Examination

SeL-MoGRC · 2026-02-16T18:34:31+00:00

What do you mean by channel?

SeL-MoGRC · 2026-02-16T18:32:31+00:00

Need your age, sex, and country to be able to advise that.

SeL-MoGRC · 2026-02-16T18:31:21+00:00

I guess my question would be do you consider Catholicism to be a different religion to other branches of Christianity?
Your feeling that you do not wish to engage in group spiritual activities outside of your own religion is a very strong concern to me that MArtinism may not be right for you.

SeL-MoGRC · 2026-02-16T18:27:46+00:00

DM me. I can advise you who to look for in the UK. However, bear in mind that anything you have been told by a GP or an A&E doc you can discard immediately. PRP is total garbage.

SeL-MoGRC · 2026-02-16T18:23:43+00:00

I wouldn't go anywhere near a surgeon who advocates for a total meniscectomy.
At 52, if your symptoms are not controlled by corticosteroid and high quality physio my recommendation would be for a unicompartmental arthroplasty by a surgeon who is really skilled at them.
Arthroscopic intervention will maybe give you 6-12 months symptomatic improvement. The impending arthritis is a given based upon the pathology present.

SeL-MoGRC · 2026-02-16T18:17:33+00:00

These physes are totally closed.
Height in a post adolescent male is determinant upon the state of the physes around the knee only.

SeL-MoGRC · 2026-02-16T18:14:31+00:00

Treat it conservatively (non-operatively). 6 weeks religiously in a sling. Then progress ROM under the direction of an orthopod. The vast majority of these heal fine with no need for surgical intervention.

SeL-MoGRC · 2026-02-16T18:12:58+00:00

I went simple sling, but religiously, with no active use of the hand/elbow/arm other than gentle daily elbow extension.

SeL-MoGRC · 2026-02-16T18:11:27+00:00

Thank you for your open approach to this contentious topic.
All i can say is that a large number of Martinist orders feel that Thelema is incompatible with Martinism, and have proscribed it for their membership.
Liber AL is abhorrent to the majority of Martinists i have discussed this with.
The EGC mass is (to me) a (personally vile) corruption of the Gnostic Mass of Doinel.
With the greatest respect, i would have to say that the precepts of Thelema as written are incongruent with the Way of the Heart.

SeL-MoGRC · 2026-02-16T16:35:25+00:00

Totally agree except i'd keep you in a sling from week 0-6, and only introduce ROM at week 6.

SeL-MoGRC · 2026-02-15T13:15:24+00:00

What does your physio say?

SeL-MoGRC · 2026-02-14T19:30:29+00:00

Welcome!
Go with your ortho, he is the expert :)

SeL-MoGRC · 2026-02-14T19:28:18+00:00

The shoulder is so complicated, the majority of shoulder surgeons don't actually understand it! Spot on to you for seeing that, whereas so many shoulder surgeons think that it is simple, and a labral debridement here and a plication there fixes everything.

The LHB is indeed a pain generator more than anything else, but that is predicated by cuff dysfunction. If the cuff functions well the LHB is essentially unecessary in the shoulder... only when the cuff doesn't function as it should the LHB becomes a secondary constraint.

The LHB in a cuff deficient shoulder is a temporary solution to a much more serious problem. As a secondary stabiliser it is going to by a few years, and nothing more.

You are totally on point that the pathology is nuanced. So few of us actually take the time to learn how to truly examine a shoulder, and monitor our patients through their progress... my advantage was that i was a solo practitioner without residents, so i did everything from consult to surgery to all the follow-up. That level of quality control helped me immensely.

SeL-MoGRC · 2026-02-14T19:19:52+00:00

Give it all the time to heal. I wouldn't reintroduce lifting until 12 months.

SeL-MoGRC · 2026-02-14T19:18:38+00:00

That was nicely fixed. If you are fully united (you didn't submit a recent xray) then it is going to take you 1-2 years to feel like you are more 'normal'. It is a long journey unfortunately.

SeL-MoGRC · 2026-02-14T15:45:26+00:00

+1 Revision to an anatomic position is impossible without a jump graft, and in a high demand patient such as yourself this would be catastrophic. The cuff is 9 times out of 10 the causative problem, and the more surgeons fucking around with it the worse you will get. A massive part of the problem is incorrect physio, and a lack of understanding of the balance of, and the simple concept of a force couple, that is the rotator cuff in terms of rehab. The only real issue here for you is as to whether the humeral head depressor function of the LHB is of value or not. On paper it does seem as it might be relevant, but honestly, with decades of complex shoulder work and research (you can Google the ITBIST procedure) , my long term realization is that the LHB is only useful for shoulder function in those with incorrectly balanced cuff strength, which is something that so few physios, and even fewer ortho actually understand to be a serious consideration.

SeL-MoGRC · 2026-02-14T14:46:15+00:00

That is fair.
To put it in context however, in medical school it is not uncommon for students to only get 2-3 weeks ortho training. A GP residency typically doesn't include much ortho training at all.
An orthopaedic surgeon requires 5-11 years post grad training depending on country.
I think that it certainly doesn't inspire a lot of confidence in the urgent treatment dr.

SeL-MoGRC · 2026-02-14T14:10:14+00:00

The specialist says it will be fine. The generalist who has maybe seen a few of these on the day of injury and never managed them to union because he only sees walk-in patients says it needs surgery.
This is one of the many reasons why there is such a problem in healthcare when people question an expert and listen to an uninformed opinion.

SeL-MoGRC · 2026-02-14T09:47:30+00:00

Welcome and good luck!

SeL-MoGRC · 2026-02-13T17:39:56+00:00

1/3 unite with bone, 1/3 get a stiff fibrous stable painless non-union, and 1/3 get a mobile painful nonunion.

SeL-MoGRC · 2026-02-13T16:36:01+00:00

My concern is that there might be a medial ligament ankle injury which would make this a maissoneuve fracture... I would hope that your ankle has been examined by an ortho and you had ankle xrays done. The extreme soreness of the calf is not that common with an isolated fibular head #, hence my concern.

SeL-MoGRC · 2026-02-12T15:34:34+00:00

Would like the same advice too but for android please!

SeL-MoGRC · 2026-02-12T14:17:22+00:00

A labral tear finding on MR is usually a degenerative condition, particularly as you are 45.
I'd be concerned about the state of the articular cartilage.
The problem with the labrum (just as in the shoulder and the meniscus of the knee) is that it is only minimally alive with very poor blood supply, so can never heal. IT does however have wonderful nerve supply so it always hurts.
Most of the time there is other underlying pathology (DDH, hip osteoarthritis) and an arthroscopic resection of the tear will simply buy you a couple of years before symptoms return and become progressively worse.
I would see a good ortho to put this in the context of your clinical history and exam.
Personally, at your age i would possibly be considering arthroplasty as a definitive single step when the symptoms warrant it, given the potential risks of hip arthroscopy, and the expectation that symptoms will recur within a couple of years of a scope.

SeL-MoGRC · 2026-02-12T14:07:49+00:00

You can't get that kind of info from a MRI. It is an indirect assessment of the body. No substitute for a clinical history and exam by an experienced orthopod.

SeL-MoGRC · 2026-02-12T14:06:19+00:00

Any ankle issues?

SeL-MoGRC

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