Daniel Morgan Chiropractor

13/01/2025

This is a bit of a mental moment for me. However, some of you may have been aware of a recent study by well respected authors demonstrating that shock wave therapy is no more beneficial than placebo.

So as a result, Christoph Schmitz, Javier Crupnik, Myself, Edwards Silk, Nicola Maffulli and Antoni Morral decided to review and respond to the paper. That response is visible below and is available in pre-print version online now.

In summary, the opinion from the authors that shock wave therapy only provides placebo benefits and should not be used in Insertional Achilles Tendinopathy should not be generalised to ALL shock wave therapy with ALL devices.

The original article overlooks key fundamental research which has highlighted that not all devices perform within the same parameters, as well as, well established evidence that overall energy provided into the tissue is irrelevant when compared to single impulse energy.

Shock wave therapy, in my experience, has always played a significant role in the management of lower limb tendinopathy, and we will continue to offer this service in clinical practice.

Radial extracorporeal shock wave therapy (rESWT) is an established modality in the management of Achilles tendinopathy. A recent study published in Clinical Rehabilitation reported that the addition of rESWT to exercise and education did not lead to improvements in pain, function or other outcomes c...

16/04/2023

⭐️⭐️ UPDATE⭐️⭐️

I can't believe it's been over a year since I have been active on this page! Over the last 12 months or so I've been quite busy with clinic work and social media went down the pecking order in terms of priorities. I have struggled with engaging online and I apologise for not being very present on any social media platform.

However, I do have a VERY exciting update. As some of you may know, I qualified as a registered sonographer in 2020 after completing a PGCert in MSK Ultrasound, from AECC University College. 6 months ago, I decided to top up this qualification to a complete a full Masters in Diagnostic Ultrasound, this time at Essex University.

This Masters program includes the learning of how to perform Ultrasound Guided Injections.

I am delighted to confirm that I have passed this module, awaiting external exam modulation, and will be qualified to perform ultrasound guided injections as soon as THIS SUMMER!!

Some of you have been amazing and have volunteered to be patients for the injections during my supervised learning period and I would like to thank all of you that did, and Keith Graham of Cleve Chiropractic & Physiotherapy Centrefor acting as my supervisor and is continuing to act as my mentor and an even bigger thank you to Collette Johnson at Risca Chiropractic and Wellness Clinic in Newport for allowing me to use their amazing facilities throughout the learning process.

The injections that I will be able to offer in the not so distant future include:
- Combined Corticosteroid and Local Anaesthetic
- Hyaluronic Acid Injections for Arthritis of the Knee, Ankle, Hip and Shoulder Joints as well as some tendons.
- Hydro-dilatation for Adhesive Capsulitis or Frozen Shoulder.

I am proud to be a recognised provider of Durolane which is the highest molecular weight hyaluronic acid on the market, it is this high molecular weight that makes it effective in the management of mild/moderate arthritis of the knee.

I will be accepting referrals from Chiropractors, Physiotherapists, Osteopaths, General Practitioners and Sports Therapists. Once the referral has been made, the Injection will be carried out at my discretion and all options will be discussed with the patient prior to the injection being administered.

The injection will be carried out using a clean no-touch technique with the use of Chloraprep to limit risk of infections. The patient will be provided with a pain diary following the injection to monitor its effectiveness in accordance with WHO Guidance.

I am also in the process of updating my website with this information, so keep an eye up for that update soon. Costs at present are TBC however, I have always made it my goal to make every treatment option as affordable as possible for the people of Port Talbot and the surrounding community.

So, keep your eyes peeled for details on locations of where injections will be performed, costs on my new website, which is due to be published VERY soon!

As always, thank you once again for your continued support.

All the best,

Dan

💙💙

25/01/2022

**NEW EQUIPMENT INCOMING**

I am delighted to announce that I will soon be using this piece of kit called the activforce 2. The activforce 2 is a hand held dynamometer and inclinometer in one nifty little device.

This is all well and good, but how can this help you?

Well, the idea behind this device is to gather quantitative data on you. One example of this could be range of motion of a joint:

eg. With a frozen shoulder we would often want to measure external rotation. This device allows us to not only gather data, but allows us to also provide you with instant feed back on your movement capability.

Another example may be muscle strength:

eg. With hamstring injuries, we would want you injured side to be returned to the same strength as your uninjured side before we return you back to full sporting activity. This data will drive that decision making process, but also allow us to set numerical goals for you going forward.

The bad news...I will now know if you've been doing your rehabilitation, because, well, numbers don't lie!

This tool will be a huge addition to the clinic and will hopefully allow you us to provide you guys with the next level of overall care, hopefully reducing injury reoccurrence as well as aid a quicker recovery.

