answering questions from patients - especially for those with persistent pain looking for answers in a pill bottle, sometimes endorsed by influencers.

Lately, one name keeps popping up in consults and gym conversations: BPC-157 — “Body Protection Compound 157”.

It's been around for a while but I've had a few ask about it in the past 2 weeks.

But here’s the catch with BPC-157:
❌ No quality human studies
🐀 Most research is on rats and mice
🚫 Banned by the FDA and WADA
⚠️ Not approved for medical use anywhere reputable
Yet people are paying 💸 for it.

Australian athletes need to be VERY careful — it’s banned in competition and out of competition across many sports, according to a quick search on GlobalDRO (www.globalDRO.com).

In my latest Patient Playbook blog, I cover
🔹 Why the hype around BPC-157
🔹 What peptides actually are — and how they differ from proteins
🔹 The real role of dietary protein in soft tissue repair
🔹 And why your liver is quietly panicking when you buy mystery powders online
💬 If it sounds too good to be true — it probably is.

Read the full post here: https://open.substack.com/pub/nickilicphysio/p/patient-playbook-bpc-157-the-miracle

Eat well. Train smart.
And trust the most powerful peptide system on Earth — your own body.

For more on diet and supplements in sports and exercise, check out the Sports Dietitians Australia website, it's a fantastic resource https://lnkd.in/gTNXwHNT

“I’ve Got The Bursa!” … Now What?👉 https://open.substack.com/pub/nickilicphysio/p/patient-playbook-ive-got-the-bursaYou’...
07/10/2025

“I’ve Got The Bursa!” … Now What?
👉 https://open.substack.com/pub/nickilicphysio/p/patient-playbook-ive-got-the-bursa

You’ve had your ultrasound.
It says: “Subacromial-subdeltoid bursitis with impingement on abduction.”
The GP says: “You’ve got bursitis.”

But here’s the twist 👇

✅ Everyone has bursae — around 8–12 in each shoulder.
✅ “Thickened” or “impinging” on scan doesn’t mean it’s painful.
✅ The bursa’s job is to glide and cushion under the bone.

So how do you really know if bursitis is the culprit?
By the story — not just the scan.

In this week’s Patient Playbook, I cover:
💡 What a bursa actually is
💡 Why ultrasounds can be misleading
💡 Simple ways to settle it down
💡 When to escalate to imaging or injection

📖 Read the full post on Substack:
🔗 nickilicphysio.substack.com

New subscribers get free access to their first paywalled article, then it’s just $5/month or $50/year — cheap as pub chips! 🍟

🎯 New Blog:Clinician’s Corner | Is Their Ouchy Shoulder Really “Bursitis”?👉 https://open.substack.com/pub/nickilicphysio...
05/10/2025

🎯 New Blog:
Clinician’s Corner | Is Their Ouchy Shoulder Really “Bursitis”?
👉 https://open.substack.com/pub/nickilicphysio/p/clinicians-corner-shoulder-bursitis

🎬 A not-so-uncommon scene...

A 50-year-old walks in clutching an ultrasound report:

“Subacromial-subdeltoid bursitis with impingement on abduction.”

They’ve already had a guided corticosteroid injection ($285 billed, $120 off thanks to Medicare 💸)…
But it didn’t help.

Now they’re booked for another one.
After a proper physical exam — surprise! The shoulder isn’t the problem. The neck is.

🎬 End scene.

💡 In this week’s Clinician’s Corner, I unpack why bursitis is one of the most over-diagnosed shoulder conditions in Australian practice:

🔹 What the bursa actually does (hint: it’s meant to “impinge”)
🔹 Why “thickened” doesn’t always mean “painful”
🔹 When imaging helps — and when it hijacks your reasoning
🔹 The 5-step process I use for suspected bursitis
🔹 How Medicare rebates might be fuelling the cycle

🧩 Missed last week’s blog?
👉 The Importance of the Rotator Cable
https://nickilicphysio.substack.com/p/clinicians-corner-the-importance

✈️ Coming soon: Take-Off to Touchdown | The Older Shoulder
Your full roadmap for assessment, imaging & rehab in the 40+ shoulder.

📬 Subscribe at nickilicphysio.substack.com

✅ First paywalled article = free
💰 Ongoing access from $5/month or $50/year — cheap as pub chips! 🍟

🎯 This week’s blog is live👉 Clinician’s Corner | The Importance of the Rotator Cuff Cable🔗 https://open.substack.com/pub...
22/09/2025

🎯 This week’s blog is live
👉 Clinician’s Corner | The Importance of the Rotator Cuff Cable
🔗 https://open.substack.com/pub/nickilicphysio/p/clinicians-corner-the-importance

Why should you care about the rotator cable?
Because if you’re managing older shoulders and wondering why some don’t get better with rehab, you might be missing the key structure that decides whether a shoulder soldiers on… or collapses into pseudoparalysis.

Inside this post:
🔎 Why a patient with a massive tear can still play golf
🔎 Why a patient with a tiny tear can’t even lift a plate
🔎 Why not all “rotator cuff tears” are created equal

Behind the paywall:
🪿 GOOSe vs 🧨 FLASH shoulders — the patterns that give the game away
📈 How to frame 3–6 month rehab trials honestly
🩻 When to push, when to hold, when to escalate to surgery
💪 The anatomy you really need to know if you don’t want to be fooled by MRI reports

Yes… I’ve been quiet on the cuff. But 2025 is the Year of the Cuff, and big content is on the way.

💡 Want weekly clinical gold in your inbox for less than $1/week?
👉 Subscribe here: https://nickilicphysio.substack.com/

"Oh NO! What happened?!" asks all of my patients this morning. (Never fear, I'm not rocking the old placebo-tape for not...
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 😆.

🎾 The Spaghetti Western Grip 🎾It’s US Open season — which means my feed is full of highlight reels, whacky technique, an...
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

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

Had the chance to flex my old Tennis Coach quals over the last couple of days with some players this week. It's been 10...
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! ❄️

🦶 “It’s just an ankle sprain…”Until week 3 rolls around and they’re still limping, swollen, and wondering why it’s not b...
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

📍 New Blog: Shared Decision Making in Modern Musculoskeletal Healthcarehttps://open.substack.com/pub/nickilicphysio/p/cl...
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

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