Latest / The STA Clinician Podcast / Ep.272 'Understanding Pain in 2026 - Pt1/4' with Dr. Bronnie L. Thompson & Ben Whybrow

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Ep.272 'Understanding Pain in 2026 - Pt1/4' with Dr. Bronnie L. Thompson & Ben Whybrow · The STA Clinician Podcast

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You're listening to the STA Clinician Podcast, connecting clinicians across healthcare.
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For the last five years as the Sports Therapy Association podcast.
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My name is Matt Phillips, creator of runchatlive.com.
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And as always, this episode is being recorded live on the Sports Therapy Association
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YouTube channel and Facebook page on a Tuesday night at 8pm.
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So a new month, February 2026, in case you're watching this in the future. And we have a new topic.
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Last month, the topic was neurodivergence in healthcare, with four fantastic
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episodes providing valuable information to help soft tissue therapists work
0:49
closer and more efficiently with neurodivergent patients and clients.
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Available as always on all popular podcast apps and YouTube.
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And as we mentioned last month, if you are interested in joining,
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if you're a neurodivergent MSK clinician yourself,
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whether with formal diagnosis or not, if you would like to join our private
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neurodivergent MSK clinicians Facebook group, then you're very welcome.
1:14
Created by myself just for support, a safe non-judgmental chat or just sit back
1:18
and chill and listen and whatever you like and there are joining questions but
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you're all welcome to come along to that and yeah we'd love to see you,
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Right. So February is here. And the focus this month on the SDA Coalition podcast
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is understanding pain in 2026.
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I feel like we need more than a month to get into that topic,
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but we've got a month. We've got four episodes with some amazing guests coming up.
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And I personally think never, never a better time.
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There's so much changing and evolving information out there regarding pain,
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how to explain it, when to treat it, how to treat it.
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And as healthcare professionals, we have an ethical, moral, and professional
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obligation to stay current with modern understandings of pain in order to provide
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competent, compassionate, evidence-based care.
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So easier said than done, I would agree. But to help us get through that,
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then I have a great pleasure of bringing up very shortly Dr.
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Bronnie Lennox-Thompson and Ben Weibrow in part one. But I'm just going to let
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you know before we start that, just who else is coming up with this month.
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In part two, which is going to be on Wednesday, okay, there's a bit of to and
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froing this month on Wednesday next week, which is going to be.
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On February the 11th. Then my guests are going to be Professor Dave Newell.
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Head of the Centre for Pain and Active Inference Research at Health Sciences
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University, and Anna Maria Matsieri, director of the ST School,
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who is currently a PhD student at Health Sciences University.
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The week after that, on Tuesday, February the 17th, my guest is going to be Dr.
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Rachel Dewar-Haggart, a postdoctoral qualitative researcher within the Medical
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Sociology and Health Experiences Research Group at the Nuffield Department of
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Primary Care Services University of Oxford.
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Dr. Jira Haggart is going to be discussing the gender pain gap within a biopsychosocial context.
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And finally, part four is going to be on Wednesday, on February the 25th,
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where my guest is going to be Dr.
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Rachel Zofnus, who's going to be returning to the podcast, pain scientist,
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international speaker, science writer, with her new book, Tell Me Where It Hurts,
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coming out March the 26th.
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So an absolutely wonderful series of guests coming
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up to help us tackle this episode and it starts
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off very very shortly in part one before i
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bring up my guest just saying hi to people if you have
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joined us live and you haven't been on the show before then you
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are welcome to ask questions i can bring them
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up on the screen and showcase your wonderful profile pics and
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things for example mark ewan is first through the door tonight and says hello
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all gary benson says good evening all founder the sta we've got sir glenn murphy
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um who is also here lots of people coming to the door really nice to see you
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and hoping that you take advantage of the fact that you've joined us live and
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ask as many questions as you can right then,
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The time's come. Let's bring up my wonderful guests for part one.
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Dr. Bonnie Lennox-Thompson and Ben Weibrow.
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Hey guys, how are you doing? Hey, good day. Happy to see you, Matt.
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I'm absolutely happier to see you guys. I really am.
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I really appreciate you giving up your time, particularly, I mean,
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Ben, I love you to bits, but I am a bit awestruck.
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I'm sorry, Ben, there might be a little bit of kind of, you are great and amazing
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and your episode in when you were with us before, was one of the most talked
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about for plenty of time. But Dr. Bonnie L.
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Thompson, I've been a fan of for so long. I really have.
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And it's great to have you on the show. And I really appreciate it.
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Joining us from, not from England, but from,
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New Zealand, Christchurch, New Zealand. There you go. Down under.
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Always. Do you, do New Zealand people say they're down under?
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I thought that was like an Aussie trait. But are you guys happy saying you're down under as well?
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We are down under. Oh, that's cool.
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Yeah. Learning something already. I would have thought, yeah, that's great.
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No, really pleased. I've followed you for years. Great. I mean,
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I looked at your Twitter. We'll start off, Ronnie. I looked at your Twitter,
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which I think is where I probably found you back in the good old days when Twitter was useful.
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And you joined Twitter, I think it was back in like 2009. 2009
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i mean that's like i don't make you feel old but that was
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like that was earlier than a lot of people that joined there
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so you have been around spreading fantastic information for
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so long and it really is a thrill to have you on the show ben as
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well wonderful to have you back and in fact
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just to make you feel like you're not kind of like you know the kind
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of third person here on the date then then then i want you to
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start off and tell our wonderful listeners a little bit about
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yourself you were here like i said before with just after
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your fantastic piece in msk mag
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went to see it in the mud which was just so beautiful and amazing and that was
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nearly two years ago i told you it was two years ago it was episode 194 so i'm
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calling you now i did say i'd call you yeah here we are which sounds crazy it's
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amazing but for listeners who are not aware of the work you do ben could you
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give us a little summary and what the connection is with pain and our topic tonight,
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I have the joys of working for our wonderful NHS in a pain service as a physio for the past,
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well, I've now been in the service, this is my coming into seventh year, Matt, believe it.
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And so I will come on to Modern Pain Pro, which Bonnie and I do in a minute.
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But yeah, so I get to see our great British public, help them with their persistent pains.
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The thing I tell people who don't know what pain clinics are or anything about NHS, I.
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We see the people that no one else can help. And they go, ooh, sometimes.
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So yeah, we get the joy. People who have gone through conventional physio and
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all the usual support and surgery and procedures and scans and whatnot, I've got nowhere.
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And we get a ton of, these days, widespread pain, I would say now.
