Entries by Shaun Brewster

Why do you need to know that

Do you take any recreational or performance enhancing substances? These are questions that would sound quite fitting to a police interview room, or maybe an attorney’s line of questioning of a witness. But they’re also on most allied health professional’s intake forms. These are very personal and intrusive questions to ask a stranger. We then […]

What is in your manual therapy cocktail?

As we each progress through our individual careers in manual therapy, we tend to accumulate various skills, tools and approaches. Our professional development is often built on the idea that we need to learn new things and “stack” modalities into our toolkit.  What I’ve often seen happen is practitioners ultimately feeling the need to utilise […]

My Back Pain Diary: Choosing Curiosity Over Fear

My favourite day of the week is deadlift day…After a brisk 15-minute walk to the gym, I cut a bee line and went straight to the deadlift platform. I started with two warm-up sets at 60 kg, ten reps each. Then added two more plates for the next set. On my second repetition, I felt […]

Goals and what they cost.

This is the time of year that many of us will be setting our intentions, making plans and committing to new things.New Year’s resolutions and goal setting almost feels like expectations, but why do those goals often NOT get met? In my experience, there are a few things we can do that will help increase […]

Threat Level Extreme

Is pain a manifestation of a heightened perceived level of threat? Remember that we learn what is threatening from our previous experience so we can make better decisions it in the future. But sometimes that learned behaviour sticks even after the tissue has healed of the stimulus is removed. Simply believing that something is dangerous […]

Tissue – Spinal Cord – Brain – Mind

If you’ve sat in a class room with me, you’ve most likely heard me talk about four levels of effect when it comes to manual therapies. I like to break it down this way, because it shows just how vast the mechanisms of effect that we are interacting with actually are. Old school manual therapy education told us that […]

I can feel how tight it is.. Can you?

Palpation is a valuable tool that can aid building our therapeutic alliance and support our assessment and treatment approach. It allows us to search for areas of pain and confirm these areas of discomfort with our patient. In manual therapy, we are trained to feel for tight muscles, taut bands, tender spots, with the belief […]

Pain is a process and not an entity

Shifting your mindset and understanding of pain as a process provides insight into the complexity of the pain experience. Importantly, this experience is unique to the individual person, life experience, and environmental factors, all of which can all play a role in this process.  I am often faced with interactions with other clinicians that raise […]

The value (and danger) of your opinion

As health practitioners, people come to us for advice and guidance.Our opinion is often considered as “fact” by those seeking our input. Because of this, the responsibility we bear in each interaction is considerable, and must be taken seriously. The old saying “Dr knows best” is obviously incorrect, because no medical / health practitioner will […]

Manual Therapy Retreat 2025 Greek Islands

This year we held our Greek Islands Manual Therapy Retreat 2025 on the Instagram worthy island of Santorini from Saturday 3rd to Saturday 10th May, and what an incredible week it was. To give you a better understanding of what ACE Retreats entail, we thought it is best to give you a run through of each […]

“I have a back back”

When someone says, “I have a bad back,” it often reflects much more than a description of musculoskeletal pain or pathology. This labelling implies that there is a strong internal model that is formed through prior experience, where the back is perceived as being vulnerable or damaged. Consider how you navigate the world, and your […]

Time for a new paradigm

As I travel around the country, teaching the various modalities that we cover in our courses, I often find myself having the same conversation with clinicians, about a very real challenge that they face.That challenge is tied to the realisation that when they learn something new, and decide to change they way they work, that […]

The barrier or the goal?

For many people living with pain a structural narrative becomes tightly bound to their identity.  “I have two herniated discs,” “I have osteoarthritis,” “I have a torn rotator cuff.” “I have chronic pain” Over time, these labels can become part of a person’s sense of self. The language used by clinicians, can inadvertently reinforce this identity of fragility, damage […]

The Scope of Practice Debate

A topic that often comes up in conversation at our courses, but also more broadly within the health professions is scope of practice.We’ve probably all be told at some point that a particular treatment approach, the use of certain tools, or a specific modality is outside of your scope of practice.  But what, or who […]

We are not the same

During a recent consultation, my patient told me she couldn’t run because she had a “weak tendon.” She said her Achilles had degenerated, so she avoided running. I asked her what she meant by that, and she replied, “Well, structure equals function, right?” (Interestingly, she didn’t have any Achilles pain.) Structure equals function…until it doesn’t. This principle applies […]

Staff – How to keep them

It doesn’t matter where I travel to, every clinic owner I speak to has the same or similar challenges. Paramount amongst those challenges, is finding and keeping great staff. It is so common that clinic owners struggle to find enough staff, or perhaps enough good quality staff, but then when they get them, their next […]

It’s all about the ABC’s

Who is responsible for achieving your goals? The answer lies in self-efficacy. This is defined as the belief in your ability to accomplish what you set out to do. Improving self-efficacy requires positive internal beliefs rather than relying on external assistance. In clinical practice very early in the consultation process, I will discuss with my […]

3 tips from the ACE school of marketing

Business has always been a fascination and passion of mine. I love that we can take an idea, something we have created or something we know, and turn it into something that can help others. It is so rewarding when that thing is valued by others, and if we get really good at this, it […]

Are you certain?

How certain are we about the causes we identify? Before labelling something as the cause, have we genuinely explored all possibilities? We often take the path of least resistance, seeking confirmation for our assumptions rather than challenging them. For example, if a patient presents with back pain and we examine them through a structural lens, […]

Finding confidence in uncertainty

I’ve been thinking lately about this idea of uncertainty in clinical practice, and the impact it has on us all. As clinicians, we are regularly faced with situations where what we believe will happen, doesn’t. We also regularly see patient problems that don’t fit a particular mould, and therefor are difficult to wrap a solution […]

Everything was great until…

Some time ago, I was in a Vietnamese restaurant in Cabramatta NSW. Those who know the area will confirm that ‘Cabra’ is about as authentic as it gets outside of Vietnam, hence it’s nickname ‘Little Saigon’. I was there with some work colleagues after a dry needling course. One of my colleagues ordered a combination […]

Answers to your questions 

Bo and I are very fortunate to be able to travel and teach in many locations every year, and in doing so, we get to meet and speak to hundreds and hundreds of fantastic health practitioners. Each person has their own unique experiences and perspectives.In these interactions we get the opportunity to answer many questions, […]

Who is the better driver?

Do you feel more anxious when someone else is in control? Are you more worried or less confident? Are you more tense as a passenger? Does your emotion or behaviour influence the driver and make them more tense? Or perhaps you feel more nervous in the driver’s seat and prefer someone else to take control? […]

What if it gets worse?

Okay, but what if it doesn’t? Fear can be a significant barrier to improvement and contributor to increased pain, sensitivity and avoidance behaviours. Injuries occur, and our bodies heal. But the regression of pain is rarely linear. Is there a belief that a movement is harmful, a subconscious expectation of pain, a memory that is associated with […]

Things aren’t always what they seem

I’ve been reminded of this several times recently, and it has been a good reminder that what we perceive to be the case, is not always the reality.In the world of clinical practice, arriving at a point of mutual understanding and rapport with your patient is very important. This connection and mutual respect is key […]