Podcasts about bronnie thompson

In this episode, we sit down for Part 2 with Dr. Bronnie Thompson to discuss pain, health, and physical activity. We highlight some concerns with “pendulum swings” regarding more “bio” vs. “psycho-social” contributors to pain, as well as the potential value in seeking biomedical pain solutions and the reality of pursuing a life involving living well with pain. You can learn more at Bronnie's blog here. We hope you enjoy this episode!   Additional Resources FREE Research Roundup Email Series | Get research reviews sent to your inbox, once a month, and stay up-to-date on the latest trends in rehab and fitness The Barbell Rehab Method Certification Course Schedule | 2-days, 15 hours, and CEU approved

In this episode, we sit down for Part 1 with Dr. Bronnie Thompson to discuss pain, health, and physical activity. We dive into the diverse options available to engage in fitness and enhance health, pain mechanisms, and the value in considering differences between them, along with why pain is never "just psychological". Bronnie also offers invaluable insight into ways she engages in movement practices outside of the traditional gym space for health and meaning. You can find Bronnie's blog here.    Additional Resources FREE Research Roundup Email Series | Get research reviews sent to your inbox, once a month, and stay up-to-date on the latest trends in rehab and fitness The Barbell Rehab Method Certification Course Schedule | 2-days, 15 hours, and CEU approved  

​In our latest episode of The Modern Pain Podcast, we had the privilege of hosting Bronnie Lennox Thompson, an authority in pain management and a postgraduate academic coordinator for studies in pain and pain management at the University of Otago. This enlightening conversation delves into the often-underestimated skills of active listening and compassion, both crucial elements in effective pain management. We discuss how healthcare's increasing focus on cost containment, efficiency, and productivity often leads to a loss of humanity and how we, as clinicians, can bring it back.Bronnie provides valuable insights into why clinicians need to give themselves the grace of more time and skills to truly hear and understand their patients. This not only enriches the therapeutic process but also addresses the growing issue of clinician burnout. With over three decades in the field, Bronnie argues that no patient ever complained about being listened to too much. She emphasizes that it's not just about meeting the patient's stated expectations; it's about letting them know you're listening and you care.***HELPFUL LINKS****Bronnie's blog​ - an absolute treasure trove on content to help you better utilize ACT and improve your overall pain management strategy​DANCING AROUND THE HEXAFLEX: USING ACT IN PRACTICE 1​​DANCING AROUND THE HEXAFLEX: USING ACT IN PRACTICE 2​​DANCING AROUND THE HEXAFLEX: USING ACT IN PRACTICE 3​​DANCING AROUND THE HEXAFLEX: USING ACT IN PRACTICE 4*********************************************************************

We hosted Amy Eicher and Bronnie Lennox Thompson for an open discussion on: Paternalism in healthcare and what clinicians need to know The value of having a clinical supervisor and what it involves The wider context we need to take into consideration when working with people in pain Common struggles and challenges people have when … Continue reading Amy Eicher & Bronnie Thompson – Paternalism, Supervision and Humility →

Pain is common and vital for survival. Chronic pain, though, is less vital and can significantly impact on the quality of life. Bronnie Thompson, PhD, believes it is possible to lead a fulfilled life in the presence of persistent pain. This is a must-watch/listen for all clinicians and even those who experience pain themselves. The paper we reference is listed below: Living well with chronic pain: a classical grounded theory Ready to arm yourself (pardon the pun!) with actionable strategies for assessment and treatment to use immediately in the clinic to improve patient outcomes and quality of life? Come learn with me in The Complete Shoulder Online Course. Sydney and Melbourne workshop details: Sydney Workshop, May 14, The Sports Lab Alexandria Melbourne Workshop, June 4, The Performance Centre Connect with Jared and Bronnie Bronnie's Twitter handle is: @adiemusfree Bronnie's blog is: https://healthskills.wordpress.com/ Jared on Instagram: @shoulder_physio Jared on Twitter: @jaredpowell12 Watch the full conversation on Youtube here. Disclaimer These terms and conditions apply when you listen to The Shoulder Physio Podcast.

Välkommen åter för del två av intervjun med den fantastiska Bronnie Thompson och samtalet kring Fibromyalgi. I den avslutande delen pratar Erwin och Bronnie om vanliga missuppfattningar kring tillståndet, vad som funkar bättre och sämre när man har det, bakslag och vad det är samt Bronnies tips riktade till personer som lever med tillståndet men också till vårdgivare som försöker hjälpa personer med tillståndet. Trevlig lyssning! 00:01:54 – Bronnie in 00:50:34 – Bronnie ut Mer om Bronnie hos Universitetet i Otago, New Zealand Bronnies blogg sen många år med massor av läsvärt för personer med smärta och vårdgivare Följ Tyngre Rehab och värdarna på Instagram: @Tyngrerehab, Daniel Andréasson, Kenneth Färnqvist, Adrian Valkeaoja och Erwin Lindén. Du som lyssnar på vår podcast får gärna betygsätta den på Apple Podcasts - lämna gärna en recension. Då blir podden mer synlig för andra plus att vi värdar blir glada.

On today's episode we talked about persistent pain with Dr Bronnie Lennox Thompson. She initially trained as an occupational therapist, but later got a degree in psychology. She has spent her career helping people with persistent pain live better lives. We explore ideas around helping people find meaning with their pain rather than eliminating it. We also covered the best questions to ask patients to help them understand their lives experience and how to not become over reliant on basic exercises for patients.

