Welcome to episode 16 of The Words Matter Podcast.On this episode I speak with philosopher Dr Rani Lill Anjum.Rani is Research Fellow in Philosophy at the Norwegian University of Life Sciences. Many of you will be aware of the research project she leads called Causation, Complexity and Evidence in Health Sciences, AKA CauseHealth. She is one of the leaders of the Norwegian University of Life Sciences Centre for Applied Philosophy of Science. In this episode:Rani takes us through the CauseHealth project and one of its major outputs 'the Book' named ‘Rethinking causality, complexity and evidence for the unique patient (see here). This is excellent resource, with contributions from philosophers and clinicians to help tackle  with the philosophical biases that tacitly motivate evidence-based and person-centered clinical practice.She helps us dip our toe into the concept of causation and the different ways it can be conceptualised, and the importance of these conceptions with how we recognise evidence in relation to our clinical practice.We talk about what is a paradigm and the dominance of the scientific paradigm which underpins many of the assumptions of evidence-based practice.We touch on the reliance of RCTs in generating causal evidence and the potential contribution of other methods, including qualitative research to contribute to a better understanding of casual relationships.So it all gets pretty philosophical, and this episode might require more than one listen. This sort of philosophy is hard. I know when editing the episode, and re-listening, the excellent information and philosophical concepts sunk deeper into my brain and became more obvious- so please stick with it- it’s well worth it.I cannot recommend the CauseHealth book highly enough- it’s a fantastic resource and can be downloaded for free from Springer. Rani also has an excellent video on Youtube presenting these ideas in more detail-  the video is here and is well worth watching to get a grip of this important area.Find Rani on Twitter @ranilillanjum and @Cause_HealthSee here for more about RaniIf you liked the podcast, you'll love the Words Matter online course on effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_education and @ThewordsmatterpodcastTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome to another episode of The Words Matter Podcast.We’re on episode 15, and we take a minor detour away from the common theme of previous episodes to talk to Professor Dave Newell about conspiracy, dogma and belief within our respective professions osteopathy and chiropractic.Dave graduated from Plymouth University with a PhD in molecular biology in 1986, and he holds positions of Professor of Integrated Musculoskeletal Healthcare and Director of Research at AECC University College and the post of Senior Research Fellow at Faculty of Medicine, University of Southampton.The last last 30 years have been spent teaching and generating research in chiropractic institutions internationally holding the position of Research Director in two other chiropractic programs in the UK and abroad. Dave has considerable experience in teaching research methodology, critical thinking and the natural sciences as well as curriculum design, validation and accreditation of chiropractic programs.He has published extensively in areas relevant to musculoskeletal conditions in general and the chiropractic profession in particular. Dave's contemporary interests and expertise include Patient Reported Outcomes, Service Provision Research and the role of contextual factors in the therapeutic encounter.Dave is also one of the hosts of icarechirocast, an international podcast discussion with influencers and leaders in the chiropractic profession. In this episode we talk about:The continued tension between evidence-based practice and the practice of osteopathy and chiropractic.The importance of critical thinking, scientific reasoning and how evidence is either misinterpreted or over interpreted in conspiracy thinking.The role of dogma within osteopathy and chiropractic practice; the origins and spread of these traditional dogmas and their appeal to modern day clinicians and students.We discuss the continued challenge and pursuit of professional identify for both the chiropractic and osteopathy professions and the barriers and facilitators to developing a progressive and contemporary epistemology of practice.We go in the anti-vaccination views within chiropractic, osteopathy and complementary and alternative medicine (CAM) more generallyAs you will hear, Dave and I could have talked all afternoon, and if it wasn’t for the hottest day of the year in the UK, we probably would have continued the discussion into the evening.If your not an osteopath or chiropractor, there’s still plenty in this episode for you. Dave has a real breadth and depth to his knowledge which will have value for all critically minded clinicians.I bring you Professor Dave Newell.Find Dave on Twitter @NewellDaveIf you liked the podcast, you'll love the Words Matter online course on effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome to another episode of The Words