Hypermobility Spectrum Disorder (HSD) & Hypermobile Ehlos-Danlos Syndrome (hEDS) are conditions that can often come with a variety of symptoms, well beyond being someone being extra flexible and having regularly dislocating joints.
They can also be quite difficult and controversial conditions to discuss for various reasons, hence even more important they are discussed here.
On this episode Ben is joined by Anna Higo, Specialist Physiotherapist & Speaker in Hypermobility Syndromes, where they discuss:
(00:00) – Are Those With HSD or hEDS more likely to suspecttheir diagnosis compared to other patient groups?
(05:04) – Managing These Conversations With Children & Parents
(10:26) – Hypermobility As We Age
(13:03) – POTS, Long COVID & Hypermobility
(16:08) – Explaining HSD & hEDS
(22:18) – Getting Exercise Buy-In
(27:09) – How To Discuss Lycra/Compression Garments
(34:13) – The Importance Of Getting Family On Board
(35:33) – Managing Emotions When Someone Feels They FulfilhEDS Criteria But Don’t
(39:20) – What May Change On The Upcoming hEDS Criteria Update
(41:50) – The Future Of HSD & hEDS
hEDS Criteria (2017):
https://www.ehlers-danlos.com/wp-content/uploads/2017/05/hEDS-Dx-Criteria-checklist-1.pdf
hEDS Together:
You can find Anna on LinkedIn, Facebook & X @higo_anna
You can find Ben across social media @BWhybrowPhysio
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Meniscal tears can be a significant knee injury with different treatment options available depending on a variety of factors, but how do we help patients understand the injury and management options available?
On this episode Ben is joined by Carl Clifford, Lower Limb Advanced Practice Physiotherapist, and Dr Michael Cooke, Sports Medicine & Emergency Care Consultant, both from Simply MSK where they discuss:
(00:00:00) – How Does Sports Medicine Work Life Balance Compare To NHS
(00:01:56) – What Made Them Interested In Their Specialities
(00:03:54) – Why Is The Meniscus 2nd Place To The ACL In Clinical Interest?
(00:06:16) – The Upcoming ACL Cross Bracing Lecture
(00:10:37) – How To Explain Acute Meniscal Tears
(00:16:32) – Managing Locking Beliefs
(00:22:00) – Does The Conversation Change With Athletes?
(00:24:58) – How To Discuss Management Options For Meniscal Tears
(00:34:48) – Repairing Meniscal Tears Over Meniscectomies
(00:36:44) – Discussing Non-Invasive Options
(00:38:59) – Managing Meniscal Tear Beliefs
(00:42:50) – Shared Decision Making With Degenerative Meniscal Tears
(00:45:50) – Discussing Long Term Expectations With Meniscal Tears
(00:53:55) – The Future For Meniscal Injury Care
(00:57:45) – More Info On Simply MSK
(01:01:45) – Difficult Conversations With Meniscal Tears
You can find Carl & Mike on LinkedIn
Carl is on Instagram @theknee_phys
You can find Ben across social media @BWhybrowPhysio
You can find more information about Simple MSK here:
ACL Cross-Bracing Event:
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Shoulder dislocations and instability can affect patients ofmany ages, particularly in early adulthood or with aspiring athletes.
How can we help these patients address the fears & uncertainties of having an unstable shoulder?
On the episode Ben is joined by Edel Fanning, shoulder specialist physiotherapist with a PhD in relation to shoulder instability where they discuss;
(00:00:00) – What Made Edel Pick Shoulders?
(00:03:26) – Is Social Media Improving Speed Of Research Uptake?
(00:08:35) – How Edel Finds Managing Both Athletes &Chronic Shoulder Pain
(00:10:37) – Managing “Impingement” & Other DifficultBeliefs
(00:22:30) – Helping Patients Understand How Other FactorsInfluence Their Shoulder Instability
(00:24:30) – Conversations With Children & Parents AboutInstability
(00:27:51) – Utilising Different Clinicians Who May Suit ThePatients Personality Better
(00:30:11) – Instability, Pain & Strength
(00:33:36) – Using VR For Shoulder Instability Rehab
(00:36:08) – Graded Exposure For Shoulder Instability Rehab
(00:37:27) – How To Answer “Will It Dislocate Again?”