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Sandy Hilton, David Butler and Bronnie Thompson on the show to discuss persistent pain during COVID-19.  In this episode, we discuss: -Shifting current healthcare curriculum to better educate clinicians on persistent pain -Can passive modalities empower people to pursue more active treatment options? -How to create more SIMS during the COVID-19 pandemic -Can telehealth appointments adequately address persistent pain? -And so much more!   Resources: International Association for the Study of Pain Website Factfulness Book David Butler Twitter Sandy Hilton Twitter Bronnie Thompson Twitter   A big thank you to Net Health for sponsoring this episode!  Learn more about Four Ways That Outpatient Therapy Providers Can Increase Patient Engagement in 2020!                                                                      For more information Bronnie: I trained as an occupational therapist, and graduated in 1984. Since then I’ve continued study at postgraduate level and my papers have included business skills, ergonomics, mental health therapies, and psychology. I completed by Masters in Psychology in 1999, and started my PhD in 2007. I’ve now finished my thesis (yay!) and can call myself Dr, or as my kids call me, Dr Mum.   I have a passion to help people experiencing chronic health problems achieve their potential. I have worked in the field of chronic pain management, helping people develop ‘self management’ skills for 20 years. Many of the skills are directly applicable to people with other health conditions.   My way of working: collaboratively – all people have limitations and vulnerabilities – as well as strengths and potential. I use a cognitive and behavioural approach – therapy isn’t helpful unless there are visible changes! I don’t use this approach exclusively, because it is necessary to ‘borrow’ at times from other approaches, but I encourage ongoing evaluation of everything that is put forward as ‘therapy’. I’m especially drawn to what’s known as third wave CBT, things like mindfulness, ACT (Acceptance and Commitment Therapy) and occupation.   I’m also an educator. I take this role very seriously – it is as important to health care as research and clinical skill. I offer an active knowledge of the latest research, integrated with current clinical practice, and communicated to clinicians working directly with people experiencing chronic ill health. I’m a Senior Lecturer in the Department of Orthopaedic surgery & Musculoskeletal Medicine at the University of Otago Christchurch Health Sciences.   I also offer courses, training and supervision for therapists working with people experiencing chronic ill health.   For more information Sandy: Sandy graduated from Pacific University (Oregon) in 1988 with a Master of Science in Physical Therapy and a Doctor of Physical Therapy degree from Des Moines University in December 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995. Sandy teaches Health Professionals and Community Education classes on returning to function following back and pelvic pain, has assisted with Myofascial Release education, and co-teaches Advanced Level Male Pelvic Floor Evaluation and Treatment. Sandy’s clinical interest is chronic pain with a particular interest in complex pelvic pain disorders for men and women. Sandy is the co-host of Pain Science and Sensibility, a podcast on the application of research into the clinic.   For more information on David: Understanding and Explaining Pain are David’s passions, and he has a reputation for being able to talk about pain sciences in a way that everyone can understand. David is a physiotherapist, an educationalist, researcher and clinician. He pioneered the establishment of NOI in the early 1990’s. David is an Adjunct Associate Professor at the University of South Australia and an honoured lifetime member of the Australian Physiotherapy Association.   Among many publications, his texts include Mobilisation of the Nervous System 1991 The Sensitive Nervous System (2000), and with Lorimer Moseley –  Explain Pain (2003, 2013), The Graded Motor Imagery Handbook (2012), The Explain Pain Handbook: Protectometer (2015) and in 2017, Explain Pain Supercharged. His doctoral studies and current focus are around adult conceptual change, the linguistics of pain and pain story telling. Food, wine and fishing are also research interests.   Read the full transcript below: Karen Litzy (00:00:23): Hello everyone. And thank you for joining us today for this webinar. For those of you who are here live, you got to hear a little bit of pre-conversation which is great. And of course in that pre-conversation we were talking about all the things happening in the world today, specifically here in the United States with a lot of unrest and protests for very, very good reasons, in my opinion. And so we just want to acknowledge that and that we see it and that we are trying to learn, and we are doing our best to be allies to our fellow healthcare workers and citizens across the country and across the world for all of the other countries who have been showing solidarity. So I'm Karen Litzy, I'm going to be sort of moderating this panel of minds and I'm going to now go round and just have each of them say a little bit about themselves. So Sandy I’ll start with you.   Sandy Hilton: Okay. Hi, I'm Sandy Hilton. I'm a physiotherapist here in Chicago, Illinois with Sarah Haag. We have entropy physiotherapy and our clinic is predominantly working with pain. It's like a hundred percent of my case load is people in pain and about 80% of that is pelvic pain in particular. But I still see, you know, the rest of humans. David Butler (00:01:49): Hi, I'm David Butler from Adelaide Australia. I'm a physio, although I'm completely a professional and I believe everybody has the exact same role in treating pain. I'm trying to hire, but I can't retire. And then in world, our changing knowledge and our changing potential just keeps me, keeps me on track. So yeah, any sort of pain I'm happy to talk about. Bronnie Thompson (00:02:16): I’m Bronnie Thompson, I'm an occupational therapist by original training with some psychology thrown in, and I'm an educator and clinician as well, but a teeny tiny bit of research, but not much. And I'm a painiac and quite proud of it actually.   Karen Litzy: Excellent. So again, everyone, like I said, if you have questions as we go along, please feel free to put them in the Q and a part. And I will be looking at that as we're going through now, like I said, we've got some questions ahead of time, but before we get to some of the questions that some of the listeners and viewers have wanted to ask, I also want to just quickly acknowledge that we've got a bit of a mixed audience, so we've got healthcare practitioners and clinicians and we've also got people living with pain. Karen Litzy (00:03:11): And so as a clinician for me, it's a great opportunity. I think to address people in pain who maybe don't have the access or the ability to kind of get this information that's in their town or where they're living. So I am really, I'm really looking forward to this discussion, especially for those people that are watching that are living with persistent pain. So the first question I'm going to ask is and I'll ask this of all of you. If you were to give a piece of advice to a new professional or a healthcare professional that is sort of newly working with people with persistent pain, what would that piece of advice be? Sandy Hilton (00:04:11): I'm in Chicago. I'm just going to take it. I really like to stress, especially to students that, you know, we get this concept that the longer you've been in the field, the better you are at it. And, I think that maybe we make different mistakes, but everyone is learning this. And there's so much about pain that we're learning. And so if you're just starting in, I don't know that you might have an easier time because you have less bad habits to get rid of and can start with some of the better newer research and avoid some of the mistakes we made. Bronnie Thompson (00:04:50): So she's doing the popcorn approach. She looks at me. And so I think my advice would be, listen, listen very carefully to what people tell you and trust that they're telling you your experience. Don't try and read stuff into it, just listen and reflect, show that you're listening by reflecting what you've heard. So you can give that you've understood one another, because it's really easy to come out of school with all of this knowledge packed up and your brain thinking, Oh, I've got to do an info dump just like that. And it's not that great for the person, stop and listen. David Butler (00:05:37): They are lovely comments. I'd add. I would welcome anybody to the most new and exciting area of health. And there is a true pain revolution out there. And I would say to anybody, when you come in to just lift your expectation of outcome or what, might've been five or 10 years ago, because the clinical trials and our knowledge of the potential for humans to change is just increasing so dramatically. And I say, now we can say think treatment, not necessarily management because for many people recovery or some form of recovery is on the cards and what's leading the charge is the talking and the movement therapies. It's not the drug therapies for chronic pain. And, I just like to reflect as an older therapist now, patients who maybe 10, 15 years ago with maybe complex post pain surgery or Phantom limbs or complex regional pain syndrome would have thought, and I can't really help here. Now we welcome them through the door and you can get such pleasure, pleasure from treating these people no matter how long they've had the problem. Karen Litzy (00:06:48): Great. And, I would echo what Bronnie said is, you know, really listen and also believe, you know, they're giving you their experience. So try and take your bias out of it and believe what they're telling you and try not to talk them out of it because you see this quite a bit of, Oh, I have pain with this. And well, do you really have pain with that? Or is your pain really that much? And as the patient, it's very frustrating to have someone try and tell you what your pain is. So I'm looking at it from the person who has lived with the really chronic and at times debilitating neck pain is just listen, which is good. Believe them, and try not to talk people out of their experiences because it's very frustrating and it's very sort of dehumanizing for the patient, you know? Karen Litzy (00:07:54): And when I look back at when I first met David and went up to him at an APTA event and said, would you like to be on my podcast? And he said, yeah, sure, but I'm going to New York. I said, Oh, well, that's great. Cause that's where I live. And so then he met me at my, where I was working at the time and spent two hours with me. And I just, after that felt like, Whoa, like this is the first time that someone really listened and didn't interrupt and believed what I was saying and really set me on a path that just changed my life. Like, I don't know where I would be, had I not had that encounter with David. I think it was like 2011 or 2012. And so I always reflect on that and try and be that person, because I know what it felt like. Karen Litzy (00:08:45): And then when someone does come in and, and gives you their full attention and their time and their understanding, and then says, well, challenges your beliefs in a positive way, it was something for me that, you know, and I've talked about it many times that just completely changed my pain and my life. And so, you know, try and be that person is what I would say to people.   Bronnie Thompson: It's like, we've got to remember that people with pain and I live with fibromyalgia, those of you that don't know that's my reality, it's our experience and what it's like to live without pain. You know, what it feels like to know the things that sit at off things that settle it down and our relationship to it, to that pain and conditions. We come in with a whole lot of knowledge about other people and what we've seen. So we are experts and a whole lot of stuff, but what we're not experiencing as this person's life, their experience via what they're wanting from us even, what's important to them. And that's where when we meet and we can kind of share the hidden paradigms things that we don't know about each other, then we've got a chance to make a huge change and that as we know, I just feel so good about what I do. I just love it. I'm such a pain geek. Sandy Hilton (00:10:09): And I think the pain science or the science of pain really gives as a clinician, a lot of comfort to the listen to them, believe them, you don't have to prove it. You don't have to go. And like they say, I hurt here. You don't have to go poke it to reproduce the symptoms to believe it. And that's how I was taught of you have to reproduce the symptoms so that you can document that it's true. And it was like, that's a giant piece of unnecessary that we don't even have to do anymore, which really saves us a lot of time, not to mention establishing that trust and not being one more person. That's poked them in the sore spot. But, that's the thing that I was taught in school. Bronnie Thompson (00:10:58): So the question is, do you think that all chronic pain patients were not treated particularly when they were having the first or second episodes of their acute pain or are they in any way destined to become chronic pain patients? Well, my story is I hurt my back. I was what, 21, 22, doing a tango with the patient and a doorway patient was bigger than me. I landed on the floor on my back and I had all the best evidence based treatment at the time, maybe not, maybe not all the ultrasound, but you know, they didn't lie. They're really and relax a bit. Bronnie Thompson (00:11:48): But I didn't recover. I was then seeing the Auckland regional pain Center with amazing dr. Mike Butler, who is a rheumatologist and founded, and basically was one of the first in this initiations of bringing the international association for the study of pain to New Zealand, good friend of Patrick Wall knew her stuff very well. Gave me the book the challenge of pain to read. So essentially an explain pain paradigm back in the eighties, I know pain pretty well. My pain has not gone away. So there are some people who will not have a complete recovery of all of their pain, but because none of our treatments provide a hundred percent abolition of pain and actually I'm comfortable with it. I live with the pain and it gives me some stuff that some other people don't have access to. I know what it's like to have every bit of my body feeling really rotten. Bronnie Thompson (00:12:53): At the same time. I'm not limited by my pain. And I think sometimes we look at pain removal is that end goal. But I think our end goal is to help people live full, productive, satisfying, joyful and enriched lives. And some people will bring the pain along with them and many people won’t have to and that's amazing. Let's let the person make that decision about what is the most important outcome. But yeah, sometimes we can do all the right things, but if you have a spinal cord injury and you've got a smashed up spine, probability is that at the moment, our technology doesn't give us a solution. We can help, but we can't always take it all away.   Karen Litzy: David, what are your thoughts on that, that sort of movement from acute pain to chronic pain? You know, what are your feelings on that is, is like you said, are you destined to have it are I know, cause I get this question a lot from people like, well, you know, it started out with like an ankle sprain or it started out with a knee sprain and now it's turned into this. So did I do something wrong or was something not done? David Butler (00:14:12): I think you’re not destined to have it, but I think our treatment or therapies and the politics of treating acute pain probably gets in the way. And I also think if someone's hurt their back or any part of their body bad enough to see a health professional, the data is that 50 or 60 or 70% will have a recurrence in the following year. Now most health professionals think a recurrence is a reinjury, but if they really explored what happened, that reoccurance probably happened at a time when they would look at down and flat the immune system's a bit out of balance and they might've just done something simple, lifted up and picked something we would now from pain science, reconceptualize that as well, that's quite good. It's your body testing yourself out like a fire alarm with all the stuff you've been through in the past. It's no wonder your brain. Wouldn't want to play it again to check out how your systems are working, but that just simple piece of knowledge and usually should check to make sure nothing serious has gone on because you check and you can normally say, well, that should ease in a couple of days. That's an example of a little bit of knowledge dampening down. They don't have to go through the old acute process again of more, x-rays more tests, more power. David Butler (00:15:31): I think if that's correct, that observation was seen for many years, it could save governments Billions. Bronnie Thompson (00:15:37): Oh, absolutely. We've got a great thing. The language we use don't we, is it an injury or is it just a cranky body? David Butler (00:15:46): That whole linguistics? And for me and my treatment, you're now a physio by trade. I feel it says important to help someone change the story, to have a story, to take their experience out into society and let it go. That to me is as important as having healthy movement, although they obviously like go together. Sandy Hilton (00:16:07): I was gonna say that the saving of money for systems, for sure, but also the saving of time for people and the saving in our healthcare system. Every test you go do is going to cost you a lot of money. And, that time that it takes to get it in a time away from work and family and the concern of what the test results will be. If we can divert them wisely to not do that when it's not really indicated, that's just so good.   Bronnie Thompson: Yeah. And then I also for, you know, I've had a test now I'm going to wait for the results and now I'm going to wait for what are they going to do as a result of those results? And then, Oh, it's the same. And it just feels very demoralizing to people. And I think that's something we need to think about with make the decision about when and we to stop doing investigations often. That's the sense of the clinician worrying that something, are they going to sue me? It’s not a good way to practice.   