Speaker 1:
Jared Powell:
Today's guest is me, and today's interviewer is none other than my wife, Tara. Yes, we're keeping it all in the family. I don't know how Tara actually managed to coax me into this episode, but on reflection, who better to explore the last seven years of my life than my wife and mother of my children? Now, don't worry guys. It's not a sentimental conversation. Tara, in fact, does an extraordinary job of teasing out the nuance and meaningful detail of my PhD and poses questions that I think will be interesting to both practicing clinicians and prospective or current PhD students alike.
Jared Powell:
This episode is due to go live just days after my graduation ceremony. So what better time to reflect on this PhD journey than now whilst the champagne is still flowing before we start the podcast? Without any further delay, I bring to you my conversation with myself, the newly minted Dr. Jared Powell, and my wife Tara Powell.
Tara Powell:
I'm Tara Powell and we are going to turn the tables on Jared today. I am going to be the one asking him questions. If you don't know me, I am Jared's wife, and today we are talking about his recently approved PhD. So welcome to the Shoulder Physio Podcast, Dr. Powell.
Jared Powell:
Thanks, honey. Thanks for the professional introduction there. Smooth, you're, you are a professional. You have your own podcast, everybody go give it a listen, give you a plug right at the start. I'm slightly terrified of what's about to, to happen with you interviewing me as opposed to me being in the other position. It hasn't. It's happened. I've been on many podcasts before, but my wife has never interviewed me before. So buckle up. Let's see what happens.
Tara Powell:
. Okay, well, we have the newly minted doctor Jared Powell here to answer everyone's questions about his PhD thesis thesis. And I just have a total disclaimer for the beginning. I am not a medical professional. I am a lawyer. The only thing I know about shoulders is that I have two shoulders myself and that's where my knowledge ends. So we are gonna keep this pretty high level Dar I believe that you might go into some of the more technical detail of the subject matter of your thesis in future episodes with more knowledgeable interviewers. But today we just wanted to, you know, keep it high level, start at the very beginning, make it accessible for anyone who might be interested in what Jared has been doing over the last seven years. So, Jared, my very first question for you is what, what's your PhD about? Well,
Jared Powell:
Straight into the big question. So I'll condense seven years into seven minutes. Broadly, it was about trying to understand or find out more, generate knowledge, perhaps solve a problem about how and why exercise is effective for managing what we call rotator cuff related shoulder pain, which is the most common presentation of shoulder pain. So not very clearly. The thesis wasn't designed to find out if exercise is effective. We know from a bunch of research in the past that exercise is modestly effective, it's not massively effective. That's using professional terms there, massively effective. It doesn't cure everybody's shoulder pain that walks through a physio clinic's door, but it does help people. So the job of my thesis, or the task of my thesis was to try and make progress towards understanding how and why exercise is effective. And when we're asking questions about how and why we're asking causal questions perhaps, which we'll get into a little bit more detail in a minute. So there it is. In a nutshell, how does exercise work for managing rotator cuff related shoulder pain?
Tara Powell:
I mean, I, you've been working on this for like, our whole relationship and I think that's the first time I've ever understood what you're actually doing, . I love it. So what were the main findings?
Jared Powell:
Yeah, multifaceted findings. So I guess we'll go through each of the papers. There were, there were five, six papers that make up this thesis. So the first finding was that we went and reviewed the literature. We looked at all the randomized control trials that had been published to date, investigating exercise for rotator cuff related shoulder pain. And we looked for causal explanations within these randomized control trials that try and explain how and why exercise was of benefit for people with rotator cuff related shoulder pain. And what we found was pretty overwhelming and, and fairly surprising actually, 95% of all causal explanations that have been profited in the literature up to 2021 were biomedical in nature in terms of how and why exercise may help someone with rotator cuff related shoulder pain. Now, what biomedical means was that was perhaps was a follow up question and I'll answer it for you straight away.
Jared Powell:
Biomedical, we have a thing in physiotherapy called the bio-psychosocial model. And if we divide that into biomedical and psychosocial, we kind of get biomedical things as being factors such as muscle strength or motor control or inflammation in the bloodstream or in the tissue tendon stiffness, the macroscopic features of a tendon. So what it looks like on ultrasound or MRI or all of those factors we can see and we can measure. And so that's a key property of a biomedical feature. It's something that a third party or someone can see in a laboratory or in some sort of setting where they can measure strength or measure movement or measure or take a blood test, for example. So the, the other part of that are the psychosocial factors, and they're things that are pretty hard to measure because their subjective first person experience mechanisms such as fear, such as confidence, such as something that we call self-efficacy, so on and so forth.
