The Physio Matters Podcast

In this episode of Chewing It Over, Jack is joined by Charlotte Spear from Therapy Show to discuss the transformation of Therapy Expo into Therapy Show and the ambition to create a genuinely different experience for the MSK community.Charlotte explains that the rebrand goes far beyond a new name and purple colour scheme. With the event now occupying its own hall at Birmingham's NEC, the focus has shifted towards creating an engaging, interactive experience rather than simply delivering traditional conference presentations and exhibition stands.The conversation explores how attendee feedback has shaped the event, including more hands-on learning opportunities, larger theatres and the introduction of a dedicated Business and Practice Leadership Theatre covering marketing, social media, insurance and clinic management.Jack also discusses the renewed partnership between Physio Matters and Therapy Show, highlighting the importance of genuine collaboration between organisations that share a commitment to raising standards in MSK care.Physio Matters will have its most substantial presence at the event to date, including live discussions with speakers, audience participation, interviews and opportunities for attendees to contribute their own perspectives on the profession.The episode also introduces the concept of the ultimate MSK week, combining Therapy Show on 25–26 November with the inaugural, sold-out MSK Awards on Friday 27 November.Throughout, Jack and Charlotte reflect on the importance of challenging established formats, listening to feedback and bringing together professionals with different perspectives.Ultimately, the message is that professional events should offer more than CPD points: they should create experiences, conversations and connections that genuinely advance the profession.

In this episode of Chewing It Over, Jack is joined by Andy McDonough, consultant physiotherapist and incoming co-chair of the Advanced Practice Physiotherapy Network (APPN), for a wide-ranging discussion about what advanced practice actually means.Andy argues that advanced practice is a level of practice, not a job title, profession or collection of technical skills. Being able to request imaging, take bloods or administer injections doesn't automatically make someone an advanced practitioner. The distinction lies in the clinical reasoning, diagnostic breadth, autonomy and responsibility underpinning those decisions.The conversation explores the increasingly contentious issue of undifferentiated patients, including debates about which professions should assess them and how physiotherapists can develop the knowledge required to manage more complex presentations safely.Drawing on his emergency department experience, Andy shares examples of serious pathology initially presenting as apparently routine MSK complaints, highlighting the importance of broad differential diagnosis, multidisciplinary supervision and knowing the limits of one's competence.Jack and Andy also examine the governance of advanced practice, including credentialing, professional regulation, education and the use of titles such as advanced practitioner and consultant physiotherapist.A particular concern is whether these titles can become misleading when used without clear standards or appropriate assurance, especially across different healthcare sectors.The discussion concludes with a call for stronger professional collaboration, transparent governance and greater recognition of the contribution physiotherapists can make across healthcare.Ultimately, advanced practice isn't about moving beyond physiotherapy. It's about demonstrating what physiotherapy can achieve at its highest levels.5 clinical/professional takeaways- Advanced practice is a level of reasoning, not a list of procedures. Taking bloods, requesting scans or delivering injections may form part of an advanced role, but the advanced component is knowing when those interventions are indicated, how to interpret the findings and what decisions follow.- Managing undifferentiated presentations requires diagnostic breadth. Patients don't arrive with confirmed diagnoses. Advanced practitioners must be capable of considering serious non-MSK causes of symptoms, particularly in settings such as emergency departments and first-contact services.- Supervision should extend beyond professional boundaries. Learning from medical colleagues and other disciplines can expose clinicians to different diagnostic approaches and improve their ability to manage uncertainty and risk.- Governance and titles matter. Terms such as advanced practitioner and consultant physiotherapist carry expectations for patients and colleagues. Their use should be supported by appropriate competence, accountability and transparent professional standards.- Advanced practice should strengthen physiotherapy identity, not obscure it. Progressing into complex diagnostic, leadership, research or governance roles doesn't mean leaving physiotherapy behind. Andy argues that clinicians should be proud to demonstrate what physiotherapists can contribute across healthcare.

