Sports Therapy Community Streamed

Ep2 Easy ways for Sports Therapists to understand pain science - Jamie Johnston

May 08, 2020 Kristian Weaver Season 1 Episode 2
Sports Therapy Community Streamed
Ep2 Easy ways for Sports Therapists to understand pain science - Jamie Johnston
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Sports Therapy Community Streamed
Ep2 Easy ways for Sports Therapists to understand pain science - Jamie Johnston
May 08, 2020 Season 1 Episode 2
Kristian Weaver

In this episode I am joined by Jamie Johnston to discuss pain science and how it impacts upon Sports Therapy practice.

If you want to Become An Unstoppable Sports Therapist then visit www.sportstherapycommunity.co.uk

To find out more about Jamie Johnston:
Website: www.themtdc.com
Facebook:
Jamie M Johnston and @theMTDC1
Instagram:
@jamiejohnston4 and @themtdc
Twitter:
@Jamie_MTDC



Show Notes Transcript

In this episode I am joined by Jamie Johnston to discuss pain science and how it impacts upon Sports Therapy practice.

If you want to Become An Unstoppable Sports Therapist then visit www.sportstherapycommunity.co.uk

To find out more about Jamie Johnston:
Website: www.themtdc.com
Facebook:
Jamie M Johnston and @theMTDC1
Instagram:
@jamiejohnston4 and @themtdc
Twitter:
@Jamie_MTDC



Kristian Weaver:   0:00
Welcome to the Sports Therapy Community Streamed the place where Sports Therapy Practitioners can get useful on actionable advice from industry leading experts from sports medicine to psychology to business. Here is your host Sports Therapist, exercise physiologist and creator of the Sports Therapy Community Kristian Weaver. Hello, welcome to podcast Jamie Johnson. Today we're going to be talking about pain science. So, Jamie, if we're in a clinic with you for 60 seconds, tell us who you are and what you do.

Jamie Johnston:   0:34
I'm a registered massage therapist in Victoria, British Columbia. Before I was a massage therapist, I was industrial first aid attendant in a sawmill and have been a firefighter for the last 18 years. So I do that two days a week, and I work in the clinic two days a week. Ever since I started as a therapist, back in 2011 have been pretty heavily involved in sport. So I worked with the local hockey team for seven years and the National Rugby Men's rugby Sevens team. I have been with the Canadian women's development program for the last five years. 

Kristian Weaver:   1:19
You really busy with the the ice hockey and all that going on? So how do you fit it in? 

Jamie Johnston:   1:26
Well, unfortunate with hockey, I like working Canada because it's just a couple times a year. So we usually have a camp in August in Calgary. So little there for 2 to 3 weeks and just do the camp. And then, depending on which team I end up with usually in January or like and a December beginning in January, usually world championships or something like that if I'm with the under 18. So I was in Slovakia this last year doing that, so it's just a couple times a year to go with them.

Kristian Weaver:   1:57
Great stuff. So as sports therapist or therapists, and we also need to know about pain science. So, can you just expand on that and what you should have understand by pain science.

Jamie Johnston:   2:08
Once it's kind of funny because you know what a people think that it's a new technique or something like that, which it isn't. It's Ah, it's more understanding, um, understanding how pain works in the body but also understanding that there's things other than just tissue damage that influence a person's pain. So,, I think a really good example is we look at the bio psychosocial aspects of pain. So if we were to look and just because my experiences in hockey, if we were to look at a player who maybe is out with a concussion in the old days, it was always that you put them in a dark room and you keep them away from everything. Were as now? We've started to understand that that's not really beneficial for some people with concussion, Um, so we look at things like, you know, the psychosocial aspects of it  or you know, are they still doing things with the team? Did they still have that social surrounding and the support of their team while they're dealing with in injuries like the concussion? Are there psychological factors that are influencing the level of pain that that person is experienced or that athlete is experiencing? So you know, and quite often it can be that you look at, like an old injury that they used to have. and then they get injured again. And they automatically think that it's the same as that old injury that they've rehabbed and got back. So there's a whole bunch of things kind of around it that when it comes to pain science that we that we look at that it's not just tissue damage that's causing a person's pain. There can be several other things that influence the level of pain or the duration of came that experience. 

