Adelphi/Andrew Seymour Physiotherapy

30/07/2026

22/07/2026

08/07/2026

𝗧𝗵𝗲 𝗚𝘂𝘁-𝗕𝗿𝗮𝗶𝗻 𝗖𝗼𝗻𝗻𝗲𝗰𝘁𝗶𝗼𝗻 𝗶𝘀 𝗠𝗼𝗿𝗲 𝗣𝗵𝘆𝘀𝗶𝗰𝗮𝗹 𝗧𝗵𝗮𝗻 𝗪𝗲 𝗧𝗵𝗼𝘂𝗴𝗵𝘁: 𝗛𝗼𝘄 𝗬𝗼𝘂𝗿 𝗖𝗼𝗿𝗲 𝗠𝘂𝘀𝗰𝗹𝗲𝘀 𝗦𝗾𝘂𝗲𝗲𝘇𝗲 𝗬𝗼𝘂𝗿 𝗕𝗿𝗮𝗶𝗻

◼️ For a long time, the central nervous system was thought to be mechanically isolated from the rest of the body, protected by the rigid skull and vertebrae.

◼️ But groundbreaking new research has revealed that the brain is intimately linked to the physical dynamics of our core.

◼️ In fact, every time you brace your abdominal muscles, you are physically moving your brain.

◼️ Here is a deep dive into how researchers uncovered this fascinating hydraulic connection, and what it means for brain health, waste clearance, and conditions like obesity.

𝗪𝗮𝘁𝗰𝗵𝗶𝗻𝗴 𝘁𝗵𝗲 𝗕𝗿𝗮𝗶𝗻 𝗠𝗼𝘃𝗲 𝗶𝗻 𝗥𝗲𝗮𝗹-𝗧𝗶𝗺𝗲

◼️ To figure out what drives brain motion, researchers used high-speed, multiplane two-photon microscopy on awake, head-fixed mice.

◼️ By integrating an electrically tunable lens, they were able to rapidly switch focus between the skull and the brain tissue beneath it, allowing them to track relative movement.

◼️ They found that during wakefulness, brain movement is primarily driven by locomotion, not heartbeat or respiration.

◼️ When mice moved, their brains shifted forward (rostrally) and outward (laterally).

◼️ Strangely, this brain motion often preceded the actual physical movement of the mouse's body.

◼️ To find out what was causing this pre-movement shift, researchers implanted EMG electrodes in the mice's abdominal muscles.

◼️ They discovered a perfect correlation: before the mice moved, they tensed their core, and this abdominal muscle activation perfectly predicted the brain's movement.

◼️ To confirm this wasn't a coincidence, researchers placed a tiny pneumatic pressure cuff on the abdomens of lightly anesthetized mice.

◼️ Simply squeezing the abdomen immediately caused the brain to shift forward.

𝗧𝗵𝗲 𝗦𝗲𝗰𝗿𝗲𝘁 𝗛𝘆𝗱𝗿𝗮𝘂𝗹𝗶𝗰 𝗣𝗮𝘁𝗵𝘄𝗮𝘆: 𝗧𝗵𝗲 𝗩𝗩𝗣

◼️ How does a squeeze in the belly reach the brain?

◼️ The answer lies in the Vertebral Venous Plexus (VVP), a network of valveless veins.

◼️ Using microCT scans to reconstruct the vascular system, researchers found small holes in the lumbar and sacral vertebrae of mice.

◼️ Blood vessels run from the abdominal cavity through these holes, connecting directly to the vascular network lining the spinal canal.

◼️ When abdominal muscles contract, intra-abdominal pressure spikes drastically.

◼️ This forces blood out of the abdomen and into the spinal canal.

◼️ This rush of blood acts like a hydraulic pump—it narrows the dural sac, pushes cerebrospinal fluid (CSF) upward, and physically squeezes the brain against the skull.

𝗪𝗵𝘆 𝗗𝗼𝗲𝘀 𝗧𝗵𝗶𝘀 𝗦𝗾𝘂𝗲𝗲𝘇𝗶𝗻𝗴 𝗠𝗮𝘁𝘁𝗲𝗿?