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I'm telling a lot of people that, I'm calling the Peter O'Sullivan patients,
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you know, the people who have got the back pain, afraid of movement,
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worried about the scan, et cetera.
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They're being dealt with a lot quicker, a lot better these days.
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So we're getting all the ones that don't fit that box.
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So that's why I do day-to-day workers on the side, which we talked about last time.
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There's a communication skills facilitator at Cambridge University,
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which is across the road from me.
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And teach medical students how to talk to people and try and change people's behavior.
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Fantastic. Well fitted in. That was amazing. And we should give a shout out
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also to your wonderful clinical communication podcast as well,
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which you've had some amazing guests on.
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And you put your voice to fantastic use there as well.
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All of these links to this will be in the show notes at the end of it.
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So, yeah, great to have you back. Thanks so much, Ben. And for people listening
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to the podcast, I suppose, watching live, Ben is actually tonight trying to
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break the world record for holding a rather large microphone for a show.
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It's in his left hand at the moment.
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So if you hear the noise, it's just the strain as his bicep is collapsing. Exactly.
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Right. Amazing. And Donnie, Donnie? No, Dr.
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Bronnie Lennox-Thompson. Thank you so much again. Could you,
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for people who don't know about you, and I'm hoping there's lots because what
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a great way to educate people.
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Tell us a little bit about your involvement, how you have come to be who you
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are working with this topic of pain.
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Thanks so much. And what a great opportunity to talk to a bunch of people who
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also want to learn about this weird thing that we call pain.
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I've been working in pain management, oh, most of my clinical career,
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in a wide range of roles from primary prevention,
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musculoskeletal management, so early management, ergonomics,
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right through to persistent pain management.
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I've been involved in policy development and now I am the lead for our post-grad
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programs in pain and pain management at the University of Otago.
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My background is occupational therapy with
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a psychology degree in the mix and my I guess on social media I've been writing
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a blog since 2007 which is an astronomically long time and that's been my contribution
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to the literature really I don't.
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Publish a lot of peer-reviewed research because I'm an educator and I live in
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that translation space.
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What does this stuff mean? Because I care about the fact that in my clinical practice,
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I have heard so many people tell me that sad story of hope and then despair
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as they've been offered something that wasn't ever going to work for their chronic pain,
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and the way that people have been stigmatized and poorly treated,
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their concerns dismissed.
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And I don't want to see that happen again.
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Part of it is that clinicians just don't know, and particularly over the last
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30 odd years that I've been in this business, many people still don't get given good education on.
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Anything other than neurobiology in their undergraduate training,
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which is concerning to me.
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And so clinicians don't know. And then our systems don't allow those clinicians
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that do know to do what we know works and helps people who are living with pain.
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So my passion is to get that knowledge out there to everyday clinicians and
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language that I hope isn't too esoteric and distant from actual speaking.
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Let's make it real, folks.
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That's great. Yeah, and just to reiterate, your WordPress, and it's still called
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healthskills.wordpress.com, so that shows like, you know, still the .wordpress.com,
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which is a testament to it as well.
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Don't monetize it. It's not flash because this is not about,
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for me, this is about a passionate way of getting stuff that's currently locked
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behind paywalls often or language that's really difficult to understand.
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And I want to get it out there. Because I don't know how many times clinicians
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have said, I don't know what to do.
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It's not working. How come? What do I do differently? Let's make it real.
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Fantastic. So people, if you are, please, if you're sending me an email,
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what CBD should I do, Matt?
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I'm just going to reply for the next week or so. You've got 20 years worth at
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healthskills.wordpress.com.
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Okay, there's a nice little bit of free stuff to read through there and see
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the evolution of thought as well, which must be amazing sometimes over 20 years.
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Great. Well, thank you guys. Also, just before we start getting into the meat
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of the question today, we should give a shout out as well to Modern Pain Care.
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How did you guys get involved with that? Because there's been,
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Mark's done some fantastic interviews recently, and I've loved watching him
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and the guests he has. He's such a good interviewer, really is.
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And for me to say that, that means that that's big kudos to him.
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So, yeah, how did you get involved with Mark? When did that happen?
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Mark and I have intersected, oh, gosh, probably before one of the San Diego Pain Summit meetings.
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And I really admire his passion and heart for helping people where they're at.
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And so I started to help him with developing the ACT Acceptance and Commitment
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Therapy teachings because I'm an ACT practitioner and I think it's a really
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flexible, useful way of helping people, anybody, including clinicians,
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figure out what to do when somebody's there in front of us.
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And so that's how I first met. And then Ben came along and has wowed us. It's just amazing.
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So Mark and I had briefly encountered before, just like we are tonight.
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And then I think it was about spring of last year, I got a message on X saying,
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are you free to chat about an idea I have?
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And he basically tried to grow Modern Pain Prone as it is now, extra stuff on it.
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And so I came in, when did we start that first program? The summer, I'm going to say.
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And it's been the three of us ever since supporting, I don't know how many people we have now.
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A good amount, yeah. And it's just, well, Ronnie and Mark do,
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is it twice a week, I think, group mentoring as part of that?
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We have regular content, monthly webinars with one the other weekend,
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which we alternate. and so far everyone's not signed up is hanging around so
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we're clearly doing something right.
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Yeah. The aim is that people hear new material but often it's that translating
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it into practice and how do I do it when I'm on my own?
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And we know that growing and developing as clinicians shouldn't ever stop but
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often people are left there feeling like they should know it all and do it all.
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And that's not really feasible.
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In my profession, occupational therapy, clinical supervision is part of what we do.
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It's normal, that mentoring, that growth and development as a clinician,
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but that doesn't apply to all professions and so what we're trying to do is
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offer that, that mutual ongoing learning and discovery and problem solving.
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It's been a real privilege to watch people learn new stuff, try it out,
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discover what works for them at that moment and then continue.
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That's just the most incredible thing to watch. I love it.
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Yeah that's amazing right then
14:47
oh just i was saying off air i just feel like we're biting off
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so much more than a chew i'd never feel just so overwhelmed by
14:53
a topic like it's about pain but it's so we're
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going to try and break it down i mean the idea is and particularly why
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i'm so excited that you two are opening up this series some
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of four episodes is because i think you know
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one one of the lovely things i love about you guys is you
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do manage to break the complex down into like digestible but
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not kind of too diluted there
15:14
lose its meaning i think you both got a great knack at that so i'm
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going to start off with a question of of what do
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you think are the most important developments over let's
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say the last five or ten years in terms of
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understanding pain that's a
15:31
horrible question it's a big one isn't it when did
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we when did the term nosy plastic come along i want to say it was like 2017
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was over i think the fact that we it's even just because we even use if we start
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with brain right and then we're in oh no it's not just brain it's nervous system
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and now it's not just even nervous system it's just hold but i know it's just gone.
