About Louis Gifford

I'm a Chartered Physiotherapist specialising in pain. Over the last 25 years I've written and lectured on the clinical biology of aches and pains and it's management.

A Review of Louis Gifford Aches and Pains by Professor Paul J Watson PhD FCSP

Louis Gifford Aches and Pains
CNS Press Falmouth UK
ISBN 978 0 9533423 5 8

A Review: Paul J Watson PhD FCSP, Emeritus Professor of Pain Management and Rehabilitation, University of Leicester, UK. November 2014.

Most people reading this review will be familiar with the work of Louis Gifford who died in February 2014. Over many years Louis delivered a number of courses and these form the basis of these three volumes. I must declare that Louis was a friend who I admired greatly as a clinician, author and teacher so this review may lack some objectivity; however, both the author and the potential reader deserve a fair review so I will try my best.
This final publication from Louis Gifford is presented in a boxed set of three volumes: Aches and Pains, The Nerve Root, and Graded Exposure and Case Histories. This is a difficult series of books to review because they defy a traditional classification. They are part autobiography, part literature review with a focus on teaching through the use of the author’s own professional experience with clinical examples. Throughout the books the reader is impressed with the sense of wonder Louis had in the phenomenon of pain, how this presented itself clinically and how the patient’s presentation and response to treatment could be interpreted and understood through an in-depth appraisal of the research literature. The books are written in the author’s own witty and idiosyncratic style which I find easy to read, rather like chatting to an old friend, but those who want a dry and studious book may find the style frustrating but I encourage them to persevere; it will be worth it. The tone is frequently opinionated and outspoken about the short comings of the professions and approaches used in the management of pain especially chronic pain, although there are occasional apologies for this there is no doubting the author’s irritation at the lack of critical thinking which attends the management of many painful conditions.
A traditional review would criticise the series for not using the most up to date references throughout the book to illustrate the many fundamental points made. This would be erroneous and misses the point of much of the book which is a reflection of the journey Louis took to come to his understanding of pain through his learning and clinical practice. Instead he encourages the reader to “read what I’ve read”. This does not make his conclusions and his interpretation any less valid, most of the references cited are seminal in our understanding of the current theories of pain. In taking this approach he invites us to see if we too would reach the same conclusions with this information and states early on in the book that the work represents his understanding of the literature and he ask us to “feel free to challenge it and offer an alternative explanation”. In doing so it is a call to use this as a basis for understanding and a stimulus to better our own knowledge and understanding rather than to accept something as the given dogma.
Personally I found the first two books the most satisfying maybe because I, like Louis have a deep and unending fascination with the neurophysiology of pain in all its guises. This is not, mercifully for the casual reader, a complex discourse full of detailed descriptions of neurotransmitters, brain areas and detailed neurophysiology, it is described with a lightness of touch which few authors can achieve. This is peppered with case histories to illustrate points which clinicians will find very close to home and will recognise in many of their own patients. It lets the reader understand that pain is a dynamic, ever changing process which evolves into a complex phenomenon and, I hope, will stop people seeing acute injury pain and chronic pain as two completely separate entities. Louis has tried to bring together the neurophysiology, psychology, behavioural and immune responses together with the social environment within which the pain is interpreted and shows how these alter the presentation in clinic and how a better understanding can make us more effective clinicians.
It is in this section that Louis expounds further on his Mature Organism Model of chronic pain which was a seminal advance in the understanding of pain for many physiotherapists. With the passage of time since the original model was published more information has come to light which helps to support the model and to develop it further. In conversations with Louis he always considered this a work in progress which was unlikely to ever be complete.
The third volume is increasingly clinical and gives much space to case histories to explain and illustrate clinical applications which come from the author’s vast experience. This is likely to be the section many physiotherapists will enjoy reading – how we can put much of the learning into clinical practice. It includes Louis “shopping basket approach” to patient management which puts rehabilitation at the forefront of the whole of patient management and presents a model of clinical reasoning which demands a broad mix of skills without declaring one is a ………. insert your guru/dogma of choice in here….. therapist, the focus instead is on the patient, their presenting problems, their social circumstances, psychological needs and the ultimate rehabilitation aim; from this stand point one chooses what is appropriate for the individual.
Some will argue that there is a lack of reference to some of the more recent developments in the management such as more focused use of screening, the recent developments in the use of values driven rehabilitation approaches and mindfulness in chronic pain programmes but to me these are to be forgiven.
Minor niggles are an occasional repetition of information from one section to another and a lack of indexing making it hard to find information quickly. I am not sure the poetry and song lyrics contribute to the chapters but these are examples of the idiosyncrasies of the author, I am sure in a lecture he would make them seem perfectly in place. There are incomplete sections which were not completed before Louis became unable to continue, the sections are completed by his wife Philippa suggesting what Louis would have written; this adds a poignancy to the books.
I found these books eminently readable and I have read all 450,000 words with ease and found greater clarity in them than in many other textbooks on the subject. Even though the books are aimed primarily at physiotherapists I would recommend these to all clinicians from all professions. For students and people new to the study of chronic pain it gives a context for the current views of pain and synthesises a vast area which one could not hope to cover as quickly as one will by reading this series. The books are a testament to the intelligence, wit and charm of the author and represent a fitting final tribute to an excellent teacher and communicator.

