Clinical Communication

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

A cranial nerve examination can be part of a general neurological examination for some clinicians, but often not considered by others. Whilst resources and guides now exist online on how to perform a cranial nerve examination, less guidance is available on what to say to patients before, during and after performing one. Until now. Alan Taylor is a Specialist Physiotherapist in Vascular Flow Limitations, especially related to Cervical Spine Risk, as well as being an Associate Professor at The University of Nottingham. In this episode Ben & Alan Cover: (00:00:00) – Introduction (00:00:50) – What led to Alan Being Interested In Cranial Nerve Testing? (00:03:50) – Why Are Cranial Nerve Examinations Not Taught As Much At Undergraduate Level? (00:07:18) – How Accurate Are The Cranial Nerve Tests? (00:08:50) – How To Prepare Patients For A Cranial Nerve Examination? (00:10:54) – What To Say During Each Part Of A Cranial Nerve Examination? (00:20:49) – Can The Torch On A Mobile Phone Replace A Pen Torch? (00:22:57) – What Should We Say To Patients After The Cranial Nerve Examination? (00:29:40) – What Is It Like To Be An Expert Witness & Who Should Consider Doing It? (00:34:10) – Alan’s Hardest Clinical Conversation (00:39:20) – What Is The Story Of Alan & Rogers Not Country Music Band?   You can find Ben across Social Media: @BWhybrowPhysio   Alan’s Social Media: X/Twitter: @TaylorAlanJ Instagram: @alan_taylor_physio YouTube: @alantaylor1068   Alan’s Cranial Nerve Examination Paper Discussed: A Guide To Cranial Nerve Testing For Musculoskeletal Clinicians https://pmc.ncbi.nlm.nih.gov/articles/PMC8725776/ Lawrence County Band: https://www.youtube.com/@Skiffleshow https://linktr.ee/lawrence_county?fbclid=PAZXh0bgNhZW0CMTEAAaYxduB4Kcna3j5NI8XIulc8pDwQqlZMuXOZIOK-WIG5gz0gJ2D89APPTG0_aem_84E4Qu8lQKBU2EoDXM5AJA

Trying to influence individual patient beliefs is tricky, but can be made even harder when someone else in their life is giving opposite information to you and having a greater influence. This episode talks through who else could influence a patients belief and how you could try to manage it. If you find this useful then do share & subscribe. For more follow @BWhybrowPhysio on X, Instagram, TikTok, YouTube or LinkedIn.

One of the hardest conversations in clinical practice is when the person in front of you holds the opposite belief to you as to how their problem should be managed, and they are not open to changing their mind. Engrained beliefs don't change suddenly, but how these conversations play out can be made more productive and collaborative for everyone involved. This episode discusses how to achieve this and important aspects to consider. Find this useful? Then please subscribe and share it with anyone you think would find it useful. You can find Ben on X, Instagram, YouTube, TikTok & LinkedIn - @BWhybrowPhysio Thank you for listening.

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

The tone of voice we use to communicate is as important as the words we say, and yet much less attention is made towards it. Until Now. This episode covers essentials points on using different tones of voice with the patients we see, as well as giving some examples and when to use them. For more, subscribe and follow @BWhybrowPhysio on your social media of choice.

How should we explain spinal-related nerve pain to patients? What should we say to those who want scans, but it’s not indicated? How should we explain imaging results to patients? For answers to these and a lot more, check out this conversation with Adam Dobson, Spinal Advanced Physiotherapy Practitioner. (00:00:00) – Introduction (00:00:43) – Would Adam Ever Become “The Space Physio”? (00:02:45) – How To Explain Spinal Related Nerve Pain (00:10:33) – What To Say If They Ask “Have I Got A Trapped Nerve?” (00:15:12) – What If They Ask “Will This Get Better?” (00:18:40) – What To Say When It’s Not Their Nerves, It’s Their Blood Supply (00:24:50) – Screening vs Work-Up Imaging (00:32:50) – What To Say When Imaging Findings Come Back “Normal” (00:43:00) – How To Explain Relevant Imaging Findings (0047:42) – What Does Nerve “Abutment” Mean? (00:49:30) – What To Say When Someone Wants A Scan, But It's Not Indicated (01:01:50) – How To Discuss Prostate Issues During A Back Pain Appointment (01:11:35) – Difficult Conversations Around Pain (01:18:18) – Success Stories From Adam’s “Back To Health” Programme   You can find Adam on social media @AdamDobson123 His website is: https://www.theradicularclinician.com/ You can find Ben on social media @BWhybrowPhysio

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

Want to have greater influence over the people you come across in life and interact with? “The Influential Mind” by Tali Sharot was released in 2017 and is still one of the top regarded books for this topic. This episode of “Clinical Communication” takes some important lessons from the book and how you can apply them to the person in front of you, to potentially have greater influence.   For more; follow @BWhybrowPhysio on X, Instagram, TikTok & YouTube. If you’re really keen do drop me a message and send me any questions you have.

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