Clinical Communication

How To Reassure Patients with Ian CowellReassurance is included in clinical practice guidelines acrosshealthcare and is usually a part of any assessment. Yet, very little research and guidance existed on how to go about doing it. But there has been recent new research that suggests whatdoes (and doesn’t) work when trying to reassure those with chronic low back pain, which could be applied across many other conditions.On this episode Ben is joined by the lead author Ian Cowell.Clinician, Educator & Researcher with the Evolve Pain Academy/Cognitive Functional Therapy group. Where they discuss;(00:00:00) – Introduction(00:00:51) - Reaction To Ian’s New Published Paper(00:03:00) - Why Hasn’t There Been Much Published OnReassurance?(00:05:07) - Where Did Attempted Reassurance Go Wrong?(00:07:37) - Asking or Responding To Concerns(00:20:33) - The Importance Of Non-Verbal Communication(00:21:54) - What Allowed Reassurance To Go Well(00:29:58) - Using Behavioural Experiments For Reassurance(00:38:03) - Managing Patient Beliefs(00:42:07) - What To Do When Behavioural Experiments Don’t Go To Plan(00:44:27) - What Cues Did Clinicians Miss?(00:53:13) - Who Doesn’t Cognitive Functional Therapy Work For?(00:58:15)- Is Persistent Pain Research Becoming MorePositive?(01:00:39) - Ian’s Hardest Clinical Conversations (01:05:07) - Could This All Be Applied Across Healthcare InGeneral? Ian’s New Reassurance Paper:“A Detailed Analysis of How Physiotherapists "Give" Reassurance for Patients' Concerns in Back Pain Consultations” – Cowell et al (2025).https://pubmed.ncbi.nlm.nih.gov/40455078/Also Read:“How do physiotherapists solicit and explore patients'concerns in back pain consultations: a conversation analytic approach” – Cowell et al (2021)https://pubmed.ncbi.nlm.nih.gov/31392911/ You can find Ian on X/Twitter @brookphysio & LinkedInEvolve Pain Care Academy: https://evoolvepaincare.academy/ You can find Ben across social media @BWhybrowPhysioYou can send emails to clinicalcommunication@outlook.comPlease share & subscribe.

Resistance and strength training is often highly recommended for the management of many conditions affecting older adults, with many guidelines and recommendations available.Yet many barriers can get in the way, whether they’re physical, psychological or something else.In this episode Ben is joined by Physiotherapist & Author of “Never Too Old To Lift” Chris Tiley, where they discuss:(00:00) - Introduction(01:08) - How To Manage The Situation Where A Family Member Is Protecting The Patient?(05:40) - How Can We Help An Older Person Understand The Benefits And Risks Of Lifting?(09:05) - The Benefits Of Groups(12:46) - Is There Anything Communication Wise You Wouldn’t Do With An Older Adult, That You May Do With Someone Younger?(15:35) - How To Get An Older Person Motivated To Lift, WhenThey Appear To Have Given Up?(24:02) - What About If They Need To Slow Down?(30:40) - What Does Chris Wish He Knew About Writing A Book Before He Wrote It?(33:50) - How To Manage Limiting Beliefs In Older Age(40:48) – How Stories Help With Buy-In(43:49) - The Effect Greg Lehmans Course Had On Chris(48:22) - Never Too Old To Lift Website & PodcastYou can find Chris on LinkedIn & Instagram@nevertoooldtoliftHis website mentioned is: www.nevertoooldtolift.com His Podcast, Facebook & YouTube Channel is “Never TooOld To Lift”Chris’s Therapy Expo Talk: https://youtu.be/53r1Ly0lUpM Upcoming Greg Lehman Course: https://www.tickettailor.com/events/reconcilingbiomechanicswithpainscience/1496927 You can find Ben across social media @BWhybrowPhysio or by emailing clinicalcommunication@outlook.comPlease Share & Subscribe

Menstrual cycles are considered the fifth vital sign for awomans health and can have an impact on functions all over the body. Yet many clinicians may feel uncomfortable discussing the topic with the person in front of them, with little guidance on how and when to raise the subject.Until Now.On this episode Ben is joined by Michelle Lyons, SpecialistPhysiotherapist and Lecturer in Pelvic and Women’s Health. In this episode they discuss;(00:00) - Introduction(01:39) - How do we raise the topic of menstrual cycles when the patient hasn’t?(17:35) - What if they’re on contraception and don’t know their period health?(20:40) – How to raise the topic of bowel health(23:07) - How do we encourage women to track their periods?(29:40) - What if they come from a culture where menstrual health isn’t regularly discussed?(32:10) – Being aware of iron deficiency anaemia(35:00) – Michelle’s hardest clinical conversation(40:32) – The impact of lifestyle factors on menstrual health(42:50) – Michelle’s Podcast & Courses You can find Michelle on social media: Instagram: michellelyons_muliebrityX/Twitter: @ml_muliebrityAnd on LinkedIn Her Podcast is: Celebrate Muliebrity Her Website with Courses is: https://celebratemuliebrity.com/ You can find Ben across social media: @BWhybrowPhysioPlease Share & SubscribeYou can send in questions, stories or suggestions to: clinicalcommunication@outlook.com

