Admittingly, I use analogies to get my point across during clinical education to students for imagery and basic fun. More admittingly, they are typically horrible but do get a good laugh across….and some blank stares.

As a Duke college basketball fan and overall being stoked here lately due to March Madness fever, I expressed to current intern a similarity between providing pain science education, shooting 3 pointers and getting results in clinical practice. Hang in there…

As they say for Duke, you ‘live and die by the 3’. If they go in and you’re hot, you have a better chance. If not, pack your bags.

No matter how sexy and new (3 point line came around in 1986 vs basketball starting in 1891), it is not the main squeeze in the game. You have to go back to basics, have an inside game, and big men to step up in the paint. If not, you don’t get the results…and you lose.

I think pain science education is like shooting 3’s. It makes sense, it takes skill, knowledge to step back behind the line and you can get more out of it if its successful. It is the newest approach out, it takes a different skill set and you can show off your distance. However, it is not a high percentage shot—unless you’re Andre Dawkins.

I am a goober just like everyone else when it comes to pain science. I like to be up-to-date. I have created my own “Cartesian-Pain” on my whiteboard in the office, I have a specific ‘Knowledge Track’ section on Medbridge to share with my students and I had second row seats to see Moseley/Butler at CSM in Vegas a few months ago. Sound like a groupie??

However, I know it has its limitations. I am sure you do too. I haven’t seen exemplary results from implementing it into my practice patterns, but it is a part of it for sure. There are a few cheers when the pain education sinks in, but many times—long bricks when it doesn’t.

Our profession is growing exponentially. Our brand is improving. You know one of the reasons? It is because we get results. Our results are becoming several strides ahead of other MSK professionals. I don’t want science to get in the way of the art—and results in relief for patients.

You have to keep getting into the paint to get results. You have to get your hands on someone—treat locally but also think globally. You don’t need to spend the entire treatment releasing who knows what, but remember the power in results from centuries of manual therapy.

So keep throwing up the three’s and hope you get more cheers than bricks. However, don’t leave the paint as that game will always give you results and positive outcomes.


  1. Great analogy, and I;m no basketball fan! I saw Butler do one of his first Explain Pain in the US almost 15 years ago! I have been implementing Pain Science principles since then. You’re right though, other than changing our perceptions about patients in pain, and softening and improving our interactions. It does not provide quick results. There are no quick results for centrally sensitized patients. It’s also especially tough for a lone clinician to make headway when every other clinician and support the patient may have is overwhelmingly pathoanatomical and negative.

    1. Hey Dr. E,
      Yeh, I agree. I love the concepts but it hasn’t really given me much more outcomes. It may be due though to these patients that need it are tougher ones and have a poorer prognosis unofrtunately. It doesn’t give them the “instantaneous gratification” (or as you call it, rapid results). My next student coming to me in May actually said in email that he was interested in pain science…quite an unsuual request! Most want manual therapy….I’ll be interested to see hiw learning patterns then.

  2. Nice blog, being another groupie with the neuroscience approach to MSK issues, and trying to retire the concepts of a neuro vs ortho approach, to instead offer a more whole approach to our clients that we touch,….this hits well.
    BTW, go Bruins!

  3. Great point. I continue to see the many PTs think of TNE as a seperate ‘tool in the tool box’ so to speak. I think this is a mistake. Some see this apporach reserved for only those with chronic pain. Rather than viewing TNE as only for those with chronic pain, how about applying concepts of modern pain science to everyone? We should still continue to ‘get into the paint’ and get our hands on patients. The only difference is that we use an updated explanatory model based on science and drop the structural-postural explanation. How about this baskatball analogy: at one time free throws were shout underhanded. Eventually we shifted to an overhead technique since it was more effective. So continue to shoot free throws, just in an updated format.


    I too am a Blue Devils fan and this was not our year!

    1. Hey Rob,
      I like your analogy of shooting free throws! I’ll have to use this charity stripe analogy.
      And yes, as for the Blue Devils, hopefully we can keep Parker but doubtful! Next year’s class looks promising.


  4. Thanks for sharing this precious information. I like your concern in the post which is very useful for me. I like your information which is very useful for me. Thanks.

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