Christmas presents?

I am unashamedly promoting Louis’ book set – they make great Christmas presents! Our courier has advised us that overseas and UK delivery for Christmas is wisely by 19th December ( although we are happy to continue to dispatch over the holiday period).
Louis used to write notes all over every book he ever read – so don’t share, buy or give a copy and write all over it too!

DSC_4968

 

 

Thanks to Irene and Glen Hunter from Welbeing CPD and Beck Davison for kindly allowing me to promote Louis’ books at their recent study day in Truro, Cornwall. Thanks for all your support.

Philippa

ORDER VIA PAYPAL BELOW OR CONTACT ME DIRECTLY VIA info@achesandpainsonline.com or 00 44 (0) 1326 312156

Report from ‘Louis Gifford Head, Heart and Hands’ session PhysiotherapyUK 10th October 2104

ThanksSH.PhysioUK.2014.034 to Ian McMillan and Simon Hadley for reporting on Louis’ session at Birmingham on 10th October 2014.

http://www.csp.org.uk/news/2014/10/13/physio-14-speakers-praise-work-louis-gifford-pain-management-pioneer

Heather, Paul and Mick did a great job. Louis would have liked to have shared the platform with his good friends and colleagues. Thanks to all in the audience for your support. I thought we all held it together pretty well – until the end! Philippa x

 

 

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Book for UK delivery £43.00 plus P&P Total £49.50

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Fantastic Response to New Book – Louis Gifford Aches and Pains

PPA Book Stand - Birmingham

 

Wow, what a fantastic response to news that Louis Gifford Aches and Pains is now available. Thank you to everybody ( from every continent!) who has placed orders. We are working really hard to get the books dispatched and thank you for your patience! (Philippa, Louis and Mick at PPA stand Birmingham last week – thanks Neil Clark PPA PRO)

Top tip – the books are in a case and to get them out my method is to hold the case on it’s side and push the middle book out first. To return all 3 books inside the case stand the case up, put book 1 and 3 in first and then book 2 between them!
( it is very easy – but confused a few people at conference last week!)

Louis Gifford - Aches and Pains

And we have added an order form – please tell your friends!

Louis Gifford Aches and Pains – Book order form

Thank you for all your support.

Philippa Tindle

Louis Gifford Aches and Pains – New Book Launch – Available Now

louis-book-43

NOW AVAILABLE DIRECT FROM THE PUBLISHER.  ORDER YOUR COPY NOW

In the summer of 2013 Louis took up his ‘sitting down’ hobby – writing.  With his usual enthusiasm he worked from dawn until dusk and committed all his thoughts, ideas and words to this book. His 3 courses The Clinical Biology of Aches and Pains, The Nerve Root and Graded Exposure are updated and expanded  and finally put to paper. There were hiccups on the way but this project was a joy.  It helped to keep him alive. Louis did a word count in January 2014 – 450,000! A tome – even he was surprised.  But he always wanted his words to be three smaller books that could be easily picked up and held by the reader. Together they make the whole and hopefully link together logically and easily.

