Reasoning Radiculopathy, Referred pain and Radicular pain: Tom Jesson’s In Touch article.


It’s time for another guest post on the naked physio. On twitter back in June this year I read an interesting thread on types of leg and arm pain. I enjoyed the thread so much I reached out to the physio and asked him to write a blog. He was able to go one step … More Reasoning Radiculopathy, Referred pain and Radicular pain: Tom Jesson’s In Touch article.

Reasoning Exercise Dosage for Persistent Pain: Physio First In Touch Magazine Article.


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.

Blurring the lines: Physio, OT, exercise & context


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

Is avoidance behavior always related to fear and is it something that always needs to be extinguished?


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?

31 Day Project: Don’t think you are know you are


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

A response to Lorimer’s editorial in the BJSM


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

What role does exercise have on acid sensing ion channels and conditioned pain modulation?


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?

CRPS: What To Do About It? A Guest Post from Janet Holly


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

Grab a colourful infographic, post, then bail.


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.

Taking the fun out of Exercise (is Medicine) (N=1)


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)

Physiotherapy, come forward! (It’s time to step out from behind the curtain)


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)

Placebo: Much ado about nothing? A guest post by David Poulter


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

Fifty Shades of Grey Reasoning: A critical thinkers approach


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

Exercise Hacks for People Living with Long-term Pain


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

CRPS Series: Are we assessing appropriately?


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: the ongoing debate


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

Knee Osteoarthritis, bracing, surgery, exercise and pain


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

Running reduces the risk of death up to 63%, but that’s not all it does!


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!

What can whale poo teach us about biomechanics and pain?


  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?

CRPS Series: Hand, you see it? Now you don’t. Hand, you feel it? Now you don’t.


‘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.

Complex Regional Pain Syndrome Series: Peripheral Inflammation


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

Clinicians Get Creative: Creative Ways to Reframe Pain


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

Complex Regional Pain Syndrome series: Visual distortion


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

Living with Pain and Goals: Should they be SMART, MEANINGful or VAPID?


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?

Everybody wants a piece of the pain pie


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

50 ways of thinking differently in pain science: Part 2


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

50 ways of thinking differently in pain science: Part 1


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

Bridging the Pain Gap: My NZ massage article


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

Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 3


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

Understanding the Biopsychosocial reasoning process in chronic back pain: A single case study part 2


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