◼️ The brain lacks a traditional lymphatic system to clear out waste, relying instead on the movement of interstitial fluid (ISF) and cerebrospinal fluid (CSF).

◼️ Because observing fluid flow inside an awake brain is incredibly difficult, researchers used poroelastic computer modeling to simulate the effects of this abdominal squeezing.

◼️ The simulations showed that this mechanical brain motion drives fluid out of the brain and into the subarachnoid space at rates several times higher than normal CSF production.

◼️ Crucially, this waking fluid flow goes in the exact opposite direction of the "glymphatic" fluid flow that occurs during sleep, which brings fluid into the brain.

◼️ This mechanical pushing during wakeful movement might explain why deep sleep is physiologically required to properly clear metabolic waste from the brain.

𝗕𝗿𝗼𝗮𝗱𝗲𝗿 𝗜𝗺𝗽𝗹𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀 𝗳𝗼𝗿 𝗛𝘂𝗺𝗮𝗻 𝗛𝗲𝗮𝗹𝘁𝗵

👇 𝗢𝗯𝗲𝘀𝗶𝘁𝘆 𝗮𝗻𝗱 𝗖𝗼𝗴𝗻𝗶𝘁𝗶𝗼𝗻

◼️ Obesity chronically elevates intra-abdominal pressure.

◼️ This constant pressure could disrupt the normal hydraulic flow between the abdomen and the spine, potentially impairing brain fluid circulation and contributing to the cognitive decline sometimes associated with obesity.

👉 𝗔 𝗗𝗶𝗿𝗲𝗰𝘁 𝗣𝗵𝘆𝘀𝗶𝗰𝗮𝗹 𝗦𝗶𝗴𝗻𝗮𝗹

◼️ The brain contains mechanosensitive channels that respond to physical forces.

◼️ The physical squeezing of the brain caused by our core muscles might serve as a direct, mechanical way for the body to communicate its internal visceral state to the brain.

𝗧𝗮𝗸𝗲𝗮𝘄𝗮𝘆

◼️ Ultimately, this research proves that our central nervous system isn't resting quietly in a static vault.

◼️ Instead, it is continuously massaged and manipulated by the movements of our core.

07/07/2026

✨Energy Medicine, Massage and Consent: What Are Clients Actually Agreeing To?

An article from a well known US massage professional organisation has stirred a debate in the massage and bodywork profession. It raises an important question: if a client books a massage, what exactly have they consented to, and where is the line between massage, energy work, therapist belief and client expectation in evidence based practice?

The ABMP feature moves between two very different meanings of energy. It uses measurable biological processes, such as nerves, cells, electrical activity, pressure and movement, alongside metaphysical ideas such as chakras, meridians, biofields and life force. It then leans towards the familiar suggestion that ancient energy systems may have known something that science is only now beginning to recognise. This is really just another version of ‘science hasn’t caught up yet’, and another belief based claim trying to appear scientifically credible.

The literature already separates these ideas. Measurable biological energy includes electrical, electromagnetic, mechanical, thermal and biochemical processes. Energy medicine usually refers to putative or subtle fields such as biofields, qi, prana or life force, which have not been established in the same way. The problem begins when real physiology is used to defend metaphysical claims, as if both sit in the same evidence category. They do not.

The feature also makes large claims that energy work can support regulation, help clients who feel stuck and encourage body reorganisation, without clearly showing how those effects are identified or evidenced. It claims a whole person view, but still splits the person into structural, functional and energetic parts. It separates movement, manual therapy and energy work, while giving energy work a deeper regulatory role than touch, movement, context or communication.

It also presents itself as integration, but still reads like a technique first approach. It focuses on brands, named modalities and choosing between methods. From an evidence based perspective, this is the problem with the wider modality empire. More brands do not automatically mean better clinical reasoning. It can still keep therapists centred on the method, not the person.

There is an important distinction between benefit and mechanism. A client may genuinely feel calmer, lighter, safer or more settled after energy based work, and that experience should not be dismissed. But a positive experience does not prove that chakras, meridians, biofields or life force have been changed. The benefit may be real, while the explanation remains questionable.

