
Saying the unsayable and thinking the unthinkable - a critical look forward with Prof. David Nicholls
11/25/20 • 98 min
Welcome to another episode of The Words Matter Podcast.
Today I’m speaking with Professor David Nicholls. David is a Professor in the School of Clinical Sciences at AUT University in Auckland, New Zealand. He is a physiotherapist, lecturer, researcher and writer, with a passion for critical thinking in and around the physical therapies.
David is the founder of the Critical Physiotherapy Network, an organisation that promotes the use of cultural studies, education, history, philosophy, sociology, and a range of other disciplines in the study of the profession’s past, present and future.
His research work focuses on the critical history of physiotherapy and considers how physiotherapy might need to adapt to the changing economy of health care in the 21st century.
He has published more than 35 peer-reviewed articles and 17 book chapters, many as first author. He is also very active on social media, writing more than 650 blogposts for criticalphysio.net in the last five years.
In 2017 he published the book ‘The End of Physiotherapy’ which is a critical history of physiotherapy, and is working on follow-up book called ‘Physiotherapy Othererwise’. He’s also just co-edited a book called ‘Mobilizing Knowledge in Physiotherapy: Critical Reflections on Foundations and Practices’.
His work on the professionalisation and socialisation of physiotherapy and crucially questioning where it’s come from and where It may be going (if going anywhere at all) resonates with my thinking about osteopathy and the social and historical circumstances which shaped its development and maintains its current practice.
In this episode we talk about:
- The role of qualitative research in helping to carve a new way of being as professionals and the revised values, identities and practices associated with this shift (including this paper by Elizabeth Adams St. Pierre on a 'post qualitative research' future).
- Building healthcare practice from the ground up with a new set of foundations and principles
- The tension which often finds its way into curricular when biomedical subjects sit alongside subjects social, psychological and humanistic topics.
- The person/body-as-machine and how this contrasts with a phenomenological view of the person of which he argues for.
- How critical theory has shaped much of his analysis and arguments of physiotherapy, such as the Impact of power on cultures, ideological-orientated enquiry (such as quantitative research), and the historical contexts within which actions takes place.
- The ‘physiotherapy paradox’
- The original questions asked by society and answered by physiotherapy and osteopathy, which catalysed the emergence and development of the respective professions.
- The social, political and economic structure which led to the development and subsequent maintenance of these professions.
- We then pose that if the original questions and needs of society have change then so should the shape, scope and purpose of professions.
- The post-professional era, which we may all be on the cusp of.
So this was a complete delight taking to David. His analysis of physiotherapy is forensic, yet the entire time he never once forgets the patient, and the front and centre role they deserve to play in both healthcare practice and purpose.
As you’ll notice when listening we wander (wade) thorough a range of related topics for over 90 minutes, and if wasn’t for the 11 hour time difference - with him needing to commence his day, and me needing to end it, we would have gone on.
Find Dave on Twitter @CriticalPhysio and @DaveNicholls3
If you liked the podcast, you'll love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.
Follow Words Matter on:
...
Welcome to another episode of The Words Matter Podcast.
Today I’m speaking with Professor David Nicholls. David is a Professor in the School of Clinical Sciences at AUT University in Auckland, New Zealand. He is a physiotherapist, lecturer, researcher and writer, with a passion for critical thinking in and around the physical therapies.
David is the founder of the Critical Physiotherapy Network, an organisation that promotes the use of cultural studies, education, history, philosophy, sociology, and a range of other disciplines in the study of the profession’s past, present and future.
His research work focuses on the critical history of physiotherapy and considers how physiotherapy might need to adapt to the changing economy of health care in the 21st century.
He has published more than 35 peer-reviewed articles and 17 book chapters, many as first author. He is also very active on social media, writing more than 650 blogposts for criticalphysio.net in the last five years.
In 2017 he published the book ‘The End of Physiotherapy’ which is a critical history of physiotherapy, and is working on follow-up book called ‘Physiotherapy Othererwise’. He’s also just co-edited a book called ‘Mobilizing Knowledge in Physiotherapy: Critical Reflections on Foundations and Practices’.
His work on the professionalisation and socialisation of physiotherapy and crucially questioning where it’s come from and where It may be going (if going anywhere at all) resonates with my thinking about osteopathy and the social and historical circumstances which shaped its development and maintains its current practice.
In this episode we talk about:
- The role of qualitative research in helping to carve a new way of being as professionals and the revised values, identities and practices associated with this shift (including this paper by Elizabeth Adams St. Pierre on a 'post qualitative research' future).
- Building healthcare practice from the ground up with a new set of foundations and principles
- The tension which often finds its way into curricular when biomedical subjects sit alongside subjects social, psychological and humanistic topics.
- The person/body-as-machine and how this contrasts with a phenomenological view of the person of which he argues for.
- How critical theory has shaped much of his analysis and arguments of physiotherapy, such as the Impact of power on cultures, ideological-orientated enquiry (such as quantitative research), and the historical contexts within which actions takes place.
- The ‘physiotherapy paradox’
- The original questions asked by society and answered by physiotherapy and osteopathy, which catalysed the emergence and development of the respective professions.
- The social, political and economic structure which led to the development and subsequent maintenance of these professions.
- We then pose that if the original questions and needs of society have change then so should the shape, scope and purpose of professions.
- The post-professional era, which we may all be on the cusp of.
So this was a complete delight taking to David. His analysis of physiotherapy is forensic, yet the entire time he never once forgets the patient, and the front and centre role they deserve to play in both healthcare practice and purpose.