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And it's just the fact that we have to zone i'm gonna say zoomed out.
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We're considering so much stuff. The Neuromatrix term came out was early 2000s or something.
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But I think the grasping of how much it can be influenced by what I say to our
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groups are anything and everything is so important.
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And we just, from just my own experience, barely say brain or barely say nervous system anymore.
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If they want to ask about it, we even just say you, right?
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And your life and stuff like that because it's you know it's a person at the end of the day,
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and i think for me it's the fact that you we've just
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it's it's anything and everything was zooming out it's
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not just what's inside it's how it's
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affecting that person the past the present and the
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future and considering all that and
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i think in a way for me this helps
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actually as a clinician feel more
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gives you more options feels more kind
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of oh it's not just about thinking certain
17:04
ways or you know resetting things anything like that it's like well could we
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consider these parts of your life and you know i'm sure people have mentioned
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in the past and we'll come on to about whether it's movement sleep mental health
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etc but and beyond that social things like what they enjoy all that stuff like,
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considering so much I feel like it opens up options and although it can sound a bit,
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high in the sky vague you know so everything and everything what does that mean to me but.
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From my view it gives you more options of things to try I think.
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It's really interesting because I've been around a while.
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And so, to me, I can see more popularity around certain concepts,
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like let's help people understand what might be going on and,
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oh, that might help change their experience.
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That's fantastic, but it's not new.
18:03
In psychological approaches, CBT and such like from the 70s, We've been doing that.
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We've been talking about the, well, we'll use biopsychosocial,
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but I want to bracket that.
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We've been using that and applying that kind of thinking to pain since Engel proposed that.
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So that's the 70s, late 70s.
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And now I call it multifactorial because biopsychosocial's got such a lot of
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baggage. pains, this multifactorial thing, experience.
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And we've spent in all our research and discourse in pain research,
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we've spent a lot of time defining terms and grappling with concepts.
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And what I've seen probably in the last 10 to 15 years is this moving from academic,
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oh, we'll talk about this amongst ourselves, to clinicians having to grapple with these concepts.
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Not always well, not always with as much nuance as is needed,
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but at least people in clinical practice are getting to understand that pain
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is not just about issues in the tissues.
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And I think that's important. That's probably the most significant shift.
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Are we there yet? Hell no.
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We have a long way to go. We still don't know how to explain consciousness.
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So how on earth we think we can explain pain, I do not know.
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However, we're at least starting to take some steps towards helping people make
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sense of their experience.
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And what as clinicians what we probably need to learn is how to better do that,
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and maybe do a little less of some of our telling people what they should know or should think. Yeah.
20:07
More hope, Matt.
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I feel like Lord Moses has been trying to say it as well but I've been trying
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to say it too when we talk about this. More hope,
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options, there's more hope people that can help. In the past,
20:22
if you'd got a fibromyalgia 20 years ago-ish, a rheumatologist would go,
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here you go, it's leaflet.
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Bye. Learn to live with it.
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I was told that. So I live with fibromyalgia. I wasn't given that label.
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I learned that I had a chronic pain problem when I was 22, 21, 22.
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I'd had pain for quite some time, but I was seen by a fabulous clinician who
20:47
I admire and respect deeply, Dr. Mike Butler.
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He was the director of the Auckland Regional Pain Service back in a long time
20:57
ago and told, here, you have this chronic pain problem.
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We don't have anything we can do to offer you medically.
21:06
And he, wonderful man, said, read this book, The Challenge of Pain by Mel Zackin-Wall.
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So I read it because I'm such a nerd and a geek and, you know, that's what you do.
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And it transformed my experience. It helped me begin to do things again. How awesome is that?
21:27
Fibromyalgia is one of those terms that's kind of tossed around.
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And what I am struck by at the time was that he said, we don't have anything
21:38
medically to help you, but the learning how to live with it part was up to me.
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There wasn't guidance. There was a pain service, but I wasn't bad enough to need it.
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So I wasn't taking medications, and I was moving, not very well.
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So that learning how to live with that part, that bit we've gotten much better
21:59
at dealing with, but we're still not there yet.
22:03
We're still thinking if I reduce the pain, the person's magically going to, bing, get better.
22:09
People with angina.
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Don't always live with it. Their angina pain is not there all the time, right?
22:18
There are times when they don't have angina. But they live life differently
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because they anticipate it could come back.
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That's why this disentangling from experiencing pain, what it is,
22:33
and what it means to that person is so important.
22:36
Because if you think, if I do something, my angina is going to happen and then
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I'm going to die, you're going to change your life.
22:46
So addressing just pain intensity is never enough.
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And so conceptually, we need to think really hard, what is it that I'm doing
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as a clinician? What am I treating?
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A person, a piece of nociception, their beliefs, the intensity of pain,
23:06
the interference, the distress, which bit am I tackling?
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Because that makes a difference to what we do and also how we think about that
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person who's experiencing pain.
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See, I said I had soapboxes.
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So not the word. So not the word. I can't think of the nemesis of a soapbox
23:27
yet, but I'll think about it.
23:29
I could just sit back and let you take turns and talking after doing that.
23:33
I really wanted to see how Ben's going to respond to Bronnie.
23:37
But I just want to kind of recap a few things you mentioned there.
23:40
I find it so difficult these days, especially in soft tissue therapy,
23:45
for example, people are laying their hands on somebody who are still being.
23:48
I'm talking about the UK now, so I don't know how much this will make sense
23:51
or applies in New Zealand.
23:53
But I think when there's soft tissue therapy, there are still a
23:57
lot of people who are being taught and therefore believe that the issue
24:00
isn't in the tissue and i still think that they
24:02
gently need to be kind of guided into moving
24:06
slightly away from that and understanding like you
24:08
say that there's a person on the end of that knee so that's still an issue
24:11
and i think there's you know it's a big challenge for a lot of
24:14
people out there but then we've also got probably a lot
24:17
of listeners to this podcast because we're at like episode what are
24:19
we 272 now we've been saying it since jack chief
24:22
started in part one with imposter syndrome that the
24:26
issue is not always in the tissue and i think with for a
24:28
large population now there is an issue where.
