DIVIDED WE STAND

Uncategorized Aug 10, 2020

Here at the BCP, we try our best to find the delicate balance between the clinical and academical worlds. But it's tough, really tough trying to find the best evidence-based solutions for our patients whilst dealing with the day to day clinical realities and challenges.

Find out how the BCP is closing the gap between the academical and clinical worldsĀ here

Despite some initiatives to bring the clinical and academical worlds closer together, it does still feel like there is a hugeĀ metaphorical divide between them.

Often clinicians feel like academics and researchers don't appreciate or understand the time and resource restrictions they face, and academics feel like clinicians are ignorant and lethargic in understanding basic scientific principles and following research-informed suggestions.

And so it appears that many clinicians and academics are 'standing divided' in their attempts to help patients and unless this divide is reduced then both are going to be united in failing pa...

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IS YOUR ANTERIOR PELVIC TILT SLOWLY KILLING YOU?

Uncategorized May 21, 2020

Now there’s a sensational title to draw you in! Admit it I got ya!

I thought would do a quick bloggy thing on anterior pelvic tilts (APT) and the associated problems they may cause based on a recent discussion I had. It is certainly not an original post by any means but it is a topic that will not die. In fact any blog post out there that focuses on a bit of the research into this topic rather than just the theory is just a drop in the ocean compared to the mountains of well…stories really. These pieces tend to be thick on biomechanical theory of X pulls Y and causes Z (generally pain) but much thinner on any real science to back it up.

ATP

That theory may go a bit like this. You sit too much therefore your hip flexors get tight which pull your pelvis into an anterior pelvic tilt that increases your lumbar lordosis which gives you your back pain.

The humble APT is blamed for all sorts from lower back pain to groin pain and hip pain, in fact any pain that is remotely connected to any

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THE 10 BEST THERAPISTS

Uncategorized May 05, 2020

A previous article I wrote called 'The 10 worst therapists'Ā a while ago highlighted some of the flaws and issues I see in many therapists across all the professions. However, I thought it's also time to look at the other side of the coin and discuss what are the 10 attributes and traits of the best therapists I know across all the professions.

However, before we get started if you want to become a better therapist then please check out THE BETTER CLINICAL PROJECT HERE.

Now before I start this is not an exhaustive list and these are by no means all my own traits. If I'm being honest I reckon I score around a 5 or 6 here, with me slipping on some of these traits from time to time. In fact I seriously doubt any of you could say you are all 10 of these, all the time. However, I think if we all tried a little harder to score as high as we can, as often as we can, then I don't think we can go far wrong. So without further ado, here are my 10 best therapists.

No 1: The Caring TherapistĀ 

I...

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FREE Webinar: Challenges & Opportunities of Online Consultations for MSK Clinicians

Uncategorized Apr 21, 2020
 

This is a full recording of our extremely popular FREE 1 hour webinar on the challenges and opportunities of online consultations.Ā 

We wanted to make this available to everybody that missed it or could not get signed up due to the popularity.Ā 

If you like what you see PLEASE go and check out the "Better Clinician Project" *CLICK HERE*Ā 

Or you can get directly signed up HERE

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10 practical tips to make your online consults BETTER

Uncategorized Apr 02, 2020

Online consults have become a big talking point amongst healthcare professionals and many have had to take their trade online with the current Covid-19 pandemic. It can be challenging and a little discombobulating at first but here are 10 things that you might want to bear in mind when you come to do It and could even improve them : )

Check out more the Better Clinician Project HEREĀ 

See it as an opportunity

We should not view this move into the online world as inferior or sub optimal, just different! In some ways it might actually be superior with people feeling comfortable in their own environments and not having the stress of travelling to us.

It also provides opportunities to focus on areas us HCPs have been discussing upskilling in for years! Building better relationships, communication, advice, coaching & promoting self management are all things I hear regularly discussed as being under emphasised. Well now is time to put away the ideology as these are the tools at your disp...

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10 reasons you and your patients should EXERCISE

Uncategorized Mar 25, 2020

Exercise is great, we know this, right?

Well sort of.

Many people know exercise is good for us on a general level, but the question is, do they know it’s right for them on an individual level and is it the right fix for their problem?

