Craig Liebenson Profile picture
Nov 21, 2020 18 tweets 27 min read Twitter logo Read on Twitter
@DerekGriffin86 LBP is complex & the social of BPS the code breaker between the dichotomization of pain science & biomechanics. I never got it when Waddell introduced Engel’s BPS model only focusing on biomechanics or YFs. Now I see social/environmental context as Job 1 to unmask. @_Tyson_Beach
@DerekGriffin86 @_Tyson_Beach “Kind Care Requires Unhurried Conversations
Health care providers must have time to know their patients in “high definition” to best meet their needs.”…
@DerekGriffin86 @_Tyson_Beach “psychological factors are only the tip of the iceberg. Social & contextual factors,which have largely been overlooked in sports medicine, directly impact health outcomes,well-being & sport injury recovery by facilitating or impeding health & health behaviour change” @LKTphysio
@DerekGriffin86 @_Tyson_Beach @LKTphysio “a shift to focus on the person is needed. This best practice approach will encourage clinicians to (1) focus on patients’ context and modifiable biopsychosocial factors that influence their pain and disability”… @jpcaneiro @JanHartvigsen @PeteOSullivanPT
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT “When a patient presents with disability, clinicians need to explore the influence of contextual elements related to the patient’s occupation (work) and social context (ie, family) on the patient’s painful symptoms and disability.”…
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT “contextual drivers...the social component of the BPS model is the weakest component of all current CSs for LBP & is scarcely mentioned in practice guidelines...Yet, like personal factors, environmental factors may have a significant influence on outcomes.” @chadcookpt
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “Patient-centred care incorporates each individual’s context, knowledge, needs, values, goals and preferences into shared decision-making about management.”…
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “Despite the development of critical thinking about PT, the assumptions of the still-dominant positivistic biomedical paradigm that values objective science above any other approach & sees the body-as-machine as a problem to be fixed, go unchallenged in the mainstream.”
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “person-centeredness entails listening and ‘being with’ rather than ‘doing to’ patients.” “effective person-centered practice means that “the clients expect from the professional to be an authority with regard to biomedical issues & to be a partner with regard to PS issues.”
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “it is not the person alone at its center, because rehabilitation is a social complex of practices that involves both the immediate stakeholders—patients, practitioners, family,& friends—and the macro-level of hospitals, politics, economics & taken-for-granted norms.”
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt “Research is needed to understand the contextual factors that may cue the practice of defensive medicine, identify when it is most likely to occur, and develop strategies to prevent or reduce its occurrence when it results in unnecessary care.” ……
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt…

@Peter_Stilwell work termed enactive gives a fresh scientific honest perspective on the Bio vs Pain Sci dichotomization. It’s not just blaming a disc or an output of brain but taking a broader approach.
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell Normally we try to simplify things in this case we try to appreciate the complexity. Of course the context is SOCIAL & this to me is where N=1 lives - their environment.…
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell “The recognition that each patient may present unique responses for a given health condition puts the client, his/her context and personal perspective at the center of the therapeutic process.” Image
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell “Traditional models of treatment prioritize remediation of defcits in structures & functions of the body, such as muscle strength & ROM. On the other hand, patients wish to improve their performance in activities they consider essential Image
@DerekGriffin86 @_Tyson_Beach @LKTphysio @jpcaneiro @JanHartvigsen @PeteOSullivanPT @chadcookpt @Peter_Stilwell “... for their physical, psychological & social well-being. Correction of deficits may benecessary to therapy, but it cannot be its ultimate goal,because it is not sufficient for the promotion of patients’interests.”…

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Craig Liebenson

Craig Liebenson Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @CraigLiebenson

Dec 28, 2022
PA affects life span as much as smoking
Read 56 tweets
Dec 5, 2021
1.Theres a lot of debate today in the LBP field specifically & musculoskeletal pain in general about manual therapy vs exercise. Motor control vs strength training. The role of patient education, etc.
2. The issue of client preferences is a no brainer to me as I’m in the trenches & validate my clients #livedexperience. I seek interaction & collaboration. @MyCuppaJo
3. This way I’m able to guide by the side & be an Alfred rather than a “fix it” Batman Superhero for them. @jasonsilvernail @MKargelaDPT…
Read 32 tweets
Mar 29, 2020
2) Zoom capped us at 100. Sorry. Anyone know how to let more in? HK, Norway, Belgium, Bolivia, Argentina ....
3) says it all
Read 16 tweets
Feb 15, 2020
Education is the first approach in evidence-based MS care
But l, education is poorly understood acc to Moseley which is why we do the Teach Back of which I’ve posted dozens online @PainRevolution
Evidence based reasurance & reactivation from Rehab of the Spine
Read 16 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!


0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy


3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!