This is where consent becomes the bigger issue.
Whole person care raises a difficult question. Should it include whatever the therapist or client believes may support health and wellbeing, or should some ideas sit outside massage unless they are clearly named and consented to? If a client believes chakra work, prana, energy healing, past lives or spiritual cleansing supports them, they have the right to choose that kind of work. But can they truly choose if the booking simply says ‘massage’?

This is also about how the therapist presents their practice. Does the website, room, clothing, language, music, crystals, symbols or treatment description tell the client what kind of therapy they are going to receive? Some clients may want only massage and would not wish to receive energy healing, chakra balancing, cleansing rituals, demon removal or anything that conflicts with their culture, religion or personal views. Others may actively seek that approach.

Consent is not only about the treatment title. It is also about what may happen during the session. Where will the therapist touch? How will they touch? Will they sit, kneel or climb onto the treatment couch? Will they hold or grasp a body part while using language about clearing, releasing or removing trauma or energy? If an emotional response happens, will the therapist stop and ask, or continue because they believe they are ‘following the tissue’?

Massage is not experienced as technique alone. It is experienced through touch, language, environment, expectation and trust. If a therapist works with energy healing, chakra balancing, emotional release, intuitive touch, tissue following or spiritual language, the client needs a clear enough explanation to understand what they are agreeing to.

The diversity of the profession has value because clients can find the therapist and approach that fits them. Energy work has a place within the wider complementary health field for clients who actively seek it. The question is whether it can, or should, be separated from massage, or whether it should only sit alongside massage when it is clearly named, explained and consented to.

What do you think?
👉When a client books a massage, what have they actually agreed to?
👉 Are you specific with clients about what your treatment may include, what may happen during the session, and what responses they might experience afterwards?
👉Is energy work part of massage, separate from massage, or dependent on how the therapist describes and practises their work?
👉If a client feels better after a session, how do you separate their experience from the claims you make about what caused it?
👉Does it matter what we call the work, or should approaches such as energy work, spiritual ideas or intuitive practice always be named, explained and consented to separately?

Articles in the comments.

02/07/2026

The Power of a Forward Lean in Foot Exercises! 🦶

Adding a forward lean to targeted foot exercises can significantly boost muscle activation and joint torque, offering a simple way to build strength in the foot and ankle complex.

A recent study by Osborne et al. (2025) provides valuable insights, analyzing both intrinsic and extrinsic muscle activity along with metatarsophalangeal (MTP) joint torque during common foot exercises.

Traditional toe-based movements effectively recruit the intrinsic foot muscles, yet they produce relatively low force output. These exercises also generate limited activation in key extrinsic muscles such as the Soleus, Gastrocnemius, and Flexor Digitorum Longus. As a result, they remain a suitable choice for gentle, lower-level intrinsic strengthening—particularly when higher loads are not yet appropriate.

In contrast, calf raise variations stand out as a highly efficient option and can be progressed by adding load.

They deliver strong activation of both intrinsic and extrinsic muscles while generating substantial MTP joint torque, providing excellent “bang for your buck” when it comes to comprehensive foot and ankle strengthening.

Reference:
Osborne JWA, Menz HB, Landorf KB, Whittaker GA, Cotchett M, Kelly LA. The influence of body posture and added mass on intrinsic and extrinsic foot muscle activation and force output during common foot strengthening exercises. J Sport Health Sci. 2025 Dec 16:101110. doi: 10.1016/j.jshs.2025.101110. Epub ahead of print. PMID: 41412495.

29/06/2026

17/06/2026

Manual therapy is evolving, and that is a good thing. 🙌

For a long time, manual therapy has often been taught as if the therapist’s job is to find a faulty or restricted structure and correct or release it.

Those explanations made sense in the teaching culture many of us trained in. They gave therapists a clear rationale, matched what we thought we felt under our hands, and helped us explain treatment simply to clients.

But science has moved on. 🧠

The current evidence does not support the idea that manual therapy works mainly because we physically correct tissues, break adhesions, lengthen fascia, remove knots, realign joints, flush toxins, or reset the nervous system.

That does not mean manual therapy is useless.

It means many of the explanations attached to manual therapy are no longer strong enough.

