Paincast

In this episode, we talked about The differences between acute and chronic pain at the physical, neurological and psychosocial level A paradigm shift in thinking about and treating chronic pain patients Acceptance and Commitment Therapy: What it is, how it works and why it can be particularly beneficial for individuals in managing chronic pain Setting realistic expectations with patients while avoiding any sense of invalidation or skepticism This is a student-led episode under the mentorship of Tiffany Tiu. Jules and Brooklyn are Master of Physiotherapy students from the University of Alberta and McMaster University respectively. Dr. Bronwyn Lennox Thompson leads the Postgraduate Programmes in Pain and Pain Management at the University of Otago, based in Christchurch, New Zealand. Dr. Lennox Thompson’s clinical background is occupational therapy and psychology, and her clinical and research focus is on supported pain self-management in daily life. Her research interests include lived experiences of chronic pain, consumer/lived experience involvement in research, policy and service development, and supported self-management in painful medical procedures. Her primary academic work is teaching an interprofessional approach to pain and pain management to clinicians from a diverse range of clinical backgrounds. She was awarded the University of Otago Teaching Excellence Award in 2022, and the University of Otago Gold Medal for teaching excellence in 2025. Resources Acceptance and Commitment Therapy resources by Russ Harris: https://www.actmindfully.com.au/ ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy by Russ Harris [book] Belton, J., & Darlow, B. (2026). Do We Trust Patients in Pain? What Would Happen If We Did?. JOSPT, 56(1), 1-3. Radical Relief: A Guide to Overcome Chronic Pain by Joe Tatta [book] Connect with Dr. Bronnie Thompson Blog: https://healthskills.wordpress.com Instagram and Facebook: https://www.facebook.com/healthskillsNZ LinkedIn: https://www.linkedin.com/in/bronniet/ Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

In this episode, we discussed: The principal use of diagnostic imaging and laboratory testing: When it should be used and when it shouldn't be used The limitations of diagnostics and ramifications of overuse on psychological, behavioural, and systemic levels Improving providers' literacy and patient education around diagnostics The impact of physiotherapists having the scope expansion and the current state of advocacy on this topic Resources The Canadian C-spine Rule The Ottawa Ankle Rule The Ottawa Knee Rule Canadian Association of Radiologists Utilization Guideline American College of Radiologist Appropriateness Criteria Brinjikji, W., et al. (2015). MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. American Journal of Neuroradiology, 36(12), 2394-2399. Flynn, T. W., et al. (2011). Appropriate use of diagnostic imaging in low back pain: a reminder that unnecessary imaging may do as much harm as good. journal of orthopaedic & sports physical therapy, 41(11), 838-846. Sajid, I. M., Parkunan, A., & Frost, K. (2021). Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care. BMJ open quality, 10(3). Scott, I. A., Slavotinek, J., & Glasziou, P. P. (2024). First do no harm in responding to incidental imaging findings. Medical Journal of Australia, 220(1), 7-9. Sharma, S., et al. (2021). “I would not go to him”: Focus groups exploring community responses to a public health campaign aimed at reducing unnecessary diagnostic imaging of low back pain. Health Expectations, 24(2), 648-658. VOMIT (Victim Of Medical Imaging Technology) Poster: https://www.aptei.ca/product/vomit-radiology-facts-wall-poster/ Rob Werstine BA, BSc, MSc, DPT, FCAMPT, Dip Sport, MBA Rob Werstine is a Physiotherapist who holds an Advanced Practice Provider position in the Rapid Access Clinic for Low Back Pain at LHSC in London and holds an adjunct teaching appointment in the School of Graduate Studies at Western University. Rob has spent his career opening access to health care for Canadians through the development of non-physician specialists. He helped create the first and only degree granting Clinical Master’s program for Physiotherapists in Orthopaedics at Western University in 2007 and helped create a National Clinical Specialists Program in 2012. He chaired the IFOMPT Conference in 2012 and has been an expert consultant for health care associations and regulatory bodies across North America. Rob has continued to help improve the ability of hundreds of non-physician health care professionals to take on Advanced Practice roles through the creation of Key Clinical Skills Inc., a continuing education provider for health care professionals across Canada and around the world, which has been providing education opportunities since 2016. Dr. Jack Miller BSc(PT), Dip MT(NZ), MClSc, DPT, FCAMP Dr. Miller completed his BSc in Physical Therapy at the University of Toronto in 1980. He then spent six years in New Zealand where he completed the New Zealand Manipulative Therapy Association’s Graduate Diploma of Manipulative Therapy in 1984. During this program he had the opportunity to be directly mentored by both Robin McKenzie and Brian Mulligan. On returning to Canada, he went on to complete a Masters of Clinical Science at Western University in London and a Post-Professional Doctor of Physical Therapy Degree from the University of St. Augustine in the USA. Jack has been the senior editor of the Canadian Physiotherapy Association’s Orthopaedic Journal, an executive member of the Orthopaedic Division of CPA, the President of the Canadian Academy of Manipulative Physical Therapy, a member of the CPA Specialization accreditation committee, the conference chair for IFOMPT 2012, and was a founding member of the Mulligan Concept Teacher’s Association. He has presented at conferences internationally, published research articles in peer-reviewed journals, multiple textbook chapters and taught high level, evidence-based manual therapy courses internationally since 1990. He works clinically as an advanced practice consultant triaging patients for imaging, laboratory investigations, medical interventions and surgery www.mulligancanada.com | www.keyclinskills.ca Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you infor

In this episode, we talked about: Tess and Jane's experiences of developing pelvic pain, the progression of pain during their youth and early adulthood, and their healthcare journey How healthcare encounters can be helpful or harmful to one's pain experience The intricate interactions between biomechanical and psychological factors in chronic pain The unique aspects of pelvic pain contrasted with typical musculoskeletal pain, especially in young women A huge thank you to Tess and Jane for their generous sharing of their pain story. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

In this episode, you'll hear about Two fascinating lived experiences of pain and chronic pain management principles unpacked by a physiotherapist and 2 physiotherapy students, Jules and Georgia How pain affected these young ladies physically, psychologically, socially, and how that impact evolved as they progressed in their journey When "pain education" helped and when it hurt, and how they reconciled it The journey from being controlled by pain to taking control over pain Jules and Georgia are physiotherapy students at the University of Alberta. They are also members of this year's Canadian Physiotherapy Association Pain Science Division Student Committee. A huge thank you to their generous sharing of their pain stories. Special acknowledgement to Jeff Vela, PT who kindly spoke and shared his insights in the episode. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

In this episode, we talked about Current healthcare gaps in managing pain in Indigenous populations + underlying causes of disparity in pain experience Clinical pearls for treating chronic pain in Indigenous communities Dr. Jaris Swidrovich, BSP, PharmD, PhD, AAHIVP, RPh (he/they) is an Assistant Professor, Tenure Stream, and Indigenous Engagement Lead in the Leslie Dan Faculty of Pharmacy at the University of Toronto. He is a queer, Two Spirit, Saulteaux and Ukrainian pharmacist from Yellow Quill First Nation (Treaty 4 territory, Saskatchewan). His mother was a 60s Scoop survivor and his grandmother and great-grandmother both survived Indian Residential Schools. He received a Bachelor of Science in Pharmacy from the University of Saskatchewan (2010), a post-baccalaureate Doctor of Pharmacy from the University of Toronto (2013), and a PhD in education from the University of Saskatchewan (2024), which earned him the Governor General’s Gold Medal. His primary areas of research and practice include Indigenous health, pain, HIV/AIDS, substance use disorders, and 2SLGBTQ+ health. As a Two Spirit, First Nations, and disabled person himself, Dr. Swidrovich brings a strong lens of equity, diversity, inclusion, intersectionality, and social justice to his research program. Dr. Swidrovich is the Co-Scientific Director of the CIHR-funded Saskatchewan Network Environment for Indigenous Health Research (SK-NEIHR) called nātawihowin (“art of self-healing” in Cree), which is a First Nations Research Network that supports researchers, students, and First Nations health leaders and communities in Saskatchewan and beyond. Dr. Swidrovich is the founder and chair of the Indigenous Pharmacy Professionals of Canada, and also sits on several other local, provincial, and national boards, including The 519, Pain Ontario, Pain Canada, the National Collaborating Centre for Indigenous Health, and the Institute Advisory Board for the Canadian Institutes of Health Research (CIHR) Institute of Indigenous Peoples’ Health. Dr. Swidrovich is an active and engaged citizen of the several communities he belongs to and has been recognized with several awards and honours, including the Queen Elizabeth II Platinum Jubilee Medal for service to the community and the National Patient Care Achievement Award from the Canadian Pharmacists Association. Resources: https://linktr.ee/jaris.s Social media Instagram: @jarisoftheprairies and @prisscryption X: @jarisswidrovich Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