This is an entirely different proposition, applying that general information to the person. This idea that these things are good for us can be quite vague, one of those things we may have glanced over in a newspaper or half heard on the news whilst eating our cornflakes.

People also build up ideas about what is the correct treatment for them. This can be from their own in depth research on the internet (right!), what they have picked up from friends and family or from previous treatment with a therapist. This can lead to some pretty strong ideas about what should and perhaps should not be done to help them.

These beliefs don’t always align with the best available data we have about interventions. A prime example of this is the belief that exercise

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EXERCISE DOSING FOR PAIN IS NOT THE SAME AS EXERCISE DOSING FOR FITNESS!

Uncategorized Mar 05, 2020

Go check out the Better Clinician ProjectĀ *HERE*

Exercise dosage in rehab is still one of the biggest areas of uncertainty in clinical practice. On one hand we have modern thinking that promotes higher loading & dosage for patients and on the other hand we have the traditional model of lower load and lower dosage that has probably evolved to minimise the risk of adverse scenarios such as increased pain and decreased patient confidence in the therapist.

Currently we have some basic dosage guidelines for rehab that focus on the physical qualities that we know can be a PART of rehab. But if we take the primary target of the majority of rehab, PAIN, and if we are being honest with our current knowledge base, we don’t really have the sets and reps, or other dosage parameters that we can use to achieve a reliable outcome on our patients pain.

If we look at the current research base for rehab exercise we regularly see that the confidence intervals around the mean effect for pain

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ARE YOU A QUALIFICATION SNOB?

Uncategorized Feb 27, 2020

Here at the Better Clinician Project we are determined not to have any egos or elitism, instead we want to create an open, honest, friendly, and down to earth community of healthcare professionals who are not up their own arses and full of academic or qualification snobbery, which unfortunatelyĀ in our experience is rife in healthcare.

If you want to find out more about the projectĀ CLICK THIS NOW

I was reminded how common academic and qualification snobbery is when I attended a large scientific conference recently. The conference was great and I learnt a lot, butĀ it was tarnished by a few conversations I had with some of the very smart and immensely qualified delegates who suddenly appeared to think my IQ level dropped through the floor when they realised I was ā€˜just’ a clinical physio, who didn’t have a PhD and wasn’t widely published.

Am I simple?

I swear to god that one guy even started to speak a little slower and louder as if he suddenly thought I was hard of hearing when I tol...

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THE DEFINITIVE GUIDE TO POSTURE & PAIN IN 3 MINUTES FLAT

Uncategorized Feb 20, 2020

Go check out the Better Clinician Project *HERE*

POSTURE AND PAIN ARE NOT WELL LINKED IN THE RESEARCHĀ 

This means no if's, no but's, no maybe’s or even worse…… ā€œin my experienceā€, which of course is completely ludicrous as someone else may have had exactly the opposite experience.

Who is right? Who the f**k knows? That’s why we have science!!!!

Evidence based practice is a game of probabilities and the probabilities are well stacked against posture being a cause of many musculoskeletal problems.

There are far to many papers to list, so here is one each for some different areas of the body. If you think I have just cherry picked these, there really is shit loads of this stuff out there so go and have a look if you don’t believe me!

Shoulder posture

Cervical postureĀ 

Lumbar posture

Thoracic posture

We have no gold standard for what is good and bad posture. So what people base their correction or postural goal on has to be a reasonably arbitrary measure.

But just bec

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WHATS THE EVIDENCE ON SIJ ASSESSMENTS

Uncategorized Feb 15, 2020

Within the therapy world the assessment and treatment of the Sacroiliac Joint, or the 'SIJ' as its more commonly known, is a fiercely debated area that often creates lively disagreements, as I recently found out when I posted a comment on Twitter a while ago stating I was surprised that many still use unreliable palpation tests to assess it. After some much RSI inducing tweeting, which ended up with one tweeter calling me a 'critical arsehole'Ā I thought I would write a piece on what my experience and more importantly what the research is telling us about assessing the Sacroiliac Joint.

For me as physio the SIJ has always been one of those areas I never did fully understand when I was a student many years ago. I can recall being in classes being confused as hell listening to tutors explaining the arthro-kinematics of it during movement, and how alterations to these movements can cause pain and dysfunction.

And it got even worse in the practical lessons with being even more confused ...

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