Jared Powell:
All of those mechanisms. A third person or a third party can't see and can't measure. We rely on reports from the patient themselves. And so 95% of all explanations in the literature were to do with these biomedical mechanisms. So overwhelmingly clinical trialists believe that exercise help via things that we can see and we can measure such as muscle strength and motor control now are the two most common causal explanations for the benefit of exercise. And then only 5% of those mechanisms were related psych features because social mechanisms weren't suggested at all. That was a key funding from a study that was published four years ago. Now, you know, I'll be a bit faster with the next explanations as chapter. The next chapter was concerned with surveying, practicing physiotherapists as to how and why they think exercise may help people with rotator cuff related shoulder pain.
Jared Powell:
And surprisingly practicing physiotherapists were far more likely to suggest that psychosocial factors may account for any benefit received by engaging with an exercise program. So interestingly, practicing clinicians, perhaps more well-rounded in their understanding of how exercise may work for shoulder pain. So that was quite a surprising finding. The next study that we did was we went and asked the same question, question to patients. So to people with lived experience of rotator cuff related shoulder pain to get their viewpoint as well. 'cause It's actually often neglected in the literature. And patients had a similar, or people with lived experience of shoulder pain had a similar understanding as to how exercise worked to practicing clinicians or practicing physiotherapists. They suggested that exercise made them feel stronger. They also suggested that it made them more confident to move, they developed less fear with moving and they felt that that had a direct influence on their perception of pain.
Jared Powell:
So, so individuals who have a lived experience with shoulder pain were pretty even in, in their suggestion that biomedical and psychosocial mechanisms were responsible for their improvement in pain. The next paper that we did was a critical review of exercise for managing rotator cuff related shoulder pain where we, I'm not gonna explain the whole paper 'cause it's 8,000 words, but we went through and with a critical lens, looked at individual facets of an exercise program to see if they were sort of largely responsible for improvements in pain in individuals with rotator cuff related shoulder pain. And so a lot of findings came out of that paper. When you apply critical lens to the literature for rotator cuff related shoulder pain, we learned that there's no real optimal dose of exercise for helping someone with shoulder pain. You can do high load exercise or high volume exercise or low load or low volume exercise.
Jared Powell:
There's no superior type of exercise. You could do progressive resistance exercise, you could do motor control exercise help, you could even do stretching, exercise, range of motion exercise can even be effective as well. We learned that you don't have to avoid pain, but conversely, you don't have to encourage going into pain with an exercise program. You sort of have to meet the individual where they are and determine whether they can experience pain or they can handle pain or not. So you, it's you and the patient who is in charge with making a decision with that, the literature's not gonna tell us, so on and so forth. So we looked at all these variables of an exercise program and we kind of found that everything kind of works and, and nothing kind of works at the same time. And then finally, we have a paper under review at the moment, which would hopefully come out soon that I won't speak too much about.
Jared Powell:
And perhaps we'll wait until that's published before we start talking about it. So the main findings of the thesis in the end, and I'm babbling a little bit at the moment, is that we don't really know why exercise works, but we think we might know that it doesn't work through traditional causal mechanisms such as getting stronger or changing the kinematics or, or how someone moves the way their scapula moves or through any number of other biomedical variables. So ask forces, physios to sort of ask questions of themselves and, and how they might wish to practice, which we might get into in a second. I'll just add one more point. We've got a ton of work to do in the future. So some of these variables that I have challenged may actually come out as being helpful in the future with better research that's dedicated towards understanding how and why exercise works, because we've really got an absolute paucity of research out there at the moment that explores this specifically. So that's a big disclaimer. This may change in the future, but as the literature reads right now, I think that's where we're at.
Tara Powell:
Okay. So as a lay person or a non-medical scientific person, are you saying that exercise works to help shoulder pain because of like the vibe?
Jared Powell:
Perhaps? If by vibe you mean like the context of the, of the clinical situation, then context really does matter. The context or the therapeutic relationship, these things directly influence somebody's experience with an exercise program and therefore their clinical outcome. So in one of our papers, the qualitative paper where we interviewed patients within this thesis, we found that the context was, the clinical context was absolutely crucial. And in fact, the exercise program itself probably matters less than the ability of a physiotherapist to develop a strong or working relationship or therapeutic relationship with the patient in front of them. You could devise the best exercise program that you could possibly do, take into account strength and conditioning principles, periodization, et cetera, et cetera, et cetera. But that program counts for nothing if that patient doesn't trust you or doesn't believe in you or thinks that you've got perverse incentives or ulterior motives. So first and foremost, that context and that therapeutic relationship is vital. And I think the exercise program itself in terms of the anatomy and the mechanics of that exercise program comes second.
