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Nick Ilic Physio Clinician

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Australia
Canberra, ACT
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.

24/08/2026

New blog just went up and honestly... I might be cancelled by Friday. 😅

Title: Research Review | The Most Racist MSK Blog Ever Written
Read it at: https://nickilicphysio.substack.com/

Confession time: every MSK clinician has had a thought like this and immediately felt weird about it —

🔎 "Asian patient, probably hypermobile."
🔎 "Japanese with a stiff, sore shoulder? Frozen shoulder."
🔎 "Polynesian, hot swollen joint... gout, right?"
🔎 "Weird curling fingers, Northern European background — check the palmar fascia."

We've all quietly done this in the two seconds between the door closing and the handshake. So I decided to actually find out: is any of it true, or are we just guessing with more confidence than we deserve?

Turns out genetics is way wilder than any of us give it credit for. Some of the stereotypes are lazy nonsense. Some are right for completely the wrong reason. And some hold up so cleanly under the research it's genuinely changed how I think about a first appointment.

Genes, gout, Neanderthal DNA, and two hips built in totally opposite ways for two totally different reasons — it's all in there.

Come read it before I get reported to the registration board 👀

Link in comments

15/08/2026

ACL content is everywhere. Primary reconstruction, primary rehab, return-to-sport timelines. For good reason too!

But second tears and revisions? Barely a mention. Which is rough, because if it's happened to you or your kid, it can feel like you're the only one it's happened to.

New Research Review is out — covers why revision ACL is a genuinely different game to the first one, the real risk factors (most of them nobody could have controlled), and what actually moves the needle if you're facing a second surgery.

There's also an interactive bit at the end — a Choose Your Own (Mis)Adventure where you roll the actual research odds and see which chapter you land in. Built it because reading "1 in 4" hits very differently once you've rolled it yourself a few times.

https://nickilicphysio.substack.com/p/research-review-acl-episode-ii-the

06/08/2026

New blog: The Brain Rattle: Why Concussion Recovery Is No Child's Play
For everyone who did everything right and still isn't better.

I used to think I had concussion sorted. 🧠

Club Rugby and Sports Medicine Australia background. Good protocols. Mandatory stand-downs, symptom-gated return, no contact before day 21.
It worked. Most of the time.

It wasn't until I attended a SportsMAP conference and a concussion presentation by Neurological Physiotherapist Katie Davies that I had my own 'academic head-knock' 🤯- gradual return-to-play protocols are just the starting line.

Then a generous knowledge-sharing session with a local expert neurological Physiotherapist colleague explained the biology. And it changed how I think about every prolonged concussion presentations.

Here's what most patients aren't told:
🔍 Feeling better is not the same as being recovered. Metabolic repair takes around 30 days minimum — even in athletes who were symptom-free at two weeks.
🔍 Between 30 and 50% of concussion patients still report symptoms at six months or beyond. That's not a rare outlier. That's a significant portion of the people walking into your clinic.
🔍 Neurodivergent patients (ADHD and autism) can have 20% longer recovery, and their medication matters.
🔍 The brain's filtering capacity takes a hit. Busy environments, screens, background noise — overwhelming not because anything is wrong with the eyes or ears, but because the brain is struggling to keep up whilst spending its limited reserves.

The new Patient's Playbook post covers the biology, the timeline, what makes recovery worse, what actually helps, and a specific section on neurodivergent patients — where the picture is more complex and the standard protocols need more individualisation.

Written for patients. Useful for clinicians who want something to hand to the people asking "why am I still not better?"
🔗 Link in comments

03/08/2026

Active kids with overuse injuries don't get adult stuff (...usually).

Rotator cuff problems in a 14-year-old aren't rotator cuff problems.
The rotator cuff is an adult structure.
Whilst we're at it, they also don't get tennis elbow, plantar fasciitis, male pattern baldness, or hairy ears.

What they CAN get is growth plate injuries — and those need a completely different approach.