Karen Litzy: Yeah. here's another, we'll do this from Louise. She says, picking up on something David had said earlier, how do we move towards being more, a professional? How do we move the pain industry toward this goal? Excellent question Louise. David Butler (00:17:51): There's a lot of answers to it, but a couple would be, I think you just got a quite badly out there would know sports trainers who could deliver an equally good management strategy to some physios, to some doctors, et cetera, right? This pain thing is across all spectrums, which is why the national pain society meetings are so good. And why everybody there is usually humbled and talks to all the other professionals because they realize the thing we're dealing with is quite hard. And we need all the help that that's a weekend get, but it ultimately comes back to provision of pain education throughout all the professions and that pain education should be similar amongst all the professions it's not happening yet. We've tried pushing it, but it's not out there. And it's incredible considering the cost of pain is to the world is higher than cancer and lung diseases together. Karen Litzy (00:18:51): Yeah. The burden of care is trillions of dollars across the world. And, you know, even in the United States, I think the burden of care of back pain is third behind heart disease, diabetes. And then it was like all cancers put together, which, you know, and then it was back pain. So, and, and even I was in Sri Lanka a couple of years ago and I did a talk on pain and I wanted to know what the burden of disease of back pain was in Sri Lanka. And it was number two. So it's not like this is unusual even across different, completely different cultural and socioeconomic countries. And, you know, David kind of what you said, picks up on a question that we got from Pete Moore. And he said, why isn't it mandatory that pain self management and coaching skills isn't taught in medical schools? Is it because there isn't expertise to teach it? Well, I mean, David's right here. He's semi retired. David Butler (00:19:58): Why isn’t that mandatory? That's a big, big question. I would say that the change is happening. Change is happening. I would say that at least half of the lectures or talks I give now are to medical professionals and out of my own profession or even more than half. So yeah, change is happening, but it's incredibly slow. It needs a bloody revolution, quite frankly. A complete reframing of the problem and awareness that this problem that we can do something about it and awareness that there's so much research about it let's just get out and do it now. Sandy Hilton (00:20:40): The international association for the study of pains curriculum and interdisciplinary curriculum would be a nice place to start. And I know some schools here in the States are using it in different disciplines to try and get at least a baseline.   Bronnie Thompson: The way we do it as the core for the post grad program, that I am the academic coordinator for it. Doesn't that sound like a tiny, tiny faculty. But anyway the other thing that we know is that looking at the number of hours of pain, education, Elizabeth, Shipton, who's just about completed. If she hasn't already completed her PhD, looking at medical education and the amount, the number of hours of pain, it's something like 20 over an entire education for six to six or more years. In fact, veterinarians get more time learning about pain then we do then doctors medical practitioners do, which suggests something kind of weird going on there. Bronnie Thompson (00:21:50): So I think that's one of the reasons that it's seen as a not a sexy thing to know about and pain is seen as a sign of, or a symptom of something else. So if we treat that something else in pain will just disappear, but people carry the meaning and interpretation in their understanding with them forever. We don't unlearn that stuff. So it makes it very difficult, I think for clinicians to know what to do. Because they're also thinking of pain is the sign of something else not is a problem in its own, right? Persistent pain is a really a problem in its own right. Karen Litzy (00:22:29): Yeah. And wouldn't it be nice if we were all on the same page or in the same book? I wouldn't even say the same chapter, but maybe in the same book, across different healthcare practitioners, whether that be the nurse, the nurse practitioner, the clinical nurse specialist, the physician, the psychologist, the therapist, physical therapist, it would be so nice if we were all at least in the same book, because then when your patient goes to all these people and they hear a million different things, it's really confusing. I think it's very, very difficult for them to get a good grasp on their pain. If they're told by one practitioner, Oh, see, on this MRI, it's that little part of your disc. And that's what it is. So we just have to take that disc out or put it back in or give a shot to this. Karen Litzy (00:23:25): And, and then you go to someone else and they say, well, you know, you've had this pain for a couple of years, so, you know, it may not be what's on your scan. And then the patient's like, who am I supposed to believe? What am I going to do? And, and you don't blame the patient for that. I mean, that's, you'd feel this that's the way I, you know, I had herniated discs and I say, you just get a couple of epidurals and the pain goes away and then it didn't. And I was like, Oh, okay, now there's so my head, I was thinking, well, now there's really something wrong.   Sandy Hilton: That's the problem. Because yeah, if you think it's the thing you did that helped you or didn't help you, then you lose that internal control. Karen Litzy (00:24:13): Yeah, yeah. Yeah. So I think, I think it's a great question and, and hopefully that's a big shift, but maybe it'll start to turn with the help of like the international association for the study of pain and some curriculum that can maybe be slowly entered or David can just go teach it virtually from different medical schools, just throwing it out. There is no pressure, no pressure. Okay. Speaking of modalities, we had a question. This is from someone with pain and it's what can be the appropriate regimen for usefulness of tens, for acute and chronic cervical and lumbar pain of nerve origin. So Bronnie, I know that you had said you had a little bit of input on this area, so why don't we start with you? And then we'll kind of go around the horn, if you will. Bronnie Thompson (00:25:24): I think of it in a similar way to any, any treatment, really, you need to try it and see whether it fits in your life. So if you are happy and tens feels good and you can carry it with you and you can tuck it in your pocket and you can do what you want to do. Why not just is, I would say the same about a drug. If you try a drug and it helps you and it feels good and you can cut the side effects, there's nothing wrong with it. Cause we're not the person living life. It's more to think about it in a population. How effective does this? And my experience with tens is that for some people it does help and it gives a bit of medium, like a couple of hours relief, but often it doesn't give long sustained relief and you have to carry this thing around. That's prone to breaking down and running out of batteries, right when you need it. So to me, it's agency, but then I put the person who's got the pain and the driving seat at all times to say, how would this fit in your life? Do you think you want to try this one out? It's noninvasive it's side effects. Some people don't like the experience and sometimes the sticky pads are a bit yuck on your skin, but you know, that's more bad. So yeah, that's my, my take on it. David Butler (00:26:44): I haven't used it for 40 years after the second world war. When you start to stop, when they, I was friendly with the guy who invented it and I'm thinking it'd be happy pet we'll would be happy to, with these comments that I agree with what Bonnie said. Absolutely. I would also say that, hi, wow, you have got something there which can change your pain by scrambling some of the impulses coming in. You can change it, let's add some other things which can change the impulses coming in or going out as well. So let's use that. Let's get you building something, maybe something repetitive or something contextual or something as well. So you you've shown change you're on the track. So I would use it as a big positive to push them on keep using it, but on the biggest things. Sandy Hilton (00:27:32): Yeah, the advantage is it's. So it's gotten so inexpensive. So for something that has minimal to no side effects and has the potential of helping them to move again, which I think is always the thing that we're aiming for. It's not very expensive. But now like several hundred dollars, right? You can order it online. Now you don't even need a prescription or approval or anything like that. Karen Litzy (00:27:59): Yeah. Yeah. That's true. And something that I think is also important is, you know, you'll have people say, Oh, those passive modalities, that's passive. You know, I had a conversation with Laura Rathbone Muirs. Is that how you say the last name? I think that's right. Laura. And we were talking about this sort of passive versus active therapies and, you know, her take on, it was more from that if they're doing these passive modalities, they're giving away their control. And, she said something that really struck and, kind of what the three of you have just reinforced is that no, they still have that locus of control. Cause they're making that conscious effort, that conscious choice to try this, even though it's a passive modality, they still made the choice to use it. Karen Litzy (00:29:03): And I think that coupled with what David said, Hey, this made a difference. Maybe there's some other things that can make a difference that I think that I don't think they're losing that locus of control, or I don't think that they're losing they're reliant on passivity, right.   Sandy Hilton: When they have their own unit and they're not coming into the clinic to have it put on you. And you lie there on the bed while you do it.   Bronnie Thompson: It's something that you have out in the world. It's not different to sticking a cold compress on your forehead when you're feeling a bit sick, you know, we did it. That's just another thing that we can do. So I see it as a really not a bad thing. And it is in the context, you know, if you can do stuff while you've got it on, then it's the hold up problem, as long as you like.   Karen Litzy: Great, great. Yeah. As long as you like it. Exactly. Yep. Okay. so we've got another question that we got ahead of time and then there's some questions in the queue. So one of the questions that we got ahead of time was how do we explain pain responses like McKenzie central sensitization phenomenon in modern pain science understanding. David Butler (00:30:35): I'd answer that broadly by saying that the definition that we've used and shared with the public in the clinical sense is that we humans hurt when our brains weigh the world. And judge consciously subconsciously that there's more danger out there than safety. We hurt equally. We don't hurt when there's more safety out there, then danger. So somebody who's in a clinic and is bending in any way and it eases pain. There will never be one reason for it. So it might just be, that might just be the clinic. It might be the receptionist. It might be all adding up. It might be the movement. They might've done one movement. And so, Oh, I can do that. And then all safety away, we go again, the next movement helps within that mix. There may be something structural. You've done to tissues in the back and elsewhere that might have eased the nociceptors that barrage up. But by answer will always be that when pain changes, it's multiple things are coming together, contributing to them. And they'll never never just be related to nociception. Sandy Hilton (00:31:49): I have to say this to say, I am not McKenzie certified. So this is my interpretation of that. I like the concept of you can do a movement. That's going to help you feel better. And we're going to teach you how to do that throughout the day. Maybe as a little buffer to give you more room, to challenge yourself a little more knowing that you'll have a recovery. And I just pick that part and use that.   Bronnie Thompson: I heard the story of how it all came about and it, and it's you know, it's an observation that sometimes movement in one direction bigger than another. And that's cool. It's like, you're all saying, let's make this little envelope a little bigger and play with those movements because we're beasts of movement. Bronnie Thompson (00:32:50): We just forget that sometimes we think we've got to do it one way. And you know, I can't tell my plumbers who crawl under houses. Look, you've got to carry things the way, you know, the proper safe handling thing. And I wasn't, I was the same safe handling advisors like me. But you know, there's so many ways that we can do movements and why can't we celebrate that? And the explanation, sometimes we come up with really interesting hypotheses that don't stand the test of time. And I suspect it might be some of the things that have happened with the McKenzie approach. It's same time. What McKenzie did that very few people were doing at the time was saying, you can do something for yourself that as we are the gold ones, that's what changed. David Butler (00:33:40): Bronnie, what's really helped us to start the shift away from poking the sore bit, come on, do it yourself. And, and I always give great credit to Robin McKenzie for that shift in life. Sandy Hilton (00:33:53): Yeah. And an expectation that it's going to get better. Right. David Butler (00:34:00): You think that’s showing something in the clinic that helps. Wow. Let's ride let's rock. Karen Litzy (00:34:07): Yeah. And oftentimes I think patients are surprised. Do you ever notice that Sandy, like, or David, or, you know, when you're working with patients, they're like, Oh, Oh, that does feel better. And they're just sort of taken aback by, Oh, wait a second. That does feel better and it's okay. I can do it. Yeah. And then you give them the permission to do so. And like you said, is it's certainly not one single thing that makes the change. But I think everything that you guys just said are probably the tip of the iceberg of all of the events surrounding that day, that time, that movement, that can make a change in that person. And I think that's really important to remember. That's what I sort of picked up from the three of you.   Bronnie Thompson: But the stories like that kind of convenient ways of, for us to think that we know what we're doing, but actually within what this person by what this person feels and how they experience it. And the context we provide us safety, security. And I'm going to look after you, that's, you know, changes, motivations about how important something is and how confident you are that you can do it. We can provide the rationale important part. The person ultimately drives that. So we can also provide that sense of safety and that I'm here. I'm going to hang around while you do this stuff. Let's play with it. Let's experiment. And if we can take that experiment, sort of notion of playing with different movements in, we've got a lot more opportunity for people in the real world to take that with them. We can't do that. Or forgive people are prescribed. You will do this movement. And this way perfectly I salute, but the old back schools, Oh, I know scary, And they did get people seeing the other people were moving. And that's a good thing that we can take from it. It's always good and not so good about every approach. Karen Litzy (00:35:11): Now I have a question for David and then out to the group, but you know, we've been talking about Sims and dims and safeties and dangers. And so for people who maybe have no idea what we're talking about, when we're talking about Sims and dims, can you give a quick overview of what the Sims and dims, what that is so that people understand that jargon that we're using? David Butler (00:36:40): Okay, it's a model we use. There's lots of other similar models out there. So basically based on neuro tag theory, the notion of a network that there's danger danger in me networks out there, and there's safety in me networks, rather simple, structured thinking here, and we've looked at these this has emerged due to the awareness, the pain science that we have a network in our brain. But me as an old therapist, when the brain mapping world came in and we realized, hang on pain, isn't just a little nest up there. There could be thousands of areas of the brain ignited indeed the whole body ignited in a pain experience. And one of the most liberating bits of information for me and my whole professional career, because what it meant was that many things influence a pain experience and a stress experience, move experience lab experience, and many things can be brought in to actually try and change it. David Butler (00:37:39): And all of a sudden means that everything matters. So this is where dims danger in me, safety sims in me, it was just a way to collect them. So an example of a dim with categorize them could be things you hear, see, smell, taste, and touch. So for one person, it could be the smell of something burning or looking at something or hearing something noise. The things you do could be a dim. It could be just doing nothing, but then there's Sims, gradually exercising, gradual exposure seems in things you hear, see, smell, taste, and touch could be going out. One of my most common exercises I now give somebody is to go down to our local market and find four different smells, four different things to taste, four different things to touch. And then they'll say, why should I do that? Because you can sculpt new safety pathways in your brain, which will flatten out some of them, some of the pathways they're linked to pain and it comes to of the things you say important. David Butler (00:38:37): You know, I can't, I'm stuffed, I'm finished. I got mom's knees. We try and change that language too. I can, I will. I've got new flight plans. I can see the future, the people you meet, the places you're with. So it's a way of categorizing all those things in life into either danger or safety, we try for therapy, we try and remove the dangerous. It is often via education. What does that mean? And we try and help them find safety and health professionals out there are good at finding danger, but we're not used to getting out there and finding those liberating safety things. And of course the DIMS SIMS thing. It's also closely linked in, we believe to immune balance. So the more dims you have, the more inflammatory broad immune system, the more sims you have, you move more towards the analgesics or the safety. And so it's the way to collect them. It's a way to collect as we try and unpack and unpack a patient's story listing to it within to unpack it and then to re-pack it again with them in a different way. Did that make sense? Karen Litzy (00:39:49): Absolutely. Yes. I think that made very good sense. And I believe you, there is a question on it, but I believe you answered it in that explanation. It says, have you had patients that cannot find Sims or it's difficult to identify and if so, how can you teach them what a SIM is? But I think you just answered that question in that explanation. David Butler (00:40:11): Once they get it. They're on their way. And we send people on SIM hunting homework. So for example, the same might be places you go, okay, if you can get out, just walk in the park or walk somewhere, then power up the SIM by feeling the grass, touching the box, spelling something. And we pair it up by letting them know that if you do that, your immune system gets such a healthy blast, that it can also help dampen down some of the pain response. Bronnie Thompson (00:40:39): And with regard to our current situation, sort of around the world COVID-19 and all