Usual Care Physiotherapy – Say what?


Usual care physiotherapy for chronic musculoskeletal pain, does anyone still do that? I recently read a single – blinded randomized controlled trial article (Domingues et al., 2019) discussing the effectiveness of combined Manual Therapy with Exercise compared to “usual care” physiotherapy for the treatment of chronic non-specific neck pain (CNSNP). The first cynical thought that [...]

31 days project: Gollum and the empty chair


The lord of the rings has to be one of my all time favourite movies. One of the most interesting characters in the movie is Gollum. People familiar with the movie will know the story of how Gollum came to be. Before the ring of Sauron poisoned his mind he was known as the hobbit [...]

Why OTs and PTs are perfectly placed to use ACT.


We can use ACT? A psychological therapy?? But that’s stepping outside my professional boundary, I couldn’t possibly…   Ok, back up! I can’t speak for Occupational Therapists (OTs) but Physiotherapists (PTs), really?? Are you honestly saying you’re crossing a line? Let’s take a wee trip down my memory lane shall we. On my journey with [...]

Why is it that we do physiotherapy in this way?


  'Oh, I've been shaking I love it when you go crazy You take all my inhibitions Creativity, there's nothing holding me back You take me places that tear up my reputation Manipulate my decisions Creativity, there's nothing holding me back There's nothing holding me back There's nothing holding me back'  Adapted from Shawn Mendes, [...]

Physiotherapy and The Marvel Effect


 “Heroes are made by the path they choose, not the powers they are graced with.” –Brodi Ashton / Iron Man(Attribution) Superheroes have fueled the imagination and inspired us. We are currently in the cinematic age and renaissance of superheroes. Since 2008, when the first Iron Man movie was released, Marvel have released no less than [...]

Heart rate formulas, how reliable are they?


I have been a bit of a runner for most of my life. Where I grew up in the Highlands of Scotland there was plenty of cross country running tracks to be explored. Of course that was mixed in with mountain biking, fly fishing, kayaking, sailing, football, hiking, rock-climbing… you get the picture. I have [...]

Exercise and Pain: Can we case formulate exercise?


I’ve pondered for quite some time if we can efficiently tailor exercise programs for people living with pain. Recent evidence (Hodges, 2019)and a consensus amongst peers, suggest that a hybrid approach to pain management programs is necessary. As proposed by Hodges, (2019) this would include stratification, identification of pain mechanism and subgrouping based on movement and/or psychology.  The multidimensional [...]

31 days project: The Power of Touch


I saw this video and just had to share it to metaphorically emphasise the power of touch. There are some in the physiotherapy profession that bang on about how pointless manual therapy is, and  whilst the evidence base confirms that we are unlikely doing anything mechanically (i.e. resetting joints, correcting leg length discrepancies, increasing tissue [...]

31 Days Project: Forrest Gump, Physiology and Philosophy of Running


I'm a bit of a runner, always have been. Nothing overly competitive but participated because of the health benefits. So, whilst exercise has physiological effects on the body there is also another side to running that interests me, the philosophy. More specifcally the sense of freedom, the adventure and the opportunity to reflect and consolidate my [...]

Chronic Low Back Pain: Can we be specific?


Persistent pain is certainly a complex beast and if we are to discuss particular body regions, low back pain would have to be the kraken* of all musculoskeletal disorders. In 2018 it was still the number one cause of disability globally and has dominated the number one spot spanning nearly 3 decades (James et al., [...]

Casey’s Story: A Guest Blog


I've decided to share a story about someone that had a wonderful outcome from engaging in a pain program. The story takes you on a rollercoaster ride of physical and emotional experiences.  I agreed to share it because the story identifies areas in our current practice that have created misconceptions about pain and what to do [...]

When is CRPS, CRPS?


Complex Regional Pain Syndrome is a tricky condition. It’s a challenging pain condition for clinicians and can be a crippling pain condition for people living with it. The condition presents as a diverse set of signs and symptoms including inflammatory, sensory/motor, autonomic abnormalities and pain. Most commonly, CRPS tends to present following an injury directly [...]

31 Days Project: Connectivity


I'm always on the hunt for new information on why physiotherapists should broaden their perspectives through 1)  how we connect with people and 2) in what ways we connect with them. Connectivity is an emerging concept in physiotherapy. Several papers have been published discussing and arguing the broader view of the connections people make between ‘one’s [...]

What’s next for Physiotherapy: Euthanizing the status quo?


  I recently carried the torch for the PhysioCPDRevolution by presenting some of my own musings and readings about what might be a direction for physiotherapy. Below is a slightly adapted version of the transcript I presented. The presentation was recorded on Facebook Live (here). The PhysioCPDRevolution was also a year old and so I [...]