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If there is one topic in sports and exercise medicine that I could happily talk about for hours, it's hyaluronic acid injections for knee arthritis. That might sound a little odd. After all, knee arthritis is one of the most common conditions I see in clinic. Surely we already know what works and what doesn't? The reality is far more interesting than that. Over the years, I have seen people gain very little benefit from hyaluronic acid injections. I've also seen people who ha

Advice from a Sports & Exercise Medicine Doctor on shoulder pain, physiotherapy, corticosteroid injections and hyaluronic acid treatments. One of the most common questions I hear in clinic is: “How long should I keep trying physiotherapy before considering a shoulder injection?” Whether you're struggling with rotator cuff pain, shoulder bursitis, a partial rotator cuff tear or persistent shoulder pain that isn't responding to physiotherapy, it can be difficult to know when to

When I developed persistent Achilles pain during running, my focus was almost entirely on rehabilitation exercises and training load. Both were important. What I paid much less attention to was nutrition. Looking back, that's something I would do differently. When most people think about injury recovery, they think about physiotherapy, exercises, scans or treatments. What is often overlooked is that injured tissue needs energy and nutrients to repair itself. Nutrition won't m

Knee pain is one of the most common reasons people seek advice at Stirling Sports Medicine Clinic. Whether you're a runner, golfer, hill walker or simply finding everyday activities more difficult, knee pain can be frustrating and can significantly impact your quality of life. The good news is that many knee problems can be diagnosed clinically and often improve with the right treatment and rehabilitation plan. What Causes Knee Pain? There are many possible causes of knee pai

When you're struggling with an injury or persistent joint pain, knowing where to start can be confusing. Should you see a physiotherapist? Make an appointment with your GP? Seek a surgical opinion? Or book a consultation with a Sports Medicine doctor? The answer depends on the problem—but understanding the different roles can help you find the right support more quickly. First Things First: When Should You Attend A&E or a Minor Injuries Unit? Some injuries need urgent assessm

No.... Initial assessment: Whether you are seen in the Emergency Department or your GP surgery, point of care musculoskeletal ultrasound (POCUS) is virtually never used. POCUS is excellent in visualising muscles, tendons and many ligaments. It can also be used dynamically to see how these tissues react when your joints move. This allows for more accurate diagnoses. Steroid injections: These are commonly available on the NHS, although not all GP practices offer them. In

Large U.S. health-claims data show hyaluronic acid injections significantly delay total knee replacement. Non-users had surgery at 0.7 years, those with one course at 1.4 years, and five or more courses delayed surgery by 3.6 years. Source: PLOS ONE study (Altman et al., 2015). A 2024 Korean national database study reported that hyaluronic acid users delayed total knee arthroplasty by about one year and had a 39% lower risk of needing surgery. More cycles led to further de

Ostenil® injections contain high‑purity hyaluronic acid used to improve lubrication in joints and reduce pain associated with osteoarthritis. Ostenil® Mini: Designed for small joints such as thumb, fingers and toes. Relieves pain and improves mobility. Standard Ostenil®: Used for medium to large joints including knee, hip, and shoulder. Helps improve lubrication and reduce pain. Ostenil® Plus: A higher‑strength version containing more concentrated hyaluronic acid and mann

Musculoskeletal (MSK) problems such as joint pain, tendon injuries, and soft‑tissue swelling are extremely common. One tool I may use during your appointment is point‑of‑care ultrasound (POCUS) — a portable ultrasound machine used right in the clinic. This guide explains what POCUS is, what it can help with, and what its limitations are, including an important note about how it differs from hospital (radiology‑department) ultrasound. What Is Point‑of‑Care MSK Ultrasound? POCU

In 2025 I decided to take the leap and started the process of opening Stirling Sports Medicine clinic . I must confess I significantly underestimated how long and complex the process would be, but hopefully Health Improvement Scotland (HIS) will give me the green light in 2026. Until then, Stirling Private Medical Group, have kindly offered me Practicing Privileges. Thank you so much Caroline