the subsequent stuff. And also the situations in the U S at the moment, is it any wonder that lots of people are feeling quite sore because we’re eating this barrage of messages to us. And so I would argue that at the moment it might be worthwhile if you're a bit vulnerable to getting fired up with the stuff said, it's a good idea to ration, how much time you're spend looking at the stuff, not to remain ignorant, but to balance it with those other things that feel good, that make you feel treasured and loved and committed. And for me, it's often spending some time in my studio, walking the dog, going outside, doing something in nature. And there is some really good research showing that if you're out in the green world nature, that there is something that our body's really relish, kind of makes sense to me. Sandy Hilton (00:41:42): So taking that concept into what's going on right now, there's been a challenge clinically of the things that helped people balance that out, got taken away from them. Yeah. So it was a complicated it still is. It was a complicated thing where it wasn't your choice to stop going to the swimming pool because it made you happy and it gave you exercise and balance this out. Someone closed the pool and told you, you couldn't go. And so there's all different layers of loss in that and lost expectations and loss of empowerment and all of these things. So we have had to help people rediscover things that they could access that could be those positives. And that's been hard and really working my muscles of how to help people find joy or pleasure or happiness or safety in an unsafe environment to really get that on a micro level when you've lost the things that used to be there. And, it's been like a lot, but you can do it. It just takes concentration. David Butler (00:42:57): An important thing. That's so important. I think a question for therapists health professionals should be a sane question should be, you know, what's your worldview at the moment. And I would ask that, and it's usually not good, but I chat and have a chat. And actually I'd like to take people through some graphs that the world is not as bad as it really is. And if you look at I've been reading a book by Hans Rosling called factfulness. And really over time, our world is getting better. There's less childhood diseases, a whole range of things, getting better, bad, and bad things, getting better. This is a hiccup. This, for example, I had a musician recently and I had a graph I could show her that say that there's now 22,000 playable guitars to a million people in the world. But 12 years ago, there was only 5,000. All right, this is just one little thing. All right, cool. There's a lot of stats that show that our world is improving, you know, children dying, amount of science, a whole range of things. And this hiccup we have that I'm hopeful humanity can get, can get through, but just a little message I pass on is therapy. Bronnie Thompson (00:44:13): Even though we can't do stuff, we can't access places. What can't be taken away as our memory of being there. So it's really easy to take a moment to back a memory that feels good to say, actually, you can't take that one away from me. I might not be physically getting there, but I can remember it, feel those same feelings. And then being mindful.   Sandy Hilton: This is funny because if you look at Bronnie's background, that's one of the memories I've been using. When I lost the lakefront, I was like, okay, I'm just going to sit there and pretend that I'm not at that beach by that pier. So it's, it's fabulous. And even pictures or recordings of things that you've done before is like, okay, now there is still good stuff. I might not have it right here, but they're still good stuff. So that's really funny. As soon as I saw the picture, I'm like, yeah. And gratitude and just, yeah. Bronnie Thompson (00:45:05): The other thing as well, we've always got something that we can be grateful for all that. It might feel trite, you know, I'm living in winter, but I've got a roof over my head. I can have a damn fine cup of coffee and probably a nice craft. I'll at the end of the day, these are things that I can do and can have any way. So we can create the sense of safety insecurity inside ourselves without necessarily having to experience it. David Butler (00:45:38): Right. Just a quick comment. I would share that with patients who can't get out are saying the things you do when you're still can be as important as the things you do when you move. Right? So let's explore. If you can't do things, you can still really work you yourself with the things you do. And you're still calm. The introspection reading, thinking, contemplation memory enhancement, go through the photo album, et cetera. And I'd also like to always say to someone to link that in that is a very, very healthy thing to do to your neuro immune complex. Karen Litzy (00:46:13): And that sort of brings, I think we answered this question. This was from a woman who is living with chronic pain and at high risk with COVID-19. So how do we get past the fear of going out where people are crowding areas to get the exercise we need to maintain our fitness and muscle tone to reduce our pain. She said, even though I'm doing exercises and stretching, I've lost the ability to walk unaided on uneven grounds through weeks of lockdown. And the hydrotherapy pool is closed. She said, she knows, I need to get out and walk more, but shopping centers, which are the best place to find level floors are out. And a lot of places that she used to go are now very crowded because people are, don't have the access to gyms and things like that. Are health professionals able to suggest options when she lives in a hilly area with only a few but all uneven footpaths or sidewalks. And she has a small house. Sandy Hilton (00:47:18): That's the kind of thing that we've been doing since it's like, okay, let's problem solve this out. Because yeah, you have your carefully set way to get through this and then it's disrupted.   Bronnie Thompson: Yeah, boy, I like having lots of options for movement opportunities. So we don't think of my exercise, but we think of how can I have some movement today and bring that sense of, we are alike to be like, if I can imagine I'm walking along the beach while I'm standing and doing something and, you know, doing the dishes or watching TV or something that still can bring some of those same neuro tags it's same illusion, imaginary stuff activating in my brain. And that is a really, really important thing because we can't always the weather can be horrible, especially if you're in Christchurch and you can't go out for a walk. Bronnie Thompson (00:48:27): Yeah. But you know, we can think novelty is really good. So maybe this is a really neat opportunity to try some play. And I've been watching some of the stuff that our two chiropractor friends do with you put, let's put, at least try some obstacle courses and the house so that it's not we're not thinking of it as exercise. And I've got, do three sets of 10, please physios change that. Let's do something that feels like a bit of fun. There's some very cool inside activities that are supposed to be for kids. I haven't grown up yet. I'm still a baby. Sandy Hilton (00:49:16): Yeah. A lot of balance and things like that you inside that would help when you have your paths back outside. Yeah, yeah.   Karen Litzy: Yeah. Great. And then sticking with since we're talking about this time of COVID where some places are still in lockdown, some places are opening up. Bronnie and David are in an area of the world where they have very, very few cases, very, very few cases, Sandy and I are in a part of the world where we have a lot more than one. So what a lot of practitioners have had to do is we've had to move to tele-health. And so one of the questions David Pulter, I believe, as I hope I'm saying his name correctly is do we perceive that our ability to be empathetic and offer effective pain education is somehow diminished by a tele-health consult. So are we missing that? Not being in person.   Sandy Hilton: I have found it equally possible in person or telehealth cause you're still making that connection. We do miss stuff. We can't read the microexpressions in people as easily. So we as therapists have to work harder, but for the person on the other end, think about what the alternative is. Sandy Hilton (00:50:46): And it's been really cool for the people with pelvic pain, that every single time they've gone to a physio it's been painful. And on tele-health it's the first time she has been able to talk to someone about all of her bits and pieces without being afraid that it's going to hurt because there was no way to see somebody inside somebody's home.   Bronnie Thompson: You get to know something more about me. I've met more pets than ever thought. It was wonderful. This is a privilege that occupational therapists have had for a long time. And I'm so pleased that other other clinicians are getting that same opportunity, because we know so much more about a person when we can see the environment that they live with. That's just fantastic, but it's harder. David Butler (00:51:39): I find I've come back into clinical practice. I thought I was going to retire because I wanted to go, but also doing it. I was hopeless at first, but I'm really enjoying it. And I actually believe, I actually believe for the kind of therapies we're doing it's equal or better than face to face. Ideally, I think I'd like to have one face to face or maybe two but then to continue on with the tele health, particularly for people are in rural areas and it's almost no this kind of therapy was coming anyway, but the COVID has hastened it. So I found myself getting anecdotally here a much more emotional, closer, quicker link to patients by the screen. They were in a safe place. They're in their house. That's number one. They're not in a clinic you're there. And you can actually look at that face in the screen, as we're doing now, I'm looking at your faces, maybe one or two feet away, and I'm just keep looking at you. David Butler (00:52:46): And there's this connection, which is there. And there's also these other elements it brings in like, you start at 10 o'clock and you finish at 10:45. So there's open and closure, which isn't really there in some of the, in some of the clinics, the difficulty I'm having with it though is I was never in face-to-face practice a very good note taker. I used to make notes at the end. I was talking too much, but what you have to do here, my suggestion with face to face is you really need to plan and make your notes straight after. What did I tell that one on the screen, last clinical context, to sort of remind you of all the little juicy bits that we've got in the interaction. So it's really, for me, it's coming back to curriculum and mind you, I'm glad I'm not doing dry needling or just manipulating it with the talking therapy, but my suggestion is to have the habit curriculum. David Butler (00:53:44): So I've got my key target concepts. I know that I've addressed them in that particular session in the next session. I know I've gone back and I've done teach them the self reflection as well. Then to come back to see if I can get it all, or if I've translated my knowledge into something functional or some change. So I'm really, I'm really loving it. And I think there's something rather new and special with this, with this interaction. But maybe that's just me as a physio who sort of used to the more physical stuff. Maybe this is something more natural to the psychologist, its perhaps, but I'm with it. Bronnie Thompson (00:54:22): I’ve been doing the group stuff. And I found that has been, I've seen, I like it because they don't have to go and travel someplace. It does mean that we can offer it to people who otherwise can't get here. You know, they can't seek people, especially rural parts of New Zealand, low broadband is not that great in many parts as well. So it gets that it's an opportunity. I'd like to see the availability of it as an option. So we can use like we do with our therapies, we pick and choose the right approach or the right piece at the right time and the right place that doesn't have to be one or the other, like you said, you could see him a couple of times in person and then a couple tele-health and then maybe they come back again and then you do mix and match.   Karen Litzy: We have time for one more question here, maybe two. So David, this was one you might be able to answer it really quickly. As a practitioner, what is the utility of straight leg raise slump and prone knee bend test and the assessment of chronic back pain. Is it still relevant? David Butler (00:55:38): Oh gosh. Oh gosh. I'm going to dodge that question and would say it, it would depend on the client who comes in so I think those neurodynamic tests, which I still do. I think the main principle from them is you're testing movement. You're not testing a damaged tissue and anytime you're doing a physical examination, the deeper thing is the patient is testing you. You're not testing them. So what that patient, what that patient offers back in terms of movement or pain responses or whatever, depends on so many things. I might however, have a client and they are out there who do have maybe a specific stickiness or something or something catchy, whatever that may well, the scar around it might well be polarized by action, where I might spend a little bit more time taking a closer look at it. Now that might be relevant. Someone might have, for example, someone might come out of hospital and have had a needle next to the IV drip, next to their musculocutaneous or radial sensory nerve there where it's really worthwhile. Let's explore all the tissues here and see that that nerve can move or slide or glide. But in the second case, I'd made a clinical decision that we probably have issues out in the tissues, which are with a closer evaluation. That's a really broad answer. Karen Litzy (00:57:11): I think it's a tough question to answer because it, sorry, got a cat behind me. I felt my chair moving and I was like, what's going on? Just a large cat. So last question. So how to manage tele-health when the patients may be kind of embarrassed of their house or context or spaces or family it's very common in low socioeconomic patients. So they may not want to turn on their camera.   Sandy Hilton: Yeah. I've had that shaking well, and I've had people in their car or very clearly like I'm kind of angled cause there's a lot going on in my house and I don't have a green screen. So where it's like, and there's just a wall behind me and it's one of the reasons like I'll talk to him ahead of time of if I'm in the clinic, it's clearly the clinic, but I'll tell them I'm at my house. Sandy Hilton (00:58:12): Cause of COVID. So, you know, no judgment, you're going to see a wall and probably a cat and just kind of be up front in the beginning of this as a thing, I've had people that start with the phone on or turn it off or whatever, you just, you roll with it. But I have those conversations ahead of time, before we even do the call.   Bronnie Thompson: It's about creating a safe space for people. You know, if somebody feels, you know, was not having the video, it won't be that long before. I hope we've got some rapport and it feels better. I'm just, I'm doing a bit of a chuckle because the reason I've got my green screen behind me as my silversmith studio, which has an absolute shambles because it's a creative space. So I'm just disguising it because it's works. David Butler (00:59:07): There is something about delivering a story of some talking in the patient's room and there's cupboard doors open and you're looking in their cupboard at the same time. And you know, looking at that, then I just look at that thing. We’re safe here. Karen Litzy (00:59:26): Well, listen, this has been an hour. Thank you so much. I just want to ask one more question or not even a question, more like a statement from all of you that, what would you like the people who are listening and they're, like I said, there were clinicians, there were non-clinicians on here. And I think from the comments that we're seeing in the chat is very valuable and very helpful. So what do you want to leave people with?   Sandy Hilton: I'm gonna echo how I started. We're learning more every single week. I'd say, day but I'm not reading that often. So even if you've gone or you've treated someone and you couldn't quite figure out a way to help them, don't give up because there's more information and more understanding and more ways to get to this all the time. And I don't think you're stuck if you hurt. David Butler (01:00:26): I'd like to mirror those comments, explore the power of tele health, lift your expectations of outcome for those patients, people who are suffering and in pain, who are listening for those who are getting into pain treatment there's a science revolution and a real power in that revolution behind what you do. So just go for it. Bronnie Thompson (01:00:52): I think don't be hung up on with the pain changes or not, be hung up on does this person connect with me. We create trust. Am I listening? Can I be a witness? Can I be there for you? Because out of that will come this other stuff. There are some people whose pain doesn't get better. It doesn't go away. And that's a reality, but it doesn't mean that you have to be imprisoned or trapped by your pain. That means you develop a different relationship with your pain. And I think that's a lot of what we are doing is creating this chance to have some wiggle room, to begin to live life. That's what I'm looking for. Karen Litzy (01:01:53): Beautiful. Well, you guys thank you so much. And for everyone that is here listening, I just want to say thank you so much for giving up an hour of your time. I know that time is valuable, so I just want to thank you all and to Bronnie and to David and to Sandy. Thank you. Thank you. Thank you. And kind of on the fly. So I just want to thank you so much and to everyone. I guess the thing that I would leave people with is, if you're a clinician or if you are a patient, the best thing that you can do, if you are in pain is reach out to someone who might be able to help you, find a mentor, find a clinician, ask around Google, do whatever you can try and find someone who like Bronnie and David and Sandy I'll echo everything. You said that number one first and foremost, you connect with and that you feel safe with. You want them to be your super SIM, you know, like Sandy's my super SIM. Karen Litzy (01:02:48): So you want them to be your super SIM. And, if you can find that person, that clinician just know that that there can be help, you know, whether you're struggling as the clinician to understand your patients or your the patient struggling to find the clinician, I think help is out there. You just have to make sure that you be proactive and search for it. Cause usually they're not going to come knock on your door. So everybody thank you so much for showing up. Thank you, everyone who is on the call and to everyone who is watching this on the playback I hope you enjoyed it. If you have any questions, you can find us we're on social media and various websites and things like that. So we're not hard to find. Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on Apple Podcasts

