tendinitis

Have this patient which is causing some probs

Supraspiantus tendinitis for last year, never took any meds or physio services as never really believed in them.

On assessment, it was tender on palpation, no other inflammatory signs.

I was thinking of trying to relieve the inflammation, but since its been 1 yr, i think it has gone into a chronic inflammatory phase.

Should i use cont US or heat modalities, and how long would you wait for stretching/commencement of strengthening exs (patient is an army recruit - quite strong!!)

Also, would low grade mobes help?

thanks ppl
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UK Refer and Do Not Refer Criteria for GP's
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HygeiaUK
1121088240

12 months ago my local PCT issued guidelines to local GP's regarding conditions which would benefit from a referral for Physiotherapy. I have raised this with the OCPPP and the CSP. I understand it is becoming commonplace for UK trusts to issue guidelines. Does anyone else out there have views on this? Firstly I do recognise the the NHS cannot fund all forms of care. Does this signify a time when we need to have centrally designed guidelines on what is and what is not covered by the NHS, as opposed to what can benefit from treatment?