Current research points towards a more realistic explanation. Responses to manual therapy may involve sensory input, mechanical loading, neurological modulation, contextual factors, autonomic responses, movement confidence, expectation, the therapeutic relationship, and short term changes in muscle activity and sensitivity.

In other words, touch is not just force applied to tissue.

Touch is information. ✋

The body is not passively waiting to be corrected. It is a living, sensing, predicting, adapting human system. When we use our hands, we are interacting with the client’s nervous system, prior experiences, expectations, sense of safety, confidence, sensitivity, movement options and current state.

That requires a different level of clinical reasoning.

Recent papers and frameworks have helped the profession move away from older structural stories. Reviews now map possible manual therapy mechanisms across neurological, autonomic, neuromuscular, neuroimmune, vascular, biomechanical and contextual domains. Best practice guidance also reminds us that care should be person centred, active where appropriate, reassuring, evidence informed and not dependent on passive correction.

Contextual factors research also reminds us that expectation, language, trust, consent, environment and therapeutic alliance are not background noise. They can influence the response to care.

That is not a weakness in manual therapy.

That is part of the biology of being human.

The outdated part is not the use of hands. The outdated part is claiming that our hands are doing something more precise, more structural or more permanent than the evidence supports.

We can still use massage, myofascial approaches, pressure, movement, stretching, rhythm, stillness, active participation and skilled touch.

But we need to update the story. 📚

Rather than replacing one simplistic explanation with another, we need to become more comfortable with uncertainty and complexity. Changes in pain, movement, comfort, confidence or function rarely come from one single factor.

A more honest position is that we cannot always know exactly why someone responds positively to care. We can observe change, monitor outcomes, explore what seems helpful for that individual, and use the best available evidence to guide our decisions, but we should be cautious about attributing success to one tissue, technique or mechanism.

That does not weaken our role as therapists. It strengthens it by encouraging better clinical reasoning, greater humility and a more person centred approach to care.

Many of us were taught explanations that sounded certain but were never as well evidenced as we were led to believe. That is not a personal failure. It is how professions develop. Training reflects the knowledge and culture of its time. Good clinicians are allowed to learn, revise, question and move forward.
Manual therapy does not become less valuable because we stop over claiming.

It becomes more credible. ✅

Therapists still play an important role in health and wellbeing. Skilled touch can help people feel safer in their body, help reduce sensitivity for some people, explore movement, build trust, ease protective guarding, support recovery, and reconnect with activity. For many clients, being listened to, touched with consent, treated with respect, and guided with confidence is deeply meaningful.

The future of manual therapy is not about defending old stories.
It is about becoming more person centred and more scientifically honest.

We do not need to pretend we are fixing tissue to be valuable.

Touch, used well, can be a powerful input into an adaptive human system.

That is a stronger, cleaner and more mature place for the profession to stand. 🌿

The attached image represents my interpretation of some of the current evidence. I've added the associated papers to the comments.

03/06/2026

👀 One reason why AI is unlikely to replace physiotherapists anytime soon. (P1)

Artificial intelligence can process information, recognize patterns, and even support clinical decision-making. However, there remains a fundamental aspect of healthcare that cannot be fully digitized: the human relationship.

At the heart of physiotherapy lies the therapeutic alliance the collaborative partnership between clinician and patient built on trust, communication, empathy, and shared goals. Alongside patient-centered care, it is one of the strongest predictors of engagement, adherence, and meaningful outcomes.

Effective rehabilitation is not only about selecting the right intervention. It is about delivering the right care, through the right mechanism, at the right time, and at the right cost for the individual sitting in front of us.
💚Empathy. Experience. Agency. Choice.💚

These are not merely clinical skills; they are human qualities that shape how people understand their condition, navigate uncertainty, and regain confidence in movement and life.

Technology will continue to transform healthcare, and AI will undoubtedly become an important tool in physiotherapy practice. But tools do not replace relationships.

💡 The future of physiotherapy is not a choice between technology and humanity it is the integration of both, while preserving the human connection that remains central to care.

📚 Disclaimer:
• Sharing a study is NOT an endorsement.
• You should read the original research yourself and remain critical.