Hi all It’s taken a bit longer than a week to get the second part up. Exams, courses, training, lecturer problems and a holiday took more of a priority. So here’s part 2 of the Low Back Pain case study. Hope you find it interesting, perhaps of some value and of course I’m always open … More TNTOASP: Low Back Pain Case Study: Part 2
Here’s part 1 of my recently submitted assignment. Hope you enjoy and get something out of it. Feedback of course is always welcome! Part 2 will follow in a week. A clinical perspective of pain management for Low Back Pain: A case study Abstract Low back pain (LBP) remains a prevalent health burden according to … More TNTOASP: Low Back Pain case study Part 1
CLINICIANS GET CREATIVE: V2 YES FOLKS, CLINICIANS GET CREATIVE RETURNS! On the success and reception from clinicians get creative at San Diego Pain Summit (SDPS) 2016, it will be returning to SDPS 2017, this time with a podium slot! Wow! Clinicians get creative was inspired by our need and abilities to think critically and creatively, … More Clinicians Get Creative: Version 2
As part of my studies I had to develop a patient resource. So I decided to do one on back pain entitled: ‘My back pain journey’. The presentation (is supposed to) works like a website. It’s interactive and informative, and supported by evidence. All you have to do is click on the screen to interact … More My Back Pain Journey
Welcome to part 2 of my 50 ways of thinking differently in pain science. I got the idea after reading an Auckland chamber of commerce article that applied the title to business. I thought to myself there are a lot of similarities here in thinking in business and pain science. Nothing like a bit of healthy … More 50 ways of thinking differently in pain science: Part 2
I was flicking through an Auckland chamber of commerce magazine recently (it’s nice to draw creativity from other business sectors) and came across an article ’50 ways of thinking differently’ so I decided to create my own for pain science. This list is an attempt to demonstrate the level of creativity we can have when working with people with … More 50 ways of thinking differently in pain science: Part 1
A recent conversation I had with a podiatry colleague proves that translating pain science is difficult!! … More It’s all in your head, that’s ok or maybe not? Reprise
Hi all I recently had the fortunate opportunity to have an article published in NZ massage magazine. I wanted to share my thoughts with the evidence on the changing landscape in understanding pain and its multi-dimensional nature. I decided to share a small reflection on the article to highlight the change in my own personal growth … More Bridging the Pain Gap: My NZ massage article
The 3rd part of this series of naked tales of a studying physio picks up from where we left part 2. Here I talk about my observations and formulate my case for management. You can read parts 1 and 2 here and here. Observations Interestingly, as the patient walked into the examination room it was observed … More Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 3
It’s that time again for another helping of the naked tales of a studying physio. So let’s pick up from where we left off. If you want a refresh of part 1 you can do so here Treatment History The patient’s spinal fractures were managed conservatively over the course of 5 months with a spinal … More Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 2
I haven’t had a good guest post in a long time! So I thought, I should really have a guest post. Low and behold ask and you shall receive!! Many of the people I see living with long term pain are on a workers compensation (WC) scheme. It can be a pretty stressful ordeal for them … More The work compensation frustration – a guest post by Joletta Belton
Our clinical practice should demonstrate a good mix of acquired knowledge, clinical experience and supporting evidence. The person seeking care expects to receive a well-reasoned intervention hypothesis that answers questions or concerns, and delivers effective management. So, evidence based medicine appears to be cropping up everywhere at the moment. That’s not inherently a bad … More The case for and the case against: a short blog on clinical reasoning
Hi all welcome to another naked tales of a studying physio. Here’s the first part of my second assignment for my post-graduate studies. It’s a back pain case study about a thoracic disc herniation and calcification. A small note before you read on. There is minimal evidence (very low quality) (all case studies) that show … More Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study
As part of our professional development we need to maintain a reasonably competent knowledge of evidence base practice. Yet, do you ever feel like you’re chasing your tail? Perhaps you don’t know your left from your right? Maybe you feel like you’re stuck on the fairground Ferris wheel or maybe you’re just going round in circles…? … More Don’t get caught with your pants down – 5 naked tips
Hi all, after a pretty good response from part 1 here’s the follow-up to the naked tales of a studying physio – using the BPS model in clinical practice. I want to say thanks for the feedback for part 1, but more critical analysis is desirable. I mean I can’t imagine i’m that good a writer that … More Using the BPS model in clinical practice – Part 2
The more and more research unfolds the realms of Pain science the more we are beginning to understand what can influence our perception of pain. We are bombarded every single day by information that can heighten our perception of threat towards pain and injury making us vulnerable and vigilant when exposed to related contextual experiences or information Click to find out more……. … More Stewie and the vulnerable organism model
Hi all here’s another instalment of the naked tales of a studying physio. Part 1 of my first assignment from my postgraduate studies. I’ve decided to share it with all my readers as I want your thoughts and opinions on this. The more we engage in collaborative communication and sharing of knowledge the better we can … More Using the BPS model in clinical practice – Part 1
It’s important to acknowledge that we can have two sides of the spectrum when discussing notions of pain with patients. A recent masterclass article in manual therapy by Nijs et al, (2013) highlight that the biomedical framework is the core of most clinicians training and yet ‘it falls short in explaining and treating chronic musculoskeletal … More It’s all in your head, that’s ok or maybe not?
