A sparkling, glittery threat to evidence based practice

gold turd

Here at Brunel I run an MSc module on evidence based practice. In the first session of the module I run an honesty test. Here it is (answer it yourself and, well, be honest). “What sections of a research paper do you routinely read. Honestly.” Almost without exception the whole group will admit to reading the abstract and small proportion … [Read more...]

How To Form A Habit

We’ve all wondered how to get our patients to change their life habits (to the better of course…in our minds). In fact, the behavioural and physical therapies depend on us being able to convince patients to develop new habits - to  bend and straighten their knees a few times before getting up from prolonged sitting perhaps, or to walk up the stairs … [Read more...]

Teaching people about pain – a kind of position paper

Fig1_PhyTherRev_12_169

Some time ago, I wrote this paper, at the request of the journal Physical Therapy Reviews, on reconceptualising pain. It is a little old now but it has come to be a bit of a position paper. The position has four fundamentals, none of which will be very surprising to anyone I imagine: (i) pain does not provide a measure of the state of the … [Read more...]

Large flat whites taste stronger than regular flat whites

Flat white coffee

Australia is, I think, the home of the Flat White - a coffee that is a bit like a latte with less milk and that has quite recently started infiltrating the UK coffee scene. Of course, Monmouth at Borough Market has been doing a very good flat white for a few years, but then again, in my view, Monmouth at Borough Market is the BEST place for coffee … [Read more...]

Up close and personal with movement – a review from the experts

Here is a review that, if you are interested in how the brain controls muscles, and you are prepared to put in some hard yards, you should read. Simon Gandevia works down the corridor from me, so do Janet Taylor and Jane Butler. Nicholas Peterson doesn't but I once had a cup of tea from the same pot. So, I am, everyday, in the presence of … [Read more...]

Expecting back pain – the possibility of a self-fulfilling prophecy

It seems like years ago now, well, it is years ago now, that I did this study with The Walking Cortex (TWC, Paul Hodges).  This was one of my PhD studies. I think it is quite a groovy study.  We gave supposedly normal healthy volunteers painful electric shocks, through electrodes placed over the back of their pelvis.  We showed that when they are … [Read more...]

The disc in sitting – much ado about nothing

When I went through physio school, I remember feeling more and more aware of how I sat, as the course went on. We were clearly learning our stuff - we knew, that back pain was caused in no small part by discs bulging - HANG ON! Let me start at the beginning (for as Mary Poppins says, it is a very good place to start). We actually knew that the disc … [Read more...]

Faulty input makes you feel funny, but doesn’t hurt

There is a really attractive theory that has been used to explain why some people have chronic ongoing pain even though there is nothing wrong in the body part that hurts.  The theory suggests that the pain occurs because motor commands don't match proprioceptive feedback from the body.  The name often given to this theory is the sensory-motor … [Read more...]

More on the complex interaction between us and our environment….

pain1_brain_2008

There is a very clever Belgian psychologist called Stefaan Van Damme.  He has done some excellent work on attentional mechanisms involved in pain.  More importantly, however, is that he is a jolly nice fellow.  Anyway, he came to Oxford and did a great little experiment (actually, we did a couple but the other one is not ready for the real world … [Read more...]

Is that training diary doing anything?

One really cool aspect of using a software program like Recognise, is that you can keep tabs on whether or not patients actually do what we ask them to do.  This is an important issue because any treatment that involves home exercises or training depends on people doing it!  Historically, clinicians have used a training or home exercise diary to … [Read more...]