It was quite the honour to be asked by the Physio First team in the UK to write an article for their In Touch magazine. To have one of my blogposts resonate with a major physio organisation back in my home country was something very special. I was fortunate to have completed a sports and … More Reasoning Exercise Dosage for Persistent Pain: Physio First In Touch Magazine Article.
I frequently joke with many of my colleagues that I’m an OT in a physio’s body. Most of my work in pain management involves supporting people, increasing self-efficacy, addressing concerns or worries about misconceptions of fragility of the body and of course getting people moving. So, yeah I’m a physio and I often question what … More Blurring the lines: Physio, OT, exercise & context
Sometimes I wonder why I just don’t ask a simple question such as, “what are safety behaviours?” Oh no, not me I like to ask deeper questions! So, this blog is kind of an opinion piece but more ramblings about reading and interpretation. Apologies in advance if I go off track. Writing is thinking and … More Is avoidance behavior always related to fear and is it something that always needs to be extinguished?
It’s been a while since I released a 31 days project video. I’ve been reading a lot of papers back from the 80s and seeing that actually not a lot has changed in terms of pain management. One pioneering individual (he is for me) is Bill Fordyce. He identified how learning and experiences influenced the occurrence … More 31 Day Project: Don’t think you are know you are
Whole of community pain health education. for back pain. Why does first-line care get almost no attention and what exactly are we waiting for? I read with intrigue and interest Lorimer’s editorial in the British Journal of Sports Medicine (G. L. Moseley, 2018). I have huge respect for the man who has effectively flipped the traditionalist healthcare … More A response to Lorimer’s editorial in the BJSM
Complex Regional Pain Syndrome (CRPS) is commonly associated with an injury of the extremities. In CRPS type I, the most common is a fracture of the hand or foot complex. In the upper limb (which has a higher prevalence of CRPS) an uncomplicated radial fracture would normally take around 6-8 weeks to heal (if no … More CRPS series: Vitamin C a look at the evidence.
Exercise is routinely advocated by healthcare professionals as a treatment to address pain and tissue injury. The consensus that strengthening the local tissue will attenuate pain by improving its resilience whilst transitioning through a natural cycle of tissue healing. Whilst exercise does have morphological effects on local muscle it is understood that increases in muscle … More What role does exercise have on acid sensing ion channels and conditioned pain modulation?
I am very privileged to have another guest post from a Physiotherapist that has just as much of an obsessive interest in Complex Regional Pain Syndrome as I do. Janet Holly (@innerchild) is a Senior Physiotherapist at Ottawa Hospital in Canada. Janet recently had a paper (ref) published with Tara Packham (@TaraLPackham) in the Journal … More CRPS: What To Do About It? A Guest Post from Janet Holly
There’s been a lot of talk around the term fake news in the media. Mr Trump (I can’t believe he got a mention in my blog!) is a master of calling out fake news and it was so popular it was named word of the year in 2017 (reference). Fake News is the term … More Fake News! Faking or Malingering Pain.
We’ve all seen that familiar face pulled by people living with persistent who are being asked to exercise for the first time. Dosage is something we are all familiar with when it comes to taking medication. Yet with exercise will still tend to focus on the typical 3 sets of 10 or 12 or 15 … More Reasoning dosage for people with persistent pain
It’s interesting what gives you inspiration to write. Topical issues, pseudo-science, the latest research, jotting down your thoughts. I had intended my first blog of 2018 to be about my further reflections on causation. Yet after what occurred on last Friday afternoon (02/02/18), I felt compelled to change tack and blog about the nonsense that the … More Grab a colourful infographic, post, then bail.