As you’ll notice when listening we wander (wade) thorough a range of related topics for over 90 minutes, and if wasn’t for the 11 hour time difference - with him needing to commence his day, and me needing to end it, we would have gone on.
Find Dave on Twitter @CriticalPhysio and @DaveNicholls3
If you liked the podcast, you'll love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students.
Follow Words Matter on:
...
Previous Episode

Psychologically informed practice - How far we’ve come and how far we haven’t with Steven Vogel
Welcome to another episode of The Words Matter Podcast.
In this episode I speak with Steven Vogel. Steven is Deputy Vice-Chancellor (Research) at the University College of Osteopathy and Editor in Chief of the International Journal of Osteopathic Medicine.
He has twice been a member of National Institute for Health and Clinical Excellence (NICE) Guideline Development Groups formulating NICE clinical guidelines for back pain and sciatica.
Steven led the large Clinical Risk Osteopathy and Management (CROaM) study which examined adverse events and outcomes related to osteopathic interventions.
His main research interests focus on back pain, clinicians’ beliefs and attitudes and more recently, reassurance, communication and consent, safety and manual therapy, patient reported outcomes, self-management rehabilitation strategies used in practice with people with low back pain, and the effects of cognitive and affective reassurance.
In this episode we talk about:
- What constitutive ethical and professionally agnostic musculoskeletal care (see Steve's paper here).
- The early research into psychology of LBP, of which he was a crucial part (see here here and here).
- The cyclical nature of current arguments (hands on/of/psycho/manipulation etc).
- The different levels (fizzy drink scale) of psychologically-informed practice, and the psychological processes involved in clinical practice.
- The challenges of developing these skills in clinicians, and the questions up for debate such as 'what does it mean to be BPS orientated' and 'what sorts of training bests develops those competencies'?
- The frequent situation where psychological interventions have high face validity, make sense to us an clinicians but show small effect sizes when clinically trialled.
- We talk about his seminal 2013 systematic review work on cognitive and affective reassurance.
- Signs of progress and lack of progress of for PIP
- The challenge of measuring BPS-ness and the empirical actions and observable behaviours associated with such a clinical orientation.
Steven is is perhaps the most measured, rational and composed individual I know. He remains totally zen even when being faced with some the highest intellectual dishonesty in the manual-physical-osteopathy spheres.
It was an absolute pleasure speaking with Steve about his seminal work as a pioneer of psychologically-informed musculoskeletal care, and reflect on how far we have come and how much further we have still to go.
Find Steven on Twitter @UCODVC_Research
If you liked the podcast, you'll love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students (discounts for students available)
Follow Words Matter on:
Instagram @Wordsmatter_education @TheWordsMatterPodcast
Twitter @WordsClinical
Facebook Words Matter - Improving Clinical Communication
★ Support this podcast on Patreon ★Next Episode

Manual, manipulative, musculoskeletal or just therapeutic care? The journey so far with Dr Clair Hebron
Welcome to another episode of The Words Matter Podcast.
On this episode I’m speaking with physiotherapist, educator and researcher Dr Clair Hebron. Clair is Principal Lecturer at The University of Brighton, where she is course leader for the MSc Musculoskeletal Physiotherapy. As you’ll hear, Brighton University is how Clair and I know each other, where both of us were PhD students.
She has a special interest in musculoskeletal care and works with students and researchers exploring related areas such as health promotion, exercise prescription and conceptual research exploring understandings of more abstract ideas such as the therapeutic alliance, person-centredness and holistic care.
Clair has developed an interest in qualitative research methodologies such as phenomenological, phenomenographic and grounded theory approaches and utilising research integrating art, health and science.
So on this episode we talk about:
- Clair’s journey as a PhD student and her research exploring the dose-dependent effects of spinal mobilisation
- The personal challenges of applying reductionist research methods to a complex therapeutic intervention, but also how these experiences contributed to her current interest in phenomenological and conceptual research to explore a more complex and ambiguous topography of MSK practice.
- The false dichotomy associated with the hands on, hands-off debate in MSK therapy (see her 2017 paper here).
- Her rich and insightful qualitative work and how this research offers a perspective of the excellent work physiotherapists are doing but also where more changes need to occur
- Simple strategies to incorporates to start a more psychologically informed way of being as clinicians.
- Clair reads a powerful poem from a physiotherapist experiencing back pain, and the persons own feelings of guilt and embarrassment.
I had organically planned to talk with Clair about the current (but perpetual) debates within manual therapy, but was delighted not to dwell on previously well trodden discussions.
It was telling that a conversation by two MSK/manual therapists talked about the topics we did, and it is hopefully indicative of the journey individual clinicians and whole professions are making away from patients being mechanistic bodies needing fixing towards being people with complex situations, histories and experiences needing support.
Find Clair on Twitter @C_Hebron
If you liked the podcast, you'll love the Words Matter online course in effective language and communication when managing back pain - ideal for all MSK therapists and students (discounts for students available)
Follow Words Matter on:
Instagram @Wordsmatter_education @TheWordsMatterPodcast
Twitter @WordsClinical
Facebook Words Matter - Improving Clinical Communication
★ Support this podcast on Patreon ★If you like this episode you’ll love
Episode Comments
Generate a badge
Get a badge for your website that links back to this episode
<a href="https://goodpods.com/podcasts/the-words-matter-podcast-with-oliver-thomson-130070/saying-the-unsayable-and-thinking-the-unthinkable-a-critical-look-forw-10005182"> <img src="https://storage.googleapis.com/goodpods-images-bucket/badges/generic-badge-1.svg" alt="listen to saying the unsayable and thinking the unthinkable - a critical look forward with prof. david nicholls on goodpods" style="width: 225px" /> </a>
Copy