Afleveringen
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Steroid injections have been available in healthcare forseventy 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 SteroidInjections?
(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 SteroidInjection 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 SteroidInjection 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 TeesideUniversity 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
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The tone of voice we use to communicate is as important as the words we say, and yet much less attention is made towards it.
Until Now.
This episode covers essentials points on using different tones of voice with the patients we see, as well as giving some examples and when to use them.
For more, subscribe and follow @BWhybrowPhysio on your social media of choice.
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Zijn er afleveringen die ontbreken?
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How should we explain spinal-related nerve pain to patients?
What should we say to those who want scans, but it’s notindicated?
How should we explain imaging results to patients?
For answers to these and a lot more, check out thisconversation with Adam Dobson, Spinal Advanced Physiotherapy Practitioner.
(00:00:00) – Introduction
(00:00:43) – Would Adam Ever Become “The Space Physio”?
(00:02:45) – How To Explain Spinal Related Nerve Pain
(00:10:33) – What To Say If They Ask “Have I Got A Trapped Nerve?”
(00:15:12) – What If They Ask “Will This Get Better?”
(00:18:40) – What To Say When It’s Not Their Nerves, It’sTheir Blood Supply
(00:24:50) – Screening vs Work-Up Imaging
(00:32:50) – What To Say When Imaging Findings Come Back “Normal”
(00:43:00) – How To Explain Relevant Imaging Findings
(0047:42) – What Does Nerve “Abutment” Mean?
(00:49:30) – What To Say When Someone Wants A Scan, But It's Not Indicated
(01:01:50) – How To Discuss Prostate Issues During A Back Pain Appointment
(01:11:35) – Difficult Conversations Around Pain
(01:18:18) – Success Stories From Adam’s “Back To Health”Programme
You can find Adam on social media @AdamDobson123
His website is: https://www.theradicularclinician.com/
You can find Ben on social media @BWhybrowPhysio
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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 (andother 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 ControlSymptoms
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.
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Want to have greater influence over the people you come across in life and interact with?
“The Influential Mind” by Tali Sharot was released in 2017and is still one of the top regarded books for this topic.
This episode of “Clinical Communication” takes someimportant lessons from the book and how you can apply them to the person in front of you, to potentially have greater influence.
For more; follow @BWhybrowPhysio on X, Instagram, TikTok & YouTube.
If you’re really keen do drop me a message and send me any questions you have.
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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). Fromexpert to coach: health coaching to support behavior change within physical therapist practice. Physiotherapy Journal & Practice.
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A clinician will spend every working day explainingsomething to someone, but how much effort is put into ensuring the other person remembers what is said and interprets the information as intended?
This episode of Clinical Communication covers what you can do and say to ensure the person in front of you remembers what you have said and is able to relate to it.
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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In this episode Ben speaks with Dr Brad Neal who is aPhysiotherapist, 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-rayFindings
(00:20:40) – Are Normal Age Related Patellofemoral JointChanges 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 ForPatellofemoral 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 HealthcareTraining 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.
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“Messengers” is a book by Stephen Martin & Joseph Marks released in 2019. It is for anyone who wants to increase the likelihood that the messages they are giving are taken in and acted upon.
In Episode 14 of Clinical Communication we go through some of the lessons from it that can help you better manage the individual or group of patients in front of you.
(00:00) – Intro
(00:35) – You’re Not Only Judged On The Words You Say
(01:21) – Building Connections
(01:58) – Perceived Expertise
(04:29) – Warmth & Connectedness
(07:19) – Vulnerability
(09:06) – Outro
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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Osteoporosis, Osteoarthritis & Inflammatory Arthritisare conditions that many clinicians across many different specialities will see. Being able to have helpful and productive conversations with patients withthese conditions is essential for being able to provide great care for them.
Jack March is a Rheumatology Specialist Physiotherapist& Director of Operations for PhysioMatters. You can find him online by searching for “Rheumatology Physio” in whatever social media you use.
His website is here: https://rheumatology.physio/
In This Episode Ben & Jack Discuss:
(00:00:00) – Introduction
(00:00:59) – Music You Might Hear In A RheumatologyDepartment
(00:01:59) – Jack’s Top Disturbed Song
(00:03:47) – The Metal & Physio Podcast That Didn’tHappen
(00:04:30) – Jack’s New “Low Bone Density” Course
(00:05:15) – How To Explain Osteoporosis To The Patient In Front Of You
(00:09:45) – Is The “Swiss Cheese” Analogy Still Useful?
(00:13:23) – Should We Still Say “Brittle Bones”?
(00:15:55) – What To Say When They Ask “Anything I Should Avoid?”
(00:17:40) – What To Say When They Ask “Is It Curable?”
(00:20:25) – How To Explain Osteoarthritis To The Patient In Front Of You
(00:24:39) – How To Shift Patient Perspectives OnOsteoarthritis Away From Wear & Tear
(00:40:00) – What To Say If They Ask “Do I Need An X-Ray?”
(00:41:55) – What Would Trigger You To Consider AskingAdditional Inflammatory Screening Questions?
