The Back Pain Podcast

In this episode physio, Andrew Goodall goes through ACL tears from how you are likely to injure your anterior cruciate ligament through the likely treatments and the phases of recovery and rehabilitation As one of the major ligaments inside the knee, it plays an important role in stabilising the knee joint and helps to control the movement of the lower leg but is a common sports injury and Andrew shares great informative content that will help anyone to know what to expect from recovery and how to make sure their treatment is the right one for them   KEY TAKEAWAYS The mechanism, force and speed at which ASL happens means it’s likely there will also be other damage Calming the knee down means that it’s possible to get a good quality image and reduce the pain Getting the quadricep thigh muscles working efficiently as quickly as possible will bring  stability Initially, it’s about doing less but maintaining strength and function For most surgery is part of the process and in the UK 80% of people have surgery Taking a section of the hamstring tendon and using it as an ASL graft is the most common approach in the UK It’s bespoke surgery for your needs, your situation and taking into account the factors that have predisposed you to being injured  Rehab is likely to be around a year with anything less being exceptional progress Phase one is calming down, phase two is the building of load and phase three will be moving closer to training The final phase is preventative activities and a return to training   BEST MOMENTS  ‘In some sports movements, the rotation through the leg translates as an inwards movement of the knee’ ‘I’m essentially trying to come out of the session with a diagnosis and a plan’ ‘If you can rapidly reduce swelling and pain the person is more likely to be able to use the knee and keep muscle function’ ‘Stability is dynamic and controlled by lots of systems, it’s the integrity of the ligament that is crucial’   RESOURCES FOR THIS EPISODE  https://www.instagram.com/sportskneephysio/?hl=en https://www.instagram.com/puresportsmed/?hl=en https://www.completeaclrehabcourse.com/   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com    Support the show: https://thebackpainpodcast.com

Rob looks at the methodology of calming down and building up and explains how this approach to treatment works when you have non-specific back pain He shares some of the different ways pain can be effectively calmed down and how the next step is to build things up both physically and mentally in the treatment journey   KEY TAKEAWAYS Patients are looking for a cause but often there isn’t a specific reason Pain is very real whenever you are experiencing it Non-specific back pain means treatment targets are aimed at the whole back or whole body Calming things done is about understanding the movement of activity that aggravates the pain There are many ways to calm back pain down including heat, ice and understanding the role of non-physical stressors Building your back up may include learning to cope with the pain in a better way and understanding the physical exercise that can be completed   BEST MOMENTS ‘You might want to have a scan to show something that you can blame the pain on’ ‘You want to see a problem so that you know why you are suffering so much’ ‘Reassurance is so important in recovery’   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com      Support the show: https://thebackpainpodcast.com

There are lots of different things that patients think are causes of sciatica and it’s the role of the health care professional to explain when it is sciatica, what it is, what it is not and what you can do about it In this episode, Rob discusses vascular claudication, a less common cause of leg pain but due to its risk factors, it's one that healthcare professionals stay alert to. He  shares the diagnosis of intermittent vascular claudication with a patient and explains the crucial indicators that led to the diagnosis along with the treatment   KEY TAKEAWAYS Intermittent pain in both legs can have several causes Intermittent peripheral arterial disease is to do with the blood supply. When you are walking muscles in the legs require more blood supply and can't get it Patients often describe a cramping or burning sensation in the thighs Vascular risk factors including smoking, weight, diabetes and age increase the likelihood of intermittent peripheral arterial disease What he told us about the pain was crucial in making a clinical decision. The type and duration of the pain was an important indicator High blood pressure raises the likelihood of it being vascular A significant reduction in blood flow in the legs will be an indicator of a vascular issue Patients with vascular claudication have a much higher risk factor for an acute vascular episode   BEST MOMENTS ‘As health professionals, we often provoke pain to understand the source’ ‘Changes can take time but will make a difference’ ‘It’s one we have to stay alert for as health care professionals’   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com    Support the show: https://thebackpainpodcast.com

Rob takes a look at not only the role of the chiropractor but the elements that any good healthcare professional will be offering to their patients He also looks in detail at the ways the words chosen and used by professionals can impact not only on recovery but also have long-term implications and explores what a good professional and patient relationship looks like  and how it facilitates positive recovery, listen in and hear more   KEY TAKEAWAYS Around one-third of the population will suffer from lower back pain How we explain back pain is a vital part of the process The approach of different professionals should be similar and quality care should include pain education and activity advice A package of care will focus on cognitive care and manual intervention and a good assessment should include a detailed history Patients want is a good connection with their health care practitioner and a choice in the treatment to get better The words we chose to use can impact recovery and have far-reaching implications We want patients to leave the treatment room feeling positive not damaged broken and fragile Understanding what the patient wants to  achieve is a vital element in a positive recovery journey Patients want a choice so understanding their  expectations is crucial in creating treatment options that will work for them   BEST MOMENTS ‘No matter what the profession we should be hitting the same high points when it comes to managing lower back pain ‘As health care professionals we are in a hugely powerful position’ ‘We need to show our patients they are resilient, robust and strong not weak, fragile and broken’    THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com                            Support the show: https://thebackpainpodcast.com