CLICK HERE FOR SPLOSEIn this episode of Chewing It Over, Jack speaks with Nick, founder of Splose, about the evolution of practice management software, artificial intelligence and the challenges facing modern MSK clinics.Nick shares his unconventional journey from building websites for allied health professionals in Australia to developing an all-in-one practice management platform. After repeatedly encountering clinicians frustrated by disconnected systems, time-consuming documentation and inefficient administration, he decided to build something different.The conversation explores how Splose has evolved, particularly following the introduction of AI functionality in 2024. Its AI scribe now extends beyond simple transcription, incorporating patient histories, previous consultations and administrative information to support clinical documentation.However, Nick is clear that AI should support rather than replace clinical judgement. Jack challenges him on the future of automated objective assessments, the potential for increasingly sophisticated monitoring technologies and the risk of clinicians becoming complacent when reviewing AI-generated records.They also discuss Splose's expansion into the UK, where the complexity of private medical insurance billing initially presented unexpected challenges. Nick explains how partnerships with Healthcode and ePractice-related providers helped address these barriers.The discussion broadens into software development, customer feedback, investor expectations and the importance of maintaining a product-led philosophy while scaling a technology business.Finally, Nick identifies clinician burnout, administrative overload and financial pressures as major challenges facing allied health.Ultimately, the episode argues that the most valuable healthcare technology isn't necessarily the most autonomous. It's the technology that gives clinicians more time, attention and capacity to care for patients.5 clinical/professional takeaways- AI scribes are becoming much more than transcription tools. Integrating previous patient history, consultation information and administrative workflows could make documentation significantly more useful, rather than simply faster.- Clinical judgement remains essential. AI can help generate and organise documentation, but clinicians must still review and approve their records. Objective assessment is particularly challenging when important findings cannot be reliably captured through audio alone.- Automation introduces new risks as well as efficiencies. The easier it becomes to produce clinical notes, the easier it may become to approve them without sufficient scrutiny. Saving time must not come at the expense of clinical accuracy.- Practice management software needs to reflect local healthcare systems. Splose's experience entering the UK demonstrates how billing, private medical insurance and payment processes can become major barriers, even when the underlying clinical software is well received.- Reducing burnout requires more than technology. Administrative automation can reduce unnecessary work, but it cannot independently solve the emotional, professional and financial pressures facing clinicians. Education, mentorship and appropriate clinical support remain essential.

MSKAwards.comThank you to the absolute legend that is Adam Meakins for hosting Jack on his podcast to discuss the MSKAwards amongst other things like social media, the ineptitude of professional bodies and regulators as well as cowboys!MSKAwards Nominations close in 8 days (end of Sept) so click on the link and nominate yourself or a colleague/service for one of the 8 awards. Awards are open to NHS and non-NHS nominations plus the party will be absolutely fantastic so checkout the ticket options too. We will see you there!!

In this episode of Chewing It Over, Jack is joined again by Asaf Weisman for a deliberately challenging discussion about some of the prevailing ideas within modern pain science.Asaf argues that pain medicine has spent decades on a series of intellectual “side quests”, particularly following the development of the biopsychosocial model and modern definitions of pain in the 1970s. His criticism isn't that psychological, social or neurological factors are irrelevant, but that theoretical possibilities have sometimes been promoted with greater certainty than the evidence warrants.A central theme is nociception and the role of the brain. Asaf challenges descriptions of pain as simply an output of the brain or a neurological expression of perceived threat. Instead, he argues that pain requires underlying somatic signalling, while the brain participates in processing and modulating that experience rather than independently generating it.The discussion explores the language clinicians use around pain, the distinction between modulation and causation, and whether attempts to explain persistent pain have sometimes made the subject unnecessarily complex.Importantly, the conversation also identifies areas of agreement. Asaf accepts that psychological and social factors can substantially alter an individual's pain experience, even when underlying nociceptive signalling remains unchanged. Stress, context and other factors can influence pain through modulation.For clinicians, this creates a more practical discussion about management. Rather than becoming trapped in theoretical explanations, Asaf argues for identifying and addressing modifiable risk factors associated with persistent pain, while using exercise, modalities and other interventions where they help patients pursue meaningful activity.It's a provocative conversation that challenges clinicians not simply to replace one pain model with another, but to scrutinise the assumptions underneath both.Be precise about causation versus modulation. A psychosocial factor influencing the intensity of someone's pain doesn't necessarily establish that it independently caused the pain. That distinction is central to Asaf's argument.Don't turn theoretical models into established biological facts. Models can help generate hypotheses and guide research without every component of the model having been empirically demonstrated.The brain isn't being dismissed. Asaf's position is more nuanced than “pain is peripheral”. He explicitly accepts that the brain processes and modulates pain and that stress and psychosocial circumstances can change the resulting experience.Language matters clinically. Terms such as “pain output”, “threat”, “nociception” and “biopsychosocial” carry assumptions. Using them casually can make a proposed mechanism sound more established than it actually is.Don't let the theoretical debate distract from modifiable factors. Whatever model a clinician favours, the practical priority remains identifying things that can meaningfully be changed — including activity, physical health and relevant psychosocial stressors — and helping the patient address them.5 clinical/professional takeaways