Kristian Weaver:   3:44
I suppose that becomes more complex when we're talking about long term injuries, which are meaning that play is going to be out for a prolonged period of time?

Jamie Johnston:   3:54
Yeah, yeah, especially when we start to look at things that are maybe chronic pain. And I think like a good example is remember dealing with an athlete once who who had a torn ACL and then didn't opt for surgery and rehabbed it took like a year to rehab it and then got back to playing again and then took a big check on the ice and instantly felt pain in their knee that they hurt their knee and was coming off the ice. And the player was going, Oh, God, not again thinking that automatically that it had to be an ACL injury, which in this case, it wasn't so they were back playing again within two games because they had done the appropriate rehab and it wasn't enough of an injury to the ACL or anything like that. But the player automatically associated that me paying with Oh, God, I'm going to go through this again when that wasn't the case.

Kristian Weaver:   4:44
Yeah, I think sometimes we do have players who have gone through that sort traumatic injury and then when they are returning, obviously every little thing that they're almost analyzing and that they're taking that forward based upon previous experience. So we also need to take that into consideration is therapist too?

Jamie Johnston:   5:02
Totally and and I think, like, you know, one of the things that when I teach courses and things like that, but I always talk about is like look at the other things that might be influencing what's going on with this person. So if we look at a an 18 year old kid, and like I say for me, it's it's always been hockey, but it would be the same in any other sport, texture that. You know, you look at the things that could influence them while they're out injured. They might be looking and going oh, this is going to screw up the scholarship I was trying to get. This is going to screw up me being drafted. This is gonna, you know, this is gonna hurt my career down the road, and those are all sort of the psychological things that we that we need to take into account that somebody might be dealing with when they're going through and and dealing with an injury or rehabbing an injury. Um, so there are definitely things that we need to, you know, chat with them about, and maybe they need some help on the psychological side.

Kristian Weaver:   5:51
So obviously you spoke about some chronic pain type patients. So have you come across many of those patients? But in clinical practice, and if so, what seems to be the major issues associated with that?

Jamie Johnston:   6:02
Um, yeah. I have treated a lot of people chronic pain over the years. And I think one of the things that happens is perhaps the car accident or they had an injury that was maybe two years ago, and yet they're still experiencing pain. Um, we know if we look at the healing timelines and things like that, that if there was tissue damage that by that point the tissue had healed. So there should be no reason for the person to have pain from a tissue damage standpoint. But for whatever reason, you know something happens that makes the brain keeps sending on a pain signal. Um, and they're still experiencing pain a couple of years later. Um, so one of the things that I find that happens is, you know, they come in and let's just say that two years ago they were having pain in middle of their back, and they went to a practitioner who may be said something to them like, Oh, you're ribs is out. So that's why you're experiencing pain. And then every time they feel pain in that area, they automatically correlated to being Oh, it's because my rib is out. So I've had lots of chronic being patients over the years that have come in and you know that right away they're like, Oh, I know my rib must be out again because of having pain in that area, whereas we know that it really doesn't actually go out. So quite often it can be because of a narrative or a story that they've been told. That sort of keeps that pain cycle going, Um, but for, you know, for whatever reason, these poor people are dealing with pain when they shouldn't be anymore. But quite often that narrative, I think, is one of the things that perpetuates them, still experiencing pain.

Kristian Weaver:   7:35
I think there have been some research articles around the spinal pain haven't there where actually, nerves could become more sensitized, and it doesn't necessarily mean that they're still pain their but it does manifest itself almost in the patient experience in pain because of increased sensitivity around around the radicular nerve, for example?

