Here are a range of comments that clinicians have provided following the Know Pain course experience:

I was lucky enough to attend Mike’s ‘Know Pain’ course last year through my NHS clinic. Having worked in MSK practice for 5 years I have a great understanding of pain mechanisms so was unsure if the course would teach me much I didn’t already know. From the start Mike quickly proved there is much more for me to learn on pain theory. Whilst the metaphors he taught me opened my eyes to further discussions you can have with patients as to what is causing their pain. A personal favourite is the fire alarm analogy. This explains how our body’s pain sensors are similar to a fire alarm. Whilst the alarm should set off when there is a major problem such as a fire, the alarm can also be set off by slightly burnt toast. Our body can work in a similar way. So when our pain receptors kick in it does not necessarily mean we are damaged or in danger.

Many patients think that pain means tissue damage; this could be a disc herniation or muscle tear for example. Modern medicine has proven that this is not always the case. Pain is caused by a large variety of factors rather than simply tissue damage. This was a key part of Mike’s ‘Know Pain’ teaching.

How Do I use this with Patients?

I keep the book Mike gave to me in my clinic. It contains lots of visual information I can show patients to help explain certain aspects of pain. I often find clinicians can confuse patients when educating them about a condition, as we struggle to use non-medical terminology at times. The book allows me to visually support my education in a way the patient can easily understand.

I recall one patient who was suffering with ongoing lower back pain. A recent MRI scan could not find the cause of the pain and the patient was left thinking they were ‘broken’. After completing my subjective and objective assessment I did not suspect any serious pathology. This was backed up by the MRI scan. Upon exploring the patient’s thoughts in further detail they were under the impression their pain would get worse and they would need a wheelchair at some point in the future. Over 3 sessions we addressed these concerns along with other forms of treatment. Once the patient learned movement would not cause them damage, her function gradually improved. They still write a letter to the clinic every few months to update us on their progress. I have no doubt the ‘Know Pain’ course allowed me to provide the patient with a higher quality of care.

Mike was an engaging presenter and kept me on my toes listening for the whole day. I highly recommend his course to other healthcare professionals from those beginning their practice to experts in their field. I will hope to book onto the course in the future to refresh the knowledge I learned.

Jake Showler Bsc (Hons) HCPC CSP


Showler Physiotherapy

My thoughts on the Know Pain course by Helen Preston@prestonshealth

“Thanks Mike for giving your time and energy to educate us all at Prestons Health.

I can highly recommend the course to all therapists who treat persistent pain.

It is remarkable to think an average of 1% of undergraduate time in physiotherapy education is given to pain science. It dawned on me that all therapists treat pain in some shape or form and the absence of this as a core subject in undergraduate therapy education institutions is quite remarkable. However, this course goes a way in bridging that gap, whether you are a new grad or an old timer like me!

A real strength of this course is its multidimensional nature and just how practical it is in its application to clinical practice. What makes it different from pain courses I have been to before (and i have been in a few!) is how it focuses on the therapist as an educator. Hand on heart, I never considered myself primarily as a teacher before. This course changed that for me. The course provided insight into adult learning theory, which was extremely enlightening as to why my therapeutic approach had worked with some and not with others. I genuinely now approach every clinical interaction with a different hat, much more aware of my role as an educator and the patients learning styles.

Mike has become famous in the physio world for his use of metaphors and he draws on these throughout the course. I am now picking up and utilising patient generated metaphors in treatment planning for my patients. My patients had been handing me clues into how to tap into their potential before and I hadn’t even noticed. Now I do!

I particularly enjoyed the second day when Mike explored lots of different ways to approach pain education. Song lyric analysis. Chinese fingertraps (my patients love these) PHODA. Too many to mention them all!

In summary, Mike’s approach to teaching us as teachers was refreshing and full of insight. There were lots of opportunities for us to synthesise our learning with group activities and case studies at the end. I have to also mention the simply fabulous learning material for the course too. The handouts and file are very well thought out and having our very own Know Pain USB card with the presentations will help ensure the vast amount of information is not forgotten.

All in all, a course well worth investing in. And thoroughly enjoyable. Highly recommended.”

Helen Preston BSc (Hons)


Chartered Physiotherapist

Prestons Health

“I connect with my patients so much better after taking this course. I get them involved in planning their own rehabilitation and I can see how much more engaged they are. Mike helps you understand how we learn through experience and gives you the practical tools to help your patients learn in the same way. I almost never work with people with persistent pain but I’ve used the techniques I learnt with every patient this week. This course is for everyone! Thanks Mike”
Matthew Boyd
Musculoskeletal Physiotherapist
Ottawa, Ontario


“I can say with confidence that my clinical practice has been influenced positively as a result of the teaching on persistent pain that you have provided to us as a department.  I feel i have far more to offer patients in terms of management options and I believe my clinical outcomes in this patient group are better as a result.  I can also speak for my fellow collegues at Kent and Canterbury Hospital Outpatient Physiotherapy department when I say they too feel they have benefited from your teaching in what is a very complex area.  Being able to engage with patients confidently using techniques such as cognitive behavioural therapy and the use of metaphors to help patients understand their pain has led to a big change in my clinical practice.  At KCH, we have subsequently developed an “understanding persistent pain” class based on Mikes model that he developed over at QEQM.  The class runs for one hour each week for consecutive weeks and is purely aimed at educating patients about their persistent pain and how they can improve their self management. Mike has assisted us greatly in the development class and we look forward to sharing our audit results with him at six months.”

General Practitioner

“This course provided clear and simple ideas regarding a complex area of practice. The topics covered can be applied to any patients who present with pain and/or illness behaviours. I think the course encourages you to ask your patients different questions and to look at a different focus in order to help your patients achieve self efficacy.”


“Know Pain is a brilliant course. Mike is a great speaker with an excellent presentation style. Know pain challenges your own paradigm for treating patients and makes you reflect on what treatment is in patient’s best interest. The course demonstrated practical methods to challenge patient’s beliefs and help them learn to manage their persistent pain.”


“Great course and great speaker. The content focused on practical ‘how to’ methods, which is something that I need when attempting to manage my patients who struggle with persistent pain. There was great interaction with the audience and I’ve certainly made some useful links between mind blowing neuroscience and simplified patient education. Thank you!”


“I now feel much more confident discussing pain with my patients. I will now change my practice to include much more patient education about neuroscience. I always thought that this wouldn’t be possible as they wouldn’t get it but I’ve learnt some really useful, common sense metaphors and stories to help me from now on.”

Physiotherapist & Pilates Instructor

“Mike’s course has really made me look and think about the language I use with my patients when talking to them about their pain and the importance of listening. It has enabled me to develop my teaching skills in the explanation of pain so that now I have a better understanding of how to communicate effectively with my patients. The course gives you tools to use with your patients straight away and they work. A fantastic course that I would highly recommend.”

Hannah Watts – Physiotherapist & Pilates Instructor. Whitstable, UK.