(00:46:53) – Long Term Affects Of Shoulder Instability &Fixations
(00:48:12) – How To Help Teenagers Understand Instability
(00:50:58) – Discussing Labral Injuries With 40-50 Year Olds
(00:57:03) – Having Long Term Career Discussions WithAthletes On Shoulder Instability
(01:00:30) – Edel’s Hardest Clinical Conversations
(01:11:20) – The Future Of Shoulder Instability
You can find Edel on LinkedIn
Predictive Reoccurrence Instability Scale
https://pubmed.ncbi.nlm.nih.gov/32736499/
You can find Ben across social media @BWhybrowPhysio
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This episode is different to all the others.
Every Clinical Communication episode so far has been around communicating and interacting with patients.
This episode is on how we interact with each other and thesignificant effect it can have on our own wellbeing, the team around us and our patients.
On this episode Ben is joined by Dr Chris Turner, A&EConsultant and Co-Founder of “Civility Saves Lives”, an initiative to help enhance teamwork and civility in healthcare.
Where they discuss:
(00:00) – Chris’s TED Talk Experience
(10:27) – The Power Of Apology
(20:39) – Do People Struggle To Apologise?
(25:38) – The Dilemma Of Blame
(32:43) – What If We’re On The Receiving End Of Blame
(40:25) – Are We Becoming More Civil? & The Purpose Of Civility
(44:15) – More Info On Civility Saves Lives
(51:32) – Iron Maiden or Judas Priest?
You can find Dr Chris Turner on LinkedIn, more informationabout “Civility Saves Lives” is here: https://www.civilitysaveslives.com/
You can find Ben across social media @BWhybrowPhysio
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Exercise and activity are one the pillars for improving overall health and well-being, but how can we encourage people to stick with it?
On this episode Ben is joined by Sue Julians, staff writer for MSK Mag and Physio, where they discuss one of her articles earlier in the year on exercise adherence, including:
(00:00) Introduction
(00:40) – How Sue Became An MSKMag Writer
(05:05) – What Inspired Her To Write About Exercise Adherence
(09:11) – Self-Determination Theory
(11:21) – Enhancing Autonomy
(15:12) – Relatedness & How To Enhance It
(18:46) – Enhancing A Feeling Of Competence
(20:54) – The Effect Of The Environment On Exercise Behaviour
(23:11) – Personality Types & Exercise Adherence
(32:47) – The Effect Of Age On Exercise Adherence
(38:08) – The Effect Of Hormones On Exercise Adherence
(39:57) – Sue’s Hardest Clinical Conversations
(42:41) – The Future Of Physio
You can find Sue on LinkedIn
You can find Ben across social media @BWhybrowPhysio
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Cervical Myleopathy is a rare but very serious condition,which can result in rather difficult conversations, including around surgery and discussing long term expectations that could significantly affect someones life.
On this episode Ben is joined by Dr Ben Davies, Neurosurgeon& Academic Researcher into Cervical Myleopathy where they discuss;
(00:00) – Intro
(00:44) – What Made Ben Choose Myelopathy & Kept Him Interested In It
(03:49) – Why Is Myleopathy Not As Popular As A Research Area
(05:29) – What Happens In Cervical Myelopathy
(06:50) – Is Myelopathy Preventable?
(07:22) – The mJOA For Decision Making
(08:46) – How To Explain Myelopathy To Patients
(13:30) – How To Discuss Myelopathy Management Options
(22:22) – Setting Expectations For Surgery
(24:28) – Will It Inevitably Get Worse?
(26:02) – How To Discuss Recurrence After Surgery
(28:03) – Make Patients The Experts In Their Own Condition
(30:52) – Ben’s Hardest Conversations
(35:45) – The Future Of Myelopathy
You can find Dr Ben Davies on LinkedIn or here https://myelopathy.org/
You can find Ben Whybrow across social media @BWhybrowPhysio
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It's time for the 4th Bonus Content featuring extra content from recent guests including:
David Alderton (00:42):
If Doing Nothing Is Always An Option, Is There Always A ChoiceIn Shared Decision Making?