Jamie Johnston:   7:54
Yeah, yeah. When people are experiencing centralization, um, for for whatever reason on we don't always know the reason, but they go on and experience this pain. And quite often it's it's gonna be our job to educate them as to maybe why they're still experiencing some pain and then what they can do to help that, um, the central sensitization or whatever things that they have going on. And I'm I know talking to some people that are way smarter than I am that I have learned from, they said that quite often people who deal with chronic pain will have moments throughout the day where they're not experiencing pain. And if we can kind of shift their attention to those moments and start to focus on that, then we have got a better chance of being able to help them when they're dealing with pain throughout other parts of the day.

Kristian Weaver:   8:42
Yeah, fantastic in that almost brings me on to the next question. Really, Which is Is there anyone that you can point is in the direction of that we should really be looking at on a sort of identifying with in terms of the leaders in pain science at this moment in time or any articles that which have maybe come out with which we could have a look at?

Jamie Johnston:   9:00
Yeah, the Noi Group out of Australia are really leaders in the whole pain science realm. So looking at guys like David Butler and Lorimer Moseley. Those are both guys that I've learned a lot from my reading, their stuff and they have a book called explain pain supercharged, which is intended for practitioners to understand pain better and to be able to communicate with patients better about pain. Um, and they they do a tonne of great work in Australia.  I've talked with Lorimer before. They do a thing every year where they, uh, they get on their bikes and they go to  what they called they bush in Australia. But he basically what they're doing this they're going to rural communities within Australia. They've identified a lot of those communities as ones that have a disproportionately high amount of opioid usage. And so what they do is they picked these rural communities and they do a big bike ride there to raise money for it, and they go and they'll just educate people about pain for the weekend. And they don't necessarily go in and do any hands on manual therapy with them. They just go in and educate pain. And I believe the last numbers I saw is they've reduced opioid usage in those communities by something like 80% just by educating the general population about pain and how making manage pain and my pain isn't necessarily a bad thing. It's, you know, it's an important part of our life. So those are some really great guys to follow. So they an organization called the Noi Group is which is NOI,  so if you can follow their stuff, they they're right up on the pain Science research.

Kristian Weaver:   10:38
Great. I think you've hit a key topic at the moment. Education of patients obviously having to communicate more with patients at this moment in time. Education is a major part of that. So is it all really about education and listen to the patients in terms of understanding what they're going through in terms of pain, pain science?

Jamie Johnston:   10:58
Yeah, yeah, when we look at the research papers on first, for instance, the clinical guidelines of low back pain and how we treat it the steps that are laid out are to reassure the patient, educate in movement is massive because you got somebody who comes in and experiencing pain and they have a belief that they're broken for whatever reason, reassuring them that they're gonna be okay and reassuring them that, you know, their whatever painted is they're dealing with isn't necessarily some huge catastrophic injury. Maybe it's just something simpler and we can you know, you strategies and then educate them on things that they can get out of pain and get moving again and why movement is important. Um, so I think if we looked at any musculoskeletal injury, if we if we took the same approach and just reassured the patient educated got the moving, we'd probably have a lot greater success as Therapists.

Kristian Weaver:   11:52
Excellent. So obviously, you sit within the sports therapy community, but you also host your own community as well. So, do you just tell us a little bit more about what your community involves?

Jamie Johnston:   12:02
Sure, it's built around pain, science and therapeutic exercise, and one of the reasons is because I teach a live  course, with a buddy of mine. And one of the reasons that we put it together is t give massage therapist more confidence when it comes to doing therapeutic exercise in rehab with patients because it's, I know, in some areas, exercise isn't necessarily in the scope of practice for some massage therapists but for where we are in Canada and British Columbia, it's well within our scope. But we've found a lot with um talking to other massage therapists that they would quite often refer out to a physiotherapist or an athletic therapist or something like that to do the exercise end of things. Whereas most of it we can just do right in our clinic room. And it doesn't mean that you have to have, you know, ah, bar bell or a squat rack and all these other things in order to help rehab. You know what is fairly simple injuries? So that's a lot of what my communities about is just helping other therapists understand pain better. And then how to build a really have program with a patient and, you know, the stages of healing. And then you know how to go through an isometric, concentric eccentric loaded exercise with patients when they're on your table. So that's a lot of what we focus on a membership. And then, you know, lately we've been doing lots of interviews with with different people for the members so that they can understand, you know, different aspects. For instance, we had Ronnie Thompson a week or two ago talking about motivational interviewing and then have my friend Keith Meldrum come on to talk to us about the patient experience and what it's like for a chronic pain patient and what they go through and how if we can understand what they're going through better, we'll be able to provide better care for those chronic pain patients and people who are dealing with that.