First Contact Practitioners/Physiotherapists have been an evolving role for over the past five years, with it becoming a role that more senior clinicians are going into. Yet with this new role comes new challenges; time limitations, more diagnostic uncertainty and different expectations from both patients and other clinicians.In this episode Ben is joined by Matt Wedderburn, First Contact Physiotherapist and creator of “Primary Care MSK” which provides musculoskeletal educational training to primary care services.In this episode they cover:(00:00) - Intro(01:05) - How should we explain to the patient what an FCP is?(03:30) - How should we explain to other medical professionals what the role of FCP is?(09:30) - How do we manage those 20 mins without the patient feeling rushed?(19:29) - How should we discuss uncertainty in primary care with the person in front of us?(21:42) – Reassurance in FCP(24:00) - What if they want to see a GP instead?(28:55) - Your hardest clinical conversation(36:40) - What is the future for FCPs? You can find Primary Care MSK on social media @PrimaryCareMSKTheir website is https://www.primarycaremsk.co.uk/Matt is on LinkedIn You can find Ben across social media @BWhybrowPhysio Do send in Questions, Stories & Suggestions toclinicalcommunication@outlook.com And please Share & Subscribe.

Millions of people around the world regularly run for exercise and pleasure and become the identity of a runner. Yet when they need help from a healthcare clinician, some unique conversational challenges can occur with this patient group.On this episode Ben is joined by Matt Phillips, Sports Therapist and creator of Run Chat Live, where they discuss:(00:00) - Intro(00:51) - The Down Side Of Completing A Marathon (04:26) - Do Runners Have A Different Mentality?(08:54) - How To Support Someone To Reduce Their Running(12:86) – How To Encourage Other Forms Of Training(21:50) – Symptom Modification For Runners(24:44) – Myth Busting With Runners (And How Not To Do It)(33:59) – Not Everyone Wants To Be Involved In SharedDecision Making(39:51) – Matt’s Hardest Clinical Conversation(43:15) – One Of Matts Greatest Running Patient Achievements(46:59) – Run Chat Live, Sports Therapy Association Podcast& Matt’s Course You can find Matt across social media @runchatliveLink for “Gait Analysis for Runners” course:https://thestschool.co.uk/gait-analysis-course-dates/ You can find Ben across social media @BWhybrowPhysioSend in questions, stories or suggestions to clinicalcommunication@outlook.comAnd please subscribe & share 😊

Various evidence exists showing the benefits of injuryprevention programmes for reducing the risk of injury to young athletes, yet uptake in them has not been 100%. So how can we increase the number of young athletes doingregular injury prevention programmes? And how can we influence coaches and organisations to ensure it is implemented?In this Ben is joined by Tom Jacbos, who is a Sports &Musculoskeletal Physiotherapist, and also a trustee for “Power Up To Play”. A charitable organisation aiming to increase young athlete welfare with injury prevention programmes. On this episode they discuss;(00:00:00) - Introduction(00:01:52) - What Made Tom So Interested In InjuryPrevention?(00:06:43) - Should We Still Call Them Injury PreventionProgrammes?(00:17:57) – How Do We Help Young Athletes Buy Into InjuryPrevention Programmes?(00:24:43) – How To Influence Coaches To Implement InjuryPrevention Programmes(00:35:57) – Do Parents Help or Hinder Buy-In To TheProgrammes?(00:38:44) – How Do We Influence Larger Organisations?(00:46:41) – Will Making These Programmes Mandatory Make An Impact?(00:50:16) – What To Say When Coaches Have Doubts About The Programme (00:55:00) – Do The Same Principles Apply To Adult Athletes?(01:02:30) – Tom’s Hardest Clinical Conversation(01:11:11) – What’s The Future For Injury Prevention Programmes?(01:14:23) – How To Find Out More About Power Up To Play You can find more about Power Up To Play here:https://poweruptoplay.org/ You can find Ben across social media @BWhybrowPhysio Got questions or stories to share? Contact clinicalcommunication@outlook.com