A recent conversation: Patient: I met a guy recently who was in a mobility scooter. Out of curiosity because of my injury I asked him, “Did you injure your back?” To which the guy in scooter replied, “yup 4 compression fractures and a collapsed disc that ended up pushing on my spinal cord and … More Day of Destruction – The disc collapse
So I decided to take the plunge and return to study. It was an extremely difficult decision as I constantly questioned what the point was? I asked myself questions such as why am I doing it? Am I going to get anymore out of academia that I don’t get from reading myself or going on … More The Naked Tales of a Studying Physio – Nociception
There’s a particular part in the movie Wayne’s World where Wayne and Garth meet Alice Cooper. They both drop to their knees and proclaim “We’re not worthy” because of their admiration of Alice’s talent and fame. This scene reminds me of some of what we see with current pain education practice. This post is a … More We’re not worthy! Being drawn into Wayne’s World
After what can only be described as an excellent few days of meeting and greeting, rubbing shoulders and entertainment the San Diego Pain Summit lived up to my expectations! So I share with you some short post summit thoughts on my favourite talks, finishing with my thoughts of my presentation – clinicians get creative. The first … More San Diego Pain Summit – post summit thoughts
The popular comedy game show “Whose Line is it Anyway?” invites comedians to make up small skits around random topics that are suggested by either the game show host or the audience. The show is a mix of impromptu lines, humour, spontaneity, and sometimes confusion. Listening and acknowledging each others’ lines is a necessary part … More Whose Pain is it Anyway?
Well I’ve had an exciting and challenging year. Blog posts, starting a podcast (yes another fucken podcast), a facebook community page, peer review for a major journal, arranging courses, an AUT study and have met, shared and laughed with many wonderful people along the way. So I wanted to extend my gratitude to a number … More A festive thank you: 2015 round up
Our current assessment procedure is still widely used and taught throughout physiotherapy training. It is in my opinion, an area that requires serious reform. The emergence of the biopsychosocial model has shifted our understanding to a wider clinical landscape, one that lies outside of a biomedical paradigm. Shouldn’t our own assessment procedure reflect that and is … More Pre-surgical biopsychosocial screening: Is there a need? – a guest post by Robin Higginson
I saw this advert on the television last week and also heard the same message over the radio. It shocked me but then got me thinking about how a paradox may exist creating sedentary lifestyles. What did you think of it? Is it a ploy to create dependency? Does it come back to money? I … More Pain and Sedentary lifestyles: Is it a Paradox?
Burn out can be a real problem for clinicians, I’ve suffered with it, but it’s not just clinicians it can affect all of us! So why does it happen and what should we do about it? Well I am very fortunate to have asked Averil Linn, who specialises in behaviour change, to write a guest … More Burn out? How it happens and what to do about it – a guest blog from Averil Linn
I have worked in the field of persistent pain for 8 years, I am continuously challenged. I get stuck and frozen by the complexity of presentations, because no two presentations are the same, despite the fact that those two very different presentations have a referral for the same pain problem (back pain for example). People experience … More The nervous system – a phenomenological artistic perspective of pain
Extra extra! The big naked pain and brain campaign is back! I have continued to search high and low in the film industry for references towards pain! More wisdom from Yoda! ‘You must unlearn what you have learned’ and ‘do or do not there is no try’ This is a good example of what clinicians … More The Big Naked Pain and Brain Campaign: Extra extra!