Kristian Weaver:   13:47
Fantastic. So you given there's lots of information there, Jamie, lots really high quality information regarding pain. So if any of our listeners want to find out more about you, where could they go?

Jamie Johnston:   13:57
My websites a good one. So it's the mtcd.com. And then, by all means on Facebook personal pages just standing Jamie M. Johnston and then I'm on instagram and Twitter and those things as well. Um, the two instagram accounts ones for the blog and one's my personal one, you know, coming up to courses and things like that.

Kristian Weaver:   14:26
We'll put links to those all within the show notes so that then everyone in the community can access those and be able to go through to your website and have a look at the great things that you're doing. So just to finish off on their can just tells like three take way messages for sports therapists moving forward in their clinical practice?

Jamie Johnston:   14:45
Well, sure, I think I think one of the big thing is as sport therapists, quite often it's not necessarily a clinical practice that we're working, that we're working sidelines at sporting events and things like that. So, in my opinion and from my experiences as a first responders, I think that's actually the number one thing that you need to be really good at is being a first responder recognizing, you know, mechanism of injury and things like that, being able to help people, whether they're on the field or on the ice. You know, whenever you're chosen sport is that you work in. But because I think that's one thing that sets the sports therapist apart from your other average therapist is because we gotta be able to deal with, like maybe a severe traumatic injury that could happen to an athlete. So I think the number one thing that we need to focus on is not necessarily in technique but being really good first responders to be able to help those those people out when they get hurt. And I think the second thing is just to not be a jerk. Um, there's there's been so many times over the years work in sport that I watched people come in and they've got a job title and they think that they're better than you, what at whatever they're doing. And you know you're there as a team, just like the athletes are your you're there to work as a team together. So just, you know, treat every therapist with respect, recognising that we will come in with different skill sets in and different abilities. And you might be better than me at one thing, and I might be better than you at another thing. But that doesn't mean you that you shouldn't treat each other with respect and and work together and do your best work together. So that's kind of a long and short of it. I've just seen over the years where you know I've watched one practitioner looking another practitioner in and literally say, you know, what you're doing doesn't work only what I do work so you can kind of go sit over there. It's like, no, and and typically those people don't end up getting invited back to work with sports teams and things like that because it sort of gets they get weeded out fairly soon. So I think just going in with and having that collaborative viewpoint and being willing to work together with everybody, Um and I think the 3rd one is just not letting your ego get in the way. I remember the first camp that I went and worked with Hockey Canada that we had a conference call before we went out and and Mel Davidson, who was the general manager at the time. She said, You need to check your ego at the door. She said, You're all being invited out here because you're the best at what you do. Um, you wouldn't get here if you didn't have an ego. But you need to check your ego at the door because we all need to come out here and you're all gonna fulfill a specific role. And she made some great points where she said, you know, um, you might be the head trainer of the team you work with at home, but when you come here, we've got a specific role that we need you to fulfill, and you might not be the head trainer, but we need you to fulfill that specific role to the best of your ability. So, um, yeah, she was very much leave your ego out the door, which I think is gonna be important, no matter what sport you're working in, that goes back to the point I was making before about not being a jerk. Checking your ego at the door and being willing to work together and fulfill the role that you've been brought in to do. Uh, it's probably think is important for any sport therapist

Kristian Weaver:   18:05
Excellent, Jamie. Thank you very much for coming on the show and hopefully, our listeners will go and find out some more about you over on your website on on your social media handles.

Jamie Johnston:   18:15
Yeah, no problem. And I really appreciate you having me on it's an honor. Appreciate that you asked me

Kristian Weaver:   18:22
Join the most powerful and professional network specifically for sports therapists. Visit sportstherapycommunity. co. uk