I promised Louis I would publish everything but I do claim all the mistakes.

‘These books have been written with the same spirit and sentiments as my lectures were delivered. I hope you have as much fun reading them as I have had writing them’

Louis Gifford MApplSc FCSP

Chartered Physiotherapist

 


Book for UK delivery £43.00 plus P&P Total £49.50

UK delivery


Book for Europe delivery £43.00 plus P&P Total £56.00

EU delivery


Book for Rest of World delivery £43.00 plus P&P Total £62.50

Rest of World delivery


 

‘Louis Gifford Aches and Pains are truly fantastic. I cannot recall any other textbooks that cover the subject of pain with such an overarching, integrated depth of knowledge, clarity and honesty – a true biopsychosocial masterpiece!’

Steve Robson MCSP

 

‘I think these books are a fitting legacy to Louis and will continue the already huge impact he has made in ensuring that patients all over the world are treated more wisely and with more respect because of the ideas and insights he offers in them. Ideas he gives freely and generously without a hint of self-importance or ego.’

Mick Thacker FCSP

 

(For every book sold a donation will be made to Prostate Cancer UK)

Friday October 10th 2014 – Birmingham. Louis Gifford, head, heart and hands

PLEASE JOIN US AT THE CSP ANNUAL CONGRESS BIRMINGHAM UK

FRIDAY 10th OCTOBER 2014
Venue Room 1.  Time 11.00 – 12.30pm

LOUIS GIFFORD ‘HEAD, HEART and HANDS’

We are delighted that  Heather Muncey FCSP, founder member of the UK Physiotherapy Pain Association (PPA), has agreed to chair this session.

Philippa Tindle BSc BA MCSP – Louis Gifford’s wife and partner, will announce the launch of Louis’ new book  ‘Louis Gifford Aches and Pains’.

http://www.physiotherapyuk.org.uk/presentation/louis-gifford-%E2%80%98head-heart-and-hands%E2%80%99

Precis:
This session will put in to context the work of Louis Gifford and his contribution to physiotherapy pain management. It will examine how the knowledge and practise of the management of pain has changed over the last 20 years and identify the challenges faced in the future through reference to new scientific evidence on the causes of pain and the maintenance of disability in chronic pain and how these might influence clinical practice in future.

With time for a short question and answer session at the end.

We look forward to seeing you there.

 

Louis Gifford Head, heart and hands.

Since Louis’ death in February we have received many, many lovely words about him.  I would like to thank everybody again for taking the time to contact us-it really does help.

Louis had an impact on many peoples’ lives, and so, I was delighted to be asked by the Chartered Society of Physiotherapy(CSP) if they could dedicate a morning session to Louis at their annual conference in Birmingham, UK, on October 10th 2014.  Mick Thacker and Paul Watson will be speaking and we hope that you will come.  

We have called the session ‘Louis Gifford Head, heart and hands’.  There is a story behind this.  Louis’ younger brother, Colin Henwood, is a master boatbuilder in Henley upon Thames and has written a beautiful book of that name.  Louis’ neice, Megan Henwood, is about to release her second album, titled, Head, heart and hands.  Megan has written a song for Louis called, ‘Painkiller’. 
We think ‘Head, heart and hands’ describes  the physiotherapy profession in the broadest sense- we hope you do to?

Also, thanks to Adriaan and Collen Louw from the US – who have asked me if they can present, ‘The Louis Gifford lecture’, at their annual conference in June 2014, “… to bring recognition to one of the influential physios of our generation.”  