🔎 The physis is 2–5× weaker than surrounding ligaments — which inverts your entire differential in an adolescent
🔎 Vague pain in a skeletally immature athlete isn't reassuring. It's a reason to look harder
🔎 "Self-limiting" is being used as an excuse to do nothing — and that's where the harm happens

Full post covers the biology, the three injury categories, and what good management actually looks like. Worth a read if you work with or parent young athletes.
Link in comments.

$Raducanu's out of Wimbledon. Stress fracture in her lower leg, withdrew the night before her match.By the time the tourn...$

30/06/2026

Raducanu's out of Wimbledon. Stress fracture in her lower leg, withdrew the night before her match.

By the time the tournament started, 18 players were already gone. Not injured during Wimbledon. Injured before they even got there.

Every year it's the same shocked headlines. "How could this happen?" Anyone who's worked in tennis medicine could've told you in January.

A decade of injury data from Wimbledon found that 61% of injuries showing up at the tournament had actually happened beforehand. Players are cramming a surface change, a packed calendar, and almost no real off-season into a few brutal weeks, and then we act surprised when bodies give out.

I spent a several years working tennis at Challenger, ITF and Tennis Australia level. Not the elite tour, but close enough to see the gap between the player walking out under the lights and the one who comes off court after.

We're not watching the best players in the world anymore. We're watching the best survivors. 🎾

I wrote the full breakdown, the data, the calendar, and what could actually change it.

https://open.substack.com/pub/nickilicphysio/p/tennis-physio-winning-wounds-but

18/06/2026

New on Substack
Parents Playbook | Why a Growing Child Isn't a Balding Man
https://nickilicphysio.substack.com/p/parents-playbook-why-a-growing-child

Your kid's shoulder has been sore for weeks. 😔
The physio said "rotator cuff."
The GP said "just needs to stretch more."
Neither one landed — and now they're sitting out the tournament they'd been training towards all season. 🎾😞

Here's the bit that gets missed: a growing kid's body doesn't break down the same way an adult's does. 🦴

The injuries that show up in active, high-load kids tend to live somewhere completely different — the growth plate, the joint surface, the spot where a tendon anchors into bone 📍 — not the places adult diagnoses usually point to.

If your child is playing a lot of one sport — tennis 🎾, swimming 🏊, gymnastics 🤸, footy 🏉, whatever it is — and the pain's been vague, on-and-off, and not improving with the usual advice, it's worth a read. 👀

🔹 Kids aren't small adults with smaller adult injuries
🔹 Vague pain in a kid isn't a reason to relax — it's often the opposite ⚠️
🔹 The standard "rest and stretch" advice can cost real time if it's the wrong call ⏳

This week's Parents Playbook walks through exactly what happened, what it took to turn it around, and what to ask for if you're standing where this family was four weeks in.

04/06/2026

What if I told you the solution to Australian physiotherapy's biggest problem has been sitting next door the whole time? 👩🏻‍⚕️

In 2024, nurse practitioners achieved full independent Medicare access. No GP gatekeeping. No mandatory medical supervision. 34 years of work — but they got there.

They got there because in 2003 they made one structural decision Australian physiotherapy still hasn't made.
They separated their credentialing college from their union.

That single move meant that when they said "our advanced practitioners deliver better outcomes and deserve more" — it looked like evidence. Not a pay claim.
We've been making the pay claim for decades.

50,064 registered physios in Australia. 3,094 hold an APA title. Those 3,094 clinicians have the same Medicare item numbers as a new graduate. The credential doesn't travel outside the profession's own walls.

The nursing blueprint is sitting right in front of us.
An independent Australian physiotherapy college — separate from the APA, endorsed by AHPRA — is not radical. It's overdue.

The full story is on Substack — the history, the data, the nurses who built it, and why physiotherapy started this journey nine years before nursing did but still hasn't finished it.

🔗 Link in bio / https://open.substack.com/pub/nickilicphysio/p/clinicians-compass-physio-needs-a

29/05/2026

Sciatica.

Sounds like an arcade game from the early 1980s. 🕹️ IFYKYJHAS*
(*if you know you just heard arcade sounds)

New case series just published.