Matter Podcast.On this episode I speak with Dr Giacomo Rossettini. Giacomo is an MSK physiotherapist and researcher from Italy. He competed his PhD’ degree in Neuroscience in 2018 and has been working as a physiotherapist since 2009 specializing in Rehabilitation of Musculoskeletal Disorders.He is a lecturer of Methodology and Clinical Practice of the Cervical Spine in the Master’s program of Rehabilitation of Musculoskeletal Disorders at Genova University and, he also lectures at Verona University: Bachelor’s program of Manual Therapy in Physiotherapy.In the last 2 years he has promoted in Italy his course on "placebo, nocebo effects and contextual factors in physiotherapy and musculoskeletal pain”.Giacomo has a growing track record of research into placebo, nocebo and contextual effects in relation to MSK healthcare practice (see here). Some of his excellent papers on these topics can be found here, here and here and have contributed to the Words Matter online course (see here).In this episode we talk about:the nature and definitions of placebo, nocebo and contextual effects.how enriching our clinical rituals can constitute a contextual effect and boost placebo.avoiding nocebo through unhelpful clinical practice, communication and interaction.touch on the ethics of utilising contextual factors to enhance the placebo effect.we discuss the challenge of the lack of contextual factors and the ability to control such factors which has been placed on clinicians through face masks and conducting appointments via telehealth during the pandemic.Huge thanks and applause to Giacomo for stepping up to the challenge and chatting in English- if we were relying on my Italian the podcast would never have happened and we’d all miss out on his incredibly informant information and experience.I bring you Dr Giacomo RossettiniFind Giacomo on Twitter @GiacomoRoss86If you liked the podcast, you'll love the Words Matter online course on effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome to another episode of The Words Matter Podcast.So we’re up now up to episode 13- and the high quality conversation just keeps coming, and this one is no exception.In this episode I speak with David Nolan. David is an MSK physiotherapist working within the NHS at Sheffield Teaching Hospitals, in the north of England. He is a full time clinician currently spending his clinical days between Occupational Health and primary MSK care as an extended role musculoskeletal Physiotherapist at PhysioWorks in Sheffield.As we discuss in the podcast, his research interests are around manual handling and lifting. In this episode we discuss:His research looking at the views around lifting of physiotherapists and manual handling advisers and how these relation to their back beliefs. See papers here, here and here. We’ve repeated his study with osteopaths due to be published later on this year with similar findings.We touch on how lifting and back pain beliefs are constructed and the common sources of such perceptions.We talk about his systematic review (see here) which looked at the differences in lifting between people with and without back pain.David shares his extensive clinical experience in assessing and managing lifting beliefs and behaviours in people with back pain.You might notice a bit of interference in sound during the first 8 minutes which shouldn’t distract you from David’s incredibly valuable insights to lifting and back pain.Find David on Twitter @DMNPhysioIf you liked the podcast, you'll love the Words Matter online course on effective language and communication when managing back pain - ideal for all MSK therapists and students. See here.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share.Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome to another episode of The Words Matter Podcast.On this episode I speak with Dr Peter Stilwell. Peter holds a Kinesiology degree from the University of Calgary, Doctor of Chiropractic degree from the Canadian Memorial Chiropractic College, and graduate degrees (MSc and PhD) from Dalhousie University.He is currently a Postdoctoral Researcher at McGill University and his research interests include pain, suffering, and patient-clinician communication. Many of you will be familiar with Peter’s excellent paper with Katherine Hartman on moving beyond the BPS model toward a 5-E enactivist approach to understanding and managing MSK pain.In problematising the BPS model in the way that it did, the paper really caused me to reflect on how I viewed and implemented the spirit of BPS  into my work. I know that the paper was a similar stimulus for many other of my own colleagues and clinicians across the MSK professions.So in this episode we:Delve into some of the underlying assumptions and lack of theoretical foundations of the BPS model and how enactivism addresses these gaps.We talk about some of the issues of the BPS model in regards to its vagueness in its application and its tendency to crudely separate out complex component properties of the experience of pain.We also get into metaphors and how his qualitative research has illuminated the way in which metaphors are used