Derek Griffin (06:06):
Achieving Buy-In For Pacing, Finding The "Why" Behind Someones Activity Behaviour & Fibromyalgia Stigma And Beliefs
Pauline-Clare Callaghan (14:00):
Pregnancy & Endometriosis
Lianne Wood (22:02):
Challenges when trying review to review papers on exerciseadherence
Vincent Kortleve (24:59):
How Have Healthcare Clinicians Communication Skills Changed Over The Years
You can find Ben across social media @BWhybrowPhysio
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Clinicians are becoming more aware of the importance ofcommunication skills in clinical practice, but this doesn’t mean things always go to plan.
On this episode Ben is joined by Vincent Kortleve, who is a published author and educator in communication skills, as well as being a trained Psychologist and Physiotherapist.
On this episode they discuss:
(00:00:00) – Intro
(00:00:49) - How Much Has Vincent’s Communication Skills Teaching Changed Over The Years
(00:04:17) - Vincents Book “Communication Skills For Physiotherapists”
(00:06:04) - The Four Communication Pillars In The Book
(00:08:27) - Building Rapport In Life Doesn’t Mean You CanBuild A Therapeutic Relationship
(00:12:44) - Managing Emotional Conversations
(00:13:55) - What A Coaching Conversation Looks Like
(00:19:40) - Managing Resistance To Change
(00:24:29) - The Communicative Detective
(00:27:47) - When Open And Closed Questions Aren’t Used Correctly
(00:36:00) - Don’t Assume The Message You Discuss Is What IsTaken In
(00:42:53) - Vincents Hardest Clinic Conversations
(00:49:03) - Managing Quick Fix Expectations
(00:53:30) - Vincent’s View On The Future Of Communication Skills
Vicent’s book “Communication Skills For Physiotherapists” isavailable in English, Dutch & Spanish.
You can find him on LinkedIn & X @CommunicatorPT
You can find Ben across social media @BWhybrowPhysio oremail clinicalcommunication@outlook.com
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Exercise is one of the most common treatment suggestions for low back pain. Yet outcomes in the research are variable.
What are some of the contextual factors that can influence the outcome of using exercise to treat low back pain?
And how much does adherence really matter?
On this episode Ben is joined by Lianne Wood, Senior Research Fellow at the University of Exeter and Advanced Practice Physiotherapist, where they discuss:
(00:00) – Introduction
(00:58) - Lianne’s Realist Review Into Contextual FactorsFor Back Pain & Exercise
(04:08) - The Role Of Trust & Trying To Measure It
(07:16) - The Effect Of The Patients Confidence In Their OwnAbility & In The Clinicians Knowledge
(09:53) - Did Motivation To Adhere Influence Outcomes?
(11:32) - The Importance Of Individualised Input
(12:53) - The Limitations Of Current Adherence Evidence
(16:06) - The Review Into Back Pain Outcomes & AdherenceTo Exercise
(20:22) - Different Ways To Measure Adherence
(23:05) - Bias In Exercise Studies
(24:45) - The Effects Of Beliefs On Exercise Outcomes
(29:30) - The Importance Of Thinking Deeper With ExerciseFor Pain
(33:25) - Lianne’s Hardest Clinical Conversations
(38:24) - The Future For Exercise Adherence Research
Lianne’s Two Papers Discussed:
Contexts, behavioural mechanisms and outcomes to optimisetherapeutic exercise prescription for persistent low back pain: a realistreview (2024)
https://pubmed.ncbi.nlm.nih.gov/38176852/
Exercise adherence is associated with improvements inpain intensity and functional limitations in adults with chronic non-specificlow back pain: a secondary analysis of a Cochrane review (2025)
https://pubmed.ncbi.nlm.nih.gov/40175237/
You can find Lianne on X @WoodwicksLianne and LinkedIn
Her research profile is here:
https://experts.exeter.ac.uk/39689-lianne-wood
You can find Ben across social media @BWhybrowPhysio oremail clinicalcommunication@outlook.com
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The use of stem cells to treat various medical issues includingjoint pain is gaining more and more awareness, which means patients are asking about them more frequently.
Yet most of us know very little about them, so how should weanswer the questions that commonly come up?
