Kelsey Matichuk, RMT

Kelsey Matichuk, RMT Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from Kelsey Matichuk, RMT, Medical and health, 107-1505 Admirals Road, Victoria, BC.

02/18/2026

A cross-sectional study of 602 Finnish adults found that abnormalities on magnetic resonance imaging ( ) were nearly universal after age 40, with 99% of participants displaying some abnormality.

The prevalence and severity of these abnormalities increased with age, but did not differ between sexes. Importantly, rotator cuff abnormalities were present in both asymptomatic (96%) and symptomatic (98%) shoulders, and only full-thickness tears were weakly associated with symptoms, suggesting most imaging findings reflect normal age-related changes.

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02/18/2026

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This is an AP lumbar spine X-ray of a 52-year-old male.

The vertical bony projections running up the sides of the vertebral bodies are syndesmophytes. These form when chronic inflammation at the entheses โ€” where ligaments and annulus fibres attach to bone โ€” triggers new bone formation. Over time, these thin bony bridges connect one vertebra to the next.

Notice how they are marginal and vertical. Thatโ€™s a key radiographic feature. This is not typical degenerative osteophyte formation. Degenerative change tends to produce bulkier, more horizontal spurs. Syndesmophytes are finer, more organised, and follow the contour of the vertebral edges.

Also visible is bilateral fusion of the sacroiliac joints. That tells you this is longstanding inflammatory disease. In ankylosing spondylitis, sacroiliitis often precedes spinal changes, and with progression the joints can fully fuse.

As bridging progresses, spinal mobility reduces and the spine becomes mechanically rigid. That rigidity increases fracture risk, even with relatively low-energy trauma.

Important point: once syndesmophytes form, they do not reverse. Management is directed at controlling the inflammatory process early, slowing progression, and maintaining function. NSAIDs and biologic therapies such as TNF-ฮฑ or IL-17 inhibitors have changed the trajectory for many patients.

02/14/2026

๐—ง๐—ต๐—ถ๐—ด๐—ต ๐— ๐˜‚๐˜€๐—ฐ๐—น๐—ฒ ๐—–๐—ต๐—ฎ๐—ป๐—ด๐—ฒ๐˜€ ๐—ถ๐—ป ๐˜๐—ต๐—ฒ ๐—”๐—–๐—Ÿ-๐——๐—ฒ๐—ณ๐—ถ๐—ฐ๐—ถ๐—ฒ๐—ป๐˜ ๐—ž๐—ป๐—ฒ๐—ฒ: ๐—” 4-๐—ฌ๐—ฒ๐—ฎ๐—ฟ ๐—Ÿ๐—ผ๐—ป๐—ด๐—ถ๐˜๐˜‚๐—ฑ๐—ถ๐—ป๐—ฎ๐—น ๐— ๐—ฅ๐—œ ๐—ฆ๐˜๐˜‚๐—ฑ๐˜† ๐—ผ๐—ณ 1,207 ๐—ฃ๐—ฎ๐˜๐—ถ๐—ฒ๐—ป๐˜๐˜€

๐Ÿฆต The anterior cruciate ligament (ACL) serves as a fundamental mechanical and sensory stabilizer of the knee. ACL tears are among the most prevalent ligamentous injuries, with an annual U.S. incidence of 68.6 per 100,000 (https://pubmed.ncbi.nlm.nih.gov/26920430/). While much of clinical orthopaedics has traditionally focused on acute quadriceps weakness following injury, emerging evidence suggests that the long-term neuromuscular landscape is far more complex. Systematic reviews, such as those by Birchmeier et al. (2020, https://pubmed.ncbi.nlm.nih.gov/31608490/) and Schwartz et al. (2025, https://pubmed.ncbi.nlm.nih.gov/39800896/), have highlighted persistent strength deficits and muscle size alterations that remain even years after the initial trauma. This suggests that an ACL tear is not merely a structural failure but a catalyst for chronic, systemic adaptations in the lower limb.

๐Ÿ“˜ A brand-new longitudinal matched-cohort study by Alzobi and colleagues (https://pubmed.ncbi.nlm.nih.gov/41370366/), utilizing data from the Osteoarthritis Initiative (OAI), tracked 1,207 participants over a four-year period to observe how an unreconstructed ACL tear influences thigh muscle morphology and function. The researchers employed a deep-learning U-Net model to segment MRI data, allowing for precise quantification of muscle cross-sectional area (CSA) and intramuscular adipose tissue (IMAT).

๐Ÿ”‘ ๐—ž๐—ฒ๐˜† ๐—™๐—ถ๐—ป๐—ฑ๐—ถ๐—ป๐—ด๐˜€

Contrary to the common clinical emphasis on the quadriceps, this study revealed that the most significant long-term deterioration occurs in the posterior thigh:

1๏ธโƒฃ ๐—ฆ๐—ฒ๐—น๐—ฒ๐—ฐ๐˜๐—ถ๐˜ƒ๐—ฒ ๐—”๐˜๐—ฟ๐—ผ๐—ฝ๐—ต๐˜†: ACL-deficient thighs experienced progressive atrophy in the hamstrings (-28.18 mm/year) and the sartorius (-3.02 mm/year).

2๏ธโƒฃ ๐—ค๐˜‚๐—ฎ๐—ฑ๐—ฟ๐—ถ๐—ฐ๐—ฒ๐—ฝ๐˜€ ๐—–๐—ฆ๐—” ๐—ฆ๐˜๐—ฎ๐—ฏ๐—ถ๐—น๐—ถ๐˜๐˜†: Surprisingly, no significant longitudinal changes were observed in quadriceps or adductor CSA over the four-year window.