and interpreted by both clinicians and patients.Whilst it was my intention to drill down into his paper and enactivist model, time got the better of us- and I’ll be sure to invite Peter on for a follow up episode.As ever with these podcasts, I enjoyed every minute of talking with Peter. His expression “I just wants to do it all” exemplifies his passion, determination and productivity in the furthering if knowledge in person-centred MSK practice.His excitement and hunger is both palpable and infectious and have no doubt he will further build on his already significant contribution to knowledge in this area.Find Peter on Twitter @Peter_StilwellAnd more about his work hereSubscribe to www.wordsmatter-education.com , and if you liked the podcast, you'l love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome another episode of the Words Matter Podcast.On this episode I spoke with Tom Jesson. Tom is a musculoskeletal physiotherapist from Northumberland in the UK, who has recently moved to Michigan, in the USA.Tom has developed an interest in sciatica after a popular twitter thread and continues his deep immersion into the sciatica literature.I first became aware of Tom from his excellent episodes both as a host and guest on the Physio Matters Podcast, where he has talked about his deep dive into the sciatica literature and also a truly exceptional episode with John Launer on Narrative medicine, and recently an engaging and insightful episode with Tina Price on her experience of living with sciatic pain.Having listened to Tom’s thoughtful analysis and discussion on these topics, I had to get him on the podcast to talk about these issues further.In this episode we talk about:The different diagnostic labels associated with sciatica and the implications of using these terms with patients.The issue of accuracy and precision both from a medical and terminological perspective.The challenge of naming and labelling complex subjective phenomena relating to a pain experience.The sacrificing of precise terms for terms for which are more meaningful and functional for the person with sciatica.Tom was a brilliant guest and I really enjoyed the conversation. It’s clear he’s really taken time for think deeply and critically about these important and often extremely challenging areas of clinical practice.Find Tom on Twitter @thomas_jesson and check our his excellent newsletter for all things sciatica and radicular pain related  https://tomjesson.substack.com/ and for more about Tom see his personal website tomjesson.comSubscribe to www.wordsmatter-education.com , and if you liked the podcast, you'l love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome to The Words Matter Podcast. On this episode I talk again to consultant physiotherapist Matthew Low.Matthew and I spoke on episode 07 and many of you requested to 'get Matt back' which despite me trying to get this trending on Twitter I couldn’t break through the big political story of the hour.Matt and I continue our discussion about the nature of clinical practice and how evidence and the patient can help is navigate the Rocky undulating terrain of MSK care.We also go further into the role of bias and subjectivity in clinical practice and how we can help manage, understand and incorporate the patient’s values and preferences into clinical decision-making.One reason I always enjoy talking to Matt is the extensive clinical expertise he brings to the conversation.The clarity with which he is able to verbalise his ‘real world’ clinical reasoning and practice and whilst also drawing upon and situating these aspects in the philosophical, theoretical and research knowledge is both immensely engaging and impressive.Expertise such as this are something to behold, and not easily found in MSK care. We also talk about the Chapter he wrote for the new CauseHealth, Book Rethinking Causality, Complexity and Evidence for the Unique Patient. Matt’s captivating chapter titled 'Above and Beyond Statistical Evidence. Why Stories Matter for Clinical Decisions and Shared Decision Making'  formed an outline of our conversation. The book is completely free to download and is an essential resource for all clinicians. Click here to access it.I hope you enjoy my second conversation with Matt. It is really just more of the same from him-  clear, wise and insightful.Find Matthew on Twitter and Instagram and his Blog Perspectives on Physiotherapy here.Subscribe to www.wordsmatter-education.com , and if you liked the podcast, you'l love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