In this episode, we talked about The relationship between knee osteoarthritis (OA) pain and the stages of knee OA The different experiences of knee OA pain Pain phenotyping using Quantitative Sensory Testing and self-reported measures Dr. Lisa Carlesso is a an associate professor in the School of Rehabilitation Science at McMaster University in Canada with training as a clinical epidemiologist and a physical therapist. Her research program is broadly focussed on understanding the mechanisms and consequences of musculoskeletal pain with a particular focus on OA joint pain. Her research strives to optimize outcomes for people with chronic musculoskeletal disorders by 1. Understanding the complex mechanisms of acute and persistent pain through pain phenotyping to improve prognosis and treatment, 2. Using the understanding of endogenous modulation of pain to enhance conservative treatment options and 3. Improving the clinical measurement of pain. Resources Aoyagi, K., et al. (2022). Does weight-bearing versus non-weight-bearing pain reflect different pain mechanisms in knee osteoarthritis?: the Multicenter Osteoarthritis Study (MOST). Osteoarthritis and cartilage, 30(4), 545-550. Rankin, J., et al. (2022). Quantitative sensory testing protocols to evaluate central and peripheral sensitization in knee OA: a scoping review. Pain Medicine, 23(3), 526-557. Carlesso, L. C., et al. (2022). Association of pain sensitization and conditioned pain modulation to pain patterns in knee osteoarthritis. Arthritis care & research, 74(1), 107-112. Carlesso, L. C. (2023). The impact of altered neural processing of nociceptive signals on physical function in people with knee OA—we know little and have much to learn. Osteoarthritis and Cartilage, 31(7), 844-846. Neelapala, Y. R., et al. (2024). Exploring different models of pain phenotypes and their association with pain worsening in people with early knee osteoarthritis: the MOST cohort study. Osteoarthritis and cartilage, 32(2), 210-219. Neelapala, Y. R., et al. (2025). Latent transition analysis of pain phenotypes in people at risk of knee osteoarthritis: The MOST cohort study. Osteoarthritis and cartilage. Carlesso, L. C., et al. (2022). Use of IMMPACT recommendations to explore pain phenotypes in people with knee osteoarthritis. Pain Medicine, 23(10), 1708-1716. Carlesso, L. C., et al. (2021). Association of intermittent and constant knee pain patterns with knee pain severity and with radiographic knee osteoarthritis duration and severity. Arthritis care & research, 73(6), 788-793. Social media: Bluesky profile @lisacarlesso.bsky.social Dr. Carlesso's lab's website: https://painmovementresearch.healthsci.mcmaster.ca/ Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

In this episode, we talked about: Do we really understand what desensitization is? Clarifying concepts, including desensitization, hypersensitivity, sensory re-education, graded exposure, and counterstimulation Important practical considerations for using “desensitization” with patients Incorporating contextual effects of treatment and orienting patients to positive recovery expectations Dr. Tara Packham is an occupational therapist with over 25 years of clinical experience in hand and upper limb rehabilitation, and an assistant professor in the School of Rehabilitation Sciences (SRS) at McMaster University. Tara’s program of research focuses on assessing and addressing persistent pain, and continuing to advance the field of hand rehabilitation. Tara has published and presented extensively for both hand rehabilitation and pain management audiences on persistent pain conditions impacting the upper extremity. Her research spans development and evaluation of outcome measures, refining and testing interventions, and exploring the experiences of persons with health challenges accessing rehabilitation. She is the Editor in Chief at Hand Therapy and currently serves on the editorial boards of the Journal of Hand Therapy and Pain Medicine, and on the executive of the Complex Regional Pain Syndrome Special Interest Group at the International Association for the Study of Pain. Social Media X: @TaraLPackham LinkedIn: https://www.linkedin.com/in/tara-packham-21918924/ IMPRinT lab: https://painmovementresearch.healthsci.mcmaster.ca/ Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

This episode is produced during the 2025 World Physiotherapy Congress in Tokyo, Japan. I interviewed physiotherapists around the world about pain. Content: (00:01:59) Nicola - United Kingdom (00:11:54) Helen - Switzerland (00:18:52) Mio - Japan (00:20:23) Edgar - Columbia (00:30:28) Marcia - Canada (00:43:31) Rosi & Leila - Indonesia (00:45:07) Nirit - Israel (00:52:56) Mike Landry - World Physiotherapy President Episodes 8 and Episode 25 are also interviews with clinicians about pain. They are recorded during the Canadian Physiotherapy Association Congresses in 2023 and 2024. Mike Landry also spoke about World Physiotherapy in Episode 28. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

In this episode, we talked about: Non-pharmacological management options for neuropathic pain All about the Somatosensory Pain Rehab method The current research on Somatosensory Pain Rehab Dr. Tara Packham is an occupational therapist with over 25 years of clinical experience in hand and upper limb rehabilitation, and an assistant professor in the School of Rehabilitation Sciences (SRS) at McMaster University. Tara’s program of research focuses on assessing and addressing persistent pain, and continuing to advance the field of hand rehabilitation. Tara has published and presented extensively for both hand rehabilitation and pain management audiences on persistent pain conditions impacting the upper extremity. Her research spans development and evaluation of outcome measures, refining and testing interventions, and exploring the experiences of persons with health challenges accessing rehabilitation. She is the Editor in Chief at Hand Therapy and currently serves on the editorial boards of the Journal of Hand Therapy and Pain Medicine, and on the executive of the Complex Regional Pain Syndrome Special Interest Group at the International Association for the Study of Pain. Resources Patient support groups for CRPS: Canada - PARC: Promoting Awareness of RSD and CRPS in Canada https://www.rsdcanada.org/parc/english/index.html / USA - RSDSA https://rsds.org/ Packham, T. L., Spicher, C. J., MacDermid, J. C., Michlovitz, S., & Buckley, D. N. (2018). Somatosensory rehabilitation for allodynia in complex regional pain syndrome of the upper limb: A retrospective cohort study. Journal of Hand Therapy, 31(1), 10-19. Somatosensory Pain Rehabilitation Network: https://www.neuropain.ch/en/home Hebert, A., MacDermid, J., Harris, J., & Packham, T. (2024). How should we treat painful sensitivity in the hand? An international e-Delphi study. Journal of Hand Therapy, 37(1), 12-21. Shafiee, E., MacDermid, J., Packham, T., Grewal, R., Farzad, M., Bobos, P., & Walton, D. (2023). Rehabilitation interventions for complex regional pain syndrome: an overview of systematic reviews. The Clinical Journal of Pain, 39(9), 473-483. Social Media X: @TaraLPackham LinkedIn: https://www.linkedin.com/in/tara-packham-21918924/ IMPRinT lab: https://painmovementresearch.healthsci.mcmaster.ca/ Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow Paincast on Instagram: https://www.instagram.com/paincast.psd/

In this episode, we talked about: A shift in how we think about the role of our hands as our understanding of pain science and patient science evolve Discussing and addressing patient expectations for physiotherapy Advice for physiotherapists, new and experienced Graduated in 1983, Bas has extensive post-graduate experience in manual, exercise and movement focused therapies, sports physiotherapy and pain related education. He was a Mentor for post-graduate physiotherapists for the Pain Sciences Division of the Canadian Physiotherapy Association, and has been Team Therapist for the Junior National Figure Skating Team and the National Cross-Country Ski Team, and attended many National, World and Olympic competitions of a wide variety of sports. He has taught workshops in North America to Osteopaths, Medical Doctors and Physiotherapists since 1992. Sebastian will never stop learning. He enjoys his attempts at golf, loves travelling and being with friends and family. Exploring Pain: Research and Meaning Facebook Group: https://www.facebook.com/groups/ExplainingPainScience Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about The systemic challenges in Ontario’s healthcare system and pain management The importance of a quality interdisciplinary team for the benefit of the patient What it takes to create a successful high-quality patient-centred interdisciplinary team Dr. Angela Mailis obtained her medical degree from the Medical School of Kapodistriakon University of Athens Greece Summa Cum Laude; became a Fellow of the Royal College of Physicians of Canada with specialization in Physical Medicine (1982); and holds a Master’s degree from the Institute of Medical Science, University of Toronto (1988). She rose to the rank of Full Professor at the Faculty of Medicine, University of Toronto (2005) and has practiced exclusively in the area of Chronic Pain for the past 43 years. She founded and directed the Comprehensive Pain Program of the Toronto Western Hospital/University Health Network for 33 years (1982-2015). Subsequently she became the founder and director of the Pain and Wellness Centre in Vaughan, Ontario (2014-present), the only academic community-based pain clinic, funded by the Ontario Ministry of Health. Resources The Pain & Wellness Centre website: https://thepwc.ca/ Dr. Angela Mailis’s website: https://drangelamailis.com/ Pain & Wellness YouTube Channel: https://www.youtube.com/@PainAndWellnessCentre Power Over Pain: https://poweroverpain.ca/ Mailis, A., & Lakha, S. F. (2019). From (Ontario Ministry of Health and Long-Term Care) policy to implementation: a retrospective look at a community-based patient-centered model of care for chronic pain. Canadian Journal of Pain, 3(1), 114-125. Mailis, A., Deshpande, A., & Lakha, S. F. (2022). Long term outcomes of chronic pain patients attending a publicly funded community-based interdisciplinary pain program in the Greater Toronto area: results of a practice-based audit. Journal of Patient-Reported Outcomes, 6(1), 44. Lakha, S. F., Hapidou, E. G., Robinson, J., & Mailis, A. (2022). Comparison of motor vehicle accident (MVA) survivors and non-MVA pain patients attending an interdisciplinary pain management program. Psychological Injury and Law, 15(4), 385-394. Social media Facebook: https://www.facebook.com/painandwellnesscentre/ Instagram: https://www.instagram.com/painandwellnesscentre/ LinkedIn: https://www.linkedin.com/company/thepwc/?viewAsMember=true Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8 Follow us on Instagram: https://www.instagram.com/paincast.psd/