This is most definitely and unequivocally a rant! It’s a rant about the shit we say and what possesses us to say it. Actually, I’m not sure I can answer the second part of that question. I was listening to the radio the other day and an interview with a contestant from Dancing with the … More Lack of fat on the toes causes numbness? – The shit we say
I think I have lost count the number dejected looks I get when I have said, “the solution is to exercise”, particularly when I worked in the NHS. Compare that to private practice and the standard response from patients, “They only ever give out exercises in the NHS and then I don’t get seen again … More Motivation to exercise? Aaaaaand it’s gone…..
Blood flow restriction has gained a lot more attention recently, and it’s certainly an area of interest for me as I have asked the question how useful it would be when applied as a tool for patients suffering with persistent pain. So what better way of getting an understanding than by asking the experts. … More Blood Flow Restriction a guest blog by Dr. James McCarron
Can we please stop pathologising! What does that mean? Well I am pointing the finger at you the clinician. This includes me! There are plenty of us out there who are guilty of pathologising and creating a society of hypervigilance. … More Stop pathologising and wave the green flag
Sleeeeep!! Mmmmmm we all need it, it’s a necessary part of mind and body function and for life. Yet when we suffer from pain and particularly persistent pain, it can really disturb our sleep. So we assume that pain is the culprit for disturbing our sleep, right? Well this may not be entirely accurate. The thinking on pain and sleep is changing, and compelling evidence is identifying some important physiological functions that occur when we sleep revealing that how sleep may have more of an effect on pain. … More Sleep and Pain
Day 31 the final day of the big naked pain and brain campaign – getting stronger! I thought about the final clip a lot and pondered on a few ideas taking suggestions from other people interested in the project and the end result seemed to fit. I think it was best to end with this … More 31 days project: The Big Naked Pain and Brain Campaign: Day 31
Hi all I thought I would put a quick post in about my physiotalk I hosted on Monday the 2nd of March on professional boundaries. A topic that clearly affected all that participated in the chat with some really important issue raised. It was a busy hour generating a lot of discussion and 1 million … More Physiotalk on professional boundaries
Day 1 of the Big Naked Pain and Brain Campaign – Tom and Jerry I could have chosen loads of cartoons, Warner Bros, Disney etc but for me Tom and Jerry had to be the most obvious choice to start off the official 1st day! Tom and Jerry are renowned for getting themselves into all … More 31 days project: The Big Naked Pain and Brain Campaign: Day 1
The use of foam rollers has become increasingly popular in physiotherapy and in the fitness industry. It is believed that foam rolling (FR) is beneficial for releasing muscle tightness thus increasing athletic performance. Here is a quick report on the benefits of foam rolling. … More Foam Rolling: useful or a load of old polyethylene
Mirror mirror on the wall why do I experience pain with no movement at all? It’s your mirror neurons. Mirror neurons? What on earth are those? You might not believe it and it’s certainly not the stuff of fairy tales but mirror neurons were apparently discovered in the brain having an important role in allowing animals to understand movement. Mirror neurons are understood to be specialized nerves that actually fire when you recognize a movement performed by another individual. In the context of pain that is pretty important. The following post will discuss how mirror neurons might play a significant part in your pain experience. … More Mirror Mirror on the wall why do I experience pain with no movement at all?
