The Rollercoaster of Professional Life

In this classic David Butler blog there are a few parallels along the way in the many & varied choices a physiotherapist gets to make in their careers

NOI Notes

The first wave
Forty years of practice beckons – what a rollercoaster! When I emerged proudly with my degree in the late 70s, all packed with Maitland style manual therapy, I was convinced I could fix all and sundry and I often opened a clinical conversation with “what can I fix today.” ( I feel ill saying it now!) Anyway, it all worked well for a few years but then I noticed that “it” was not delivering the goods so well. Unbelievably some patients dared not get better. Things were feeling professionally grim, career changes were pondered, but then, proud and erect, fresh from New Zealand, Robin McKenzie rode into town, maybe even on a white horse!

The second wave
Wow – this was it! How silly was I to miss the disc and the novel notion of actually getting people to treat themselves and to give your thumbs a…

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Is it OK to K tape…?

Adam Meakins@thesportsphysio succinctly summarises what I had always suspected that there’s no good reason to use K-tape! I see professional tennis players using it the world over but not AFL or NRL in Australia. Hmmm….

The Perils of Explaining Pain

An emphatic David Butler explaining what “Explain Pain” is and is not! The road to an enlightened approach is sometimes derailed by well intentioned short-cuts! Thanks David & NOI



I notice more and more as I read and talk to people and look at the various handouts that practitioners send us at NOI, that we are going through a bastardisation of the Explain Pain work. Dumbed down versions of Explain Pain are all the rage – as if a simple 5 minute video clip, on its own, is enough to alter deeply held pain concepts, or prescriptive treatments that assume pain is a universal experience for all, with a minute on this and two minutes on that. It’s almost a return to the horror days when therapists offered 10 minutes of hotpack and 5 minutes of ultrabullshit. Perhaps worst of all are interventions that include some useful explanations of pain, followed by a “traditional treatment” based on out-dated assumptions that pain starts in the periphery – thus perpetuating the fantasy of pain generators and pain endings in the tissues.

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Waving E-flags and Pink flags

For a first post at Neil Wise Physio, I would like to recommend this overview which looks at some of the work of David Butler & Louis Gifford. The implications of this to everyday practice represent the extremely valuable part the world of neuroscience has played in the evolution of physiotherapy practice over my time. Thank you to Rethinking Physiotherapy for their insights.   Enjoy