Exercise is medicine (EiM) has gained a significant amount of attention since its launch by the American College of Sports Medicine in 2007. A global health initiative that has since been adopted by many other countries throughout the world to address the growing problem of chronic disease and inactivity. According to the World Health Organisation … More Taking the fun out of Exercise (is Medicine) (N=1)
Everyday, I hear, read or see some issue surrounding public health. The increases in chronic disease, the financial strain on health budgets, people are less active, the rising cost in food, issues in childhood obesity. I do my best to access and read as much research as I can (to challenge my biases) to identify … More Physiotherapy, come forward! (It’s time to step out from behind the curtain)
The placebo effect is a fascinating area of medicine. In clinical trials the placebo- controlled trial is regarded as “the gold standard” to determine the efficacy of active treatments such as in a new drug. However, placebo doesn’t come without controversy particularly in areas of clinical practice such as the use of acupuncture, which is … More Placebo: Much ado about nothing? A guest post by David Poulter
T.Rex’s ‘children of the revolution’ blasted out through the speakers in the pub where a small group of physiotherapists came together to discuss the future of the profession in New Zealand. It seems New Zealand is not the only country where a profession is grappling with its identity and how it needs to evolve for … More Physio’s of the revolution
I’ve got a bit of a habit of doing things backwards, I read magazines from the back to front cause I’m left handed, I tend to act first and think second, I don’t think I ever followed a full physiotherapy assessment by the order of the book and even my reasoning I’ll experiment with things … More Behind the mirror: A single case of mirror therapy
As Paul flicked and gazed with interest through the latest journal article he became hot and flustered and pondered on how this new information could be disseminated and reasoned into his clinical practice. “I can’t stand it!” he cried as he thrust the journal to the floor in frustration. Yet, he became overwhelmed by the … More Fifty Shades of Grey Reasoning: A critical thinkers approach
So some of you that might be reading this (and that know me) are familiar with my fascination of the use of Virtual Reality within a persistent pain setting. I am the first person to admit it is very cool and it is something that I am exploring more clinically. However, I want to put … More All aboard! The VR bandwagon
Complex Regional Pain Syndrome (CRPS) is a severely debilitating condition. It’s been ranked higher than pregnancy and amputation of a digit on the McGill Pain Index. Currently, there is no single treatment specifically for CRPS. Yet this is a common trend with all complex pain presentations. A multi-modal approach is required due to the complex … More CRPS: What’s the best treatment?
In musculoskeletal medicine, healthcare professionals do a reasonably good job of treating the tissue injury. Treating the person is a tad more challenging. Just take back pain for example. It’s the leading cause of years lived with disability (Vos et al., 2012) in the western world, so collectively as health advisors, we could be doing … More Exercise Hacks for People Living with Long-term Pain
Complex Regional Pain Syndrome (CRPS) is an incredibly debilitating condition. It effects the peripheral limbs specifically the hands and feet. CRPS usually occurs following trauma to the limb, commonly a fracture but also sprains, strains and crush injuries (Bruehl, 2015). It has also been recorded to occur following minor trauma such as a bee sting … More CRPS Series: Are we assessing appropriately?
Posture, wow it’s a popular topic, particularly in primary and community healthcare. You literally can’t go a day without seeing something that relates to improving or “correcting” your posture. Your health professional (that’s physio, chiro, osteo, pilates teacher, massage therapist, personal trainer, the media) has I’m sure at one time talked to you about posture … More Posture: the ongoing debate
Osteoarthritis is the most common arthritic complaint among older adults with pain, loss of function, disability and reduction in quality of life being the result. Pain is reported to be the most common complaint for people to undergo a total knee replacement (TKR), with the understanding being that the damage in my joint is causing … More Knee Osteoarthritis, bracing, surgery, exercise and pain
That’s a huge percentage! Yes, according to recent evidence (Artero et al., 2012) running really does reduce the risk of death by 63%! As the title suggests this relates to cardiovascular disease and all-cause mortality (cause of death), which includes other chronic conditions such as obesity, diabetes and cancer. Lee et al (2014) identified that … More Running reduces the risk of death up to 63%, but that’s not all it does!
Yeah whales, humans, biomechanics and pain. Thanks to Ben Cormack (a real geezer) from CorKinetic for his contributions to this blog. The video above on whales and their contribution to our planet is not only informative and enlightening but also serves as a great metaphor for our understanding of the human body. Confused? Intrigued? Then … More What can whale poo teach us about biomechanics and pain?
