How much is enough?

I always get asked the question, “How much is enough?” What I mean by this is treatment dosage.How long should you mobilise a joint for? What grade mobilisation should I use? How long should I leave a needle in for? How much stimulation…

Are you staying up to date?

As clinicians it is important that we are always staying up to date with evidence based practices and terminology. One very commonly used label is “Sciatica” This diagnostic label dates back to Hippocrates who was allegedly, the first…

Stop Blaming Me!

So often in clinicians and patients blame an individual muscle or structure as the cause of pain.  How often do you hear (or even say) that it’s the Piriformis, Supraspinatus or the QL… Yes, I am sure if someone presents with pain in…

TMJ in clinical practice – Part 2

Welcome back to this series on the TMJ in clinical practice. My goal in this series is to introduce you to different factors in the assessment and treatment of TMJ related pain. Today I’d like to bring your awareness to the temporomandibular…

TMJ in clinical practice – Part 1

Temporomandibular Joint Dysfunction… Where do we start?! Such a small joint, but so much to understand and consider when assessing and treating this presentation. I hear from so many of you that the TMJ is just so complex and difficult to…

Reconceptualising pain with a plastic brain

Can your brain change? Have you every changed your mind, or changed your opinion? Even when you believed something so strongly, but you were still able to change. What about that bad habit that you were able to shake? Have you…

Leadership – personal perspective

Firstly, let me start out by saying I am no expert in leadership, nor do I think I am a great leader. But over the years I have had some great leaders and some not-so-great leaders. I am lucky enough to currently be led by one of the best,…

You have a bad posture..

Does pointing out postural discrepancies help or harm? I, like many of you were taught to assess a patient’s posture, and was taught that if someone had an anterior pelvic tilt, then it must mean their hip flexors are short and tight and…

I think, therefore I am

Often there is a lot of attention directed towards the ‘condition’ or the ‘pathology’ in chronic pain, and while this is a component, we need to zoom out and look at the whole person. It is common to think and believe that the…

Don’t build something for sake of building it

In my travels I get the privilege of speaking to lots of clinicians from all over the world, and something that often comes up in conversation is their desire to build a big clinic with lots of practitioners.It makes sense of course……

The Danger in Confidence

I bet you can think of someone like this…It is the person who is so very confident in their ideas or opinions that they are incapable (or perhaps unwilling) to see that there may in fact be flaws in their perspective. Don’t…

Stress, pain and resilience

We all talk about stress, But what is stress? The World Health Organisation defines stress as any type of change that causes physical, emotional or psychological strain. But is all stress bad? Stress is a common and normal physiological…

The wrong advice

Ok, picture this… True story. I was in a shoe shop a few days ago, and happened to overhear a conversation with one of the shop attendants (SA) and a customer (C). It went something like this. SA – Hi, how can I help you today.C –…

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…

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…

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…

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…

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▶️…

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…

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…

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…

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…

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…

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…

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…