🔗 https://nickilicphysio.substack.com/p/clinicians-corner-case-series-good

Here's what's in it:

🔍 Why "sciatica" is a label that does too much work and explains too little

🔍 The difference between radicular pain (a gain) and radiculopathy (a loss) — and why they don't always come together

🔍 What else can cause leg pain that looks radicular — hip, SIJ, peripheral nerve, visceral, vascular

🔍 Why compression alone doesn't explain the pain — and what does

🔍 A walkthrough of a real lumbar spine MRI

🔍 Case 1 — Cycling Simon: acute foraminal impingement, pain to pain-free radiculopathy, 44% dorsiflexion deficit. Resolved 6–8 weeks. Essentially no treatment.

🔍 Case 2 — Deadlift Derek: L4/L5 disc herniation + suspected sequestration. Five months documented start to finish — body charts, MRI, session emails, functional benchmarks, discharge.

🔍 What the guidelines actually say — NICE, ACP, European, SPORT trial

🔍 Clinical commentary: the chilli powder analogy, heel wedges from day one, NSAIDs and why physios are too drug-averse, puddleisation vs centralisation, one thing at a time, the integrity sentence

🔍 The multidisciplinary bit — physio, GP, psychologist, EP, each doing their bit

🔍 The spectrum — from observe and support to active structured management. Neither end is the right default.

Free section covers the science + Cycling Simon.
Paid section is Deadlift Derek — start to finish.

🔗 https://nickilicphysio.substack.com/p/clinicians-corner-case-series-good

Get full access as a preview article if you subscribe for free at https://substack.com/

06/05/2026

🧲 New blog post — and this one's for anyone who's been offered a new treatment at their physio clinic lately.

EMTT. Extracorporeal Magnetotransduction Therapy. Big name, expensive machine, confident marketing.

"Almost no side effects."
"Fantastic results."
"Reactivates your sodium-potassium pump."

That last one caught my attention. Your sodium-potassium pump does not need reactivating. If it stopped working, you wouldn't be at a physio clinic. You'd be dead.

So I went and read every clinical trial I could find. Here's what's actually there:

🔹 Eight MSK trials in total. Six run by researchers with declared financial ties to the manufacturer.
🔹 The flagship "double-blind" trial wasn't blind — the machine makes your skin go red, so patients knew which group they were in.
🔹 The one independent properly-blinded trial found no difference from sham.
🔹 The condition list keeps expanding — hip OA, elbow OA, herniated discs — none of which have actually been trialled.

I've tried to be fair. The in-vitro science is genuinely interesting. Short-term pain relief from a passive adjunct can be a legitimate clinical tool. But the confidence with which this is being marketed is years ahead of the evidence.

If a clinic offers you EMTT, ask one question: is this in addition to active rehab, or instead of it? If it's instead of it — leave.

Full post at the link in bio. Includes 20 references, a fictional headstone for Timothy J. Carmichael, and a Bluetooth speaker being held to a blindfolded patient's ear.

23/04/2026

New Blog | Research Review | Shockwave Therapy — Good, Like All the Other Things

🔗 Link in bio / comments

I’ve been sitting on this one for a while, but the recent Physio Network podcast on shockwave therapy finally pushed it into publishing.

It ended up being a useful reminder of how important it is to separate confidence, mechanism talk, and polished presentation from the underlying evidence.

Inside the blog I go through:
🔹 What shockwave therapy actually is
🔹 The focused vs radial difference
🔹 What the key papers do and do not show
🔹 Why protocol variation still matters
🔹 And how to spot when external influences or conflicts of interest may need to be considered when listening to educational content

A good read for anyone weighing up shockwave therapy clinically, commercially, or just intellectually.

Address

Canberra, ACT

Opening Hours

Monday	8am - 6pm
Tuesday	8am - 5pm
Thursday	3pm - 6pm
Friday	8am - 6pm

Telephone

+61474228745

Website

http://www.physioclinician.com.au/

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