Check out the ISPI Clinical Pain Conference in 2014 – Minneapolis, MN – June 20-22, 2014  –  www.ispinstitute.com

Finally, Louis Gifford Aches and Pains, the book/s.  I am getting there, hopefully soon!

“My mate Louis” by Mick Thacker

Mick Thacker taken by Louis Gifford

Mick Thacker taken by Louis Gifford

Louis asked me to say a few words about him at his “do” last week. He gave me clear instructions to be honest, accurate and not to be too “nice”! Here is the gist of what I said, it was not intended to be exhaustive or for a physiotherapy audience but rather for his friends and family, I wanted to do him justice professionally straight from the heart and offer them an insight to the huge professional impact he made, who he was professionally and to demonstrate his brilliance and importance.

Louis started to train to be a physiotherapist in Sheffield in 1978. He had previously done a Zoology and Psychology degree and returned home from two years teaching in Sierra Leone. He secretly wanted to be like his dad, Vernon, a brilliant “hands on” physiotherapist. I loved how Louis talked about his dad, it always made his eyes sparkle just that little bit more, here is how he described him:

“His patients loved him. I came to realise that he was way ahead of his time – not only for his exceptional hands and ‘people’ skills but also for his diagnostic brilliance combined with his instinctive ability to instil physical confidence in his patients”.

My first thought on reading this was that it was about Louis, those of us who know him recognize him immediately in this description.

Louis wanted to be the best he could be – not to satisfy an ego, there wasn’t one! But so he could do the best for his patients whom he always saw as the focus whether teaching, writing or treating.

Inspired by Robbie Blake at college he wanted to be a manual therapist, he sought out and worked with the best the UK had to offer Paul Chadwick, Peter Wells and Agneta Lando amongst others. His quest to keep on improving led him to Adelaide to undertake the world renowned Graduate Diploma in Manual Therapy under the tutorage of Geoff Maitland. His year contained several notable classmates including David Butler and Mark Jones. Louis was the star pupil of his group, Geoff’s favourite and the only person he felt capable of following in his footsteps! Praise indeed.

Louis’ insightful thinking and skeptical nature meant that whilst he appreciated how much he was learning, something just wasn’t right, manual therapy applied to persistent pain patients didn’t make sense and wasn’t enough. He wasn’t seduced or limited by being a great manual therapist or by the best, it wasn’t working and he set about trying to find out why not.

He returned to the UK and set up practice at “home” with his partner and wife Philippa. He taught with David and their course became the thing of legend within the profession. Louis though was not happy with the direction that the courses were taking, they weren’t focused on the patient and their needs or answering the right sort of questions. On one of their trips Louis discovered Pat Wall’s work on neuropathic pain, here was something that made sense to him, that really helped him to understand some of the questions he had been asking himself and that patients demanded answering. He contacted Pat (the world’s foremost expert on pain) who offered to meet him for chat. Louis warmed to Pat immediately, a kindred spirit, both loved to smoke the occasional roll up and discuss science from the patient’s perspective. Louis was the first to suggest to him that pain was similar to memory, a topic he asked Steven Rose (the eminent memory scientist) to discuss with Louis. He was able to converse with the very best scientists because he understood and thought how they thought.

I got to know Pat well myself, which was not an easy task, as an iconoclast, he seldom referred to people with a depth of respect or passion, Louis was an exception, he asked me regularly how our friend in Cornwall was.

Here is Louis on Pat:

“Pat made you feel comfortable, he watched normal human life, he had the most likeable twinkle in his eyes that oozed rebellion”

I would suggest that we could swop Pat’s name for Louis’ and it would be a perfect description of him too!

Following his Master’s degree (Adelaide), Louis started to teach his Clinical Biology of Aches and Pains course. Finally he was teaching his own ideas, the ideas, which emanated from the best of current science and the questions patients asked in the clinic. The course was underpinned by an incredible wealth of support from the literature, Louis was a prolific and wide ranging reader, several authors owe him massive royalties for promoting their books! I loved exchanging books with him on every topic imaginable. He had an incredible ability to grasp the key messages and to assimilate them into his teaching and practice. I loved discussing things that came from his reading with him, our conversations were far reaching to say the least!

