ASK ANYTHING: Physio Edition — ACL Myths, Desk Pain And Kids’ Development, Hong Kong With Justin Faulkner

The Desk Injury Hong Kong Keeps Ignoring

Justin’s most common over-35 visit is not a dramatic sports crash. It is the desk jockey: slumping over a laptop, phone in hand, neck folded forward. Headaches that start at the top of the neck and radiate over the head into the back of the eyes get written off as “just my eyes” or another Panadol. The body is a clever machine. It compensates for a short step, a stiff shoulder, a dining-table “office.” Then the knock-on arrives — knee, hip, tennis elbow — and everything feels sudden.

• The biggest modern mistake? Working from home without a real setup. A laptop forces you to look down because the screen is glued to the keyboard. Eyes should be up, keyboard down. Bad chairs, screens off to the side, cramped dining tables: all of it adds up in a city short on space. Fix posture and core earlier.

Pain is a warning, not a personality trait. A little discomfort in rehab (about 0–3 out of 10) can be workable. Seven to ten means stop. You have done something wrong.

ACL Rehab Is Not A Calendar — And Surgery Is Not Automatic

The old story was simple: ACLs do not heal; operate; wait nine months. Justin says the thinking has shifted. Some specific tears can heal in a brace — tedious in Hong Kong, because you may sit at 90 degrees for nearly 12 weeks — but it can beat surgery.  If you have surgery, Justin has some excellent tips:

• ACL Surgery Rehab - Strength: When surgery is the path, time alone is no longer the gold standard. Strength plus time is. PhysioCentral uses VALD testing (force decks, force frame, dynamometer) so a machine, not optimism, decides if one leg is ready. Protocols look for roughly 85–95% symmetry before the next stage.
• ACL Surgery Rehab - Time: Post-op, Hong Kong’s A-type instinct is to rush. Justin’s advice is almost rebellious: do not try to break records in the first two weeks. Let tissue settle. People who had a small setback and rested often catch the “fast” group quickly, and they move better. Weekend-warrior injuries — slipping on a Hong Kong street after a perfect ski trip — are as common as pitch dramas. Rest is not the best treatment for most sports injuries.

Kids Are Not Tiny Adults — And Reassurance Is Part Of The Treatment

Parents arrive anxious. Milestones, comparison culture, the book that says a child “should” roll or walk by a certain week. Justin’s first message is relief: kids develop differently. If they are hitting the building-block skills that lead to a milestone, they are often fine — they just have not done the headline trick yet. Half of what a good paediatric team does is tell families they are going to be okay.

Extra tips from Justin: Kids Developmental Concerns

• When extra help is needed, PhysioCentral’s paediatric physios (including Charmaine’s neuro-focused work) treat global developmental delay, cerebral palsy, Down syndrome and early issues such as torticollis — a tight neck that pulls a baby’s head to one side and is often quick to improve.
• A flat spot on the skull can be a room-layout problem: turn the baby so interesting things sit on the other side. Treatment looks like play because it has to.
• Toddlers will not follow a 10-rep programme. Hurdles, colour targets, walking backwards on a treadmill, even an old flying fox with obstacles, are all teaching core, pattern and motor control.
• Kids do not reliably “grow out of” toe walking past a certain age. Come in when you are worried, whatever the age. Earlier is easier.