In this episode I spoke with Dr Maxi Miciak. Maxi is a physiotherapist based in Canada, and is an Adjunct Associate Professor in the Faculty of Rehabilitation Medicine, University of Alberta.Maxi received a doctorate in Rehabilitation Science in 2015 from the University of Alberta and was the inaugural Cy Frank postdoctoral fellow in impact assessment at Alberta Innovates, Canada.Her PhD research resulted in the development of a conceptual framework of the physiotherapy therapeutic relationship, which offers a rich and insightful qualitative theory and it has received significant interest in scientific and clinical communities. Her excellent papers on the conditions and connections of the therapeutic relationship can be found here and here.In this episode we:Dive into the nature of the therapeutic relationship as both a theoretical concept and also a central component to any interaction between patient and clinician.We talk about what constitutes a ‘good’ and perhaps not so good relationship with patients.We discuss the foundational conditions necessary for a therapeutic relationship to develop and how clinicians can be present with patients to help set the ground work for such a connection to be established.We also talk about how the fall out from COVID (such as virtual or tele healthcare, wearing PPE) might impact the sorts of relationships we want to develop with patients and Maxi offers useful workarounds to mitigate these negative affectsI absolutely loved talking to Maxi, we really hit it off in podcasting terms, given this was the first time we’d spoken. She is also an experienced podcaster, and co-hosts the podcast Ignite Physio, which I thoroughly recommend subscribing and listening to, as Maxi has so much valuable and insightful knowledge and wisdom to share on the area of therapeutic relationships.I bring you Dr Maxi Miciak.Subscribe to www.wordsmatter-education.com , and if you liked the podcast, you'l love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share.Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome to another episode of The Words Matter Podcast, and the first Ask Me Anything episode. Thanks for all your questions, please keep them rolling in for future AMA episodes.In this AMA I discuss:The main barriers that I encounter for musculoskeletal clinicians/osteopaths to adopt a biopsychosocial approach to their practice.Recording diagnoses in clinical notes, and moving away from specific tissues to other factors salient to the persons' situation and experience.How I got into academia, my PhD journey and suggestions for those wanting to begin to dip their toes in.The main challenges I experienced moving from student to novice and then to a more experienced clinician.My view on how evidence-based practice can and should blur the boundaries of musculoskeletal therapies, professional identities and distinctiveness. Subscribe to www.wordsmatter-education.com , and if you liked the podcast, you'l love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★

Welcome to another episode of The Words Matter Podcast. In this episode, I spoke with Matthew Low.Matthew is a Consultant Physiotherapist in the south of England, and is a Visiting Associate at the Orthopaedic Research Institute at Bournemouth University. He qualified from the University of Southampton and completed his Masters degree in Neuromusculoskeletal Physiotherapy at the University of Brighton, and is a member of the Musculoskeletal Association of Chartered Physiotherapists (MACP).Matthew has lectured and examined for pre- and post-registration students at a number of Universities in the South of England, and has lectured on subjects such as motor control, spinal manipulation and clinical reasoning skills (see here for his CPD courses).He has an interest and has published in areas of person-centred care, motor control, the theory of causation within the healthcare setting, philosophy, reflective practice and critical thinking skills. He also runs his own excellent blog with his reflections, thoughts and analysis of musculoskeletal physiotherapy, as well as being heavily involved with the brilliant CauseHealth project.In this episode we touch on many different subjects relevant to contemporary clinical practice. Matthew has a brilliant grasp of a broad range of important, complex and sometimes challenging areas- and we attempt to tackle some pretty big topics, all of which really require a dedicated podcast each to fully unpack. So this episode could be titled the knowledge sink given we threw everything into it! Matthew will most certainly be back, so please let me know what topics you’d like us to talk more about.We talk about the nature of knowledge which we use as clinicians, the assumptions of dominant knowledge structures and how these related to past and current conceptions of evidence-based practice.We dip into the challenge of applying evidence to our our practice and locating the individual patient in the the ocean of research evidence.We discuss on the role of clinical expertise and subjective judgement in evidence-based decision making.This episode will valuable to clinicians who are contemplating the complexity of their clinical practice as well as those that like a sprinkling of philosophy on their clinical work.Find Matt on Twitter and Instagram and his Blog Perspectives on Physiotherapy hereSubscribe to www.wordsmatter-education.com , and if you liked the podcast, you'l love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists or students.Help the podcast grow and don't miss an episode- Subscribe, Rate and Share. Instagram @Wordsmatter_educationTwitter @WordsClinicalFacebook Words Matter - Improving Clinical Communication  ★ Support this podcast on Patreon ★