During the recording of “Clinical Communication” episodes, before guests are asked the deep hard questions, they’re given some easier warm up questions to start with to help them feel comfortable. These are also recorded though not released at the time, until now. Some of this content from earlier episodes has been released on social media, but others from recent episodes have been held onto for this special episode, where you will hear: (00:00) – Introduction (01:26) Jo Gibson: Which Rotator Cuff Muscle Is The Heaviest? How To Build Rapport With Scousers? (04:18) Nick Lividas: Weirdest Body Parts People Have Had Steroid Injections Weirdest Substances Being Injected Where Are We Currently With Stem Cells? (14:29) Ian Reilly: What Is The Future Of Podiatry? Orthotics in Podiatry Original Podiatric Theories Do In-Soles Have To Be Specially Made? For more, find @BWhybrowPhysio across social media. Got questions, dilemmas or stories? Send them in to clinicalcommunication@outlook.com

Shoulder pain is a common reason for people to seek healthcare support. Whilst many will respond well to time and rehabilitation, certain situations and beliefs make it harder to treat and manage. This may be in relation to certain tissues being “torn”, the joint being “out of place” and “unstable” or having to break bad news when there is no easy solution. Jo Gibson is an Upper Limb Specialist Physiotherapist & International Lecturer for shoulder conditions. In this episode Ben & Jo discuss; (00:00:00) – Introduction (00:01:37) - What Influence Did Jo’s Father Have On Her Practice? (00:06:07) - Where Did “Communication Is Your SuperPower” Come From? (00:09:00) - Which Communication Skill Did Jo Find The Hardest To Master? (00:16:05) - Are We Done With The Term “Shoulder Impingement”? (00:21:00) - How To Help Someone With A Rotator Cuff Tear Buy Into Rehab (00:26:42) - How To Support Those Who Are Worried Their Shoulder Will Regularly Dislocate (00:33:03) - How To Discuss Frozen Shoulder With A Patient (00:37:47) - Jo’s Hardest Conversations (00:45:48) - What Did The Upper Limb Unit Team Mean To Jo? (00:47:57) - Jo’s Courses & Further Info Jo is on X/Twitter: @ShoulderGeek1 & LinkedIn Her course is “Shoulder Steps To Success” available either in person or online. Ben is available across social media @BWhybrowPhysio – follow & subscribe to stay up to date.

Steroid injections have been available in healthcare for seventy years for various uses. But how should we discuss the risks and benefits of them for musculoskeletal pain with patients? How should we support someone who is really keen for one, but it’s not in their best interests? On this episode Ben is joined by Nick Livadas, Advanced Physiotherapy Practitioner & Lecturer at Teeside University for which he leads the Musculoskeletal Injection Therapy module. They discuss; (00:00:00) – Introduction (00:01:25) – What Made Nick Interested In Steroid Injections? (00:04:30) – What Do Patients Usually Ask About Steroid Injections? (00:08:50) – Shared Decision Making With Steroid Injections (00:13:15) – How Have Patient Questions & Knowledge About Steroid Injections Changed Over Time? (00:13:40) – Should We Still Describe Steroid Injections As A “Window Of Opportunity”? (00:18:00) – How Should We Tell A Patient A Steroid Injection May Not Help Them? (00:19:40) – What Should We Say To Someone When The Benefit Of The Steroid Injection Lasts Longer Than Expected? (00:23:07) – How To Discuss The Risks Of Steroid Injections To Patients? (00:29:55) – How To Tell The Patient When A Steroid Injection Isn’t In Their Best Interests (00:36:10) – Are These Conversations Really The “Advanced” Part Of Being An APP? (00:38:50) – How To Support Those Who Are Afraid Of An Injection (00:41:48) – Nicks Hardest Conversations (And Helpful Strategies) (00:48:50) – The Time Limit Downside To Being An Advance Practitioner (00:54:04) – What Would Nick Change About Persistent Pain Management In Society? (00:56:23) – How NEMS was formed & What It Is (01:01:10) – How To Contact Nick & Further Courses You Can Find Nick On; X & LinkedIn – @nicklivadas His Musculoskeletal Injection Therapy Course at Teeside University is here: https://www.tees.ac.uk/parttime_courses/sport_&_exercise/ucpce_musculoskeletal_injection_therapy.cfm You Can Find North-East Musculoskeletal Society (NEMS) at: X – @nemsoc16 Instagram – @nemsociety You Can Find Ben on X, Instagram, TikTok, YouTube & LinkedIn - @BWhybrowPhysio