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Karen Litzy on her journey to become a leader of the physical therapy profession. Karen Litzy, PT, DPT is a licensed physical therapist, speaker, owner of Karen Litzy Physical Therapy, host of the podcast Healthy Wealthy & Smart and creator of the Women in Physical Therapy Summit. In this episode, we discuss: -How Karen started her career in New York City -The importance of relationship building to grow your practice -Why you should say yes to things that align with your values -A sneak peek at the Strictly Business Mastermind -And so much more!   Resources: Karen Litzy Twitter Karen Litzy Instagram  Karen Litzy Facebook FOTO Outcomes Summit, use the discount code LITZY   For more information on Karen: Dr. Karen Litzy, PT, DPT is a licensed physical therapist, speaker, owner of Karen Litzy Physical Therapy, host of the podcast Healthy Wealthy & Smart and creator of the Women in Physical Therapy Summit.   Through her work as a physical therapist she has helped thousands of people overcome painful conditions, recover from surgery and return to their lives with family and friends.   She has been a featured speaker at national and international events including the International Olympic Committee Injury Prevention Conference in Monaco, the Sri Lanka Sports and Exercise Medicine Conference, and various American Physical Therapy Association conferences.   Karen has been featured in magazines and websites like Redbook, Women’s Running, Martha Stewart Living, Family Circle, Health.com and CafeMom. She has been a guest on several podcasts including Entrepreneur On Fire, Hack the Entrepreneur, and The Healing Pain Podcast. She lives in New York City.   For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University’s Physical Therapy Program. She is also a co-founder of the podcast, “Physiotherapy Performance Perspectives,” has an evidence-based monthly youtube series titled “Injury Prevention for Dancers,” is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt   Read the full transcript below: Jenna Kantor:                00:00                Hello, this is Jenna Kantor interviewing for Healthy, Wealthy and Smart. And I am here with the founder, the original Mama Jamma, Healthy, Wealthy and Smart Karen. And I am going to be a major fan girl. No apologies for this at all because I've been wanting to interview Karen for a long time because she is just one of the most inspirational people in physical therapy. And I would say honestly amongst women and physical therapy, the leadership that you take is absolutely incredible and I appreciate you agreeing to coming on. So thank you. Karen Litzy:                                           Well thank you. And I think this is the first time I've been interviewed on my own podcast. I think so unless you count the time Bronnie Thompson was asking me questions and made me cry. But for the most part, this is definitely the first time. Jenna Kantor:                00:51                Not a meltdown in this one. Well what I'm really excited about as so anybody who is a fan of Karen lets you see all that she does. This is to really learn about her backstory and also how possible it is to get to where she is at now. So one thing we were talking about the other day, Karen, as you were saying, how you moved to New York and you knew no one, I would love for you to expand upon that and how you took those steps to knowing everyone. Karen Litzy:                                           Well, so when I first moved to New York, I knew my roommate because we had gone to high school together and maybe two other people that we went to high school with. And what I decided to do when I first moved to New York is I couldn't find a physical therapy job that I felt like it was a good fit. Karen Litzy:                   01:43                And so I ended up working at what was then called Reebok Sports Club. It's now an Equinox, but it was this sort of a country club in the city. So it was a very high end, very expensive gym. So I started working there as a personal trainer. And because of that environment, there were so many personal trainers, Pilates instructors, nutritionists, not to mention all of the people who go in and out of the gym and all the clients I was lucky enough to work with. And because of that I was able to meet hundreds and hundreds of people. And to this day, those trainers, the people who work, like a computer program there for children, there are nutritionists, pilates instructors. To this day they still refer patients to me. And that was wow, 18 years ago. So, you know, we talk about building relationships and how important that is. Karen Litzy:                   02:41                And I think having that as my first job in the city and being exposed to so many different people, I felt like it really helped me build relationships and friendships at this point that have continued to blossom and grow. And I mean, I just had a patient that was looking for a strength and conditioning coach. And so I said, well, I work with one, a person who is amazing. And he was one of the first people I met at my new job 18 years ago. So it was a bit of like an unconventional path for a physical therapist and it's just cause I couldn't find my fit. I couldn't find that niche that I really wanted and maybe the clinic that I really wanted to work at and now that being said, I knew ahead of before I moved to New York that this gym existed and that it was a high end gym and that I would be exposed to a different kind of clientele. Karen Litzy:                   03:36                I don't know why I looked that up to begin with, but it was because of that, that gave me the idea to go out on my own and to start seeing patients in their homes and home gyms and homes and offices because all of the personal trainers at this gym, we're seeing people outside of the gym. If they're doing that, then why can't I do that? Why can't a physical therapist do that? Why do they only have to come to a clinic in a more traditional sense of the word? So it was because of that first job that I met so many people and those relationships continue to grow other relationships and that I got the idea to do my business. Jenna Kantor:                04:28                That's incredible. So for you, now that your network has expanded over time, clearly it's like full bloom. Hello, I look at you almost like the Oprah of physical therapy here. So how do you keep in touch or maintain these relationships with all these people? Like what is your skill for that? Karen Litzy:                                           So as far as maintaining them within New York City, it's pretty easy because we'll get together or you send a quick text. Cause most of these people are my friends and I credit working at that gym and also playing softball in central park that I was able to meet so many people. Jenna Kantor:                                        You play softball. Hold on, pause, elaborate. Karen Litzy:                                           So one day I was running in central park and I was like, Ooh, softball. So I went down and I was like, Hey, do you guys allow girls to play? And they were like, no. And I was like, oh, um, okay. And they said, well, what do you do? Karen Litzy:                   05:16                And I said, well, I'm a pitcher. And then they asked if I was good. And I peeked my head around and looked at their pitcher. I'm like, I'm better than the one you have. And so the next week I went for my tryout and then I became their pitcher. And then the following, summer I was recruited to play in a fast pitch like windmill fastpitch league. So I played there for several years and all the guys that I played with on that softball team, are lawyers, and they have referred patients to me. And you know, you just keep in touch. And so I met my two best friends that way in the city and they refer people to me from a business standpoint, but they're also my friends, you know, and they're part of my lifeblood of being in the city. And so my best advice if you're moving to someplace where you don't know anyone is to get involved in things you like to do. Karen Litzy:                   06:07                So I love playing softball. So that's what I did, you know, and I loved working out. So I decided to work in a gym as my first job. So instead of kind of pigeon holing yourself into what just physical therapy or just this, just that, like really kind of open yourself up because you never know who you're gonna meet. So in this city it's easy to keep in touch, well, I shouldn't say it's easy. It's not easy, but if it's a priority for you and your life, you make it and you make it a priority and you put in the effort. And so for me, and as you know, Jenna, you keep in touch with a lot of people. You spend your time on networking and on making those relationships. And the best way to do it is to make it a priority. Karen Litzy:                   06:47                And so I may have, you know, my week is sort of chunked out so I have patient care, but then there's times where I'm like, okay, all I'm going to do is write emails and send messages to people and it's in my calendar, it's write emails and send messages to people just so that you're still in there hemisphere. Jenna Kantor:                                        You know, it's keeping those relationships. Otherwise it becomes that long lost relationship. Even if when you hang out with them again you could just act like no time has passed. It's still something that needs to be rekindled. So it avoids that. Karen Litzy:                                           And it's putting in the effort. Like a good friend of mine, his name is Dr. Jordan Metzl who's a physician in New York and he does free workout classes every month. And so I try and make it a point, okay, I'm going to go to one of his classes even though I can't walk for two or three days because my legs are so sore afterwards. But I make it a point because he's my friend and I want to support him and I think what he's doing is important. Jenna Kantor:                07:37                I love that. I'm sure I've probably seen pictures of you after the workout going, just finished the workout with Metzl right now. I love that. And you actually are tapping upon something that I know we are 100% agree upon is really supporting what other people are doing. Showing up for what they do is a real big part of the networking and how your life and your career has truly grown. Karen Litzy:                                           Yeah. It's just being supportive of people that you believe in. So going to something like the CSM where there's 16-17,000 people here, like there are people that I want to make it a point that I at least say hello and that I have a conversation with, even if it's just five minutes, you know, because it's important to me and I hope it's important to them, but I know that it's important to me because I want to show up for them and I want to support them. Karen Litzy:                   08:31                And so that's just what you do if you want to keep your relationships going. And as far as keeping relations with international colleagues, it could just be a quick, a quick note on Twitter or a quick email or hey, I thought about you the other day because I really want to introduce you to this person because I think you guys should at least know each other cause you're doing the same research or you know, I met a colleague in the Netherlands and he has since referred patients to me in New York and he's a physio in London, but you just keep in touch with people and you do good work. And I think that's the best way to keep your relationships going. And it doesn't have to be every day, right? It could be consistent. Karen Litzy:                   09:24                It takes five minutes. A lot of times I do this when I'm on the bus cause I'm going from patient to patient. So what else am I supposed to do on the bus? You know, so that's sometime when I'd be like, okay, I'm going to make sure that I reach out to so and so in Australia or to this person in Pennsylvania or to this and that's a good time. So I'm lucky in that sense that I have like random downtime. Chunks during my week and you just, if you think about someone, just let them know. Jenna Kantor:                                        Yeah, it takes seconds. It takes seconds. Okay. So you have your hands on many things which I love about you. So you have this podcast, which is amazing and soaring and now you also have a team working for you with this podcast. Jenna Kantor:                10:07                You have your own practice, you have the speaking course. What am I missing? You have a course coming up that's going to be helping practitioners, which is amazing. You’re the nominating committee for the private practice section? Am I missing anything? I want to make sure we tap and tap everything. Okay. So you're doing all these things now, did they all come about all at once for you to achieve it? Or did some of them overlap as you were developing them? Oh, and you're working to become a paid speaker. I mean these are a lot of fantastic things, all a hundred percent possible to achieve in a life, but for you achieving each and every one, have some of them overlapped in the process of growing? I would love to hear that journey. Karen Litzy:                   10:56                Yes. And I also think that one allows for the next and allows for the next. So one event allows for the next event and for the next and for the next or one experience allows for the next. So for instance, starting the podcast many years ago, I took a couple of years off to go back to get my DPT, but starting the podcast had led to credibility and has led to visibility and in maybe some vulnerability on my part. So when people can see that you're being credible and you're being authentic and you're putting yourself out there, they're drawn to that. And so from that, I was invited to be on a proposal to CSM and then that got me public speaking a little bit. And then maybe from that someone sees you, it's like, hey, you know something, I really like this. We should try this. Karen Litzy:                   11:50                And so I kept saying yes, yes, yes, yes. And to say as a piece of advice, say yes to everything until you can say no, terrible advice. I don't know. It was terrible advice. Awful. So what I started to do, cause I was saying yes, everything and it is overwhelming and you get burnt out and you start to cry and then you don't feel like you have a personal life. And I want a personal life as well. So now what I've started to do is say yes to things that align with your values. Say Yes to things that in your gut it's a hell yes. Because when you start saying yes to things that are like, I guess I should do it, it's a no, like if you're saying I guess I should do it, you don't want to be shoulding things. Karen Litzy:                   12:30                It's like, yes, I want to do this. Not, yeah, I guess I should do it. And so I think having that in my mind has been able to narrow my focus a little bit more. So it sounds like I'm doing a lot, but it's all inter related. Jenna Kantor:                                        It's connected.  And I even left out that you have the annual women in PT Summit. Karen Litzy:                                           But again, that's all connected, right? So I think it started with the podcast and then doing a little bit of speaking and then I really started to enjoy speaking more and more. And because of that I have made that a priority. And for me each year I pick a word that I like to kind of follow my year and to base decisions on and things like that. And so this year it's courage. And so one of the things that I really wanted to have the courage to do was to do more public speaking and to put out a course to help physical therapists create their own private practice and occupational therapists create their private practice. Karen Litzy:                   13:27                And these for me, takes a lot of courage and planning and things like that. But if you, like I said, I sort of planned my week in little chunks. So if you can do that, you can get everything done. You just have to put your mind to it. And I also as just a FYI on how I manage my time is that I kind of use pomodoros. So a Pomodoro is a concept that's a 25 minute work block. So I'll set a timer for 25 minutes. I turn everything else off. Sometimes I'll put theta wave music on in the background or binaural beat music because that music is supposed to help increase theta wave, excitability in your brain, which is supposed to have, this is all very, you know, but it's supposed to help you be able to block out distractions and help you focus and things like that. Karen Litzy:                   14:17                It's the kind of music you hear when you're at the spa. And so I will do that and block everything else out. And it's amazing how much you can get done in 25 minutes. Like so if you are full of distractions, yeah, it's going to take you forever. But if you can really focus for 25 minutes, then you can write that blog post in 25 minutes instead of screwing around for three hours. You know what I mean? And if emails come in, like I'm not the president of the United States, like it's not that important. It's just not. I think we're in a world now where everything has to happenmnow. Now, now, now, now. Whereas I mean, I can say, I mean I started my podcast in 2012 and then took a couple of years off. Karen Litzy:                   15:03                It's 2019 so it's not like it's an overnight success. You know, I started speaking, the first CSM I spoke, it was in Indianapolis, which was, I don't even know how many years ago. So again, this is just been years of work and years of working on your reputation and years of working on myself in order to get to these points. Nothing is an overnight success because you're always laying foundations and groundworks that can take months or years. So I think it's really important for people to understand that. Jenna Kantor:                                        And habits, habits are a big thing too, because I'm sure it took you a bit to even make this, this 25 minute habit. Karen Litzy:                                           Oh my God. Yeah, because I love to be distracted. Squirrel. I'd be like, what? I love to be distracted. But it's true. So to be able to do that and calm my mind down to focus on one thing took practice, but just like we tell our patients with like practice your exercises, if you practice these methods, you become better at the methods. It's the same thing. Jenna Kantor:                16:02                Yeah. I definitely can relate with that. So now for you, what is your next, oh my gosh. I can't wait for you to listen back to this podcast in like a couple of years and be like, what is your next, cause you have, you have things coming up and maybe those will be your next you would want to discuss, but I would love for you to share that. Karen Litzy:                                           My probably biggest next is the soonest are the quickest next, let's put it that way. The quickest next would be this course that I'm developing for physical therapists and occupational therapists called Strictly Business Mastermind. And it's to help them create their own cash PT or hybrid or if you already have a practice and you're trying to transition out into a cash based practice. Karen Litzy:                   16:52                So it's really for those two groups of people. And I'm really excited about that and hopefully we'll have that solidified in the next couple of weeks and put that out there. Jenna Kantor:                                        That's going to be incredible. And honestly to speak to the fact that we don't have a woman and physical therapist yet leading something like this and we need to, it's for anyone. You need to see somebody who you can even visually identify with. So on top of the content that you're going to be providing, which is going to be off the charts, I'm grateful that you are filling a void that needs to be filled in. Karen Litzy:                                           And I think it's important to know that I'm not teaching this on my own because I don't have the answers to everything. I can't do everything. It's just physically impossible and mentally impossible. Karen Litzy:                   17:36                Like I can't do it. So I'm lucky to have a lawyer involved. I'm lucky to have an investment advisor involved. And someone who's an expert at SEO and Michelle Collie who's an amazing colleague with like 5,000, no, not really, but like a whole bunch of clinics in the Rhode Island area because these are people who quite frankly are doing things better than I am. And so to be able to share their knowledge with people, I think it's going to be a little bit unique in that space. Because I know I can't do it on my own. And so I asked for help. Jenna Kantor:                                        And it's okay to ask for help. And honestly, I definitely wouldn't use the Hashtag better together right now for this because it really is, as much as you are taking the lead on it, it is so good to get to work with other people and everybody benefits from it. Karen Litzy:                   18:26                Of course. Of course. I just feel like that's important for people to understand that you can't do any of this alone. And that if, if you do, you'll burn out, but if you have the wherewithal to find out, well, what are your weaknesses? Like, what are you good at? What are you not so good at? What do you love? What will someone pay you for? And if you can fill that out and kind of connect the dots, then you'll know what you're good at and then what you're not good at. Just find someone else who is. Because you're doing a disservice to yourself and you're just doing a disservice to people who are spending their money and their time to learn from you. So it's all about respecting the audience. And so what I really want to do is respect the audience and give them the best user experience that they can get and meet those expectations. And I'm my harshest critic. Jenna Kantor:                                        So I think everyone is, I think everyone is their harshest critic. Well, thank you so much for coming onto your own podcast to just share this. I love how you're just so authentic and insightful and just so true to your own story. And I think a lot of people just appreciate that about you and I definitely do. So thank you. Karen Litzy:                   19:52                Thanks for having me on.     Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!  