12/11/2020

Great afternoon completing another webinar for EMS! This time, we had a special guest. The new DolorClast Radial Shock Waves device. Oh, and let’s not forget, a special thank you to Chris from CT Medical Sales for being a very complying patient. Here’s to the next one - where we will run though hip and upper limb practical sessions!

21/10/2020

Today, I became a Fellow of the Royal College of Chiropractors and its Sports Faculty.

This is something I've been working towards over the last 5 years and it means the world to me!

Just wanted to say a huge thank you to everyone who has helped me along the way (there are way too many to name!!) and a huge thank you to the support I've received from my family during University and through my career so far.

19/10/2020

It is an absolute honour to be asked to speak to the Chiropractic Students at London South Bank University tomorrow about the science and physics of Diagnostic Ultrasound.

I would like to say a huge thank you to Senior Lecturer Mark Thomas for the invite.

In this talk we will cover:
- What is Ultrasound?
- Basic Physics
- Type of Transducers
- How are Ultrasound Wave Produced?
- Propagation of Ultrasound Waves
- Ultrasound safety
- Pro's and Con's of Diagnostic Ultrasound
- Doppler US and Elastoography

04/08/2020

Had a great first day scanning at Risca Chiropractic & Wellness Clinic. A day full of shoulders but saw everything from tears, to calcifications, to impingements. Reports completed on the same day and now patients are better informed on how to proceed with their care! Thanks for having me!

07/07/2020

**KNEE OSTEOARTHRITIS**

Knee OA is condition that affects 250 million people world wide and is a leading cause of disability.

Many people suffer in silence with Knee OA, however a lot of patients and practitioners are unaware of the role that Shock Wave Therapy can play in the management of this condition.

Research by Zhoa et al. (2013) demonstrated that Shock Wave Therapy is effective for improving function and decreasing pain scores in patients with Knee OA. The study demonstrated that in as little as 3 months, patients on average reduced their pain scares from 7.5/10 to 4.9/10.

This was done with just 4 sessions!

Zhoa et al (2017) demonstrated that patients who have Grade II/III changes (according to the Kellgren Lawrence scale) respond the best to Shock Wave Therapy. This means if you have moderate or moderate/severe arthritis (Observed on x-ray) you are likely to benefit from Shock Wave Therapy for Osteoarthritis changes in your knee.

If Knee OA is affecting you, you can arrange your consultation and Treatment with myself via:

our online booking software found at:
www.beacheschiro.co.uk
or call reception on:
01639 888822

07/07/2020

**Diagnostic Ultrasound Scan**

This is another image we have caught during one of our scanning clinics since coming back from lockdown (I did say there was plenty more where that first one came from).

This patient has refrained from a great deal of speed work for quite some period of time, however during lockdown attempted to return to speed work and return to maximal velocity work.

After a few short distance sprints the patient felt a "pop" in the quadriceps region causing him to stop. There was no immediate bruising, so the patient rested and attempted to try a gentle jog which was still causing pain. This caused him to pop in for a scan on the region.

As you can see from the video below, there is quite a large tear in the re**us femoris muslce measuring approximately 5.58cm.

In the cross sectional image (number 2) you can see the central tendon and the tear laying alongside it. The patient is quite lucky that the central tendon remains intact as this would mean a much greater recovery period.

Research carried out on hamstring muscles shows that on average muscle tears that involve the central tendon takes on average 72 days to recover, compared to 21 days for muscular injuries that do not involve the tendon. (Comin et al., 2012).

05/07/2020

**Ultrasound Scans**

Since coming back to clinic we have caught some lovely images on Ultrasound. (There's more where this came from!!)

This patient is exceptionally active and has continued to do so despite being in pain for some period of time.

Most people hear the words "tear" and immediately assume this means some form of surgical intervention is required. This is absolutely not the case. This patient has continued to be active despite this injury and we have adopted a conservative approach to manage the functional deficits that are present.

We have advised some neuromuscular control and accessary work to go alongside thier compound movements that they would do usually.

Edwards et al. (2016) wrote:
"According to reports in the literature, conservative treatment is effective in 73–80% of patients; however, not all patients will respond favorably or quickly. When opting for conservative treatment, it is important to understand that the responsiveness of patients and symptom recurrence will determine the potential for a successful outcome of exercise rehabilitation."

01/07/2020

We’ve had many runners in recently who have been enjoying more runs of later due to the lovely weather!

Runners, love to run! But they often overload the need for strength training alongside their running load.

In clinic we always discuss strength work with our runners. Load tolerance with athletes is vital to injury prevention.

This little infogram produced for BJSM gives some simple advice and dispels some myths regarding strength training.

Take a little look...

Strength training should be high repetition, low load to improve running performance, right..? Great to see another put to the sword in the current edition! 🏃‍♀️🏃‍♂️🏋️‍♀️

http://ow.ly/xQOO50AinA6

21/06/2020

Oh, and by the way...