Cauda Equina Syndrome is a rare but very serious condition that can keep many clinicians awake at night. In this episode Ben speaks with Rob Tyer all about speaking with patients about Cauda Equina Syndrome (and other important topics) as shown below. Timeline: 00:00:00 – Introduction 00:01:14 – Was It Hard For Rob To Transition From Taekwondo to Jiu Jitsu? 00:03:32 – How Does Rob Feel Taekwondo Has Changed Over The Years? 00:08:53 – What Made Rob So Interested In Cauda Equina Syndrome? 00:12:52 – Where Is The Right Environment For Further Tests If You Suspect Cauda Equina Syndrome? 00:17:32 – When Should You Ask The Cauda Equina Syndrome Screening Questions During A History Taking? 00:20:35 – How Should We Set-Up The Cauda Equina Screening Questions? 00:23:34 – Is There Any Advantage To Asking The Questions On A Screening Tool Prior To The Appointment? 00:24:55 – Is There A Way To Make Asking The Questions Feel Less Awkward? 00:28:25 – How To Ask About Bladder & Bowel Control Symptoms 00:32:25 – How To Ask About The Sensation Changes 00:35:08 – How To Ask About Altered Sexual Function 00:41:47 - How To Ask About Altered Gait/Balance/Drop Foot 00:45:11 – Do The Questions Need To Be Asked In An Order? 00:49:50 – How Should We “Safety-Net” Someone About Cauda Equina Syndrome? 01:03:22 – What Should You Say To Someone If You Feel They Should Go To A&E Due To Potential Cauda Equina Syndrome Symptoms? 01:12:23 – Rob’s Hardest Conversations 01:23:58 – What Did Rob Wish He Knew About Writing A Book Before He (And Tom) Wrote One? 01:29:23 – Rob’s Question For Ben Link for Rob & Tom Jessons book, “Cauda Equina Syndrome: The MSK Clinicians Guide” – https://shop.tomjesson.com/products/cauda-equina-syndrome-the-msk-clinicians-guide You can find Rob on social media - @CombatSportPhys You can find Ben on social media - @BWhybrowPhysio Do subscribe and get in contact if you have suggestions what would make this better.

Motivation can be a powerful tool for Behaviour Change. But there is different types, extrinsic and intrinsic. What do these terms mean? And how can we enhance them to lead to greater long term behaviour change with the people in front of us? Find out in this episode of Clinical Communication. For more follow @BWhybrowPhysio on X, Instagram, TikTok & YouTube. Reference: Rethorn, Z. D., Bezner, J. R. & Pettitt, C. D. (2021). From expert to coach: health coaching to support behavior change within physical therapist practice. Physiotherapy Journal & Practice.

In this episode Ben speaks with Dr Brad Neal who is a Physiotherapist, Lecturer and Researcher at the University of Essex with a special interest in Patellofemoral Pain. In This Episode We Discuss: (00:00:00) - Intro (00:01:00) – Brad’s Views On Current Cricket (00:02:55) – Could Brad Ever Have Been A Cricket Physio? (00:03:41) – Brad’s Experience Of Working In Elite Sport (00:06:00) – Why Did Brad Choose Patellofemoral Pain To Work In? (00:09:45) – How To Help Patients Understand The Multi-Factoral Nature of PFP (00:11:10) – What To Say To The Patient When They’ve Been Told They Need To Strengthen Their VMO (00:15:00) – Why We Should Tell Patients With Patellofemoral Pain What Isn’t Going On (00:16:50) – Does The Patellofemoral Joint Cartilage Tear? (00:17:10) – How To Reassure Someone With Patellofemoral Pain (00:19:10) – How To Discuss Chromalaecia Patellae X-ray Findings (00:20:40) – Are Normal Age Related Patellofemoral Joint Changes Found In Those Who Are Asymptomatic? (00:22:00) – Should We Still Use Term “Patella Maltracking” Or Is Their A Better Way? (00:24:00) – Are There Any Surgical Options For Patellofemoral Pain? (00:25:55) – Does This Help Us With Buy-In To Rehab? (00:27:45) – What To Say When They Ask “Will It Get Better?” (00:29:10) – What’s Next For PFP Research (00:33:20) – What Lessons From Academic Teaching Can We Use With The Patient In Front Of Us (00:35:00) – Is There A Way To Assess Patient Understanding Of What We’ve Explained? (00:37:45) – How Should Information About Conditions On Websites Be Laid Out? (00:40:20) – Is Teaching Training Part Of Healthcare Training Or Should It Be? (00:46:20) – Brads Hardest Conversations (01:01:30) – Why People Should Watch & Play Baseball (01:04:20) – Is Baseball The American Version Of Cricket? (01:08:45) – Where To Find Brad Online You can find Brad here: X/Twitter: @DrBradNeal Instragram: @teampfp www.teampfp.com You can follow Ben on @BWhybrowPhysio on your social media platform of choice.