In this episode, we talked about: How we can reinforce our own confirmation bias and how to break the cycle What matters the most as physiotherapists How your experiences as a physiotherapist drastically change as you shift your paradigm from a fixer mindset to a guide mindset How Bas refined the art of connecting with patients over the years and help them understand pain science Why is it of paramount importance that we help patient understand their pain Graduated in 1983, Bas has extensive post-graduate experience in manual, exercise and movement focused therapies, sports physiotherapy and pain related education. He was a Mentor for post-graduate physiotherapists for the Pain Sciences Division of the Canadian Physiotherapy Association, and has been Team Therapist for the Junior National Figure Skating Team and the National Cross-Country Ski Team, and attended many National, World and Olympic competitions of a wide variety of sports. He has taught workshops in North America to Osteopaths, Medical Doctors and Physiotherapists since 1992. Sebastian will never stop learning. He enjoys his attempts at golf, loves travelling and being with friends and family. Exploring Pain: Research and Meaning Facebook Group: https://www.facebook.com/groups/ExplainingPainScience Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about: Experiences of having cancer and cancer-related pain The significance of physiotherapy in cancer rehab and managing cancer-related pain Common misconceptions about physiotherapy for people living with or beyond cancer How physiotherapists can consider the evidence of cancer rehab and the unique biopsychosocial realities of individuals when providing care Jenna Smith-Turchyn, PT, PhD, is a physiotherapist and Assistant Professor in the School of Rehabilitation Science at McMaster University. She is also co-chair of the Canadian Physiotherapy Association’s Oncology Division. Jenna has an active research program at various cancer centres across Ontario. Her research focuses on cancer rehabilitation for individuals living with or beyond a cancer diagnosis, with the goal of maximizing participation and physical functioning. Holly Edward is a physiotherapist and PhD Candidate working under the supervision of Dr. Jenna Smith-Turchyn at McMaster University. Holly's thesis project explores and evaluates the use of a physiotherapist-navigator role for individuals newly diagnosed with cancer. Holly's research promotes symptom assessment and management to be included in standard and routine cancer care in Canada to promote optimal physical function and improve the quality of life in individuals living with and beyond cancer. Holly is also a member of the executive of the Canadian Physiotherapy Association’s Oncology Division. Resources Canadian Physiotherapy Association Oncology Division website: https://www.oncologycpa.ca Exercise Guidelines for Cancer Survivors (Campbell et al., 2019): https://pmc.ncbi.nlm.nih.gov/articles/PMC8576825/ Cancer Care Ontario Exercise Recommendations: https://www.cancercareontario.ca/sites/ccocancercare/files/ExerciseGuide.pdf Prospective Surveillance Model (Stout et al., 2012): https://pubmed.ncbi.nlm.nih.gov/22488693/ Cancer Care Ontario Symptom Management Guide- Pain: https://www.cancercareontario.ca/en/system/files_force/symptoms/CCOPainFull.pdf?download=1 Website containing free resources to learn about oncology: https://www.learnoncology.ca/modules Social Media handles X and LinkedIn @SmithTurchyn Instagram and LinkedIn @oncologyphysiotherapy @holly_edward Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about The past, present, and future of pain advocacy in Canada The role of the professional association in supporting advocacy initiatives The reception of physiotherapists' advocacy The ripple effects of our pain advocacy efforts Krissy Bell, CEO, Canadian Physiotherapy Association Krissy Bell was appointed Chief Executive Officer of the Canadian Physiotherapy Association in March 2023. Since joining the association in 2019, she has been an essential member of the executive team, driving organizational growth over the past five years through various leadership roles. Krissy's career prior to her role at the association includes consulting for some of Canada's largest non-profits and charities, where she specialized in organizational problem-solving with a focus on business development and strategic planning. Before her consulting career, Krissy served for seven years as an Artillery Officer in the Canadian Forces, followed by diverse roles in business development, marketing, and event management within the sports sector. In addition to her professional experience, Krissy is actively involved in volunteer work, particularly in governance roles within the sports sector. She has served as a Board member for not-for-profit organizations for nearly twenty years, and is currently in her final term as Vice-Chair of Canada Snowboard, the national governing body for snowboarding in Canada. As a mother of two herself, Krissy is a passionate advocate for working mothers who champions women through the intentional development of working environments that support those who want to balance family life while advancing their careers. Arthur Woznowski-Vu, PT, PhD Arthur Woznowski-Vu has been a practicing physiotherapist since 2013. He has been teaching the Pain Management Strategies course at Concordia University since 2023, and has previous teaching experience at Université de Montréal and McGill University. Early in his career, Arthur focused on developing his physiotherapy expertise in chronic pain. He pursued several continuing education courses and then went on to complete a PhD in Rehab Science (focusing on chronic pain) at McGill University in 2023, receiving several prestigious scholarships (e.g., CIHR). As Chair of the Pain Science Division at the Canadian Physiotherapy Association (2021-2023), Arthur led several initiatives including a national physiotherapy advocacy in response to the Canadian Pain Task Force's Action Plan for Pain in Canada: https://physiotherapy.ca/advocacy-updates/national-physiotherapy-month-2023-4/. In 2023, Arthur opened The Chronic Pain Rehab Clinic as his solo physiotherapy private practice in Montreal: www.chronicpainrehab.ca. Nathan Augeard, PT, MSc Nathan Augeard has been a practicing physiotherapist since 2018, with a strong focus on chronic pain management. He is currently completing his PhD in Rehabilitation Science at McGill University, where his research focuses on improving pain management education in entry-level physiotherapy programs across Canada. Nathan has received several awards for his work, including the Ronald Melzack–Canadian Journal of Pain Paper of the Year Award. He has been actively involved in pain advocacy, serving as an executive member of the Pain Science Division of the Canadian Physiotherapy Association (2021-2023) and the current Director of the Working Group on Pain Advocacy. As the founder of Physio Connection (www.physioconnection.ca), a virtual physiotherapy service, Nathan is committed to enhancing access to evidence-based care for individuals living with chronic pain, especially in remote regions. Resources CPA Position Paper and other pain advocacy resources for physiotherapy professionals, bilingual: https://physiotherapy.ca/advocacy-updates/national-physiotherapy-month-2023-4/ 3 reports from the Canadian Pain Task Force: https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force.html National action network that coordinates all pain-related organizations in Canada towards implementation of the Canadian Pain Task Force's Action Plan for Pain in Canada; and provides resources for public and professionals: https://www.paincanada.ca/ Summary on the illegal opioids crisis: https://www.canada.ca/en/health-canada/services/opioids/overdose-crisis-toxic-illegal-drug-supply.html Campbell, F., et al (2024). Advancing Chronic Pain Care in Canada: History and Impact of the Canadian Pain Task Force. Canadian Journal of Pain, 2358332. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and th

