I´m joined by Dr. Greg Lehman a physiotherapist, chiropractor and strength and conditioning specialist from Canada.

Greg works both clinical, write academic papers and travels the world with his course, Reconciling Biomechanics with Pain Science. 
Greg is very active on social media where he seems to enjoy  discussions and dissemination of knowledge. 

I´ve worked with Greg (as a course host in Aalborg, University College Northern Jutland) which have resulted in many insightfull a reflective discussions with Greg. some of our talks have inspired the topics we cover in the podcast. 

We cover some of Gregs most recent publications and why data that is 20 years old is necessary to publish again in a different format when trying to work responsible.

What are the fundamentals of recovery and how do we tailor it.
- Cognitive restructuring
- Specific load
- Micro load
- Macro load

Guideline based treatment and how our practices has developed over the years. Are we under- or overtreating the sufferer ? 
Can our messages regarding low back pain be to positive ?

Why do people continue to have very strong opinions when the data really isn´t that robust
and which strong opinons or narratiuves have Greg and I been guilty of earlier in our career.

Finally Greg gives advices and wishes for the future.

Pain or injury? Why differentiation matters in exercise and sports medicine. Morten Hoegh, PhD & Tasha Stanton, Associate Professor

Morten and Tasha 

In this episode I´m joined by Claus Kjærgaard form Denmark and Richard Rosedale from Canada.
Both Claus and Richard are involved in teaching McKenzie courses nationally and internationally.

What is Mechanical Diagnosis and Therapy (MDT) ? Well from my perspective it’s just a part of what we use in our encounter with the human in front of us . But let´s hear what claus and richard has to offer when they deliver their perspective.

MDT It’s been accussed of being a very biomedical and reductionistic classification system but is that a fair statement ?

We cover some of the  data supporting MDT. Is it better, equal or worse than other ways of dealing with the msk population i.e is it evidence based and is it cost effective . A recent study showed it to be cost effective in primary low back pain care. 
https://www.tandfonline.com/doi/full/10.1080/10669817.2019.1613008

In the last decade there has been a lot of focus on what predict prognosis but we have mainly focused on what predict a negative outcome . The data is pretty clear that patients presenting with either centralization or DP has a good prognosis. We discuss why it is that we do not focus on this positiveprognostic tool. A tool which really is a low hanging fruit.

MDT has recently been updated and Richard helps us thought these and explain why it has been necessary to update.  

We talk about some of the  greatest pitfalls you encounter both clinically and on the courses from those using MDT. 

Finally we discus the bastardization and mistepresentation of MDT in the scientific literature. This could indicate that it’s poorly understood. It’s also a problem that it’s even funded or that it passes a review process or used in systematic reviews. 

You can find more about the McKenzie institute international on this link https://mckenzieinstitute.org/

In the last week of the Tokyo Olympics (2021) i joined up with the newzealand physioterapist Greg Lynch to talk about how rehabilitation of the athlete could be performed. 

Large events like the olympics and and world cup events normally put quite a lot of focus on the health and rehab of the athletes and the Tokyo games were no different in that perspective. 

We thought that we would share our thoughts on what rehabilitation and performance enhancement of the athletes should focus on and not spend time on kinesiotape, cupping and such elements which at best is marginal gains, but more like could have a detrimental effect on the athlete and not least on the public watching.

Besides sharing his and mine experience working with athletes including some clinical nuggets we discuss following subjects;

The importance of understanding the human and their expectations.
The relevance of knowing the mechanical demands of the sports.
Are there measures / specific tools we choose when working with the athlete.
The use of passive modalities and the narrative surrounding them.
Is Mechanical Diagnosis and Therapy (MDT) applicable in an athletic population? we´re obviously biased but will give a clinical example.
How do we handle when we have to back of a little of the load in the athletes training and which explanations could we offer the athlete to involve.
The importance of collaboration with the athletes coaches to provide and understanding and acccept of the situation.
Finally we will provide some advice for physiotherapsist who would like to make a career where working with athletes are a part of the case load.

I podcasten taler vi med speciallæge og praksiskonsulent  Mette Bolvig.

Som fysioterapeut er vores tætteste samarbejdspartner ofte de privatpraktiserende læger. Jeg synes derfor det er interessant og vigtigt at vi ved hvad hinanden gør når vi har med folk at gøre som søger vores hjælp pga lændesmerter. 
Mette og jeg drøfter bla følgende;

Hvad gør man som læge i almen praksis når der kommer et menneske med rygsmerter. Mette opsummerer sin undersøgelse og sine overvejelser

Her er linket til forløbsløbsbeskrivelse til mennesker med smerter i ryggen som vi ontale ri podcasten . https://www.sundhed.dk/content/cms/21/116421_rygskema-marts-2021.pdf

Hvorledes finder vi som faggrupper et fælles fodslag og sprog om den uspecifikke lændepatient så vi ikke forvirrer mere end vi gavner. En ting er at tale om en positiv prognose men samtidigt skal det være afstemt med at vi er realistiske så folk ikke skuffes.

