I was a physiotherapist for 14 years before I made the move to an education business that now helps other health professionals. 

At the risk of sounding smug, physiotherapists really are the unsung heroes in health. 

We possess as much anatomy knowledge as a surgeon, yet we develop lifelong relationships with our patients to drive enduring outcomes. However, physiotherapy isn’t without its challenges. 

The physical and emotional toll of the work often leads to burnout and it’s not surprising that just under 20 per cent intend to leave the profession after as little as five years. 

When I moved into online education, I needed to actually educate my audience. 

This was challenging because I didn’t know what the Ahpra guidelines were. 

I didn’t know what I could do, only what I couldn’t. From banning the use of online testimonials to prohibiting discounts, many Ahpra guidelines rightfully centre the best interests of patients, who shouldn’t be influenced into comparing their results with someone online or inadvertently sold services they don’t actually need. 

However, it can present a tricky issue when highly qualified physios are hesitant to use their skills to offer general advice and guidance to a wider audience online. 

Particularly during COVID-19, we saw this knowledge gap filled by influencers offering health advice mired in misinformation and untruths, while those with an evidence-based background stayed quiet. 

When I sought advice from Ahpra, it still wasn’t clear. As a result, I didn’t renew my registration with the Physiotherapy Board of Australia, which was disheartening because I truly loved my work as a physio. 

I feel that there is space to develop safe and sensible codes of conduct that support physios to confidently build their digital presence and provide valuable education to wider audiences. 

Nervous system-informed care 

After ten years working as a physiotherapist, I’d begun to see how powerful brain–body communication was when delivered at the right time. 

Working through a nervous system-informed lens will transform how you treat patients. 

Understanding the language of the nervous system helps you to better communicate with patients and to develop appropriate treatment plans. 

An awareness of your own nervous system will also reduce burnout and make you more attuned to the energy you’re bringing into the treatment room. 

A bottom-up approach to patient care—using interoception and breathing interventions and changing reflexive self-protective postures (such as bracing with anxiety or collapsing when feeling hopeless)—was effective when patients were experiencing dysregulation. 

Then I would address top-down factors such as thoughts about pain and a patient’s narrative on it and challenge fear based beliefs when the patient was more regulated. 

In a state of regulation, there’s more access to the frontal lobes of the brain and therefore a greater chance of learning and reflecting. 

I’d also been exploring brain–body communication informed by research on heart rate variability and cardiac vagal tone.

Using these to track the nervous system provided useful insights into the balance of the autonomic nervous system and helped to tailor treatments that took into account a patient’s particular state. 

At the beginning of my journey into the study of the nervous system, I’d planned to travel to the US to study interoception, trauma and the brain. 

However, around the same time I lost my brother Sam to suicide. It sounds strange but three weeks after he died, and with the blessing of my amazing parents, I booked a one-way ticket to the US. 

Losing my brother and best friend had only strengthened my belief in using an integrated approach to the body and brain. That kickstarted a two-year journey of upheaval, loss, growth and transformation. 

During this time, I learned about interoception and how people experience the sensations within their body. I studied under psychologists Tara Brach, Jack Kornfield and Bo Forbes. 

I also completed a six-week Certificate in Orthopaedic Manual Therapy. This training in modern pain science, neuroscience, neuroplasticity, interoception, trauma, biofeedback and vagus nerve regulation marked my professional shift towards helping others work with their own nervous system. 

Ultimately, it made me a better physiotherapist when I moved back to Australia two years later. I’d love to return to physiotherapy one day. 

I love the physio community, the passion of its practitioners and the ample opportunities for professional development.

When Ahpra recommended deregistering due to my increasing public profile, it was disappointing. 

In the future, it would be great to see the physiotherapy profession become more digitally proficient and increased opportunities for physios to provide educational information. 

>>Jessica Maguire is a former physiotherapist and author of The Nervous System Reset. Jessica teaches science backed
methods to help us understand and harness the nervous system to achieve better emotional and physical health.