24:31
They've they've read explain pain they've done that and
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they've watched all the mosley videos and everything and they've gone
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through this stage now where they are kind of falling into
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the trap of moving everything into the brain now and pain's an
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output of the brain and and in a way they're still forgetting about the
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person aren't they because suddenly they just move from the it's still
24:49
a tissue of the brain and they're not really thinking about the
24:52
ecosystem everything around it so but i think most
24:55
of our population are probably in that at the moment and i
24:57
think that that could take some assistance in
25:01
in just basically realizing that a lot of those
25:04
principles that came out of mosley and butler
25:07
in such entertaining form with the tales and and and the laughs and the comedy
25:12
really infectious stuff that they they have actually made the brain a little
25:17
bit too centered and they've correct this they continued the dualism if you
25:21
like which we're trying to work away from and see the whole individual as one.
25:25
So what tips would you have for people who are slowly starting to see that.
25:31
What they may have been doing for the last five, six, seven years has been,
25:35
even if they've been trying not to do it, it has been heard by the patient as,
25:39
oh, so the pain's in my head.
25:42
It's a tricky one, isn't it? Can I give you an opinion, Matt?
25:46
This is kind of going to answer Mark's question he just put as well.
25:50
It was a similar question about kind of pain education falling out of it.
25:54
We've all seen that video. I think it was 2013, that Loma Mosey video. It's got like one.
25:58
We should have done. It's necessary. everybody else with a small behind 101 isn't it yeah,
26:05
Now, if I take you to that video, Matt, what do you remember from it?
26:10
Is this the snake? Yeah, yeah. That's the first half. What's in the second half?
26:15
I get confused. There's tools for you, which I watched religiously.
26:17
No one will remember. Yeah.
26:20
The key thing with this is, and
26:23
people saw that. I'm making sweeping assumptions here. But we saw that.
26:28
Here's this guy on the stage or someone else. And they do, as you say,
26:32
really interesting, great presentations.
26:35
The impression oh if i then say these words
26:39
about the nervous system to my patient they'll get it they'll feel
26:41
better the problem
26:44
is that you can say that stuff but what worked with those wasn't the words right
26:52
it's how it was delivered and now i don't know laura i don't know all the internet's
26:58
at all but i'm sure he practiced i'm sure he had a bit of help and he planned it right,
27:05
and let's be honest it's a bit entertaining of a talk so he
27:09
you know there's it's how
27:12
it's delivered right has to be relevant to the person not
27:15
just saying about nerves and brains and stuff like that because that will just
27:19
fall flat and most of us in a clinic on a tuesday afternoon aren't in the same
27:26
charismatic mode as lorimer on a stage and all that jazz okay we don't have
27:31
and he uses stories where we've been using facts,
27:33
which land a lot better.
27:36
So in my view is that it's not what said, but it's how it said.
27:42
And the problem is the message of, oh, if you just tell people the nervous system
27:45
and the brain, they'll get it. They'll feel better.
27:48
But that wasn't what made the difference. It was how it was done instead.
27:54
And if I can add to that, it's not just the how, it's also why.
28:01
Does it matter? Yeah. I'm a nerd.
28:04
I'd be really happy if you threw all the neurobiology at me as my rheumatologist did.
28:10
Read this book, he says, and it got me really interested.
28:14
But if my main concern about my pain is, can I still work? Am I going to be able to sleep?
28:23
Is this going to last forever? What about my sex life?
28:27
Then I actually don't think explaining anything is going to make a blind bit of difference.
28:34
So I prefer to think about this education.
28:39
We are in the game of helping people understand this weird thing that's happened
28:44
to them, is happening to them.
28:47
Some of that's going to come from what we say.
28:51
Some of that's going to come from the way we are with them, our compassion,
28:55
our care, our being human.
28:57
Some of the sense-making is going to come from what they experience as we do
29:03
things together, move differently, explore different things.
29:07
Some of the sense-making people make comes from what they read,
29:11
what they see on social media, when they talk to Aunty Mabel,
29:15
when they listen to their kids.
29:18
And so if we go away from this idea, I'm going to educate the patient,
29:22
and we think instead we're helping this person make sense of what's going on for them,
29:28
we might think a little less about the words that we use and a lot more about the end result.
29:35
Which is that this person starts to feel more confident, that they start to
29:40
feel like it's okay to move again.
29:44
That the weirdness of what they're experiencing does not mean they're losing the plot,
29:50
That's really what some of the functions of this explanatory model.
29:56
As humans, we really want coherence. We want to make sense of everything.
30:00
And sometimes the sense-making that we come up with is completely erroneous.
30:06
If you've ever lain in bed in the middle of the night as a kid and seen a shadow
30:11
on the wall from the outside, and you've thought, oh, that's a dog or a bogeyman
30:16
or something, that's sense-making.
30:19
It's not truth with a capital T, but it made sense because humans do that.
30:27
And I think if we can bring that idea that humans try to make sense of everything.
30:33
And that doesn't always mean that it's truth, but it's sense at the time.
30:40
It's a story. It's helpful or not helpful explanation or narrative.
30:45
And that even having made sense, it doesn't make a lot of difference if it doesn't
30:50
change the person's willingness to start doing.
30:54
And sometimes we need to do the doing for things to make sense.
30:59
That might shift the way that we think about this explanatory stuff that we throw at people.
31:06
We just sort of jump on people because, look, I'm smart and I know this stuff
31:10
and you don't, I'm going to tell you what you should know and what you should think.
31:13
I'm not sure that that's very humane and it's not very sensitive to what this
31:19
person's main concern might be.
31:22
See soapbox i mean
31:25
i think both bony and i are giving the impression as we've
31:28
become into these pain roles we
31:31
actually explain less right yeah because when you write it and i completely
31:38
agree a lot of the time people there's far more important things that the people
31:41
are concerned about may not always be necessary and actually think about it
31:46
patients remember what 20% if-ish of an appointment.
31:50
And the more powerful things, as Pony completely said, is the doing.
31:55
People talk about behavioural experiments or thought challenges or whatever
31:59
terms you want to use, but that will stick with someone a lot more, that experience.
32:05
Than saying, well, the nosy sectors in your lives are hypersensitive and they
32:11
will go up these tracks, so this will blah, blah, blah, blah.
32:13
Okay, they'll forget that.
32:15
But they will remember doing let's take bending as an example bending task on
32:21
doing it in a relaxed way that made them feel more comfortable and able to do
32:25
it for the first time in two years for example and that will have a much bigger
32:29
and they can probably get the same understanding from that,
32:33
as they can from a 20-minute pain explains you that will forget anyway yeah
32:40
i mean it's Absolutely reasonable.
32:43
Somebody has a concern that, why do these drugs not work for me?
32:48
It's really reasonable to explain that drugs work for certain types of pain
32:54
and your type of pain is one that doesn't.