Rob and Dave use a real-life example to explore how they would treat and manage a  patient who comes to them having already experienced conflicting advice They go through the steps that are covered in an initial appointment and discuss the points at which a scan is the right choice along with what sorts of manual therapy can be a good choice Practitioners approach patients in different ways but you should always expect a very individualised treatment plan and this is a great opportunity to find out about what you should expect and why   KEY TAKEAWAYS The first step should be taking a really detailed history and the patient's thoughts and beliefs are a vital part of the conversation It provides insight and an understanding that helps with building a personalised plan It’s the two-way conversation between the practitioner and the patient With sciatica, it’s about calming down the most aggravated part first Sometimes over testing  can make it more difficult to assess, move up to the pain, it’s not about aggravating it Patients can be fearful and avoid particular movements but it can be used as part of the methodology of building toward graded exposure The most important exercise is the one the patient does You need to look at an individual patient's tolerance to pain and make  any exercise  personalised A lot of changes seen on a scan are perfectly normal It's about focusing on the structural pathology There are always the red flag questions that result in a scan being the right approach Manual therapy provides  a window of opportunity to feel better   BEST MOMENTS ‘People who are fearful and worried about their pain tend to have  longer term  back pain’ ‘If a patient believes something should be done it’s important to explore it’ ‘If something is painful it doesn’t mean it's being damaged’   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com                            Support the show: https://thebackpainpodcast.com

Rob and Dave are both seeing patients every day in their clinics and in this episode they take a look at how things have changed over the last 10 years They share the learning that has changed how they work with their patients and discuss the vital importance of movement and how evolving to work with patients as someone who is supporting that individual’s journey to recovery, not the hero clinician builds positive and productive relationships   Listen in to hear Rob and Dave reflect on how their practice has evolved and why it’s always important to stay on top of new developments if you want to be a great clinician   KEY TAKEAWAYS It’s important to take a considered approach and look at emerging clinical research and trends. It's updating, evolving, and staying on top of it Worry and anxiety about your posture is only going to potentially exacerbate your back pain It’s not the specific exercises that make a difference it’s about keeping the movement going We start with the basics of good quality movement and then fine tune Some movement is important it doesn’t have to be a specific granular program Conversations in the clinic have changed from ‘I’m the therapist here to save you’ The clinician is no longer the hero fixing you, the patient is now the hero with the clinic providing a helping hand It’s not about waiting for someone else to do it for you, it’s about taking responsibility for yourself and your recovery supported by the clinician You will have a much better long-term relationship if you are happy to give the praise away to the patient Having difficult conversations is a skill that needs to be developed Talking to patients about their fears is a crucial element in building a relationship and understanding the patient   BEST MOMENTS ‘We can’t be blinkered we need to be looking for the newest research and turning points in the science ‘When they are as knowledgeable as possible that’s when the magic happens’ ‘I understand now the power of better movement and communication’   RESOURCES FROM THIS EPISODE https://podcasts.apple.com/gb/podcast/what-is-cauda-equina-syndrome-rob-tyer/id1511515312?i=1000506119396 https://www.cpdo.net/Lederman_The_fall_of_the_postural-structural-biomechanical_model.pdf   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com    Support the show: https://thebackpainpodcast.com

Rob and Dave are looking at some of the most frequently asked questions from the communities they work with and in this episode share great content in answer to a question on the difference between chronic and acute They also discuss what Kinesio tape and foam rolling actually do and what part of the routine where  Kinesio tape and foam rollers  are used is really important, listen in and hear the answers   KEY TAKEAWAYS Acute and chronic are used to refer to the time frame, the amount of time you have had the pain Chronic refers to pain for over 3 months anything under that is described as acute The skill of any practitioner is going from medical language to patient language Part of our journey as healthcare practitioners is understanding the impact of the language we use Tape changes the sensation from a painful area to a non-painful one giving your brain something else to focus on There are lots of claims about what foam rollers can do but they are in reality a way to self-massage The action of getting up and moving to complete physical actions is what’s important Warming up is a vital part of the exercise you are Walking increases blood flow far more than rolling around on a Victorian torture device   BEST MOMENTS ‘It’s elasticated tape at the end of the day, it doesn’t do anything magical ‘I will warm up for the session doing squats, I won’t spend twenty minutes flapping around on a foam roller and getting into weird positions’ ‘Never do anything that actively causes pain’   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ      ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com                          Support the show: https://thebackpainpodcast.com