In this episode, we talked about Using the Assess, Predict, Treat framework to direct our patient care The radar plot, triangulation, arms-length approach, and phenotyping Correlation and causation; confounders, moderators, and mediators The significance and practical tips of practicing trauma-assumed care Professor Walton is a clinical researcher who focuses on the intersection between trauma, pain, physical and mental health. He uses both quantitative and qualitative approaches to explore these phenomena, and engage in critical theory around measurement of pain, wellness, and other clinical outcomes to enrich the rehabilitation and life experiences of people living with pain. He was one of the pioneers in Canada in the area of Pain Science in Physiotherapy, and was one of the co-founding members of the Pain Science Division of the Canadian Physiotherapy Association. He co-authored Musculoskeletal Pain---Assessment, Prediction, and Treatment, A Pragmatic Approach with Dr. James Elliott, which is the textbook we will be discussing in the episode. Resources Walton, D., & Elliott, J. (2020). Musculoskeletal Pain-Assessment, Prediction and Treatment. Jessica Kingsley Publishers. Lee, J. Y., et al. (2020). Defining pain and interference recovery trajectories after acute non-catastrophic musculoskeletal trauma through growth mixture modeling. BMC Musculoskeletal Disorders, 21, 1-11. Walton, D. M., Tremblay, P., Seo, W., Elliott, J. M., Ghodrati, M., May, C., & MacDermid, J. C. (2021). Effects of childhood trauma on pain‐related distress in adults. European Journal of Pain, 25(10), 2166-2176. Elliott, J. M. et al. (2023). Biopsychosocial sequelae and recovery trajectories from whiplash injury following a motor vehicle collision. The Spine Journal, 23(7), 1028-1036 Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about What is good ACL rehab? What are the psychological, social, and contextual factors influencing ACL rehab outcomes, and what can we do about them? What about ACL healing and Cross Bracing Protocol? Clinician-Scientist | Physical Therapist | Post-doctoral Fellow Expertise and research focus: Qualitative research Mixed methods research Musculoskeletal (MSK) and sports rehabilitation Digital health implementation Models of care in rehabilitation Current Focus: Postdoctoral research on innovative care models and the integration of digital health solutions for MSK pain management. My work bridges the gap between clinical practice and digital health technology, aiming to improve patient outcomes through evidence-informed strategies. My clinical expertise lies in management and treatment of traumatic knee injuries (e.g., ACL injuries). I currently work part time at a local physiotherapy clinic and teach within the Master of Physical Therapy program at the University of British Columbia in Vancouver Canada. Resources Kotsifaki, R., Korakakis, V., King, E., Barbosa, O., Maree, D., Pantouveris, M., ... & Whiteley, R. (2023). Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction. British journal of sports medicine, 57(9), 500-514. Whittaker, J. L., Culvenor, A. G., Juhl, C. B., Berg, B., Bricca, A., Filbay, S. R., ... & Crossley, K. M. (2022). OPTIKNEE 2022: consensus recommendations to optimise knee health after traumatic knee injury to prevent osteoarthritis. British journal of sports medicine, 56(24), 1393-1405. Article on non-surgical ACL rehab: https://www.physio-network.com/blog/growing-evidence-non-surgical-acl/ Podcast on group rehab ACL https://podcasts.apple.com/dk/podcast/ep-41-life-in-the-fast-lane-with-linda-truong-christina-le/id1522929437?i=1000526250993 Podcast on social and contextual factors https://bjsmbmj.podbean.com/e/taking-the-social-and-contextual-seriously-in-sports-medicine-with-linda-truong-ep-469/ ACL rehab criteria: https://www.melbourneaclguide.com/docs/ACL_Guide.pdf Social media connection X @LKTphysio Instagram @lint.fit IG Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about Different options after an ACL tear What the current body of evidence say about the outcomes of different options Clarifying research terminologies: statistical vs clinical significance, levels of certainty, what constitute good research Clinician-Scientist | Physical Therapist | Post-doctoral Fellow Expertise and research focus: Qualitative research Mixed methods research Musculoskeletal (MSK) and sports rehabilitation Digital health implementation Models of care in rehabilitation Current Focus: Postdoctoral research on innovative care models and the integration of digital health solutions for MSK pain management. My work bridges the gap between clinical practice and digital health technology, aiming to improve patient outcomes through evidence-informed strategies. My clinical expertise lies in management and treatment of traumatic knee injuries (e.g., ACL injuries). I currently work part time at a local physiotherapy clinic and teach within the Master of Physical Therapy program at the University of British Columbia in Vancouver Canada. Resources Owen, P., et al. (2023). Infographic. Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries. British Journal of Sports Medicine, 57(13), 882-883. Saueressig, T., et al. (2022). Primary surgery versus primary rehabilitation for treating anterior cruciate ligament injuries: a living systematic review and meta-analysis. British journal of sports medicine, 56(21), 1241-1251. Beard, D. J., et al. & ACL SNNAP Study Group. (2024). Comparison of surgical or non-surgical management for non-acute anterior cruciate ligament injury: the ACL SNNAP RCT. Health technology assessment (Winchester, England), 28(27), 1. Culvenor, A. G.,et al. (2022). Rehabilitation after anterior cruciate ligament and meniscal injuries: a best-evidence synthesis of systematic reviews for the OPTIKNEE consensus. British journal of sports medicine, 56(24), 1445-1453. Beard, D. J., et al. (2022). Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial. The Lancet, 400(10352), 605-615. Frobell, R. B., et al. (2010). A randomized trial of treatment for acute anterior cruciate ligament tears. New England Journal of Medicine, 363(4), 331-342. Reijman, M., et al. (2021). Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: COMPARE randomised controlled trial. Bmj, 372. Whittaker, J. L., et al. (2022). OPTIKNEE 2022: consensus recommendations to optimise knee health after traumatic knee injury to prevent osteoarthritis. British journal of sports medicine, 56(24), 1393-1405. Kamper, S. J. (2019). Interpreting outcomes 2—statistical significance and clinical meaningfulness: linking evidence to practice. journal of orthopaedic & sports physical therapy, 49(7), 559-560. Kamper, S. J. (2019). Interpreting outcomes 3—clinical meaningfulness: linking evidence to practice. journal of orthopaedic & sports physical therapy, 49(9), 677-678. Social media connection X @LKTphysio Instagram @lint.fit Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about What Music Therapy is and how it can immensely benefit patients The affect of music on the biological, psychological, and social aspects to improve pain and overall health and wellness? Recent research evidence for Music Therapy in dementia and palliative care populations Important future developments of Music Therapy Dr. Amy Clements-Cortés PhD, RP, MTA, MT-BC Dr. Amy Clements-Cortés is an Associate Professor, Faculty of Music, University of Toronto; Credentialed Music Therapist, Registered Psychotherapist and a Fellow in the Bonny Method of Guided Imagery and Music, and Neurologic Music Therapy. Amy has extensive clinical experience working with clients across the life span, with a specialty in mental health, dementia and palliative care. Her research contributions have had a significant impact in the understanding of understudied phenomenon, resulting in excelled treatments provided by professionals in music and medicine. She has authored 70+ peer reviewed journal articles, multiple book chapters, co-edited 2 books, and provided 300 conference and/or invited academic presentations. Her work has been cited by over 1300 scholars. In 2020, she received the World Federation of Music Therapy Clinical Impact Award honoring a music therapist who has had a long-term impact on advancing the knowledge and practice of music therapy within a specific clinical area or population through the publication or presentation of his or her work. Resources: Xiao, X., Chen, W., & Zhang, X. (2023). The effect and mechanisms of music therapy on the autonomic nervous system and brain networks of patients of minimal conscious states: a randomized controlled trial. Frontiers in Neuroscience, 17, 1182181. Loewy, J. (2022). Underlying music mechanisms influencing the neurology of pain: an integrative model. Brain Sciences, 12(10), 1317. Lee, J. H. (2016). The effects of music on pain: a meta-analysis. The Journal of Music Therapy, 53(4), 430-477. Kulinski, J., Ofori, E. K., Visotcky, A., Smith, A., Sparapani, R., & Fleg, J. L. (2022). Effects of music on the cardiovascular system. Trends in cardiovascular medicine, 32(6), 390-398. https://www.notesbyamy.com/ Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about The consequences of poorly managed paediatric pain Evidence-based practical suggestions for managing acute, transitional, and chronic pain How we can advocate for better paediatric pain management in our healthcare encounters and in hospitals Dr. Christine Chambers, PhD RPsych FRSC FCAHS is an international leader in children’s pain research and a national voice for children’s health. Named one of Canada’s Top 100 Most Powerful Women, she creates connections and partners with patients to advance research, mobilize knowledge and improve the lives of children, youth and families. She is a Professor and Tier 1 Canada Research Chair in Children’s Pain at Dalhousie University, a faculty member of the Centre for Pediatric Pain Research at IWK Health Centre, Director of The Chambers Lab, and Scientific Director of Solutions for Kids in Pain and the CIHR Institute of Human Development, Child and Youth Health. Resources: 1. Solution for Kids Pain: https://kidsinpain.ca/ A national knowledge mobilization network whose mission is to improve children’s pain management by mobilizing evidence-based solutions through coordination and collaboration. 2. It Doesn't Have to Hurt: https://itdoesnthavetohurt.ca A patient-oriented research program in children’s pain management. 3. Paediatric Pain Management Health Standard Download from: https://store.healthstandards.org/products/pediatric-pain-management-can-hso-13200-2023-e Executive summary at: https://kidsinpain.ca/wp-content/uploads/2023/04/Exec-Summary_Pediatric-Pain-Management-standard.pdf 4. Follow Dr. Chambers on social media @DrCChambers 5. Follow SKIP @kidsinpain Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about: What World Physiotherapy does What physiotherapy looks like around the world How the profession can help each other globally Michel D. Landry is a Professor in the Departments of Physiotherapy and Global Health at the Western Norway University of Applied Sciences (Bergen, Norway). He was the Chair of the Department of Physical Therapy and Associate Dean for Global Health in the College of Health Professions at Virginia Commonwealth University (VCU) in Richmond, Virginia, from 2021-23, and was a Professor and Division Chief of Duke University’s Doctor of Physical Therapy Division in Durham, North Carolina from 2011-2021. At Duke, he successfully led an essential rebuild of the program that is now one of the top physical therapy programs in the United States. Before arriving at Duke University, he was a tenure-track Assistant Professor at the University of Toronto (2007-2011), where he was also a Career Scientist at the Ontario Ministry of Health and Long-Term Care. He has held senior clinical management positions within the private rehabilitation sector in Ontario (Canada) and leadership positions within international humanitarian aid and development agencies in conflict, emergency, and disaster settings. Dr. Landry is a past president of the Canadian Physiotherapy Association and the current President of World Physiotherapy, the global body that represents 700,000 physiotherapists around the world. He delivered the 2020 Enid Graham Memorial Lecture, and in 2023, he received the Dean’s Award of Excellence from the University of Ottawa’s Alumni of the Faculty of Health Sciences for his commitment to global health and physiotherapy. Connect with Dr. Mike Landry X: @drmikelandry www.drmikelandry.ca insta: mikelandryphysio Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about: The value of hard work for physiotherapists The necessity of innovating the future of physiotherapy Important mindset changes for physiotherapists Michel D. Landry is a Professor in the Departments of Physiotherapy and Global Health at the Western Norway University of Applied Sciences (Bergen, Norway). He was the Chair of the Department of Physical Therapy and Associate Dean for Global Health in the College of Health Professions at Virginia Commonwealth University (VCU) in Richmond, Virginia, from 2021-23, and was a Professor and Division Chief of Duke University’s Doctor of Physical Therapy Division in Durham, North Carolina from 2011-2021. At Duke, he successfully led an essential rebuild of the program that is now one of the top physical therapy programs in the United States. Before arriving at Duke University, he was a tenure-track Assistant Professor at the University of Toronto (2007-2011), where he was also a Career Scientist at the Ontario Ministry of Health and Long-Term Care. He has held senior clinical management positions within the private rehabilitation sector in Ontario (Canada) and leadership positions within international humanitarian aid and development agencies in conflict, emergency, and disaster settings. Dr. Landry is a past president of the Canadian Physiotherapy Association and the current President of World Physiotherapy, the global body that represents 700,000 physiotherapists around the world. He delivered the 2020 Enid Graham Memorial Lecture, and in 2023, he received the Dean’s Award of Excellence from the University of Ottawa’s Alumni of the Faculty of Health Sciences for his commitment to global health and physiotherapy. Connect with Dr. Mike Landry X: @drmikelandry www.drmikelandry.ca insta: mikelandryphysio Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