Research on chronic pain tends to aim at identifying factors that are in deficit, or are the so called "risk factors" for those who develops chronic pain. In this episode, we discuss a paper that takes a different angle in looking at what factors do those people who are successfully living well with chronic pain share. The primary author is friend of the show, Bronnie Thompson, who has made guest appearances in previous episodes. Living well with chronic pain: a classical grounded theory. Lennox Thompson B, Gage J, Kirk R. Disabil Rehabil. 2019 Jan 11:1-12. doi: 10.1080/09638288.2018.1517195. [Epub ahead of print] Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Music by Kevin MacLeod - incompetech.com: Intro - Brandenburg No4 and Meatball Parade Close - Meatball Parade

Dr. Bronnie Thompson comes onto HET Podcast to chat about how she teaches the International Association for the Study of Pain (IASP) curriculum into a unique international interdisciplinary program along with discussing how she teaches pain to groups of patients in New Zealand.    Bronnie's Email Address: bronnietnz@gmail.com   Bronnie's Website & Blog: https://healthskills.wordpress.com/  Bronnie's University Profile: https://www.otago.ac.nz/healthsciences/expertise/profile/index.html?id=1773  Bronnie's Twitter Page: https://twitter.com/adiemusfree  Master of Health Sciences endorsed in Pain and Pain Management from the University of Otago: https://www.otago.ac.nz/christchurch/study/postgraduate/otago011631.html  International Association for the Study of Pain Website: https://www.iasp-pain.org/  San Diego Pain Summit Website: https://www.sandiegopainsummit.com/  Motivational Interviewing Website: https://motivationalinterviewing.org/  Kevin Polk's Website: http://www.drkevinpolk.com/  Kevin Polk Videos on YouTube: https://www.youtube.com/user/DrKevinPolk  Russ Harris's Website: https://www.actmindfully.com.au/  Russ Harris's YouTube Page: https://www.youtube.com/channel/UC-sMFszAaa7C9poytIAmBvA  Clip from Bronnie's Presentation on "Getting From "Perhaps" To "Yes": Motivation, Confidence And Communication" at the 2016 San Diego Pain Summit: https://www.youtube.com/watch?v=YyVr1AQ-y3k  Bronnie's Interview on the Modern Pain Podcast: https://itunes.apple.com/us/podcast/modern-pain-podcast-episode-4-interview-bronnie-thompson/id1435013970?i=1000418987399&mt=2  Bronnie's Interview on The Physio Matters Podcast: https://itunes.apple.com/us/podcast/session-21-fathoming-fibromyalgia-dr-bronnie-thompson/id785762010?i=1000351510267&mt=2  Bronnie's Interview on The Pelvic Health Podcast: https://itunes.apple.com/us/podcast/graded-exposure-drs-sandy-hilton-bronnie-lennox-thompson/id1022705760?i=1000416545258&mt=2  Bronnie's Interview on The Healing Pain Podcast: https://itunes.apple.com/us/podcast/episode-77-dr-bronnie-lennox-thompson-how-to-live-life/id1112764695?i=1000405608266&mt=2  Bronnie's 1st Interview on the Healthy, Wealthy & Smart Podcast:https://itunes.apple.com/us/podcast/176-living-well-w-chronic-pain-w-dr-bronnie-thompson/id532717264?i=1000354627788&mt=2  Bronnie's 2nd Interview on the Healthy, Wealthy & Smart Podcast:https://itunes.apple.com/us/podcast/177-living-well-w-chronic-pain-part-2-w-dr-bronnie-thompson/id532717264?i=1000354839842&mt=2  Bronnie's 3rd Interview on the Healthy, Wealthy & Smart Podcast:https://itunes.apple.com/us/podcast/234-dr-bronnie-thompson-living-well-w-chronic-pain/id532717264?i=1000376757639&mt=2  The PT Hustle Website: https://www.thepthustle.com/  Schedule an Appointment with Kyle Rice: www.passtheptboards.com    HET LITE Tool: www.pteducator.com/het  Anywhere Healthcare: https://anywhere.healthcare/ (code: HET)     Biography: Bronwyn Lennox Thompson initially trained as an occupational therapist, graduating 1984. She later completed her MSc with first class honours in Psychology in 1999 at Canterbury University, and in 2015 was awarded her PhD from the Department of Health Sciences at the University of Canterbury, Christchurch, New Zealand. She has worked in pain management for most of her clinical career, with her primary focus on pain management at work. She has practiced in interdisciplinary pain management programs, private practice, case management both for private organizations, and ACC, primary prevention and secondary prevention, and since 2002, teaching postgraduate papers in pain and pain management at Otago University. Her main interest areas include pain and anxiety, motivation for self-management, resilience and daily coping choices. The effect of her occupational therapy training has never fully left Bronwyn's aims in pain management. Occupational therapy has always targeted function, or the ability to fulfill life roles despite limitations. In the same way, Bronwyn's goals for pain management are to help people reduce the functional impact of pain and improve their engagement in living life to the full.