32:56
So, nice plastic pain, for example.
32:59
Great. Here's that. It's answering a question, answering a concern for that person. Okay.
33:06
To just tell somebody stuff because you know it and because you think they should
33:11
know it, like it's some sort of curriculum, I'm not convinced.
33:17
But people will be making sense
33:19
of everything that we say and do and everything that they experience.
33:23
But guiding people through trying stuff out and gaining confidence in their
33:28
own body, I think that's what we do as clinicians in pain.
33:32
We help people try stuff out in a safe environment that we titrate the challenges
33:42
of movement, context, everything.
33:45
And then we help people become, we help them try it, we help them reflect on
33:51
what it feels like. We help them make sense.
33:55
It's therapeutic, but often it means the target of our therapy isn't what we think it is.
34:02
Like, it's not the exercise and the fitness. It's the confidence.
34:07
It's the, oh, yeah, I could try that. Oh, my body feels different.
34:13
That kind of revolutionizes the way that we think about our work as pain clinicians,
34:19
whether it's acute pain or longstanding pain.
34:23
And yet we need to know that stuff for sure. I'm not saying we shouldn't,
34:28
but I don't know that we always need to tell people stuff.
34:33
That's what I was thinking. I'm glad you said that at the end because I'm thinking
34:36
exactly what I was going to ask you.
34:37
Is it a case where as clinicians, I mean, we're trained to be the kind of knowledge
34:45
dispensers and a lot of our identity is, even if we don't wear a white coat,
34:49
we need to feel that that's what the patient's seeing.
34:51
You know so we've got confidence in ourselves so are you suggesting that part
34:56
the take-home message for listeners should be that.
35:02
And it's like you just said, it's good for you to know this stuff.
35:04
That gives you the confidence to do what you do and to actually decide,
35:07
right, I'm going to get that patient to do a squat now, even though I've done
35:10
all the tests and I don't think I'm going to break them.
35:12
So it's good for you to know as a clinician to have the confidence,
35:14
but you don't need to give them a dialogue as you're putting them through that
35:18
exercise to explain to them why you're allowing them to do it.
35:21
Just keep it more in your head and just make it more about them and doing stuff.
35:24
Is that kind of a take home?
35:27
Pretty much. We need to know the stuff. We surely need to know it because that
35:32
will influence our confidence.
35:34
And, you know, research looking at pain education for clinicians shows that
35:40
what it does change is a clinician's confidence to look at stuff that perhaps
35:46
they hadn't felt confident to look at before.
35:49
For example, psychosocial factors for people who are primarily musculoskeletal clinicians.
35:55
So education helps us as clinicians, for sure.
36:00
What we've really perhaps haven't defined so much is what competencies,
36:06
what skills, what really works in practice in our interactions with people that are in pain.
36:13
We've got some good ideas. There's some really nice papers that look at competencies
36:17
for, I guess you could call it psychologically informed practice.
36:22
I'd rather call it just good clinical practice. It's not psychologized what we do as clinicians.
36:29
So we know some competencies that are really important but we haven't really
36:33
thought about them as inactive and we're doing inactive work with ourselves and with our clients,
36:41
our patients that's the bit that perhaps we need a little bit more work on ourselves and what.
36:50
Does fundamentally, there'll be a few people, like, I'm going to use Bonnie's
36:56
example here, who want to know more.
37:00
And by all means, if they want to know more, grand.
37:03
You can, even as a clinician,
37:09
you can know the basics, but unless you're doing a PhD in pain pharmacology
37:15
or something like that, all of the substance P, blah, blah, blah,
37:18
is not going to change what you do.
37:21
It's all about that person and what their needs are.
37:25
What do they want? What are their goals? Everyone says, isn't it?
37:28
What's their values, etc.?
37:31
Most people, if they've got a diagnosis, especially of a widespread condition,
37:36
they've probably seen a few other clinicians by the time they've seen you.
37:39
If they've got a diagnosis, there's a high chance they've Googled it, gone on to AI, whatever.
37:46
Found out, or may even be part of support groups.
37:49
I will simply ask them, you've got this diagnosis, you've seen these people
37:52
already, are there questions you have about this you'd like to ask if people haven't yet answered?
37:57
I'll be honest, I would say 60 plus percent, the answer is no.
38:03
And then we just move on and then get on to what's important to them.
38:08
I think, yes, if someone's really interested or you feel it is,
38:12
and this is very, very rare that they need to know something for whatever reason, fine.
38:18
But otherwise, its role, as we've discussed, is getting less and less and less.
38:25
We have to ask, what is it that people are looking for when they're asking,
38:29
when they're coming to see a clinician?
38:31
Some good research that talks that people want to know a name for what they've
38:35
got because names are really helpful shorthand.
38:39
If I say fibromyalgia, lots of people know what I mean by that.
38:45
And they may be wrong, but at least it's a handle that we can use to talk about
38:50
this experience that I have.
38:52
So they want to know what it is. They want to know how long it's going to hang around for.
38:56
They want to know what they can do to get better or if they can get better.
39:01
And they want to know what not to do, pretty much.
39:05
And then they want to know how can I do the things that matter to me?
39:11
That's why people are seeking help. And we often assume that they're there to
39:19
get their pain gone, and that can be part of why somebody comes to see us.
39:26
And yet, if we ask a little more deeply, why do you want your pain to change or to be gone?
39:33
It's almost always because I want to be able to do the things.
39:38
I'm missing out on who I am, on what I want to do, how I want to be.
39:43
So we assume again in clinical practice that if I take the pain away,
39:48
they'll be able to go back to being who they were and doing what they were doing.
39:52
That doesn't hold up in reality.
39:56
Because if you've told somebody or they've learned that, oh,
39:59
I must not do these particular movements, otherwise I'll end up with this horrible
40:05
fate of living with pain, They're not living their best life.
40:10
They're living a whole lot of rules.
40:13
I hope that's not what we do, but I've heard it too many times to believe that
40:19
it isn't still happening.
40:21
So our idea of what it is that we're doing in therapy, I think,
40:26
might need to shift a little bit.
40:28
So we think a bit harder about, why is this person coming in to see me?
40:32
I teach in our post-grad program the
40:35
kind of question, why is this person presenting in this way at this time?
40:40
What's maintaining their predicament? And what is their main concern?
40:45
If we answer those questions, we might have a bit of a chance of helping that person.
40:52
Because if we're not addressing their main concern, then we're doing something wrong.