In this episode, we talked about: 1. What preventing post-traumatic knee osteoarthritis (PTOA) means; 2. Risk factors for developing PTOA and how to mitigate/manage; 3. Practical tips in clinical care around preventing PTOA. Dr. Whittaker is an Associate Professor in the Faculty of Medicine at the University of British Columbia (UBC), Senior Research Scientist at Arthritis Research Canada, and recognized as a Clinical Specialist in Musculoskeletal Physiotherapy by the Canadian Physiotherapy Association. Dr. Whittaker’s research focuses on long-term athlete welfare with a specific focus on musculoskeletal health after sport-related injuries. This includes research to improve injury care pathways, understand the consequences of injuries, and develop approaches to optimize function and healthy behaviours after injury. Two themes that cross cut Jackie’s research are exposing and overcoming gendered environments that disadvantage female athletes, and partnering with people on the front lines including athletes, family members, coaches, trainers, and health care providers to ensure her research produces solutions that are acceptable, relevant, and empowering. Resources: OPTIKNEE: https://msklab.med.ubc.ca/optiknee/ SOAR clinical trial information: https://www.arthritisresearch.ca/research/soar-clinicial-trial/ Dashboard for ACL Reconstruction Testing (DART): https://acldashboard.com/ Anyone interested in doing a PhD with Jackie: https://bit.ly/3rtmGQb Twitter handles: @jwhittak_physio and @OPTIKNEE Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

I had the pleasure and privilege of attending the annual Canadian Physiotherapy Association Congress in Beautiful Vancouver in April. This episode compiles 8 interviews I conducted during the congress with clinicians. I think this is one of the best ways to involve more clinicians in the discussion of pain and physiotherapy. Last year, I asked about their views on and approaches to pain. This year, I asked them about their feelings about treating pain, what they wish to learn more about, and a memorable experience as a clinician. I also have a student interview at the end. Timestamp (00:01:31) Lawrence - MSK PT (00:09:20) Emilee - MSK PT, clinic owner @emiwhitt (00:18:35) Cheng, MSK PT, clinic owner @OTPerformanceRehab (00:27:14) Onkar, MSK PT, clinic owner @pfp_physio (00:34:03) Florence, MSK PT, clinic owner @northburnabyphysio (00:45:05) Patrick, MSK PT, clinic owner @thrivenowphysio (00:52:20) Amy, Ontario Physiotherapy Association staff, former primary care chronic pain group provider @chroniclesofhondronicols (01:03:28) Iris, first year PT student @irisw_pt Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

