Physiotherapy/Biopsychosocial/Pain Science

I’ve only just woken up to the biopsychosocial model, which is being embraced across various disciplines.  It’s worth exploring.  The easiest place to start is probably with

Explain Pain by David Butler and Lorimer Moseley

If you despair of getting those chronics to improve, and feel like all you’re doing is giving them regular massage, then wake up to this whole new world of biopsychosocial models and neuroscience.  Explain Pain is pretty osteopathic, but it gives you a great structure and lots of tools to work with patients in terms of psychology and understanding and life changes.  Explain Pain is a book and a course, and is probably enough to get you going, but there are also lots of great you tube clips (just type in Lorimer Moseley) and other tools available from the NOI group website.

Read the blog I wrote after a weekend Explain Pain course with David Butler

If you start getting into pain science and the biopsychosocial model, you will be riding a wave.  It’s very now.  Increasing numbers of people are churning material out at a rate, and are all social media savvy and prolific posters.  Lorimer Moseley also has a website called Body in Mind, worth a look.

Aches and Pains by Louis Gifford

Click here for a link to Mark Andrews’ review.  This book seems so obviously to be the classic, seminal text for manual therapists that it’s hard to believe it only emerged a couple of years ago.  It’s long, but there is practical help and wisdom and humour on each page.  Enough said.  Please buy it here.


Some of us osteopaths might feel that we have been working with consciousness for years, but the physiotherapists are discovering it in a big way as they get more into neurology and questioning exactly what is going on between the clinican and the patient.  If you can cope with a long and fairly hard core read, try this neuroscience:

 The Feeling of What Happens – Antonio Damasio – Only read this if you are really, really interested in neurology and/or consciousness.  It’s not a light read.  What I took from it (maybe wrongly) was that consciousness is associated with awareness of our body through its proprioceptive function.  So whereas normally you have a map in your brain of where your body is, how it feels and so on, when you have a heightened awareness of your body’s state and position changing, you create another map on top of the first, which he calls a second order map.  He thinks it’s significant that the brain structures involved in this are all midline structures.  And this creation of second order maps, in some way, represents consciousness, or a raising of consciousness?  I think this might be a very important avenue to explore in cranial research.  We are using our attention to scan someone’s body,and can often sense things remotely or subtly which then change in response to our attention (attention – another difficult thing to define – and we wonder why it’s so difficult to explain cranial.)  Anyone who’s been on a biodynamics course will be aware that many people come away at the end feeling more alive, connected, present – in short, maybe more conscious.  The two (cranial treatment and consciousness) are possibly connected, and not only by virtue of both being so hard to research (consciousness is notorious for being the “Hard Problem” in neuroscience.)

Some other good physio blogs and websites

All of these also have twitter accounts I can’t recommend this highly enough.  Funny, down to earth and refreshingly iconoclastic. This guy is a shoulder physio who cuts through the proverbial with ease.  Read this and you will be able to junk a lot of notions that you always suspected were a bit dubious – trigger points, testing SI levels, the importance of technique, and on and on.  He does the deep research, too; the site is packed with references. This has 609 likes on Facebook, but it should have about 6 million.  Go here for loads of really useful articles and tips about pain.  It’s written by an ex-massage therapist who now reads and researches extensively on pain.  You can also find articles on alternative therapies (he is mystified as to why his article on epsom salts is so incredibly popular).

Becoming more human  Neil Maltby is a physio I think, and writes on a deeper level about what we are all doing in the treatment room.