Hvorledes bakker vi op om hinanden som faggrupper så fys ikke siger noget og egen læge noget andet.

Hvordan forklarer vi folk at deres rygsmerter er uspecifikke og godartede.

Hvorfor det at bruge tid på at forklare en mr-scanning  til patienter kan være givet godt ud

Mette redegør hvorfor hun gerne vil have epikriser og korrespondancebreve samt hvorledes man med fordel kan formulere sig

Vi snakker selvfølgeligt også om fysioterapeuter har en plads i lægeklinikker og hvad der taler for og i mod

Min gæst i denne episode er Thorvaldur Palsson, Fysioterapeut og Ph.d.

Vi taler om SI-led/bækkensmerter. Selvfølgeligt kommer vi omkring det diagnostiske "build up" og den kliniske ræssonering som guider os i vores praksis.

Historisk set har fysioterapi, kiropraktik, osteopati og lignende været professioner hvor man anvendte palpation og ortopædiske test til at diagnostisere patienter. Den tilgang er med årene blevet grundigt undersøgt og på mange områder har man måtte konkludere at dette både er utroligt reduktionistisk og nogle meget upålidelige redskaber når det kommer til diagnostik. 

Vi forsøger i podcasten at forklare og skabe et rationale for hvorfor SI-led/bækkensmerter ikke kan diagnosticeres med oldnordiske test og dermed hvorfor vi ikke bør fortælle patienter at der bækken sidder skævt, har et upslip/ downslip eller noget helt 3.

Vi hjælper lytterne til at forstå hvilke befolkningsgrupper de primært vil finde folk med  bækkensmerter og hvilke udsagn og fund man typisk hører ved folk med SI-led / bækkensmerter. 

Som en naturlig del af samtalen vender vi evidensbaseret praksis og hvorledes vi kan forsøge at navigere som klinikere når litteraturen eller vores erfaring ikke kan guide os 100% i mål.

In this episode I´m joined by the brilliant and creative Tim Beames

Tim shares his ideas og thoughts.

A really delightful conversation with Tim about humans, clinicians and CREATIVITY and why we should not piss in the wind.

If you like creativity and actually are a bit in love with the word itself this is definitely a podcast worth a listen

Tim gives his perspective and deliver some clinical pearls while we touch on subjects such as;

Graded motor imagery - GMI

Why being flexible and creative is helpfull and why 2-5 Guiness can facilitate thoughts, ideas and creativity. 

Talking context sensitivity using straight leg raise as an example.

How do we come around exercise when people look like the word exercise makes them wanna run a way 

How the assessment itself is an important part of validation and exploration 

We also touch on the subject about getting rid of our egos, it’s okay to tell patients that we as health practitioner maybe aren’t the right one to help them.

How our communication involves pitfalls when taking about accept and facilitating optimism 

What it’s the pipeline for GMI in the future

Tims advice, learn to be a good human being, be reflective and test yourself in various ways. Not least find ways of working that you enjoy.

Find out more about Tim and what he is up to;

https://lepubscientifique.com/
https://www.noigroup.com/instructor/tim-beames/
http://www.gradedmotorimagery.com/

thanks for listening

In this episode my guest is Thomas Jesson.

Tom is an english physiotherapist with a crush on radicular pain. 
Tom and I discuss and share our thoughts regarding radicular, radiculopathy and somatic referred symptoms.

As a natural result of talking about sciatica we also discuss what happens when nerves are pissed of.

We touch on the differences and characteristics radicular pain has vs how low back pain behaves and why it sometimes needs to be managed differently.

We do admit we don´t know everything and why we think that such mesages to patients are ok but why we at the same time think it´s important to remain optimistic. 

Go grab a listen and maybe sign into Toms newsletter https://tomjesson.substack.com/

In this episode i´m joined by DR Mark Laslett from New Zealand.
We´re discussing diagnostics and specific vs non-specific low back pain. Mark takes us through his thoughts why he thinks that we´re able to diagnose low bak pain better than what is currently accepted and why we need to research more into the subject instead of giving up.

We discuss the possible pitfalls of accepting non-specific low back pain and providing a generic approach.

Due to Marks extensive insigth regarding the subjectt of the sacroiliac joint we naturally come across this as well and how the clinician based on very few clues and findings can raise the probability of an sij problem or exclude it.

Mark has been in the profession for almost 50 years which gives us a unique opportunity to track backwards into our history as a profession. A path backwards that I believe raises our awareness of where we are today and how we could learn from it. Who knows such trip back in time can also result in rejecting a few myths if you dare to stick along !!

But do not make the mistake of believing its all just a stroll down memory lane, cause Mark has a lot of knowledge and commitment to offer both for the present and the future.

This episode is also the premiere of my brand new intro jingle made by my good buddy Martin Melby who is a damned cool physiotherapist and a dedicated blues musician

Thanks for listening