Listen to Dr. Mark Kargela interview New Zealand Occupational Therapist and PhD Bronnie Thompson where they discuss communication skills and strategies when interacting with a person in pain*********************************************************************

Jared Updike shares his story about his experience with pain in this episode. He received diagnoses of psychogenic pain, central sensitization, myofascial pain syndrome, and fibromyalgia. Jared wrote a terrific blog post ("Doctor Masseuse"), which I discovered via Paul Ingraham's post on PainScience.com.  Jared Updike is Los Angeles-based software developer who learned about chronic pain and fatigue at the school of hard knocks. He hopes other sufferers can become their own health advocates, learning to manage their issues through patient education and their own informed, considered experimentation. He dishes out life advice and writes about technology, photography and his programming projects at his blog, Jareditorial, at jared.updike.org. You can follow him on Twitter @JaredUpdike. Jared shares his experiences -- including successes and struggles -- and we discuss some of the interesting science about pain. Jared shares his thoughts for health care providers and for patients struggling with pain. I also found out that Jared has been to 56 of the 59 National Parks! We discuss many resources about the science of pain. For more information, consider the following: Dr. Lorimer Moseley's post on Body In Mind: "Resconceptualising Pain According to Modern Pain Science" Dr. Karen Litzy's Healthy, Wealthy, and Smart Podcast with Dr. David Butler about Explain Pain Supercharged The Pain Science & Sensibility Podcast with Dr. Sandy Hilton and Cory Blickenstaff. Dr. Bronnie Thompson's post: "Is Central Sensitization Really A Thing?" Dr. Thompson's blog Health Skills blog contains many other helpful articles about pain. Tedx Talk in Adelaide from Lorimer Moseley - Why Things Hurt. The Message Pod with Dr. Lorimer Moseley: The Revolution in Managing Chronic Pain. MyCuppaJo.com - A blog from Joletta Belton about her experiences with (and without) pain. If you have a story to tell as a patient, provider, or both, then contact Zach Stearns on Twitter @zachrstearns or Dave Reed @DReedPT. Please note that nothing in this episode or any episode of the Voice of the Patient podcast should be considered medical advice. ---------- *Find more helpful podcasts & blog posts at http://TheVoiceOfThePatient.org *Check out the other podcasts in the Senior Rehab Project at http://SeniorRehabProject.com