Rob and Dave talk with Martin Christensen, a physiotherapist who joins them from Norway Martin has gained a huge following for his Friday Physio Confessions and in this episode talks about the importance of building relationships and discusses why it’s vital that patients understand that physios are human and like all humans will make mistakes. If you want to know what a good clinician and patient relationship can be like, listen in and find out more   KEY TAKEAWAYS A good healthcare professional makes the experience of the time matter more A patient should feel listened to and that their concerns are taken seriously There needs to be a rapport between the patient and the healthcare professional The healthcare professional and patient need to communicate effectively and honestly about what the goals are Asking the right questions is a crucial element in building rapport A great practitioner can bridge the gap and build rapport with any patient, making the patient feel comfortable by adapting to them and meeting them on their individual level We need to acknowledge that professionals are not machines but human Because practitioners are human, like all humans they will make mistakes Being authentic and being honest is about sometimes saying we need to wait and see Building a relationship with a patient means it’s possible to say when you make a mistake   BEST MOMENTS ‘It’s the dynamics of the relationship between two people, getting along and finding out what works’ ‘A good healthcare professional is someone who treats you like a person’   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    RESOURCES FOR THIS EPISODE Friday Physio Confessions - @Martin_nekkolai   ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com                          Support the show: https://thebackpainpodcast.com

Dave and Rob are joined by Adam Dobson regular on the podcast and Annina Schmid, physiotherapist and neuroscience researcher who leads the Neuromusculoskeletal Health and Science Lab at the University of Oxford. They discuss in detail radiculopathy, what it is and how it is diagnosed. With the neurological examination a key clinical diagnosis this is a great opportunity to hear about how Annina effectively uses sensory examination and what the results mean. Learn about radiculopathy and the sensory exam with great content in this informative episode   KEY TAKEAWAYS Nerve related pain is usually a radiating pain, not a pain that can be pinpointed to one spot Always compare left and right  talking to the patient about how the affected side feels compared to the other side We need to establish a normative area, you cannot just compare left and right because you may miss a sensory deficit Test sensation using something neutral like tissue or cotton wool The key to neurological examination is understanding single items in isolation have no relevant value it's putting together the pieces You have to make the pieces fit together to understand the picture Studies use the reference testing of MRI imaging or inter surgical findings which don’t tell us anything about the loss of function, the definition of radiculopathy Radiculopathy is a clinical diagnosis that includes the neurological examination The reference standard should be the clinical diagnosis because that’s what radiculopathy is For a nerve to be affected it doesn’t need something to be directly encroaching or deforming it We are imaging macro structure but a nerve can be affected on the inside so we should be looking further are the inside of the nerve Severe motor deficit or progressive motor deficit will be a referral We do not need to be specialists but we do need an awareness of what can masquerade as radiculopathy and refer to the right professional   BEST MOMENTS ‘If the patient has  lower back pain and it radiates into the buttock it’s enough for me to do an examination’ ‘With radiculopathy, the reference standard should be the neurological examination’  ‘If there is a pain and it radiates this would trigger a neurological examination’   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    RESOURCES FOR THIS EPISODE Annina Twitter https://twitter.com/AnninaBSchmid Annina Website http://www.neuro-research.ch/   ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com                              Support the show: https://thebackpainpodcast.com

Dave is going solo and shares the advice and reminders that everyone venturing back out into the garden really needs to hear because it’s this time of the year that many clinicians are seeing a very specific patient – the gardener There's lots you can do from strength work throughout the year through to changing it up with different tasks and knowing when to stop As the sun starts  to shine listening to this is a great way to get back into the garden the best way- without back pain   KEY TAKEAWAYS It’s a seasonal activity so not doing anything and then doing lots can be challenging Gardening doesn’t have a graded exposure mentality Lightweight activities completed over an extended time period may not be ideal Gardening is weather dependant and this can lead to excessive activity load in a short time frame There is a steep exposure when you get back into gardening in the spring Repetitive exercise over the year can help as graded exposure activity making you better prepared for gardening Switch up your tasks to break up long term exposure, break the activities down into manageable chunks Set yourself specific targets and monitor how you feel building before extending the task target   BEST MOMENTS ‘That 20kg bag of compost still weighs 20kg and you may not have been maintaining your 20kg lifting muscles over the winter ‘Stay active and strong throughout the year’ Don’t fall into the ‘just a little bit more trap’   THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ    ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram    Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   SOCIAL MEDIA LINKS Instagram Twitter Facebook   CONTACT US hello@thebackpainpodcast.com    Support the show: https://thebackpainpodcast.com