40:59
Fundamentally if they're worried about sweeping example someone's got their back pain,
41:08
they're worried something's broken I remember seeing someone ages ago who their
41:15
concern was that one of the lumbar discs had been removed somehow and they'd
41:24
been scanned and I could get up the scan and show,
41:29
No, it's a rare example, but sometimes those, and this is again,
41:34
beyond explaining things.
41:36
And again, as we just said, knowing the person,
41:39
sometimes you have to address those things first or in a way where you do a
41:44
thought challenge or you do a behavior experiment, which helps address it,
41:47
that can then help them move forward.
41:52
I think, I look at Cecily's question about is confidence in moving an easier
41:58
cell than taking away pain? I would say no.
42:01
I would say, actually, an easy cell is to say, oh, I'll take this,
42:04
we'll do this, and your pain will go away.
42:06
I would, from the experience, say it's harder to say about things that aren't,
42:12
you know, again, you don't know why they're there, necessarily.
42:14
You have to ask and find out.
42:16
But I will often say to them that what we're going to go through hopefully help
42:23
mean the pain interferes less in your life and then you can do more of what these,
42:29
you've asked about their goals and values so you can do more of X,
42:32
Y, Z, whatever that thing is,
42:34
so you're not, I don't think you're straying in your thinking at all it's about sometimes,
42:40
reframing it because yeah What I say is pain,
42:45
can I help you find that pain is less of a problem for you?
42:49
That's my admission is to help pain become less of a problem for you.
42:54
Because one thing that we can't do is directly change pain.
42:59
And very little of what we do if we're not offering people drugs is changing my perception.
43:05
Really, we're not changing it very much, if at all, whether it's with our hands or our movement.
43:12
All we're doing is giving the environment or the context where nociception and pain might change.
43:20
But we're not directly addressing it.
43:22
So if we can help pain become less of a problem for this person,
43:27
if we can help the problems that pain poses for that person become less of a
43:32
problem, then we might be doing something really helpful.
43:36
Subtlety, right? Yeah, absolutely. Absolutely.
43:40
Those are the things that make the difference. Self-efficacy and confidence
43:43
and all that stuff, rather than just, you know, where's it hurt?
43:50
Or, you know, how strong you are.
43:54
You could come on our group programs, Bonnie's done group programs.
43:57
You could look around our groups.
43:59
There'll be some strong people. There'll be some weak people.
44:02
That doesn't mean who's in the most pain.
44:04
Interesting. So he lost his weight as well. Yeah, he'd be very good people.
44:09
I had a guy who used to swim like 100 lengths off the Olympic pool,
44:14
backwards and forwards, but he was not able to sit.
44:18
He couldn't work because he was so sore.
44:23
Fitness, strength, that's not what we're targeting.
44:27
Confidence is often the thing that we might be actually targeting the most.
44:34
How much you mentioned before acute and
44:37
chronic pain and i how about
44:40
clinicians who are there and they're looking after people who have got like
44:43
seemingly sporting related injuries and they can't run anymore and again that
44:47
could have a massive effect on their psyche and it's definitely worth investigating
44:51
that how much of this applies to people who aren't necessarily living with chronic
44:55
pain but they just want to get back to sport again i think it's the same thing.
45:01
It's about how much concern we have about that pain what does it mean,
45:08
And if we're beginning to get someone to move again after an ankle sprain,
45:14
if they're a runner, we've got to start somewhere and we start low and we start progressing.
45:21
And we frame that with lots of talk about what it might be, give you explanations.
45:26
We've been doing that since time immemorial.
45:30
Ultimately, though, that person is beginning to gain confidence in their ability
45:35
to do the thing that they want her to do.
45:37
I can't see much distinction if any really,
45:42
it is about us knowing stuff and creating that environment with the person so
45:48
that they can make sense of and begin to experience their body differently or
45:54
gain confidence whether the pain hangs around or it doesn't,
45:59
I guess as well you may well and this might apply with athletes as well that,
46:04
you've got to see whether you're as layman
46:07
would kind of put it with the bear some people are afraid of
46:10
the bear and you've got to ask them to poke the bear but some people
46:13
are just ready to grab the bear and beat the hell out of it so you've got
46:16
to when somebody is doing too
46:19
much you've got to kind of help them realize and guide them that you're doing
46:23
too much and this isn't going to be a shorter path what kind of cute help sort
46:27
of ideas would you have when you're dealing with something like that it's not
46:29
necessarily it's not kinesophobia or anything it's the opposite quite common
46:33
too maybe yeah yeah Yeah, definitely.
46:37
If I give an example, I can think of someone a couple of years ago who exactly,
46:43
as you said, was the very much gun for it.
46:45
They did like six, seven exercise classes a week of the belief that if they
46:50
get strong enough, they're going to be strong enough.
46:52
Or fit enough that the pain will become, go away.
46:57
And with all these things, this isn't just a pain, I don't know,
47:00
I don't know, sometimes these things get coined as pain skills or pain terms.
47:05
It's a term for anything, like you were talking about there,
47:07
about someone's going with a knee sprain.
47:10
You're still going to use these skills of asking these Socratic open questions,
47:15
well, how's that gone for you? Or what do you feel that's affecting on you?
47:19
If I just turned around and said, well, do less, it might not end well.
47:24
But can you perhaps, you know, help with them?
47:29
Guided discovery is a big technical word, isn't it, Monty? But,
47:32
you know, work with them. What could be driving this?
47:35
What could be influencing? What could they do different?
47:39
That person who was overdoing it, their goal at the end of our group thing was to watch TV twice a week.
47:46
Okay? So actually, our psychologists say,
47:49
soothe or calm things you know
47:52
it's a is a we talk about selling
47:55
but it is a harder challenge for me i think for others because to say about
47:59
doing less rather than more or helping them discover that because i think the
48:04
public assumption is oh if you're fit enough or if you're strong enough or flexible
48:09
enough or whatever that would be good for you right.
48:13
Because we see it you know in social media you know we're in this situation
48:18
now in healthcare where we don't tell people to go and have bed rest for six
48:21
weeks for their back pain they need to get up and keep moving but,
48:25
But it can go the other way and can go too far for whatever reason.
48:30
I like that. What have you tried and how has it worked? Yeah.
48:34
In the short term and the long term. So what have you tried?
48:36
Well, I've tried pushing through. How did it work in the short term?
48:40
Well, I got to do the thing. In the long term, well, my pain's still hanging around.
48:46
And then what else have you tried? And just working through it.
48:50
And then where does it leave you?
48:52
You've tried all these things. Here's the short and the not so,
48:55
you know, the good and the not so good and the short and the long term.
48:58
What sense do you make of that? What can we do differently?