On this episode of the Healthy Wealthy and Smart Podcast, Dr. Sandy Hilton and I went into the crowd at the San Diego Pain Summit on the last day to get the attendee's views on the Pain Summit this year.  In this episode, we learn: - The common theme running through the San Diego Pain Summit - Which talks resonated with a lot of the attendees of the summit - The reasons why you should attend the summit - What is in store for the San Diego Pain Summit 2018 - Lots of great behind the scenes conversations happy after hours - And much more!   "You know you are in the right room when you are definitely not the smartest person in the room" - Ben Cormack "There is nothing I don't like about the San Diego Pain Summit" - Eric Purves "It is a gathering of all of the clinicians I admire most in the world. Great to be able to to talk with them and pick their brains" - Laura Dunkley "Wonderful conversation about clinical and scientific problems to learn and share together" - Jonathan Fass "We are all a work in progress and you have to be a student first." - Nick Tumminello "The emphasis on making things real for patients. We do things that matter for people" - Bronnie Thompson   Resources: The San Diego Pain Summit   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my blog post on the Top 10 Podcast Episodes of 2016!  

On this week’s episode, I share the first part of my talk with Dr. Bronnie Thompson from one year ago on chronic pain management which will change the way you practice. Dr. Thompson has worked in the field of chronic pain management, helping people develop ‘self management’ skills for 20 years and has a passion to help people experiencing chronic health problems achieve their potential. In this episode, we discuss: -How to learn to live well despite chronic pain and her research on the 3 phases to reoccupy your self-concept -How to incorporate values based pain management into your practice -The value of motivational interviewing, the specifics of implementation, and why it’s not always about pain -Why patience is key to a person-centered practice -And so much more!   Healthcare providers should address the nature of chronic pain and the goal of treatment should be to educate patients on how to understand and manage their pain. Dr. Thompson found that for patients with chronic pain, “Hearing that this pain is likely to remain was a really important turning point for all the participants. So they stopped that search for the cure.”   Dr. Thompson promotes a psychosocial approach to learning to live well with chronic pain and making new sense of your self-concept.   Dr. Thompson states, “When pain comes on, life becomes incoherent—it doesn’t make sense anymore. Your self-concept, the person that you think you are, suddenly goes. You can't rely on yourself to do the things that you used to be able to do and the expectations you have of yourself disappear. For a long time, people are sustained on this search to go back to the person they used to be. But 5, 10, 15 years later, they are never going to be that person. It’s about saying, ‘Who can I be now?’ The process of learning to live well is about recognizing, ‘I do need to let go of that desire to go back to my old self and look to build this new person.’”   One of the key aspects of learning to live with chronic pain is to find a sense of community and begin building new meaning in your life. Dr. Thompson states, “Carrying that invisible sort of separation, ‘I’m not who I used to be, I feel like I’m not who I used to be and yet nobody can see that’ is so isolating. It’s unbelievably isolating. To be able to say, ‘I can connect,’—what you do connects you with other people, the way you dress, the way you happen to tidy your house or not, the way that you drive—you’re going to look at other people and you’re going to say I'm like them or I'm different from them and that’s how we find our way.”   For more about Dr. Thompson: I trained as an occupational therapist, and graduated in 1984. Since then I’ve continued study at postgraduate level and my papers have included business skills, ergonomics, mental health therapies, and psychology. I completed by Masters in Psychology in 1999, and started my PhD in 2007. I’ve now finished my thesis (yay!) and can call myself Dr, or as my kids call me, Dr Mum.   I have a passion to help people experiencing chronic health problems achieve their potential. I have worked in the field of chronic pain management, helping people develop ‘self management’ skills for 20 years. Many of the skills are directly applicable to people with other health conditions.   My way of working: collaboratively – all people have limitations and vulnerabilities – as well as strengths and potential. I use a cognitive and behavioural approach – therapy isn’t helpful unless there are visible changes! I don’t use this approach exclusively, because it is necessary to ‘borrow’ at times from other approaches, but I encourage ongoing evaluation of everything that is put forward as ‘therapy’. I’m especially drawn to what’s known as third wave CBT, things like mindfulness, ACT (Acceptance and Commitment Therapy) and occupation.   I’m also an educator. I take this role very seriously – it is as important to health care as research and clinical skill. I offer an active knowledge of the latest research, integrated with current clinical practice, and communicated to clinicians working directly with people experiencing chronic ill health. I’m a Senior Lecturer in the Department of Orthopaedic surgery & Musculoskeletal Medicine at the University of Otago Christchurch Health Sciences.   I also offer courses, training and supervision for therapists working with people experiencing chronic ill health.   Check out her blog HealthSkills for more great resources and follow Dr. Thompson on twitter, facebook, and LinkedIn.   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen   P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on The Do's and Don'ts of Social Media!   P.S.S. Check out the inaugural Women in PT Summit here! Sign up now as space is limited!

In this special episode of Pain Science and Sensibility we are co-releasing with the Naked Physio Podcast, joining up with Paul Lagerman and Bronnie Thompson (who you may remember was also a special guest on Episode 11) to revisit and expand thoughts on the Inhibitory Learning paper from Episode 12. Listen in as Sandy and Cory learn that their inventive pronunciation skills can also be applied to places in New Zealand.

This is the continuation of the interview with Dr. Bronnie Thompson from last week about living well with chronic pain.  In this episode we answer listener questions!  In this episode we go through the following questions: * What she would say to give confidence to someone who is afraid that no matter what they do, they will always hurt? * Is there value in a pain diary? * Any tips on instituting an exercise program in widespread pain syndromes such as fibromyalgia? * Any helpful strategies to get a reluctant patient on board with exercise? * How does Dr. Thompson's research in pain apply to the manual therapy profession? * And much much more!   I want to send lots of love and thank yous to Dr. Bronnie Thompson for an amazing interview experience and sticking around for this very important part two of our conversation.  Thank you for all of the positive comments and kind words from last week's interview and I know you will find the same value in this episode! Have a great week and stay Healthy Wealthy & Smart!   Karen

I know what you are thinking...living well with chronic pain?!?  Some thoughts that went through my head were: "Are you kidding me...that sounds impossible" "Sounds like an oxymoron to me." "Does that mean take lots of pain meds to feel better?"  And I am sure you can think of lots of other things to say!  But after you listen to this incredible interview with Dr. Bronnie Thompson, your thoughts will be challenged!  You will start to see that yes...you can live well with chronic pain.  You can find value and fun in your life doing the things you love despite pain. In this episode we talk about: Values based pain management Dr. Thompson gives some amazing examples of motivational interviewing (I am talking really great so be ready to take notes!).   The process your patients can follow to reoccupy their self-concept in the face of chronic pain. How to be a real human with all of your patient interactions.  Making the patient the center of your practice. And so much more! This is the first part of a two-part interview with Dr. Thompson.  The second part will air next week!   Thanks for listening and if you like what you are hearing please share it and leave a rating here!  Have a great week and stay Healthy Wealthy & Smart!  Karen ***PS....You will also listen to what made me totally break down and cry for the first time on air!  Get the tissues ready!  

Putting big mouths and big ideas behind microphones. The Physio Matters Podcast is a feature of Chews Health's third core value ‘We