(00:49:05) - When Should We Ask The Inflammatory Screening Questions During A History Taking?
(00:54:00) – What Should We Say To Patients When Referring Them To Rheumatology?
(00:59:00) – How To Explain Inflammatory Arthritis To The Patient In Front Of You
(01:04:00) – Jack’s Hardest Clinical Conversations
(01:17:00) – The FA Cup Semi-Final Incident
(01:21:25) – Jack’s Courses & CPD Resources
(01:22:50) – Jack’s Final Thoughts
You can find Ben on social media: @BWhybrowPhysio
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Every clinician has the potential to do the perfectassessment and come up with the ideal treatment plan for the patients needs and aspirations.
However, all of that is useless if they are unable to committo it and carry out whatever has been discussed.
This episode is all about simple and practical tips you canuse with any patient you see to increase their commitment to the shared plan once they get home, so that they are more likely to carry it out, and more likely to think it will help.
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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Metaphors are an effective way to help patients easily understand complex ideas we talk about, be it diagnosis, treatment options or prognosis.
In this episode I go through three metaphors I use regularly in clinical practice that most of the patients you see can relate to and will hopefully benefit from, regardless of the speciality you are in.
They are;
The Computer Default Setting (2:04)
The Mobile Phone Analogy (4:30)
The Cocktail Analogy (7:28)
For the visuals on The Cocktail Analogy, you can find them on social media @BWhybrowPhysio or the YouTube video of this Podcast titled "Steal These Metaphors!".
Do let me know how you get on using them and tell me other metaphors you use which you feel are effective, they might just get read out.
If you have suggestions for what would make this resource better, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, leave a review & subscribe.
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Silence, or using a pause, can be one of the most underappreciated communication skills in clinical practice.
Using it effectively can allow you to;
Gain more useful information from the patient in front of you,
Get a clear idea of how they feel about information you have provided and how to move forward,
Manage emotionally charged situations easier.
If you have suggestions for what would make this resource better, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, or leave a review.
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Mirroring or Matching are common terms used in communication skills training.
But what do they mean, and What are the different types?
This episode covers how Mirroring or Matching can be applied to:
Body Language
The Words We Use
Tone of Voice & Presence
How they can be utilised and what effect they may have.
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, or leave a review.
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Speaking with angry patients can be some of the mostdifficult conversations to have.
This episode goes through what to do, and what not to do,when speaking with someone who is very angry or frustrated.
Reading Suggested:
How To Have Impossible Conversations – Boghossian &Lindsay
How To Deal With Angry People – Dr Ryan Martin
For More follow @BWhybrowPhysio on X, Instragram, TikTok & YouTube.
Do send in any questions, topic suggestions & guests to get.
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“Supercommunicators” by Charles Duhigg has been one of the best new releases in 2024 on communication. This episode looks through lessons from it and they can be applied to clinical life.
Covering:
- Knowing what type of conversation you are having,
- Emotional contagion & deep questions,
- How to know if someone is or isn’t enjoying aconversation,
- Managing conflict & difficult conversation.
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube,or leave a review.
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Simply telling people what to do and how to do it is often a very ineffective way to change behaviours. Instead they need to have the feeling that they have come up with the idea themselves.
How do we do this?
With Questions.
But not just any questions, this episode goes through both specific open and closed questions that are more likely to lead to behaviour change.
Do contact @BWhybrowPhysio on X, Instagram, TikTok andYoutube, or leave a review.
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The ICE questions are an essential component of any medical consultation. But what do they stand for? And why are they so essential?
This episode covers not only this, but the additional extraquestions that should come with it.
Plus;
- When to ask them?
- Do you have to ask them in order?
- How to respond to answers you may get.
If you have suggestions for what would make this resourcebetter, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok andYoutube, or leave a review.
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First impressions matter, and the way we are with the patient in front of us for those first few minutes can havea profound effect on the rest of their time with us.
This episode covers: - The first things to say on meeting someone new,
- Body language and positioning before you start talking to them,
- Small talk and the timing of certain questions,
- Signposting or “Setting The Scene” at the beginning,
- And more.
Reference:
Roberts, L. (2019). Effective Communication: Making TheMost Of The Consultation. Lumbar Spine Online Textbook (Section 10, Chapter 1).Available Free Online
If you have suggestions for what would make this resource better, topics to cover or guests to suggest;
Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, or leave a review.
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Empathy is a buzzword in communication skills, everyone claims they are empathetic, but patients may not always agree.
In this episode we'll discuss:
- What Is Empathy
- The Difference Between Empathy & Sympathy
- How To Demonstrate Empathy To The Patient In Front Of You
- The Risks Of Empathy Coming Across As Fake
- What Not To Say
Further Reading:
Howick et al (2018)
"Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis"
Open Access Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047264/
Licciardone et al (2024)
"Physician Empathy and Chronic Pain Outcomes"
If you have suggestions for what would make this resource better, topics to cover or guests to suggest;Do contact @BWhybrowPhysio on X, Instagram, TikTok and Youtube, or leave a review.
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