49:03
And the hardest thing, I think, is when somebody tends to push themselves is
49:09
there's some mind chatter that's saying, I must, I should.
49:14
It's good if I don't. All of those thoughts get in the way of actually chilling out a wee bit.
49:21
And that's what we're tackling when
49:24
we're helping people change an aim or a
49:27
goal but if we use their experience what
49:31
how well did it work what did you notice oh well
49:35
actually my pain got worse and you know
49:37
then we can help them reflect on what's
49:41
going on in the real world minds are really
49:44
really bossy and especially if you're
49:47
a fairly driven performance kind of person it's
49:50
really hard to not push yourself because
49:53
then you're thinking well I'm being lazy and I'm
49:57
just not going to be good enough and I'm never going to make it back and back to
49:59
square one and well listen to that mind have a go at you and I guess that's
50:04
partly why I come to using acceptance and commitment therapy because minds are
50:10
so bossy and sometimes we need to have a little help to park them over there thanks for that,
50:18
help mind but right now that's not helping and go with what I'm actually feeling
50:24
and experiencing in my body and I think that's something that's.
50:30
MSK clinicians of any kind can use. Guiding somebody to experience what it is
50:35
like in their body when they try a thing out, rather than framing it with a
50:40
whole lot of explanation,
50:43
giving room for people to feel what they're feeling and notice it.
50:49
And then the making sense part, that happens. There's some really nice research
50:53
quite a while ago now from Vryan's lab in the Netherlands looking at,
51:01
well, Belgium can't remember where now,
51:03
looking at the active ingredient in a CBT program.
51:08
What they did was they looked at, let's do the cognitive thing,
51:12
let's do the talk bit, let's do the behavioral bit.
51:16
And we'll start, we'll do this with individuals, but we'll measure each person
51:22
individually and will vary when we do this information versus behavioral thing.
51:28
In their analysis, what they found was it was the doing part that created the
51:33
change, both to pain intensity and to the interference, what person did. It wasn't the talk part.
51:41
Doing, dare I say it, trumps talking about it. I know.
51:48
But doing, experiencing, feeling is so much more powerful. we can get that,
51:55
Wow. Somehow it's four to nine. I don't know where that went. So it's interesting.
51:59
I'm kind of thinking that this has been the introduction to understanding pain in 2026.
52:05
And probably the title itself is something that we need to, maybe it should
52:09
be why you don't need to understand.
52:10
I know you don't need to understand pain, but you don't need to tell your patient
52:13
about it. I mean, that would be the longer title.
52:15
Understand pain as much as you want and geek out, but don't feel that you have
52:18
to explain it all to your patient.com.
52:20
That should kind of be where we are the most in In terms of evolution.
52:25
I'm going to check about that. Helping people make sense of pain. Yeah. For themselves.
52:31
Because that's really, I think, what we're doing.
52:35
And it's what people are doing with or without our involvement.
52:40
They are making sense. Sometimes the sense making isn't helpful.
52:46
Because it's based on information that isn't correct or their mind is telling
52:50
them stuff that seems to make sense but actually doesn't fit with what they
52:54
really want and what they experience because we've got bossy minds.
53:00
And so maybe if we think about that as what we are doing and also how we think
53:06
about pain, maybe that might change our approach and we can get a little less
53:12
tangled up in the linguistics.
53:16
And, yeah, I'm an utter geek and conceptual clarity and being a pedant is kind
53:24
of part of my jam because I think it's important that we know what it is that
53:28
we're trying to influence.
53:30
However, I don't know that everybody needs to have a lecturer or even us as clinicians.
53:38
We don't need to have all this knowledge about neuroimmunology and all cortical
53:44
processes and peripheral nociception.
53:48
We kind of have some good ideas, but they're theories.
53:53
They're incomplete and we don't know.
53:56
And working in this uncertainty is actually where we're at and a little bit of,
54:02
one of the things I do appreciate about Wiseman's pain education paradox and
54:07
validation gap is their acknowledgement that we don't know and it's okay to
54:15
sit in that space but man,
54:17
it's hard because that's not what we're taught it's not how we're trained it's
54:23
not how our minds want life to be,
54:26
And yet, that's where we are, you know, when we're working with one individual in front of us.
54:33
It's funny, isn't it, how by thinking we don't know that, we lose our value.
54:39
We don't think we should be charging anybody when really it's the people who
54:42
manage to think like that, who have got every right to charge more because they're
54:46
going to be helping a patient probably much more by not, you know, by changing the chip.
54:50
Right, look, we've got like what I'd love to do, and it's tricky,
54:54
but I wanted to try and something that our listeners could do tomorrow morning
54:59
or in the next couple of days, which would start putting this into effect.
55:03
I know i know that both you're going
55:05
to come out with just an absolute clinical pearl here that's going to be the soundbite but
55:09
just something where you think when you go to work tomorrow and you
55:11
open your door and you think right let's let them in just a different frame
55:15
of mind or something or maybe something physical that you could avoid doing
55:18
or do what would you think who wants to go first i will say then and this i've
55:27
said this before but based off what we said tonight.
55:31
Asking those questions and and then working out,
55:36
where they are in their journey and we said about explanation but really now
55:41
actually what do they already know what do they want to know if anything what
55:46
do they need to know which is often not a lot,
55:50
and then roll with it from there because most of the time they'll know a lot a high chance,
55:59
there might not be much they want to know and very little in our roles we're
56:04
not life and death services so very little they need to know if they have some
56:08
questions go for it but otherwise as Bonnie said this earlier the big thing
56:12
they probably want to know is,
56:14
how can I move forwards,
56:17
what can I do to improve the situation.
56:21
Yeah I would suggest asking the person what is their main concern about their problem,
56:28
That would be the first thing. I like to ask people, what's your theory?
56:32
What do you think is going on?
56:34
What sense have you made of what's going on? So I can use that to help me understand
56:40
the decisions that they've been making and their concerns and then roll with it.
56:49
Let's collaborate with the person. They bring immense knowledge.
56:55
They're the only person that knows what their pain is like, is doing.
57:01
They are the only ones in their body.
57:04
And so we use that. And it's also their life, damn it.
57:08
So anything that we ask people to do needs to fit inside their life,
57:13
not our idea of what their life should look like.
57:17
I'm saying that to exercise prescribers here.
57:21
Use movements that people actually want
57:25
to do and enjoy doing and it might not look like going to the gym or running
57:31
or whatever exercise you want let's do movement stuff that people really want
57:36
and need to do so that they will do it otherwise we're not doing much.