In the mid 90’s Louis was recruited by the Physiotherapy Pain Association (PPA), started by Heather Muncey, a star in her own right, the organization composed a handful of dedicated members. Louis and Philippa threw themselves into the support and promotion of PPA and were responsible for an exponential growth in its membership and they made sure all their professional contacts were fully exploited by the PPA also. It was an exciting time, refered to those of us involved as “The Physiotherapy Pain Revolution”. At the heart was Louis’ writing and his editing of the PPA newsletter and the publication of the Topical Issues in Pain books; presented as the PPA yearbooks the cost of publication and dissemination was underwritten by Louis and Philippa with no guarantee of success! The PPA continues to be a success today thanks to the energies of Louis et al from the early days.

Louis became and remains the most influential figure in the arena of pain and physiotherapy of his generation, his mature organism model revolutionised physiotherapy theory and practice and continues to influence the thinking of clinicians and scientists way beyond its’ intended audience.

His work was rightly recognised with a Fellowship of the Chartered Society of Physiotherapy, the highest professional award in the UK. This was followed by a Fellowship of the MACP – a double fellow no less.

I have great memories of our time teaching together, there are too many stories to relay here, including many of us questioning the sanity of what we were doing! My favourite was when he came and taught the undergraduates at St Georges, in the morning he was the supreme teacher, diligent and accurate and a lot more professional than I ever was! He realised this at lunchtime and told me he was going to relax in the afternoon, the session post lunch consisted of him recounting his LSD induced psychedelic experience at the Isle of Wight rock festival where he “saw” his hero Jimi Hendrix. Louis the professional and the rebellious – just as we all knew him! It was impossible for me to follow and whenever I bump into those students they always say what an amazing experience it was and how Louis was the best lecturer they ever had (thanks mate)!!

Louis pic - taken by Mick Thacker

Louis pic – taken by Mick Thacker

On a personal front, Louis and I became the best of mates, greatly at ease in each other’s company. Our names professionally linked through our teaching and writing together. I feel lucky, privileged and humbled to be mentioned together with him. He was the person from whom I would seek counsel in all aspects of life. He supported me from my early days, encouraging me to learn more and to follow my somewhat nerdy passion for the molecular aspects of pain; he challenged me and made me ask important and pertinent questions; lifted me when I found the occasional challenge daunting. I loved talking to him. Over the last few months I have had the amazing privilege to have proof read all 450 000 words of his new books. It is without exaggeration a masterpiece, it reignited my interest and passion for pain. We have had the most amazing discussions, allowing us the excuse to talk for hours at a time not just about the book but about life and his experiences, I will cherish these precious times forever. I loved him very much and will miss him more than words could ever describe.

The word great is over used today but Louis was a GREAT:

A great physiotherapist, writer and educator.

A great friend to many, many people.

A great brother to Adrian and Colin.

A great dad to Ralph and Jake who are the two loveliest young men I have ever met and whom we hope our sons grow up like!

A great husband –

To the other half of the team, Philippa, a force of nature!

Louis described her as “his rock” throughout their entire relationship; “no matter what Micky she always loves me”. Louis could not and would not have done it without you!

A great human – I think amongst all the great tributes and accolades that have been paid to Louis his greatest legacy is that patients all over the world are being treated more wisely and with more respect because of his ideas and teaching, both of which he gave freely and generously without a hint of self importance or ego. A truly great bloke!

Message from Philippa, Louis’s wife and partner

picture of LouisPhilippa here – the other half of the team.

Many of you may have already heard that Louis died on Sunday 9th February 2014 – our sons, Ralph and Jake, and I were with him.

Louis was diagnosed with prostate cancer 7 years ago – he was just 54.  His prognosis was pretty poor – so living this long has been a real bonus.  Louis just got on with life and lived with cancer – he definitely wasn’t a victim, sufferer or cancer fighter – he carried on working, but did stop teaching, and squeezed as much fun into everyday. He had a huge and wide number of interests – fishing, sailing, running, bike, golf, reading, writing, mushroom foraging, woodworking, breadmaking, snowboarding… and he was good at them all!