This episode showcases how Virtual Reality, VR in short, can be used to facilitate, advance, and even transform pain education, management, and research. You'll hear about a few different applications of VR in physiotherapy, including using VR as a tool for pain neuroscience education, VR for phantom limb pain, and VR for research. We also highlight the current literature related to these applications. Note that this episode is a limited demonstration of how VR can be used in different aspects of pain care and there are a lot more out there. Interested listeners can refer to the review papers I have cited in the episode description. Timestamps: (00:01:14) Reality Health: VR as a tool for Pain Neuroscience Education (00:27:48) VR as a tool to prevent or manage Phantom Limb Pain (00:43:52) SilicoLabs: VR as a versatile research and clinical tool Relevant resources: VR for pain overview: Ahmadpour, N., et al. (2019). Virtual Reality interventions for acute and chronic pain management. The international journal of biochemistry & cell biology, 114, 105568. Trost, Z., et al. (2021). Virtual reality approaches to pain: toward a state of the science. Pain, 162(2), 325-331. VR for phantom limb pain: Limakatso, K., et al. (2020). The effectiveness of graded motor imagery for reducing phantom limb pain in amputees: a randomised controlled trial. Physiotherapy, 109, 65-74. Purushothaman, S., et al. (2023). Assessment of efficiency of mirror therapy in preventing phantom limb pain in patients undergoing below-knee amputation surgery—a randomized clinical trial. Journal of Anesthesia, 1-7. Cheung, J. C. W., et al. (2023). X-reality for phantom limb management for amputees: a systematic review and meta-analysis. Engineered Regeneration, 4(2), 134-151. SilicoLabs: www.silicolabs.ca Reality Health: https://reality.health/home/ Skidmore, N., et al. (2024). Acceptability and Feasibility of Virtual Reality to Promote Health Literacy in Primary Care from the Health Professional’s view: A Qualitative Study. Patient Education and Counseling, 108179. Making pain education better: historical underpinnings & recent innovations – a discussion paper: https://www.petalcollaboration.org/uploads/1/4/4/1/144169171/moseley__ryan_petal_discussion_paper_making_pain_education_better_120923.pdf Video introduction to the platform: https://vimeo.com/915832727/e6572e2a5c?share=copy Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Neil Pearson is a physical therapist, yoga therapist, author, researcher, Clinical Associate Professor at the University of British Columbia, faculty in three IAYT-accredited yoga therapy programs, board member for International Association of Yoga Therapists and pain care advocate. He is the founding chair of the Canadian Physiotherapy Association’s Pain Science Division, and the recipient of awards honouring his work in pain care, patient education and physiotherapy by Queen’s University, the Canadian Pain Society, and Physiotherapy Associations of BC and Canada, including the Canadian 2021 Medal of Distinction. Neil is involved in research studying the effects of yoga and pain-informed movement practices on people with knee osteoarthritis, and has written numerous peer-reviewed papers on yoga, yoga therapy and pain, including a white paper describing the position of yoga therapy within comprehensive integrated pain management. He is a consultant to Partners in Canadian Veterans Rehabilitation Services, and to Lifemark’s 300+ clinics in Canada. Neil is a past board member for Pain BC, Canada’s premier non-profit transforming the way pain is understood and treated. He co-authored – Yoga and Science in Pain Care 2019, authored the patient education ebook, Understand Pain Live Well Again in 2008, and is lead contributor to many free patient resources offered by Pain BC. Neil provides physiotherapy and yoga therapy to veterans at the Broken Squirrel Clinic in Courtenay, BC. In this episode, we talked about what pain-informed movement is, its underlying cognitive and neurophysiological mechanisms to help chronic patients move more with more ease, and practical considerations on implementing pain-informed movement. Enjoy! Relevant resources: www.paincareaware.com https://lifeisnow.ca/ Blickenstaff, C., & Pearson, N. (2016). Reconciling movement and exercise with pain neuroscience education: A case for consistent education. Physiotherapy Theory and Practice, 32(5), 396-407. Nijs, J., & Meeus, M. (2016). Five requirements for effective pain neuroscience education in physiotherapy practice. https://paininmotion.be/blog/detail/five-requirements-effective-pain-neuroscience-education-physiotherapy-practice Modarresi, S., et al. (2023). Pain Informed Movement for people with knee osteoarthritis: Protocol for a pilot randomized controlled trial. Osteoarthritis and Cartilage Open, 5(4), 100402. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Peter Stilwell is a Postdoctoral Researcher at McGill University in the School of Physical and Occupational Therapy, where he holds a Fellowship from the Canadian Institutes of Health Research (CIHR). His research is focused on the topics of pain, suffering, and person-centered care. For the past two years, he was the Ronald Melzack Fellow in Chronic Pain Research at the Alan Edwards Centre for Research on Pain (AECRP) at McGill. He was recently awarded the MSCA Fellowship from the European Union, which he will start later this year at the University of Southern Denmark. He has a Doctor of Chiropractic degree from the Canadian Memorial Chiropractic College (CMCC) and has worked mostly with people living with persistent spinal pain and he placed an emphasis on patient education, exercise, and supported self-management. In addition to his research and clinical background, he has been heavily involved in teaching, student supervision, and community-based initiatives, including co-creating and facilitating a highly successful free health education and walking program that attracted over 1700 members. Dr. Timothy Wideman is an associate professor at the School of Physical and Occupational Therapy, at McGill University. The overarching goal of his research program is to improve the lives of people living with pain. His lab works toward this goal by focusing on three streams of research including understanding and targeting biopsychosocial risk factors for prolonged pain and disability, improving entry-level pain education for health professionals through large-scale knowledge translation initiatives, and understanding and addressing pain-related suffering. In this episode, we talked about an alternative framework to the biopsychosocial model for a whole-person approach to pain care, how metaphors are commonly used languages to describe pain, and the emerging theoretical research to better understand pain-related suffering. Resources: Twitter: @Peter_Stilwell Website: www.drpeterstilwell.com Open access paper on pain-related suffering: https://pubmed.ncbi.nlm.nih.gov/34852304/ Painful metaphors: https://mh.bmj.com/content/47/2/235 Dr. Timothy H Wideman website: https://www.mcgill.ca/spot/timothy-h-wideman Tim’s twitter: @TH_Wideman Paper published in 2023 on inclusive definition of pain-related suffering and targeted care: https://www.jpain.org/article/S1526-5900(22)00459-X/fulltext Barker KL, et. al. Divided by a lack of common language? A qualitative study exploring the use of language by health professionals treating back pain. BMC Musculoskelet Disord. 2009; 10(123): 1-10. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to listen critically. While there is an effort to incorporate research evidence, and the topics are always researched by the host, we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Tyson Beach is currently a teaching professor at the University of Waterloo, teaching courses on the biomechanics and assessment of human movement, exercise prescription, and low-back disorders. His previous research focused on quantitative motion analyses, prevention of work-related musculoskeletal disorders, and advancing fundamental knowledge of spinal mechanics, control, and injury causation. He also collaborates with other knowledge producers (researchers) and users (practitioners) to design, implement, and evaluate physical activity and exercise programs for workers and athletes. In this episode, we discussed the literature on exercise interventions for low back disorders. Continuing the discussion from previous episodes (Ep19-20), we talked about factors affecting how people lift, movement-related strategies to manage low back disorders, and how we can encourage people to participate in physical activity. Note that this episode presents perspectives in movement-based strategies for low back disorders through the lens of biomechanics and exercise. It is not an attempt to address the topic exhaustively, nor does it attempt to address all of low back disorders. Relevant articles Carnegie, D. R., et al. (2023). Can we enable individuals to reach further down without rounding their backs before beginning a lift? Examining the influence of starting foot and trunk position on reach depth. Ergonomics, 1-30. Beach, T. A., et al. (2014). Unilateral ankle immobilization alters the kinematics and kinetics of lifting. Work, 47(2), 221-234. Hayden, J. A., et al. (2021). Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. J Physiotherapy, 67(4), 252-262. Owen, P. J., er al. (2019). Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British journal of sports medicine. https://uwaterloo.ca/centre-of-research-expertise-for-the-prevention-of-musculoskeletal-disorders/resources/position-papers/there-no-such-thing-non-specific-back-pain Discussion flow (00:01:19) How different task and personal constraints affect reaching or lifting abilities (00:05:32) Movement variability in the population (00:12:43) Non-specific low back pain and strategies for movement prescription (00:21:58) Are there specific exercise modalities that are more effective for low back pain? (00:25:20) Exercise helps no matter what and the psychosocial considerations (00:27:50) Thoughts on encouraging more movement and physical activity (00:31:22) Physical activity paradox (00:34:57) All types of physical activities are movement that stresses all systems (00:41:55) Concluding Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episodes posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topics are researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Tyson Beach is currently a teaching professor at the University of Waterloo, teaching courses on the biomechanics and assessment of human movement, exercise prescription, and low-back disorders. His previous research focused on quantitative motion analyses, prevention of work-related musculoskeletal disorders, and advancing fundamental knowledge of spinal mechanics, control, and injury causation. He also collaborates with other knowledge producers (researchers) and users (practitioners) to design, implement, and evaluate physical activity and exercise programs for workers and athletes. This episode is a continuation of the discussion from the last episode. We continued to discuss important factors to consider when reading the literature relating to lifting and spine flexion. In this episode, we went more in-depth in spine biomechanics during lifting in different contexts. Relevant articles (Part 2) Frost, D. M., et al. (2015). Exercise-based performance enhancement and injury prevention for firefighters: contrasting the fitness-and movement-related adaptations to two training methodologies. J. Strength Cond. Res., 29(9), 2441-2459. https://uwaterloo.ca/centre-of-research-expertise-for-the-prevention-of-musculoskeletal-disorders/resources/position-papers/improving-workplace-manual-handling-training-programs Mawston, G.,et al. (2021). Flexed lumbar spine postures are associated with greater strength and efficiency than lordotic postures during a maximal lift in pain-free individuals. Gait & Posture, 86, 245-250. Marras, W. S., et al. (1995). Biomechanical risk factors for occupationally related low back disorders. Ergonomics, 38(2), 377-410. Marras, W. S.,et al. (1993). The role of dynamic three-dimensional trunk motion in occupationally-related low back disorders. Spine, 18(5), 617-628. Dolan, P., et al. (1994). Passive tissues help the back muscles to generate extensor moments during lifting. J Biomech, 27(8), 1077-1085. Dolan, P., & Adams, M. A. (1993). The relationship between EMG activity and extensor moment generation in the erector spinae muscles during bending and lifting activities. Journal of biomechanics, 26(4-5), 513-522. Kalkhoven, J. T., et al. (2021). Training load and injury: causal pathways and future directions. Sports Med, 51, 1137-1150. Adams MA. Biomechanics of back pain. Acupunct Med. 2004 Dec;22(4):178-88. doi: 10.1136/aim.22.4.178. PMID: 15628775. Discussion flow (00:01:37) How movement-focused training facilitates the transfer of movement behaviour from training to work (00:05:51) Why typical occupational training does not work to change injury reporting (00:11:18) There is no universal safe way to lift for all people (00:15:05) Arguments for the irrelevance of flexion: "Most heavy lifting is associated with back pain", "everyone flexes when they lift", and anecdotes of people lifting flexed with no pain (00:19:09) How movement plays a role in load management in principle and in practice (00:26:19) Unpacking how flexed lifting postures produces greater lifting strength and efficiency (00:31:40) Meaning of "efficiency" (00:36:37) Ability to adapt to loading in active vs passive tissues (00:38:00) Details of multi-level spine modelling, flexion increases shear loading and decreases passive tissue tolerance (00:42:16) Different perspectives amongst biomechanists and meaning to the practitioners (00:43:32) Posture plays a role in load management (00:44:59) Neutral/lordotic posture creates muscle shear to counter external anterior shear (00:48:04) Relationship between flexion and compression forces along the column (00:51:14) Meaning of "neutral" on a tissue level, functional level, and practical level (00:55:53) Involvement of the flexion-relaxation phenomenon (00:59:27) Amount of flexion perceived in the eyes vs in the joints (01:01:53) What conclusion can we make? (01:04:35) What about powerlifting? Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Tyson Beach is currently a teaching professor at the University of Waterloo, teaching courses on the biomechanics and assessment of human movement, exercise prescription, and low-back disorders. His previous research focused on quantitative motion analyses, prevention of work-related musculoskeletal disorders, and advancing fundamental knowledge of spinal mechanics, control, and injury causation. He also collaborates with other knowledge producers (researchers) and users (practitioners) to design, implement, and evaluate physical activity and exercise programs for workers and athletes. In this episode, we discussed the epidemiological and biomechanical literature around lifting with spinal flexion. Acknowledging that biomechanics is only one of the many factors in low back disorders, the goal of the discussion is to highlight the nuances in understanding biomechanics literature rather than to provide a definitive answer to this topic. Relevant articles (Part 1) Saraceni, N., et al. (2020). To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? A systematic review with meta-analysis. JOSPT, 50(3), 121-130. Nelson, N. A., et al.. (2009). Quantifying relationships between selected work-related risk factors and back pain: a systematic review of objective biomechanical measures and cost-related health outcomes. Int. J. Ind. Ergon., 39(1), 202-210. Wells, R., Van Eerd, D., & Hägg, G. (2004). Mechanical exposure concepts using force as the agent. Scand J Work Environ Health, 179-190. Impellizzeri, F. M.,et al. (2023). Understanding training load as exposure and dose. Sports Med, 1-13. Kalkhoven, J. T., et al. (2020). A conceptual model and detailed framework for stress-related, strain-related, and overuse athletic injury. J Sci Med Sport, 23(8), 726-734. Callaghan, J. P., et al. (2001). Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clin Biomech, 16(1), 28-37. Gunning, J.L., et al. (2001). Spinal posture and prior loading history modulate the compressive strength and type of failure in the spine: a biomechanical study using a porcine cervical spine model. Clin Biomech, 16(6): 471 480. Gooyers, C. E., et al. (2015). Exploring interactions between force, repetition and posture on intervertebral disc height loss and bulging in isolated porcine cervical functional spinal units from sub-acute-failure magnitudes of cyclic compressive loading. J Biomech, 48(13), 3701-3708. Discussion flow (00:01:35) Introduction (00:04:53) High-level summary of the flexion discussion (00:06:40) Discussion on the epidemiological evidence: Issues with measuring exposure (00:10:05) Discussion on the epidemiological evidence: Measurement of spine motion (00:12:55) Discussion on the epidemiological evidence: Reporting absolute vs normalized spine motion (00:16:03) The kinematic of flexion needs to be nuanced by the corresponding kinetic information and load distributions (00:17:50) The challenging nature of epidemiological work (00:20:12) Summarizing the epidemiological discussion (00:23:23) The necessity to contextualize "flexion" (00:24:56) Evidence from the ergonomic literature (00:26:58) Evidence from tissue biomechanics (00:29:43) Criticisms of evidence from tissue biomechanics (00:30:51) Caveat with using tissue disruption studies to understand low back pain (00:33:41) Nuancing tissue loading and adaptation (00:34:58) Short summary of discussion on the tissue biomechanics literature (00:36:06) Addressing the argument of facilitating tissue adaptation by progressively overloading spinal flexion Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Lucas Lima is a research associate at the Alan Edwards Centre for Research on Pain at McGill University. He is a physiotherapist with a PhD and postdoctoral training in pain neuroscience. His latest research, published in the Science Translational Medicine journal, has garnered significant media attention for challenging current practices in acute musculoskeletal pain management, specifically the suggestion that NSAID’s might increase the risk of developing chronic pain. In this episode, we talked about what inflammation is, recent evidence on the relationship between inflammation and chronification of acute pain, the benefits of exercise to prevent chronic pain, improve recovery of present and future injury, and evidence-based recommendations on NSAIDs and cryotherapy (icing) post-injury. Resources Main paper: https://www.science.org/doi/full/10.1126/scitranslmed.abj9954 Pain center Youtube page: https://youtu.be/751NtSbCh6Q?si=U7rFeRfYXzPgkUFZ Dr. Lima's email: [email protected] Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Laprade received her degree in Physical Education at the University of Western Ontario and then went on to complete her Physical Therapy degree, MSc and PhD in the Department of Anatomy at Queen’s University. She has previously taught Anatomy and Physical Therapy courses at Queen’s University and The Hong Kong Polytechnic University. Currently, she is the Anatomy Course Director for the Kinesiology & Physical Education, Dentistry and Physical Therapy programs at the University of Toronto. Dr. Laprade also teaches an exciting anatomy elective, ANA411Y: Anatomy in Application: Exercise & Biomechanics. Her research in the past has primarily focused on clinical assessment and evaluation of patellofemoral pain syndrome (PFPS) as well as acupuncture management of musculoskeletal disorders. More recently, she has embarked on developing and assessing educational tools for anatomy learning which are designed to enhance 3D learning. In this episode, we talked about misbeliefs about patellofemoral pain etiology and management strategies, relationship between anatomy, biomechanics, empirical evidence, and clinical reasoning, and the importance for clinicians to keep up with anatomy and the literature. Resources Lan, T. Y., et al. (2010). Immediate effect and predictors of effectiveness of taping for patellofemoral pain syndrome: a prospective cohort study. AJSM, 38(8), 1626–1630. https://doi-org.myaccess.library.utoronto.ca/10.1177/0363546510364840 Barton, C., et al. (2014). Patellar taping for patellofemoral pain: a systematic review and meta-analysis to evaluate clinical outcomes and biomechanical mechanisms. BJSM, 48(6), 417–424. https://doi.org/10.1136/bjsports-2013-092437 Wilson, T., et al. (2003). A multicenter, single-masked study of medial, neutral, and lateral patellar taping in individuals with patellofemoral pain syndrome. JOSPT, 33(8), 437–448. https://doi.org/10.2519/jospt.2003.33.8.437 Tiu, T. Using Kinesiology Tape in Physiotherapy Practice for Pain Management. Physiotherapy Practice. Canadian Physiotherapy Association. Spring 2023. Available from https://physiotherapy.ca/app/uploads/2023/05/English.April28.pdf Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Cory Choma has been in clinical practice since 1996 and is a founding member of CSA. He is one of only 4 Clinical Specialists in Pain Science in Canada and one of a handful of people awarded an Honorary Fellowship at the Institute for the Study and Treatment of Pain. Cory has been teaching GunnIMS domestically and internationally since 2003 and is a senior instructor for the Continuing Professional Development branch of the Faculty of Medicine at the University of British Columbia. Cory is one of the contributing authors for the chapter on GunnIMS in the text ‘Trigger Point Dry Needling: An Evidenced and Clinical-Based Approach’. In this episode, our discussion surrounds how we engage in therapy with those living with persistent symptoms—all about talk therapy. We talked about how pain education can be simplified, how the body and the mind affect one another, how the biopsychosocial model can be harmonized and manifested, and more. Recommended resources for you: Singh, B. et al. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. BJSM. http://dx.doi.org/10.1136/bjsports-2022-106195 The Upside of Stress by Kelly Mcgonigal Brain Rules for Aging Well by John Medina Why We Get Sick by Benjamin Bikman Mindset by Carol S. Dweck. Spark by John J. Ratey Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Alex Chisholm, PT, BScPT, PgCPain, FACHS is a Physiotherapist with over 30 years of clinical experience. Alex received her postgraduate certificate in Multidisciplinary Pain Management from the University of Alberta. She is one of the executives of the Pain Science division of the Canadian Physiotherapy Association and was part of the working group that helped create the Chronic Pain Toolkit with Physiotherapy Alberta. She is a Fellow of the Alberta Clinical Hypnosis Society, previously the Canadian Federation of Clinical Hypnosis, and is a member of the Alberta Pain Society’s Planning committee for their annual Pain conference. In addition, she is a certified ‘Comfort Talk’ trainer. Alex currently works on the Burns and Plastics team at the Foothills Medical Center where she pursues her passion for burn survivor rehabilitation, and has taught nationally and internationally on Pain, Hypnosis and Pain management techniques. In this episode, we talked about what hypnosis is, how it can help patients, practical considerations when using hypnosis, and the power of therapeutic alliance and word choice. Bicego A. et al. Neurophysiology of hypnosis in chronic pain: A review of recent literature. Am J Clin Hypn. 2022 Aug;64(1):62-80. Hansen E, Zech N. Nocebo Effects and Negative Suggestions in Daily Clinical Practice - Forms, Impact and Approaches to Avoid Them. Front Pharmacol. 2019 Feb 13;10:77. Fusco N. et al. Hypnosis and communication reduce pain and anxiety in peripheral intravenous cannulation: Effect of Language and Confusion on Pain During Peripheral Intravenous Catheterization (KTHYPE), a multicentre randomised trial. Br J Anaesth. 2020 Mar;124(3):292-298. Lang EV, Rosen MP. Cost analysis of adjunct hypnosis with sedation during outpatient interventional radiologic procedures. Radiology. 2002 Feb;222(2):375-82. Lang EV. et al. Can words hurt? Patient-provider interactions during invasive procedures. Pain. 2005 Mar;114(1-2):303-9. Kinney M. et al. The impact of therapeutic alliance in physical therapy for chronic musculoskeletal pain: A systematic review of the literature. Physiother Theory Pract. 2020 Aug;36(8):886-898. Ferreira PH. et al. The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain. Phys Ther. 2013 Apr;93(4):470-8. doi: 10.2522/ptj.20120137. Epub 2012 Nov 8. Provençal SC. et al. Hypnosis for burn wound care pain and anxiety: A systematic review and meta-analysis. Burns. 2018 Dec;44(8):1870-1881. Romanowski KS. et al. American Burn Association Guidelines on the Management of Acute Pain in the Adult Burn Patient: A Review of the Literature, a Compilation of Expert Opinion, and Next Steps. J Burn Care Res. 2020 Nov 30;41(6):1129-1151. Jensen MP, Patterson DR. Hypnotic approaches for chronic pain management: clinical implications of recent research findings. Am Psychol. 2014 Feb-Mar;69(2):167-77. Milling LS. et al. Hypnosis and the Alleviation of Clinical Pain: A Comprehensive Meta-Analysis. Int J Clin Exp Hypn. 2021 Jul-Sep;69(3):297-322. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Lisa Greenbaum is a Certified Yoga Therapist and E-RYT 500 Yoga Teacher and Educator. She is the founder of Lisa Greenbaum Yoga + Wellness, a Yoga Education School with a trauma-informed lens. Recognizing that the chronic physical pain we experience is intensified through the chronic stress, poor sleep and mental health challenges that go along with the pain, Lisa’s approach is centred on creating balance for the nervous system that includes meditation, breath work and movement to quiet the fight/flight response and build ease within the body and mind. In this episode, we talked about what yoga is, how yoga can be adapted for people experiencing pain, and how physiotherapists can work with yoga therapists. There is also a breathing meditation demonstration at the end for you to experience. Resources: Training for Yin+Restore practice, pain management including Chair Yoga https://lisagreenbaum.com/yoga-for-wellness/ Virtual classes that I teach https://lisagreenbaum.com/weekly-online-yoga-classes/ Study on Yoga and Pain: A Mind/Body complex system https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996306/ Study - Needle electromyographic evaluation of trigger point response to a psychological stressor https://pubmed.ncbi.nlm.nih.gov/8008795/ Yoga Therapist Search https://www.iayt.org/search/search.asp?csy=209092 IAYT also lists a number of studies on Yoga Therapy and Chronic Pain: https://www.iayt.org/page/YTT_IJYT_Pain Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Michael Mash is a Physical Therapist in the United States. He is also the founder of Barbell Rehab, an education company helping fitness and rehab professionals improve the management of their clients dealing with pain. He has a special interest in resistance training for improving strength, power, and longevity. In this episode, we talked about conceptualizing strength training from the biopsychosocial perspective, the role of strength training in pain management, and how physiotherapists can work with fitness professionals. Website: https://barbellrehab.com/ Instagram: @barbellrehab Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Amanda de Chastelain has been working at the Alberta Children's Hospital since 2014 at their outpatient orthopaedics, complex pain clinic, and burn clinic. She is also a current board member and the past president of the Canadian Physiotherapy Association. In this episode, we talked about pain in the pediatrics context, concrete ways to support children experiencing complex pain and their families, and effective ways of communicating concepts of pain with children. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