On this episode Ben is joined by Dr Ansar Mahmood, Consultant Orthopaedic Trauma Surgeon and American Board Certified in Regenerative Medicine, where they discuss:
(00:00:00) - Introduction
(00:00:59) - The history of stem cells, what they do & how they work
(00:13:02) – Sleeper stem cells
(00:15:36) – Delays in research to practice
(00:17:08) – The intelligence of stem cell function
(00:20:20) – What expectations should be given for stem cell injections for joint pain
(00:21:30) – Different regulations for stem cell implementation
(00:28:40) – When might we see stem cells for joint pain being used in the NHS?
(00:31:12) – What is pharma trying to do with stem cells?
(00:35:32) – The biggest drivers for research development: collaboration & AI
(00:41:43) – The risks of stem cell injections & production
(00:47:15) – Setting expectations for the length of stem cell injection effect
(00:54:38) – Future joint preservation clinics
(00:57:03) – Will stem cells eradicate steroid injections?
(00:59:17) – Dr Mahmoods social media and courses
You can find Dr Mahmood on LinkedIn and Instagram @dransarmahmood
The Kyzn Clinic – www.kyzn.co.uk
The Academy of Regenerative Medicine - https://abrm.thearm.co.uk/ or @RegenAcademy on social media.
You can find Ben on social media @BWhybrowPhysio or email clinicalcommunication@outlook.com
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It is estimated over 190 million women around the world haveendometriosis, and with awareness increasing and more management options becoming available, those with the diagnosis may have more questions than ever before.
On this episode of clinical communication Ben is joined by Pauline-Clare Callaghan, Specialist Pelvic Health Physiotherapist and Educator with Endometriosis UK. On this episode they discuss:
(00:00) - Introduction
(01:00) - The dangers of the edometriosis MRI report
(03:07) - Why does it take so long to diagnosis
(03:39) - The pros and cons of social media for endometriosis
(04:25) - Endometriosis specialist centres
(04:46) The variety of endometriosis presentations
(06:24) - How to help your patient understand endometriosis
(14:09) - How to manage endometriosis surgical beliefs
(17:51) – Conversations around intimacy related pelvic pain
(23:12) - How to achieve buy-in for non-surgical treatment
(25:05) - Managing different cultural sensitivities in pelvic pain
(26:12) - Prehabilitation for endometriosis surgery
(27:10) - Adenomyosis
(28:00) - Pain persisting after endometriosis surgery & injustice
(29:44) - Managing questions about genetic risk with endometriosis
(31:20) - Is endometriosis awareness improving?
(32:36) - Paulene-Clare’s hardest conversation
(38:54) - Memorable improvements with non-invasivemanagement
(41:15) - The future of endometriosis care
You can find more about Endometriosis UK and their work here:
https://www.endometriosis-uk.org/
You can find Ben across social media @BWhybrowPhysio or emailclinicalcommunication@outlook.co.uk
Shared decision making appears in almost every clinical guideline — but in the real world of clinical practice, how often do we actually do it well?
In this episode of Clinical Communication, Ben is joined by David Alderson, Senior Lecturer at Sheffield Hallam University and Specialist First Contact Physiotherapist, whose specialist interest is shared decision making during consultations. They explore how clinicians can genuinely share decisions with patients. From practical strategies to common pitfalls, andinsights that can help you make consultations more collaborative and patient centred.
They cover:
(00:00) Intro
(01:18) The choice dilemma in shared decision making
(05:06) The “Mum Test” for shared decision making
(06:46) Are clinicians doing as much shared decision making as they claim?
(07:58) How the ICE questions guide shared decision making conversations
(15:23) How to manage expectations when they can’t be met
(16:28) What to do when many management options exist
(19:07) How to spot and manage your own biases in shared decision making
(23:08) When to mention doing nothing as an option
(25:40) Are clinicians willing to do nothing?
(28:11) How to use stats without steering the patient’s decision
(31:53) What to do when patients don’t want to be involved
(35:49) Two powerful questions every clinician can use in shared decision making
(39:29) David’s hardest clinical conversation
(46:29) Will shared decision making change with AI?
(48:42) David’s course: Essential Consultation Skills for FCPs
🔗 Resources & Links
Essential Consultation Skills for FCPs – MACP Event
Do we really allow patient decision-making in rotator cuff surgery? Torrens, Miquel & Santana (2019) Open Access Paper
📲 Connect with David on LinkedIn
📲 Connect with Ben across social media@BWhybrowPhysio and on LinkedIn
📩 For teaching, mentoring & more:clinicalcommunication@outlook.com
Fibromyalgia can be a tricky condition to discuss as variousopinions on it exist across society and evidence around it is always evolving.