Last June he started to write full time – and around 450,000 words later we have 4 books (a boxed set!).  I promised  him that  I will get them published as soon as I can – there is still work to do but Louis  jumps out from every page.

Louis had no fear of death, although he would admit to wanting to live another 20 years- he had so much to do. He wanted no funeral, so we are having a party on Monday 17th Feb at our local beach café to celebrate him – we expect a crowd!  Louis made 2 requests – no black and he asked his very, very special friend Mick Thacker to speak.  Very few people and patients in Falmouth, where we live and work, know what Louis has done professionally.  To most he was just the local, but well respected, Chartered Physiotherapist at Swanpool – he didn’t want or need to be anything else.

A  remarkable, humble human.

We have received many amazing messages from all over the world and we would like to thank everybody for taking the time to write.  Louis touched (literally!) many people’s lives and he would be thrilled to see the words and thoughts of you all.  We will have another book of appreciation.

Thank you.

Philippa Tindle, Ralph and Jake Gifford

This blog will be kept open and I will add any material I have of Louis’s.  Louis was unable to write his ‘centralisation’ piece as promised because his new books took priority. Sorry.

Topical Issues in Pain – Relaunch!

[Go to the Topical Issues in Pain page to link to sellers]

After much deliberation and chatting with a good number of you, plus many of our old colleagues and friends who were involved in the UK pain revolution of the 1990’s and early 2000’s; Philippa and I decided to relaunch all the Topical Issues in Pain books with the intention of making them cheaper in all respects. Their quality though, remains excellent if not better than, the originals.

Topical Issue in Pain 1 and 2 have been out of print for about 4-5 years. Interestingly there has been a recent surge of interest in all five titles in the USA, Canada and even as far away as Australia and New Zealand.

We have had them republished by a firm called ‘Authorhouse’ as ‘print-on-demand’ books in hardback, softback and also in ebook form so they would be available easily worldwide and, super-cheap! ( If anyone buys a softback or hardback in Europe or Australia I’d love to know what they’re charging you for mailing!)

My big thing is that they are great books by world experts, the material is still hugely relevant, and to a great many ‘pain’ minds, need revisiting with the rather alarming lurch back to passive and modality based approaches to pain that seems to be going on.

Please don’t let Physiotherapy lose our speciality – skilled rehab, -and for pain, – skilled rehab used alongside skilled CBT techniques.

If you buy them as ebooks they are $3.99 – so you can get the full set for a tad less than $20.00!  You can download in pdf format – a strong recommendation!

I haven’t been posting any new material recently because I’m really in the last throws of my ‘giffords aches and pains’ book.  It looks like it’s going to be 4 hold in the hand sized books sold as one in a neat sleeve. Why 4 separate ? – because I’ve written nearly half a million words!  Controlled swearing, real patients, lots of pain material from the tissues to the brain and back out again…and lots of to clinically ponder I hope. If you like the style of the blog, the books similar!   I’ve thoroughly enjoyed writing it and I hope you all like reading it.  It’s been my life, and blended in is a story of my journey from frustration to fulfillment without being sentimental.  These final days take time but it should be well on the way by the early new year.   I feel it’s really going to happen now.

For those of you who attended my lectures and courses in the past –

‘The clinical biology of aches and pains’  ‘The nerve root’ and the ‘Graded exposure’ course – it’s these that form the backbone of the books plus a lot more.

So,

I’d love you all to tell your colleagues about the Topical Issues in Pain books and their new availability!

I’m still working on pain ‘centralisation’ piece – meaning centralisation in ‘McKenzie’ terms – and I’m also thinking about putting some thoughts out there about the graded motor imagery treatment.

Thanks for listening.  Don’t forget it’s ‘Movember’ – a good cause to back.

Louis.