Entries by Shaun Brewster

What kind of a plant is painful?

A faceplant.. Ok that’s enough jokes… But it does link in with today’s topic so I couldn’t resist. Our bodies and our aches, pains, injuries and overall wellbeing can be a bit like a garden. You put good stuff in, you get good stuff out. You plant nothing, then you get nothing out. Sometimes, a plant in […]

The Trigger Point

A trigger point is something that you will deal with in everyday clinical practice when treating patients with musculoskeletal pain presentations. Unfortunately, the myofascial trigger point is often an overlooked contributor to chronic myofascial pain and central sensitisation.  So what is a trigger point? As defined by Travel & Simons a trigger point is a “A […]

A perspective of change

Definitions in the world of science continuously change. Just as our skin ages and changes so do our brains. The ideas and beliefs that we held to be true when we first learned about manual therapy in our undergraduate studies should also change and evolve as the understanding improves. When our understanding fails to evolve, […]

6 Myths about sacroiliac joint pain

Myth #1 The SIJ can become unstable The SIJ functions to provide stability and the transmission and dissipation of load from the trunk to the lower extremities. (Thawrani, 2019) The SIJ is an inherently stable structure with only a small 6 degrees of movement available during normal activity.  (Palsson et al. 2019) During development the SIJ changes structure, it […]

Hip and Groin pain

Anterior hip and groin pain could be due to a number of different reasons. But let’s talk about intraarticular hip pain. ▶️ Intra-articular hip pathology refers to pain and pathology within the hip joint▶️ It typically presents as deep pain in the anterior hip and groin region and can also present as buttock pain▶️ Common […]

If it is working, go all in

Such simple advice, but why don’t we all follow it? Be it in the clinical setting, in business or in life, far too often we change course or try something new when the thing we were doing was already working so well for us. It’s easy to become led in a different direction when we are constantly […]

A Problem well stated is a problem half solved.

In my experience, often the best and fastest way to a solution is to first get clear about the “real” goal.I say “real” because the first stated goal or the one that seems most obvious is not always the true one. For example, a patient may say that they have come to see you because […]

The importance of patient expectations

Patients’ beliefs and expectations need to be better understood by clinicians to improve management. Asking the question, What is your understanding of your pain? Do you believe that it is just a physical / mechanical problem? Spending the time to really hear your patient’s story and understand what they expect from this treatment regarding their pain and […]

Managing lateral hip pain

Following on from last week’s email about the Lateral hip pain. This week we will take a look at the management. One of the key components to successful management is education. Educating our patients about potential contributors to their pain is key. AS discussed last week the gluteal tendons are vulnerable to compression at the insertion […]

Lateral hip pain

Lateral hip pain is very common and debilitating source of pain. There are multiple pathologies associated with anatomical structures of the lateral hip including: 👉 Gluteal tendinopathy👉 Proximal ITB syndrome👉 External snapping hip syndrome👉 Gluteal tears👉 Gluteal bursitis Pain in this region has been termed Greater Trochanteric Pain Syndrome (GTPS) which is an umbrella term. […]

Referred Pain

What is it? Referred pain can be confusing and often misunderstood. Patients regularly present to us in clinical practice with referred pain symptoms. But what is it? Where does it come from? and why can it be so different?   Firstly let’s start out by stating that referred pain is different to neuropathic pain. Referred […]

Your back is not out!!!

Ok, this is potentially going to upset a few people… Mostly because what we are discussing today will go against some long held beliefs of many practitioners and their patients. The old “structural” model of understanding in relation to joint position and related pain is far too simplistic and lacking in understanding of modern pain […]

Running Injuries

It has got to be the simplest, most accessible, yet frustrating sport known to human-kind. Yep, running… You either love it or you hate it. For me, it was a deep passion for almost 20 years and now is something that I have learned to enjoy with a little more balance and perspective. In the early […]

Overservicing patients

Are you guilty of this❓ I’m likely to get a few people off side with this article, but it is something that needs to be shared.Overservicing our patients is a problem for so many reasons, and we can fall into this trap in a number of ways. Let’s firstly look at what it is, and […]

I have Sciatica…

What does that even mean?! Sciatica is a symptom that may be originating from a plethora of pathophysiological causes. Firstly, we should consider that the layman may understand sciatica as ANY pain that is referred into the leg, and Dr Google will often (unfortunately) confirm their suspicion of this… When a patient presents to your […]

Do you take ownership?

Would you agree with this…? Assuming responsibility in any given situation can be a frightening proposition because that responsibility requires you to be accountable to the outcome being sought. What “taking ownership” means? For us in clinical practice, taking ownership means recognising that someone has literally come and placed their time, money and needs in your […]

Shoulder pain: The influence of imaging and diagnostic labels

How often does a patient present to you in clinic with an imaging report ordered by a GP, (or other practitioner) But the practitioner has not taken the time to go through the report and educate the patient on what it means using normalising / unthreatening terminology. There is often terminology like “partial thickness tear” […]

Gaining trust

One factor in clinical practice that really isn’t given enough emphasis in training is TRUST. We focus heavily on the clinical sciences, critical decision making, treatment planning and delivery, but it can be too easy for the patient to be “left behind” in it all. It doesn’t take much digging to find research papers on […]