57:43
Very cool okay i think this is gonna
57:46
this is gonna be a great take home and it'll lead very nicely into
57:49
the next three episodes so yeah understanding pain 2026 is about making sure
57:55
that you're giving opportunity to understanding the person in front of you and
58:00
getting the answers from them rather than getting knee deep and in debates and
58:05
things yeah great okay fantastic,
58:09
I don't want it to end, but it has to. It's 9.02. Well, we're not asking any questions.
58:13
Perfect. So there were some questions here. I just wanted to say thank you for
58:16
the people who did ask the questions. I'm just going to quickly run through
58:19
them because I'm not ignoring you.
58:20
Mark, Ewan, that was a really good question about pain education and Laura Mosley.
58:24
And I think we went through that and answered that in a valuable way.
58:28
Steve Kirby, you had some questions about how you acknowledge pain as physical,
58:33
physiological, and psychological.
58:35
You're asking whether Bonnie and Ben would agree activation of the nervous system
58:41
helps prevent pain and improve quality of life.
58:43
I guess activating the nervous system is something you're doing every time you
58:46
ask the patient about themselves and get them to think and say things out loud
58:49
so they can hear themselves.
58:51
When we talk about activation of the nervous system, that's one of the most
58:54
valuable parts, I imagine, isn't it?
58:56
When is the nervous system not active? Yeah. When we're dead.
59:01
So anytime we're doing, we've got a nervous system that's working.
59:07
So what we're helping people do is self-regulate. So that's up and down regulation.
59:13
And that's experiential.
59:18
I would say, actually, most of the time, it's already overactive.
59:25
Again, we're trying to calm it down. And again, activation of the nervous system is a very broad term.
59:33
And that's going to be subjective, isn't it, of course? What does one mean by that?
59:37
But as we've also said tonight, it's not just about a nervous system.
59:41
It's about the person and their life, any more than that.
59:45
Definitely. Everything around them. Great.
59:48
I'm just checking in. Nikki Mansfield says, the final cue on my intake form
59:52
is, what would you like to get out of treatment with me?
59:55
It's the most valuable question on there, which makes me ask you,
59:58
Nikki, why is it the last question you asked them? I'm just going to drop that one there.
1:00:01
We can argue about that another time. But yeah, great point.
1:00:04
It's such an important question rather than just spouting out.
1:00:07
As soon as you see them and you think, I know what this is. It's the last CPD
1:00:10
workshop I did. I know what you've got. I'm going to fix it.
1:00:13
Very nice. Oh my gosh, royalties in here. David Poulter has joined us. Drupal 1-6.
1:00:18
I can't believe I'm... Right, that's it. We're going on for another half hour. No, we're not.
1:00:23
David has said, charisma and delivery enhance the contextual effects.
1:00:27
Contextual effects, including placebo responses, are the strongest clinical
1:00:31
effect we have. Gain trust. First seek to understand.
1:00:35
Absolutely. Love that.
1:00:37
Dave, you should come to the show and say that. We'll have to talk about it.
1:00:39
Lovely to have you come on the show and say that out loud. It'd be really nice.
1:00:42
I'm 100% too much pain-splaining. Good words, pain-splaining.
1:00:45
Not enough empathetic listening. It's about them, not us. Very much so.
1:00:50
If you still use X or Twitter, and there are some reasons to still go on there,
1:00:55
and David Poulter 1116 or Rhett Looping is one of the reasons to still be on Twitter.
1:01:00
So, yeah, Rhett Looping. We'll put that link in there. Even though he's not
1:01:03
on the show, we'll make sure it goes into the show notes.
1:01:04
Right i don't want to keep these wonderful people longer than i promised
1:01:07
i would so thank you so much gary benson founder of the sta says
1:01:10
thanks very much for an interesting talk about pain knowledge its value
1:01:13
and knowing when to share it it's very cool heads rehab
1:01:16
lovely to see you in here bonnie says thank you so much
1:01:19
great opening to this month's talks on pain i think so too thanks
1:01:22
very much bonnie right so just to let you
1:01:25
know this is going to be the topic for the rest of month but we are going
1:01:28
to come back next wednesday bear in
1:01:31
mind if you are one of the wonderful people who joins us live then yeah it's
1:01:34
going to be moving to a wednesday next week and just to bring this up for people
1:01:38
who do like to see the visuals like i said before we're going to be here next
1:01:43
week um a fantastic really good geek out chat looking at modern views of pain
1:01:49
we're going to be joined by professor dave newell.
1:01:52
I'm from the Health Sciences University and the head of the Health Sciences University.
1:01:56
And Anna-Maria Matsieri, who a lot of you know, who might not know,
1:01:59
she's doing a PhD at the moment because she needed something else to do to fill
1:02:03
her time at Health Sciences University. Fantastic.
1:02:05
We were talking about neurodivergency earlier. And there we go.
1:02:07
There's a prime example. Fantastic. Good on you, Anna-Maria.
1:02:10
It's going to be fantastic spending time with you there and hearing all about that.
1:02:14
And then the week after, back to Tuesday, February the 17th,
1:02:17
with Dr. Rachel Dura-Haggart.
1:02:18
And that's going to be looking at a very interesting episode.
1:02:20
So that's going to be addressing gender pain gap within the biopsychosocial context.
1:02:25
And then finally, as I said before, our guest is going to be Dr.
1:02:28
Rachel Zofniss, pain scientist and international speaker, science writer.
1:02:31
And she's got a new book coming out, Tell Me Where It Hurts,
1:02:34
coming out March 26th. That's going to be a wealth of information as well.
1:02:37
So thanks very much, everyone who
1:02:39
joined us live. Sometimes I forget about thanking you. I do appreciate it.
1:02:42
But most of all, thank you to Dr. Bronnie Lennox-Thompson and Ben Weibrow for
1:02:47
giving up their time tonight. Thanks, guys. Really appreciate it.
1:02:51
As always thank you so much if you
1:02:54
have enjoyed the show as i always say do please leave
1:02:57
a review or a rating um on your preferred
1:03:01
podcast app it really makes a difference it just helps this information get
1:03:04
out there when people do a google search um so that'd be really cool if you
1:03:07
could take time to do that and subscribe to youtube that helps as well it's
1:03:10
all connected in this getting information out there which is the biggest barrier
1:03:13
to anything probably to patients as well it's just getting quality information
1:03:16
out to clinicians so the clinicians can do the great stuff to the patients.
1:03:19
So you can do your bit and help by helping this quality information get out there.
1:03:23
We'll be back on Wednesday, like I say, but until then, as always,
1:03:26
take care of yourselves and each other.