The final part of my Pain series had intended to look at the current management approaches for persistent pain. I thought about this and decided against it. Why? Well teaching you to suck eggs is not the way. I could offer the same as everyone else – solutions, guidance, strategies to empower you, to aid in the management of pain which has, in part, been highlighted in this pain series journey, but I won’t. Instead I’ll share my thoughts on physiotherapy and how new evidence is paving to what I believe could be a more refined direction for Physiotherapy…… … More Physiotherapy Rehabilitated: Change
This is a brief thank you to all that have supported thenakedphysio this year. The last 5 months of 2014 writing my blog page has seen a mixture of thoughts, reactions, inspiration and collaboration. Having had some real eye-opening discoveries during my clinical career and meeting like-minded people (one in particular) have inspired me to write and join the blogging world. I have received some real complements and criticisms this year already that were completely unexpected and those that…… well……. I did expect. … More 2015: A new year for more nakedness
Manual Therapy is the bread and butter some clinicians might say when it comes to treatment. There are various schools of thought on treatment application. This is a short report on my thoughts on Passive therapies and the evidence and critiques surrounding it. The discovery of pain science and a better understanding of brain neurophysiology has changed the way we think about treating patients. … More Passive Therapies are they obsolete??
The turmoil of the unknown, living with pain, months/years of suffering, it’s a huge journey, something that I have never personally experienced for such a duration. Yet it is a common experience in everyday lives and is presented in many a clinical practice. Pain is the experience commonly presenting itself as a physical manifestation or disability to a persistent pain sufferer. It is fascinating how much pain can affect the human spirit, changing character, behavior and perceptions. This post reflects a clinical experience…… … More Tears of acceptance – months of unknown
Since I am the naked physio I thought it was about time that I would bare all…….. on a topic that can be pretty sensitive for some people – Pelvic Health. I had the absolute pleasure (it was titilating) of interviewing the awesome Sarah Haag a Pelvic Health Physical Therapist (that’s physiotherapist for the rest of us :-p) based in Chicago in the United States. Sarah has been practicing for well over 10 years as a Pelvic Health PT. So without further ado lets get into talking private parts and water works. … More Interview with Sarah Haag Pelvic Health PT: Private Parts and Water Works
“If the technique makes a difference and makes the person better then that’s what I’m after”, said the tutor at the one day course I attended recently. The course, a CrossFit Movement and Mobility course aimed to have participants be able to identify, prioritize, and begin to program for common movement dysfunctions like low back pain, knee pain, and shoulder pain by the end of the course. I was keen to attend a CrossFit course as this increasingly popular form of exercise is available and suitable to all willing participants. As with all sports, CrossFit has been known to cause a few injuries. Read on to follow my experience of this one day intensive course….. … More CrossFit – Crossing the line?
If I said to you, “your spine is crooked” or “you have degenerative changes” What would you think? How would you interpret it? Although you may not think it the power of a word can have a significant impact on your pain experience. Part 4 of my pain series looks at the use of metaphors and language and how they can affect our beliefs and behaviors. … More Pain: Part 4: What’s in a word?
Part 3 you’re half way through my pain series!! Lets take a journey through the nerves and the spinal cord up to the brain. It’s a complex journey, which we know more and yet so little about but research is unraveling those mysteries. In part 2 I talked about pain being a sensory and emotional experience and … More Pain: Part 3: The Journey from tissue to brain
Welcome to part 2 of my pain series. Would you sleep on a bed of nails? Why is standing on a tack more painful? In this post I want to share some pain stories with you that can help to uncover the mysteries of pain. So are you sitting comfortably, relaxed in your favorite armchair with a cup of tea, recording your favorite tv program on your sky box so you can read my short stories and watch your program after? Well perhaps not but if you have got this far I encourage you to read on…… … More Pain: Part 2: Pain Stories
Welcome to my 5 part pain series! Yep 5 parts! Why? To try to explain Pain in one post is too simplistic and pain is definitely not simplistic. So I’m gonna break this up into 5 small bite size posts and take you on a journey to understand pain. I intend to attempt to explain what pain is, how it enters the body, what happens in the nervous system and what can affect it becoming a persistent problem, a tough challenge I have set myself and indeed arduous! … More Pain: Part 1: The origins
This post is my first attempt at being all philosophical and stuff and it is mainly directed at healthcare professionals but it benefits everyone. I’ve been writing my blog for a very short time now and I joined twitter around the same time for the purpose of connecting and engaging with other like-minded health professionals that … More Create a movement – think horizontally