Thankfully on this episode Ben is joined by Derek Griffin,Specialist Musculoskeletal Physiotherapy and International Speaker on persistent pain management, especially Fibromyalgia. On this episode they discuss:
(00:00:00) - Introduction
(00:01:15) - Awareness Of Fibromyalgia In Society
(00:07:07) - How To Help Someone Understand Fibromyalgia
(00:25:38) - Should We Explain It The Same If It’s SecondaryFibromyalgia?
(00:32:06) - When Discussing “Sensitivity” Can Backfire
(00:40:26) - The Importance Of Picking Up On Visible Cues
(00:52:58) - What To Say When They Ask: “Will This Get Better?”
(00:58:26) - The Importance Of Acknowledging & DiscussingFlare Ups
You can find Derek:
On Instagram - @derek_griffin_phd
On X - @DerekGriffin86
And on LinkedIn
You can find Ben & Derek’s Therapy Live Pain MasterclassTalks here:
https://www.tickettailor.com/events/physiomatters/1314746?
You can find Ben across social media @BWhybrowPhysio
Sign Up for Pain Practice OS here:
https://pages.modernpaincare.com/painprogram
Want to discuss teaching or mentoring? Email clinicalcommunication@outlook.com
And finally do share and subscribe.
Before every Clinical Communication episode extra questionsare asked to guests to help them get settled in. The responses aren’t released at the time, until now…
On this bonus content episode:
(00:00) - Introduction
(00:56) - Ian CowellHow A Cognitive Functional Therapy Paper Comes Together
(14:16) - Jo TurnerHow Clinicians Can Feel Comfortable Not Always Knowing The Answer
(20:32) - Chris Tiley What Exercise Gets Harder As We Get Older?
(22:37) - Bill Taylor Should We Match Patient Language For Private Body Parts
(30:22) - Michelle LyonsHow To Discuss Menstrual Cycles With Your Partner
You can find Ben across social media @BWhybrowPhysio
Or email clinicalcommunication@outlook.com for queries on mentoring, teaching and more!
Finally, do Share & Subscribe!
Clinical communication knowledge is always progressing andwe are way beyond just listening and having good rapport. So what else do we need to consider and how should it be taught to future healthcare professionals?
This episode is from a recording of the “Healthcare Education Transformation” podcast that Ben was recently on with Dr F Scott Feil, where we discuss:
(00:00) – Introduction
(07:21) - Why Communication Is Important
(21:44) - What Is Going Well In Communication Teaching InHigher Education
(34:50) - The Future Of Healthcare Communication Education
(42:25) - Communication Top Tips
(46:27) - What Would Ben Change About Higher Education
You can find Dr F Scott Feil on LinkedIn, as well as on X& Instagram @FScottFeil_DPT
You can find Ben across social media @BWhybrowPhysio
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More resources are becoming available on how to supportthose with persistent pain, yet challenging conversations can still occur, especially when someone is still going through a medical journey and expectations are still uncertain.
This episode is a recording between Ben and Dr Mark Kargela, Specialist Physical Therapist in Persistent Pain, on Mark’s “Modern Pain Podcast” where they discuss:
(00:00) – Introduction
(05:42) – How Communication Knowledge Has Evolved Over Time
(11:26) – Guided Discovery & Open Questions
(23:32) – Managing Diagnostic Uncertainty
(32:28) – Managing “Fix” Expectations
(38:49) – Best Ways To Develop These Skills
(45:46) – The Future Of “Explain Pain”
Pain Programme Link:
https://pages.modernpaincare.com/painprogram
You can find Mark across social media @modernpaincare
His Website: www.modernpaincare.com
You can find Ben across social media @BWhybrowPhysio
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A few weeks ago I was a guest on the Physio Pulse podcastwith Jeff Morton & James Horner. They kindly gave me a copy of the recording to release here, where we discuss:
(00:00:00) – Introduction
(00:05:00) - How Ben Became A Communication Skills Facilitator
(00:10:50) - Why Communication Skills Are Becoming More Embraced By Clinicians
(00:19:51) - Does Having A Specialist Job Title & Appearance Come With Greater Influence Over Patients?
