In this episode we were joined with Dr Bronnie Lennox Thompson and we discussed some of the beliefs that underpin when and why a person seeks care, and why a clinician should take the time to investigate this and also make sure the check their own assumptions. Bronnie also touched on why pain reduction/resolution is not always the primary goal, and discussed her research which looked into how some individuals live well with pain whilst others do not. This episode gestures toward the importance of history taking, motivational interviewing, pain science and human psychology (as as such has immediately become Ian’s favourite episode!)
Paul Ingraham is a Vancouver science journalist and creator of PainScience.com, a website about the science of pain, injury, treatment, and rehab with about a million monthly readers. In this episode he discussed the reasons people ritualistically stretch (beliefs about flexibility, injury reduction, improving performance etc) and the whether the scientific literature backs them up. He also made reference to certain structures which are biomechanically awkward/impossible to stretch, some of the sensory adaptations/neurology that may be involved, and whether stretching is indeed as beneficial as it society believes it to be.
In this episode with are joined by Matt Cotchett who has published extensively within the field of plantar heel pain, and in this episode we tackle the topic of terminology (fasciitis Vs fasciopathy Vs PHP), the associated psychological variables, dry needling, and the best evidence based practice/approach to treating heel pain in clinic.
About Matthew Cotchett:
Dr Matt Cotchett PhD is a Lecturer and researcher in the La Trobe Rural Health School at La Trobe University, Melbourne, Australia. He works as a Podiatrist in private practice with an interest in the assessment and management of exercise-induced musculoskeletal disorders. Matthew has a particular interest in the management of pain beneath the heel and completed a PhD which evaluated the effectiveness of trigger point dry needling for plantar heel pain. He regularly teaches dry needling courses to podiatrists across Victoria. Matthew’s research interest is in the psychosocial aspects of musculoskeletal pain, with a particular focus on cognitive, affective and behavioural factors as drivers of pain and disability. In addition, Matthew is leading a project to improve knowledge translation and treatment of people with plantar heel pain.
In this episode we talked about “the language of behaviour change” and asked our guests why this is important for all Podiatrists. Why don’t some patients just do what we tell them (the so called ‘difficult patient’) and what approaches may be beneficial to take in such cases? Have a listen for a brief introduction to MI, and why (and how) it should be viewed as a patient centred collaborative approach rather than simply a tool to get people to do what you tell them to. Loads of great resources were mentions; see the comments below for links. Our guests were Dr Joanne Paton from Plymouth University, Jodi Binning from Glasgow Caledonian University, and Andrew Hill who is doing his PhD at The University of Bath.
In this episode we talked with the sports therapist, Ben Cormack. We talked about what he believes are the key components to a successful rehab programme (and why they may fail), along with how we promote self efficacy, empower and motivate our patients and the evidence base behind strength work (and the differences between strength and load tolerance).
About Ben Cormack:
Ben has a passion for getting people moving and using and understanding movement as an important tool to help others. Originally from a fitness background, Ben has gone on to study Sports therapy and widely in the fields of rehabilitation, pain science and movement over the last 15 years. Ben owns and runs Cor-Kinetic, an educational company who use modern research into pain, movement and neuro sciences to provide a reasoning process and rehab skills to those who also place a priority on using movement and exercise as key competencies. Cor-kinetic have provided educational services for the NHS, Elite level sports clubs and universities as well as individual physio’s, Osteopaths, Chiropractors, sports therapists, rehab, and personal trainers.
In this episode we welcomed Physical Therapist Jarod Hall on to talk us through what his history taking looks like, the language he uses (and tried to avoid), how he asks about the complex topic of pain and the importance he places on educating those sitting across from him in his clinic office.
About Jarod Hall:
Jarod went to and graduated from Texas A&M University in 2011 with a B.S. in Exercise Physiology and Theories of Motor Control. After Graduating from Texas A&M Jarod moved to Fort Worth to attend the UNT Health Science Center’s Doctor of Physical Therapy program. He completed his doctorate in May of 2014 after being named the recipient of the Dean’s Award for Academic Excellence.
In this episode, we talk about the complexity of pain with physiotherapist and pain educator, Mike Stewart. It is crucial for us to understand pain better than we have historically (and be able to effectively communicate this to our patients). We conclude that pain is a personal experience; an output of the brain in response to real or perceived danger with the goal of protecting us and getting us to modify our behaviour. It is contextual and influenced by numerous factors. Clearly, this has implications for our history taking, the language we use (or don’t use) and ultimately our management of MSK pathology.
About Mike Stewart:
Mike is a physiotherapist who works as a Spinal Clinical Specialist for East Kent Hospitals University Foundation NHS Trust. He is a full-time clinician with over fifteen years of experience managing complex, persistent pain conditions. In addition, he is a dedicated practice-based educator committed to providing evidence-based education to a wide variety of health professionals. Mike is currently undertaking an MSc in Clinical Education at the University of Brighton. Mike runs the Know Pain courses around the world. Both Craig and Ian have attended this course.
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