I just put out a Movement Optimism Podcast on whether Physios suck at exercise prescription. It is in response to a trend over the past few years where I hear physios/rehab pros being criticized. The criticism is that Physios don’t understand the basics of Strength and Conditioning and that if they knew these better they would get better results with their patients. From putting this out there and the discussion that ensued you could see a lot of misunderstanding of my points and a lot “talking around each other”. And I’ll admit that a lot of that miscommunication was my fault. It’s hard to de ..read more

Is Movement Optimism for Movement Morons? This is a good question – a tad insulting but lets let it slide. Because we should challenge Movement Optimism. But first we need to look at what Movement Optimism is (good old blog here). Just fan literature on Movement Optimism Movement optimism started as a rejection of the Kinesiopathological Model. Where the basic tenet of the KPM (link here) is that movements that deviate from neutral or prolonged extreme postures lead to pain or tissue breakdown in the future (e.g you will pay for it later). This manifests in assessments that look at posture an ..read more

As someone who has literally been reading research for 30 years this is an odd opinion to hold.  I love reading research papers.  I’ve been a nerd for a long time.  But…I think the pressure put on working clinicians to stay “up to date” is for the most part totally over cooked. Big Caveat: I’m not saying our profession does not need research.  We actually need more.   So, what the hell are you saying? I think that continuing education providers, researchers hell bent on knowledge translation, research review services and Instagram PubMed warriors can make clinicians ..read more

A comprehensive approach to using a traditional biomechanically based practice within a biopsychosocial approach.    This course has been taught more than 120 times on 5 continents.  It is constantly being updated and we consider it a great course for new grads and seasoned veterans.  New grads report that it helps give some direction to their new learning and old pros often find it reinforces much of what they know but gives some additional practical insights into improving what they do.  We recognize that some of the material is contestable but many of those who have ..read more

You click bait jerk. I know. But hear me out. Apologies for the length of the post. It was meant to be a microblog but it morphed into pre-course reading for those taking Reconciling Biomechanics with Pain Science. I know many people hate the term non-specific low back pain.  The assumption being that if you know the anatomical source of pain you can give tailored treatment to your patients.  But not only do I think that doesn’t matter much in the spine (there are exceptions and I wrote about that here) but it also doesn’t matter much at other joints.  Let’s talk about the kne ..read more

Clinical experts often hold strong opinions about the interventions they champion.  They have no doubt helped a lot of people and have also been involved in research that supports their opinions. I want to listen to these people and learn from them. But, they have blind spot that they don’t recognize.  They will often hold negative opinions about some interventions that they are against and I think this is an area where we should listen to them less. For example, I am an advocate of heavy resistance training for a number of conditions.  In years past I was strongly against str ..read more

Why this blog: This is a bit of thought experiment. Bear with me. I hate running Not sure why I do it. I do prefer talking about though ASSUMPTIONS ABOUT PAIN, INJURY AND RUN TRAINING Tissue injury/failure is considered to be a cause of running related injuries and pain. It is assumed that building tissue strength will decrease our injury risk. Hence, we say things like injuries occur when Load exceeds Capacity. Yes, there are issues with the term Capacity but that’s another blog Some research suggests that Bone and Connective Tissue (tendons, fascia, ligaments, cartilage) do respond posi ..read more

Let’s jump into a few areas where joint stiffness, tissue stiffness and joint mobility might matter. Please don’t consider this exhaustive. 1. When it matters to you Easy-peasy eh? If you are concerned about the feelings of stiffness and think it is contributing to your pain then its something we need to discuss. We need to figure out if it is really contributing to your pain or function or if your feelings of stiffness are just “victims” from whatever else is driving your pain. The thought here is that sometimes we might be trying to “fix something” (perceived tightness) that actually isn’t ..read more

Traditional physiotherapy has often looked to find “deficits” in someones function and then suggested those deficits are what is causing pain.  Deficits are typically any type of physical functions or attributes that deviate from averages.  Typical examples being altered postures when you are standing that deviate from neutral (e.g your head might be forward, your pelvis might be tilted more anteriorly than average, some muscle is weak or range of motion is less than average). A very common and fully unsupported explanation for all sorts of pain problems would be the lower crossed ..read more

This is going to be a three part blog.  The first two parts will explore the reasoning why stiffness/tightness is often irrelevant for pain.  The last blog will discuss times where stiffness and mobility might be relevant for pain and injury. Part 1: Why you can stop worrying about stiffness Muscle and joint tightness can be viewed as two things: 1.  Actual or perceived joint and muscle stiffness.  Stiffness is a mechanical concept that describes how much force it takes to move a joint or structure.  Stiffer materials or joints require more force to lengthen or move ..read more