3๏ธโƒฃ ๐—™๐˜‚๐—ป๐—ฐ๐˜๐—ถ๐—ผ๐—ป๐—ฎ๐—น ๐——๐—ฒ๐—ฐ๐—น๐—ถ๐—ป๐—ฒ: Corresponding with the physical atrophy, hamstring strength decreased significantly (-3.49 N/year), while quadriceps force remained relatively stable.

4๏ธโƒฃ ๐— ๐˜‚๐˜€๐—ฐ๐—น๐—ฒ ๐—ค๐˜‚๐—ฎ๐—น๐—ถ๐˜๐˜†: There were no significant differences in fat infiltration (IMAT) or contractile percentage between ACL-deficient and ACL-intact groups, suggesting the primary issue is muscle volume rather than "marbling" of the tissue.

๐Ÿ’ก ๐—–๐—น๐—ถ๐—ป๐—ถ๐—ฐ๐—ฎ๐—น ๐—œ๐—บ๐—ฝ๐—น๐—ถ๐—ฐ๐—ฎ๐˜๐—ถ๐—ผ๐—ป๐˜€

The results suggest that the loss of the ACL-hamstring reflex arcโ€”a feedback loop where ACL mechanoreceptors trigger hamstring activation (https://pubmed.ncbi.nlm.nih.gov/3618871/, https://pubmed.ncbi.nlm.nih.gov/11206261/)โ€”may lead to chronic disuse and subsequent wasting of the posterior muscles. This "quadriceps dominance" can further destabilize the knee by increasing anterior tibial shear. These findings challenge the traditional "quad-centric" view of ACL recovery. To protect the long-term health of the knee, rehabilitation must evolve to include rigorous, targeted strategies for hamstring preservation.

02/12/2026
02/09/2026
02/05/2026

Iโ€™ve been asked multiple times this week around my thoughts on Lindsey Vonnโ€™s decision to pursue another Olympic campaign while living with an ACL-deficient knee that occurred on 30 Jan.

Understandably to many outside the elite sport set up, often due to myths and misconceptions around injury, it seems to have sparked strong opinions, but much of the public conversation misses the reality of how elite sport, elite rehabilitation, and elite decision-making actually work.

Having worked with high performance athletes making these very decisions, I wanted to share some of the likely decisions, conversations and risk management strategies that have led to this decision.

Obviously I donโ€™t have specific insider knowledge on this particular case, but itโ€™s an education opinion based on my professional experience.

The key message is that this is not a case of an athlete recklessly ignoring a fresh injury or charging downhill on a swollen, unstable knee.

Vonn has lived with complex knee pathology for years, has undergone extensive rehabilitation and multiple surgical procedures across her career, and has repeatedly demonstrated that she can train and compete with a knee post significant injury.

In sports medicine terms, she falls into what is often described as a โ€œcoperโ€ category: an athlete who, through exceptional strength, neuromuscular control, movement strategy, and task-specific adaptation, can function at a very high level, potentially despite the absence of a ligament that is traditionally viewed as essential.

Importantly, her situation exists within a tightly controlled ecosystem that most recreational athletes and general public never experience โ€” daily access to rehab and treatment, sports physios and physicians, frequent imaging and performance testing, individualised strength and conditioning, constant load monitoring, and ongoing reassessment of risk within a tight knot, first class multidisciplinary team well versed in managing these risk / reward scenarios, specifically when such a big prize is within a defined and explicit time period.

That framework turns unknown danger into managed risk.

It also matters that downhill skiing, while undeniably hazardous, is largely predictable and sagittal-plane dominant, with stiff boots and the option of bracing that can offer additional mechanical support, making it more compatible with an ACL-deficient knee than many cutting and pivoting field sports such as rugby, basketball and football, which is where Iโ€™m sure most of the comments of negativity and doubt will be coming from, as these sports have a lower threshold for managing the potential ACL deficient risk.

None of this suggests the choice is risk-free; Vonn will be acutely aware of the possibility of further exacerbation or injury and any potential affect on her long-term knee health.

But elite sport has always involved conscious acceptance of risk. The crucial point is autonomy: Vonn is not being coerced, misled, or left uninformed. She is an exceptionally experienced athlete, supported by a multidisciplinary medical team, choosing to pursue a time-limited, deeply meaningful goal with full understanding of the potential consequences.

That reality can coexist with the message that this is not a model for recreational athletes and not a blanket endorsement of competing with an ACL rupture. It is, instead, a highly individualised exception โ€” a reflection of extraordinary preparation, supervision, and personal choice, rather than recklessness.

We donโ€™t know if and how she will perform at this stage, we simply know the risk of trying in order to achieve such a potential reward has been carefully considered and deemed acceptable at this stage, whilst a carefully managed and controlled review and monitoring plan is in place.

This does not mean โ€œYou should play (insert sport) with a torn ACLโ€, or that โ€œSurgery is unnecessaryโ€, or that โ€œRehab alone is always enoughโ€

It means elite cases are individualised exceptions, not templates. Most recreational and sub-elite athletes do not have the same neuromuscular capacity, do not have the same support systems and perhaps most importantly, do not face Olympic-level decision calculus.

This story is not about glorifying injury.

It is about:
Long-term adaptation
Exceptional physical preparation
Medical oversight
Informed risk-taking
Athlete autonomy

Most of the perceived controversy comes from the shock and awe media reporting and sensationalism.

Perhaps a more accurate headline would be:

โ€œAthlete with chronic ACL-deficient knee, extensive rehab history, and full medical support chooses to pursue one final Olympic cycle after comprehensive risk assessment.โ€

That doesnโ€™t sound as sensational โ€” but it is far closer to reality.

02/04/2026
02/03/2026
02/02/2026

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107-1505 Admirals Road
Victoria, BC
V9A2P8

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