(00:22:18) - How To Have Difficult Conversations With More Senior Colleagues
(00:24:21) - When Communication Skills Have No Effect
(00:29:43) - How To Respond To Cues
(00:34:54) - The Power Of Silence
(00:40:29) - Non-Verbal Communication
(00:41:32) - Managing Patient Requests For Imaging
(00:50:37) - How To Manage Disagreements With Colleagues
(01:03:26) - Do Ben & Jeff Ever Get Angry?
(01:06:24) - Jeff & James’s Hardest Conversations
(01:16:35) - The Birthday Cake Dilemma
You can find Jeff on Instagram @jmortonphysio
You can James on Instagram @thenerdyphysio
Their podcast is the Physio Pulse Podcast.
You can find Ben across social media @BWhybrowPhysio
You can email in to clinicalcommunication@outlook.com
And please Share & Subscribe
It is well known that the more perceived expertise andcompetence we have in someone, the more likely we are to trust them and have a better outcome.
This is great if you are a clinician with extensive expertisein a certain area, though not all of us are. But there are ways we can sound like an expert to achieve the same results without being disingenuous. Which is the topic of this short episode.
Find this useful? Then do share & subscribe.
You can follow Ben across social media @BWhybrowPhysio
Mark Kargela’s Pain Management OS Course :
https://pages.modernpaincare.com/painprogram?redirect_from=podpage
Therapy Live Pain Masterclass:
https://www.physio-matters.com/Pain25/
How To Reassure Patients with Ian Cowell
Reassurance is included in clinical practice guidelines acrosshealthcare and is usually a part of any assessment. Yet, very little research and guidance existed on how to go about doing it.
But there has been recent new research that suggests whatdoes (and doesn’t) work when trying to reassure those with chronic low back pain, which could be applied across many other conditions.
On this episode Ben is joined by the lead author Ian Cowell.Clinician, Educator & Researcher with the Evolve Pain Academy/Cognitive Functional Therapy group. Where they discuss;
(00:00:00) – Introduction
(00:00:51) - Reaction To Ian’s New Published Paper
(00:03:00) - Why Hasn’t There Been Much Published OnReassurance?
(00:05:07) - Where Did Attempted Reassurance Go Wrong?
(00:07:37) - Asking or Responding To Concerns
(00:20:33) - The Importance Of Non-Verbal Communication
(00:21:54) - What Allowed Reassurance To Go Well
(00:29:58) - Using Behavioural Experiments For Reassurance
(00:38:03) - Managing Patient Beliefs
(00:42:07) - What To Do When Behavioural Experiments Don’t Go To Plan
(00:44:27) - What Cues Did Clinicians Miss?
(00:53:13) - Who Doesn’t Cognitive Functional Therapy Work For?
(00:58:15)- Is Persistent Pain Research Becoming MorePositive?
(01:00:39) - Ian’s Hardest Clinical Conversations
(01:05:07) - Could This All Be Applied Across Healthcare InGeneral?
Ian’s New Reassurance Paper:
“A Detailed Analysis of How Physiotherapists "Give" Reassurance for Patients' Concerns in Back Pain Consultations” – Cowell et al (2025).
https://pubmed.ncbi.nlm.nih.gov/40455078/
Also Read:
“How do physiotherapists solicit and explore patients'concerns in back pain consultations: a conversation analytic approach” – Cowell et al (2021)
https://pubmed.ncbi.nlm.nih.gov/31392911/
You can find Ian on X/Twitter @brookphysio & LinkedIn
Evolve Pain Care Academy: https://evoolvepaincare.academy/
You can find Ben across social media @BWhybrowPhysio
You can send emails to clinicalcommunication@outlook.com
Please share & subscribe.
Plenty of podcast, articles, videos and other resources talk through the words and analogies we can say to help someone understand their pain.
This can give clinicians the right words to say, but they may still have no effect, as it is not just knowing WHAT to say, but knowing WHEN and HOW to say it.
This episode is the audio from a recent webinar I have given called "Advanced Pain Communication".
Want to have this or something similar delivered live to you or your team?
Want to see the video version of this episode with slides?
You can message Ben on X, Instagram, TikTok or YouTube @BWhybrowPhysio
Or email clinicalcommuncation@outlook.com
And please Share & Subscribe.