‘Now you see it, now you don’t’ is a popular idiom that magicians use whilst performing illusions, with the intention of leaving the viewer flummoxed. The phrase is used to express that something is gone without clear explanation of how and why. Take the rubber hand illusion (RHI) for example, this is an interesting neurological … More CRPS Series: Hand, you see it? Now you don’t. Hand, you feel it? Now you don’t.
Professor Andy Clark is philosopher of mind and cognitive science. He has taught and written in areas of cognitive science, in particular his publication ‘Natural Born Cyborgs’ is an insightful read about the extended mind. This session of the big naked pain and brain campaign looks at an example of his work on the extended mind. … More TBNPABC – The extended Mind
Complex Regional Pain Syndrome (CRPS) is a complex and poorly understood problem. There have been several proposed interacting pathophysiological features of the condition including altered sympathetic nervous system function, central sensitisation, inflammatory factors, immune factors, genetic factors, brain changes and psychological factors (Bruehl, 2015; Marinus et al., 2011). Most diagnostic criteria come from clinical features … More Complex Regional Pain Syndrome Series: Peripheral Inflammation
Ready to engage with people living with pain in a creative way? I like to think that with all the courses, blogs and content on social media out there, clinicians have a better understanding of language use, creativity and communication skills. Well, you might think that but then your likely mistaken. There’s still much to do … More Clinicians Get Creative: Creative Ways to Reframe Pain
Ever since I read Moseley et al’s (1) paper back in 2009 on visual distortion I was instantly succumbed to the idea of embodiment and wanting to work with people living with Complex Regional Pain Syndrome (CRPS). I admit I didn’t fully understand what embodiment was back then, but there was a small part of … More Complex Regional Pain Syndrome series: Visual distortion
I thought I would have a crack at seeing into the future. No not from a Doc Brown perspective, more from the next exciting and interesting stage of human understanding – predictive processing. Now this is by no means academic at any level however, it may go above some readers heads. This is just my musings … More The Future! Can we predict it?
As you can see this is a very short blog. Yet helpful all the same! I have created my own version of the TSK – 11 adapted from Goubert et al., (2004) and Woby, Roach, Urmston & Watson., (2005). I have also added the Avoidance and Harm sub scales. Please feel free to click the link … More The Tampa Scale of Kinesiophobia – 11
I have a goal, a goal to reduce my social media time. Why? Cause it can make me miserable! It distracts me from more important things and it can engage me in conversations that are just… well… pointless! That’s a whole heap of productive time, lost! Anyway that’s my problem, my own personal issue and something … More Living with Pain and Goals: Should they be SMART, MEANINGful or VAPID?
Please note: This blogpost expresses humorous exchange of language between the nakedphysioette and myself as means of coping when she has a flare up. It is not meant to be taken literally. It is intended that people whom read this blog may relate either through their own choice of verbal, facial or bodily expression. Platitudes are common … More Platitudes at Your Peril
It’s that time of year again when we all wind down for the holidays (I’m still trying to get my head around Christmas in the summer??) and us bloggers share our musings of the year. 2016 has been a very exciting year for me on a personal and professional level. It has delivered some … More The dinosaurs commeth: 2016 round up
Yes it’s Big Naked Pain and Brain Campaign again! I am always on the hunt for new videos, films, educational skits and always on the look out for suggestions from followers that want to contribute to TBNPABC. Understanding pain, it’s as easy as learning to ride a bike! This reprise is a favourite of mine. The … More TBNPABC: Reprise: The Backwards Bike
Over the last week I’ve been travelling (with a small team from the company I work for) around the north island of New Zealand delivering in-service training talks to allied health professionals, (Physios, OTs, Psychs, counsellors, medical specialists) about the new Accident Compensation Corporation pain service that has been rolled out nationwide across NZ. My … More Everybody wants a piece of the pain pie
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
Tom Jesson @thomas_jesson published his thoughts and reflections on radiculopathy on Twitter recently. Reading through the feed I really enjoyed the questions he wanted to answer. I found it so helpful that I reached out to Tom and asked for his permission to convert the feed into a blogpost so that others could benefit from … More Reasoning radiculopathy a guest post by Tom Jesson