The Mulligan concept, or Mobilization with Movement (MWM) is an approach to manual therapy that combines active movement, pain neuroscience, patient autonomy, and hands-on mobilization. We have two very qualified guests to discuss this topic. Jack is the senior editor of the Canadian Physiotherapy Association’s Orthopaedic Journal, executive member of the Orthopaedic Division of CPA, the President of the Canadian Academy of Manipulative Physical Therapy, a member of the CPA Specialization accreditation committee, and was a founding member of the Mulligan Concept Teacher’s Association. Jack has presented at conferences internationally, published research articles and multiple textbook chapters, and taught high-level, evidence-based manual therapy courses internationally since 1990. Jack works clinically as an advanced practice consultant triaging patients for imaging, laboratory investigations, medical interventions and surgery. Jim is the National Director of Clinical Training and Development at CBI Health. Jim has been a clinician for over 30 years and has been teaching the Mulligan Concept in Canada since 2007. He is passionate about communication and storytelling in health care and also teaches clinical relationship building. The writing and study of stories and poetry build empathy and narrative competence to not only get to know ourselves but to meet others where they truly are. Jim utilizes poetry to reflect upon the uncertainty and mystery of being a clinician. He released his first book of poetry, Cuoreosity: The heArt of Being in 2022. In this episode, we discussed MWM's philosophies, therapeutic effects in the literature, and practical considerations when applying MWM. Links: https://bmulligan.com/ https://www.mulligancanada.com/ Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

