The state of mind
Tecoma Myo Blog #1- Myo Matter’s #1- Building a Community Network
Myo Matter’s #1- Building a community network
By Mathew Richardson
The Idea for a networking group started 3 years ago when I created a small networking group in the outer east of Melbourne for Myotherapist’s. This idea never really took off as we were running these events during the week. One year ago, I wanted to see how an event organized by Myotherapists would be viewed by the local community and the Bendigo Pain Summit was born. Together with Polly Bongiorno, Lisa Fiddes and Anthony Byrne we held the event at a pub in Bendigo in October 2018 and wanted to show how we as Myotherapist integrate modern pain science into clinical practice. The event was a success, and attracted 24 practitioners from a wide array health profession and we had to cap the numbers. From there we created the networking group BioPsychos Going Social With the first event being held in the last weekend in August- Myo Matter’s #1- Building a Community Network.
The aims of the Biopsychos Going Social networking group is to create a community of practitioners to share knowledge, support each other and to explore the latest research and how it applies to us in the clinic, in a nonjudgmental and supportive environment. We will aim to hold the Myo Matters events every 6 months and look at getting different Myotherapist’s to present. This will be a platform for people to learn the skills of presenting and to share their knowledge and skills.
The first event was a success and what I was impressed with is how the 3 presentations worked together and the common themes and threads throughout the day. The key themes of the day were the narrative around your treatment, promoting self-efficacy, listen to the client’s story and adapting assessment and treatment to the contextual needs of the patient. Do we still do soft tissue treatment? Yes when appropriate, but is in all in context of with all the Biopsychosocial factors of the patients world.
Mat Richardson- Interplay between chronic pain and mental health
The first presentation on the day was me sharing my own experience with chronic pain and mental health. I focused more on how my sense of self was being eroded even in the years before I had pain. As Louis Gifford would say:
“The vulnerable organism is more prone to pain states, when you are low you hurt more easily”
Then the turning point where I decided to take control and changed from a patient into a person again. I started finding my self-coherence again by reoccupying myself with valued goals and activities. Gradually over the years I have developed coping strategies like Mindfulness, exercise and learning what is important to me and what makes me, me.
The next part of the presentation I explored the risk factors for the transition from acute to chronic pain. The amount of damage is not the biggest risk factor it is more to do with what we call the yellow flags: Psychological distress, low self-efficacy, no social support, pain associated fear and disability, inaccurate beliefs about pain and severe and uncontrolled acute pain. Early intervention and referral to appropriate help is essential to stop people spiraling into chronic pain and associated mental health conditions.
Alot of the research for chronic pain is around treating the disability around pain and not building resilience (Thompson 2019). Bronnie’s Brilliant paper Living well with chronic pain: a classically grounded theory, explores how do people live well with Pain? Was their a process they went through? These participants were all people self assessed as living well with pain and have not been to a psychologist or pain management clinic. What Bronnie found was that the main concerns of people in the study was resolving a disrupted self coherence. Resolution involved reoccupying self, involving 3 processes of making sense, deciding to move forward inspite of pain and flexibility persisting (Thompson 2019).This study is s must read for any healthcare practitioners and for me tickled alot of my confirmation biases.
“Clear, relatable and interesting”
“Mat always keeps the content fresh and light, you don’t get bogged down with too much science making it easy to absorb”
Polly Bongiorno- Yoga and Pain
Polly showed her brilliance of merging her passions of yoga and pain science. Using pain science to back up many aspects of yoga, Polly was able to show an evidence informed practice of yoga.
The takeaways form Polly’s presentation for me were that Yoga is the practical philosophy intended to assist the individual in the uncovering the causes of suffering and its alleviation. The correlations between the 8 ‘pathways’ or specific guides of yoga and how western science can be used to show plausible mechanisms. The global chronic pain epidemic desperately needs higher quality non pharmacological active treatments that operate in a Biopsychosocial framework. Yoga with its multi-factorial aspects, Yoga is optimally placed to treat pain from a Biopsychosocial perspective. The primary aspects of yoga that could influence pain are movement, Breath work, contemplative practices- these are evidence-based methods to treat sensory and cognitive practices to change the persons relationship to their pain. Being a mindful movement, we may see changes in the cortical representations and can assist in redefining the body maps. Yoga practices promote self-efficacy, self-awareness, behavioral modification and self-compassion/ empathy, social connection and relationships. Yoga practices are a low cost, noninvasive, accessible, practical, personal, safe and low risk.
“would love to see Polly introduce a class for practitioners to integrate into practice”
“Upbeat and informative, I am looking forward to starting yoga”
Nathan McKeown- Bio mechanical Clinical Reasoning Models
Nathans presentation got the cogs turning as he explored bio mechanical clinical reasoning models and the limitations in research. He really got me thinking about evidence informed practice vs evidence-based practice. To be honest I had never really explored the difference and I can now see a lot of what I do in the clinic is evidence informed practice. Evidence informed practice utilizes research, the clients experience and understanding and the expertise and knowledge of the practitioner. Many individual conditions have inadequate research to inform our decisions and multiple conditions together have even less, we must use our evidence informed practice to guide us and it is important to recognize what does not work.
Biological components are important, but in context with all the Biopsychosocial factors. “Without movement we die”, movement is how we interact with the world and not just about pain it is about safety and choice in life (how we live our lives now and, in the future,). It is important to listen to the patient’s story as it makes up about 80% of our working Dx. The cornerstone of a good therapist is effective communication skills and create an appropriate narrative on the presenting client and taking and utilizing information from all aspects of the Biopsychosocial domains. Other factors to consider with your clients are the stages of behavior change and the reediness to hear the information when implementing pain science education and developing a plan for each client.
“excellent open-minded approach whilst explaining necessary reasoning”
“keeping it real, a good reminder to remember the bio in Biopsychosocial”
Special thanks to Lisa Fiddes for being MC for the day and recapping key themes and linking together the presenters and the day.
Thanks to all the guests for supporting the event and we will look at running more events in the future.
“Inspire and Build Community”
Thompson, Gage, Kirk, Living well with chronic pain: a classically grounded theory, rehabilitation and disability, 2019