I had the pleasure and privilege of attending the annual Canadian Physiotherapy Association Congress in Quebec City last month in July. Episodes 09 and 10 showcase what our CPA, provincial branches, and CPA division leaders are working on. I also asked them about what they like about getting involved, why they wanted to take on these roles, what they hope to see in the profession, and ways we as physiotherapists and students can get involved. This is part 2 of the 2-part series on leaders in physiotherapy, featuring 6 divisions within the CPA. Part 1 featured the CPA and 2 provincial branches. List of interviewees: (00:01:40) Lyndal Solomons (Acupuncture and Dry Needling Division - chair) (00:11:24) Melissa Cursons (Pediatric Division - chair) (00:17:22) Meaghan Adams (Neurosciences Division - chair) (00:24:42) Arthur Woznowski-Vu (Pain Science Division - past chair) (00:30:25) Meghan Curle (Orthopaedic Division - chair) (00:39:06) Karim Meghji (Private Practice Division - chair) Link to learn more about CPA divisions: https://physiotherapy.ca/membership/divisions/

I had the pleasure and privilege of attending the annual Canadian Physiotherapy Association Congress in Quebec City last month in July. Episodes 09 and 10 showcase what our CPA, provincial branches, and CPA division leaders are working on. I also asked them about what they like about getting involved, why they wanted to take on these roles, what they hope to see in the profession, and ways we as physiotherapists and students can get involved. This is part 1 of the 2-part series on leaders in physiotherapy, featuring the CPA and 2 provincial branches. Part 2 will feature 6 divisions of the CPA. List of interviewees: (00:01:44) Oren Cheifetz (Ontario Physiotherapy Association - president) (00:05:56) Courtney Bean (Ontario Physiotherapy Association - president-elect) (00:17:35) Geoff Schneider (Alberta Association of Physiotherapy - president) (00:29:46) Amanda de Chastelain (Canadian Physiotherapy Association - past president and current board member) Link to learn more about CPA branches: https://physiotherapy.ca/membership/branches/

I had the pleasure and privilege of attending the annual Canadian Physiotherapy Association Congress in Quebec City last month. This episode compiles 10 interviews I had during the congress, featuring physiotherapy students, researchers, new grads, and experienced physiotherapists, from all over Canada and abroad. These 10 interviews cover acute care, rehab, private practice, in musculoskeletal, neuro, sports, and cardioresp, across pediatric, general population, and older adults care. I asked about their views on pain, how they manage and support patients in pain, and the value of physiotherapy in their contexts. I have added timestamps of each interview in the episode description if you'd like to jump around interviews. List of interviewees: (00:01:55) Aaron - PT Year 2 student at UofT (00:07:56) DeAnna - Neuro PT in BC (00:11:55) Blaise Dubois - keynote speaker, President of The Running Clinic (00:21:19) Lizzy - PT consultant for a school in Ottawa (00:26:01) Stephanie - PT Year 2 student at Dalhousie, interested in burn care (00:31:37) Jennifer - MSK chronic pain PT and PhD candidate in China (00:39:59) Brandyn - Assistant Lecturer and PhD candidate at UofA (00:48:44) Khang - MPT/PhD student at McMaster University (00:57:06) Isabel - MSK and pelvic floor PT in Switzerland (01:17:44) Simona - PT Year 1 student at UofT

This episode features the patients' perspective of pain. Elijah developed idiopathic lower extremity joint pain (i.e., hip, knee and ankle pain of an unknown cause) in 2018, during his final year at university. He has gone through very difficult times because of the pain. He is still living with it, but it thankfully has been stabilized. In this episode, we explored his journey of going through and coming out of severe joint pain, his physical, emotional and social experiences of pain, his consultations with various healthcare professionals, and what it means to live well with pain. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Mark is a professor of physiotherapy at Macquarie University in Sydney. He has over 20 years of clinical experience as a musculoskeletal physiotherapist working in a primary care setting. Mark now works primarily as a researcher, focusing on the diagnosis and management of back pain. He has published over 200 peer-reviewed papers and his work has been accompanied by editorials and received wide media attention. He is a part of the RESTORE trial, which is the largest clinical trial on Cognitive Functional Therapy (CFT), a biopsychosocial model of care for back pain. In this episode, we talked about what CFT is, discussed various aspects of the recent RESTORE trial, as well as practical questions about implementing CFT. For more about the RESTORE trial, please visit the website https://www.restorebackpain.com/. Full citation of the RESTORE trial: Kent, P., Haines, T., O'Sullivan, P., Smith, A., Campbell, A., Schutze, R., & Hancock, M. (2023). Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel-group, phase 3, clinical trial. The Lancet, 401(10391), 1866-1877. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

"Don’t wait until the opportunity has passed, prepare yourself to take to take advantage of the upcoming opportunities" — Rob Werstine Rob Werstine is an Advanced Practice Provider in the Rapid Access Clinic for Low Back Pain at the London Health Sciences Centre. Partnering with Jack Miller, he started Key Clinical Skills Inc. which has been providing Advanced Practice education across Canada since 2016 to improve the ability of hundreds of non-physician healthcare professionals to take on Advanced Practice roles. In this episode, we talked about the value of advanced practice providers in the healthcare system, the current advanced practice model, and how physiotherapists are well-positioned to respond to the need for better pain management in Canada. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Arthur Woznowski-Vu is a licensed physiotherapist, PhD candidate, and the Chair of the Pain Science Division. While he is finishing up his PhD studying central sensitization to physical activity, he is currently in the process of launching his own chronic pain rehab clinic. In this episode, we get into Arthur's research and advocacy at the pain science division, the value of the pain science division, and the importance of integrating pain science with physiotherapy practice. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Lindsay Rite is the director of Integrated Health at Change Pain Clinic in Vancouver. She is a chiropractor with advanced training in movement and exercise as a kinesiologist and clinical exercise physiologist. In this episode, we talked about the evolution of pain care, integrated and individualized approach to patient care, and the importance of validating patients with chronic pain. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Stuart McGill is world-renowned for his expertise in low back biomechanics and treating low back pain. He is a distinguished professor emeritus at the University of Waterloo and the Chief Scientific Officer at Backfitpro. In this episode, we covered his thoughts on degenerative disc disease, exercise prescription approaches, and refining the art of patient interaction. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8

Dr. Stuart McGill is world-renowned for his expertise in low back biomechanics and treating low back pain. He is a distinguished professor emeritus at the University of Waterloo and the Chief Scientific Officer at Backfitpro. In this episode, we discussed the validity of non-specific low back pain, the implications of using this label in our practices, and the intersection of a biomechanical approach with the biopsychosocial approach. Paincast is dedicated to bringing together researchers, clinicians, and students to discuss topics related to pain and physiotherapy. The primary purpose is to facilitate knowledge translation and critical thinking. Some episode posit themselves as more educational than others, and some more opinionated than others. The listener is encouraged to critically reflect on the content. While there is an effort to incorporate research evidence, and the topic is researched by the host (Tiffany), we recognize there is room for improvement and there is expertise in the community. As such, we invite constructive critique and that you inform us of any inadvertent errors, so that we may correct them. You may submit your feedback through this form: https://forms.gle/UFfbUHBh8uKwSKgS8