Tara Powell:
So based on what you have discovered through this research, are you going to change anything in the way that you treat patients yourself?
Jared Powell:
Yeah, so I've been, I've been changing every week over the last seven years by doing this research. So there, so there's not gonna be some line in the sand where I completely change my practice next week. I've hope I've take pride in evolving my practice over the years with, with the evidence. So I'll always, not always, I will, my bias is to use exercise for helping people with shoulder pain because I think in terms of bang for your buck treatment, it is the best option out there in terms of effectiveness, cost effectiveness. It's like people don't have to go into a clinic three times a week to do an exercise program. They should be able to do it at home unsupervised if they're being given the right program. It's equitable. By equitable, I mean most people should have access to doing an exercise program.
Jared Powell:
You don't even need equipment. Sometimes you can just do body weight exercise. And that can still be effective as well. It's, it's better for the environment than an operation and an injection and all of this medical industrial complex stuff that goes along with, with running this. So I think when you look at all of the facets, and this is what we call the right care in medicine, where we don't just look at the clinical effectiveness of something, we look at the effectiveness, the cost effectiveness, the accessibility of it, the the equitable nature of it, its carbon footprint and its impact on the environment as well. All of these things, then we make a well-rounded decision as to whether that intervention is worthwhile for a patient or not. And I think that exercise is probably the best option that we've got to set most of those criteria.
Jared Powell:
So I will continue to champion and prescribe exercise. Now, what has changed for me over the last few years has been my obsession with saying that in order to get out of pain, you must substantially increase your, your strength. And so that has been something that's changed to me over time.
Jared Powell:
I still like to see people get stronger. Okay, so I'll still prescribe exercise with that in mind, but I'm not overly concerned if they don't get materially stronger over the next 12 weeks because I know that their pain may not be mediated by that. I haven't, I I really don't care about how somebody's shoulder moves from a motor control perspective. I don't really pay too much attention to the scapula. I don't try and fix what we call scapular dyskinesis. I, I'm aware that we probably can't, I'm also aware that we can't reliably assess it in the first place. And I am aware based on the evidence that we've got is that it's not a mediator of clinical outcomes, therefore it's probably a waste of time to concern yourself too much with in a clinical consultation, so on and so forth. So what I've learned from this PhD, which is really crystallized how our practice is that changing biomechanical markers in somebody's shoulder doesn't need to be a primary treatment aim or a primary treatment target.
Jared Powell:
So it's being aware that exercise may help this person from a number of different mechanisms, some of which we're not totally aware of it the moment, but some of those mechanisms will probably be helping that person feel more confident in moving their shoulder or having less fear with moving their shoulder or any number of psychological mechanisms that we could, that we could start rattling off. So that's how I've evolved over the last seven years and that's what I teach in my courses and that's what I talk about on my podcast ad nauseum to all those who have listened. And the reason why I do that is because it's been informed by this seven year research program.
Tara Powell:
And so as part of doing your research, was there anything that you were really hoping that you would find an answer to that you didn't solve or find an answer for?
Jared Powell:
Yeah, at the start you have lofty ambitions. When you do a PhD, you're actually a bit diluted with what you do. And then you, you get your supervisors and your examiners who slap you across the face figuratively say, Hey, this is impossible to do. Relax, chill out, man. And so, so yeah. So I, I went in that thinking that I was gonna do a bunch of different studies that would culminate in a crescendo of a randomized control trial with a mediation analysis where I would test once and for all, whether muscle strength was a mediator of clinical outcomes for people with rotator cuff related shoulder pain. I'm really comfortable with the fact that I didn't get to do that study because a randomized control trial is an absolutely immense undertaking and can take many, many years to do so. I, my work will inform that randomized control trial that I hope will be done in the future. And I, I actually hope to be a part of it and I'm talking to some research groups at the moment about being a part of it. But yeah, so I didn't, when you look at it, and I actually end my thesis with a nice quote from Carl Pop, which I might just pull up if you don't mind me indulging in this for a moment.
Tara Powell:
Go ahead. It's your podcast.
Jared Powell:
It's my podcast. I can do what I want. Yeah, exactly. So this is a quote by Carl Popper. A change of emphasis of a problem may make all the difference, not only to our understanding, but to the problem itself, to its fertility and significance and to the prospects of an interesting solution. It is important for a scientist to be awake to these changes and shifts and not to make them either unconsciously or surreptitiously for, it often happens that a reformulation of a problem can reveal to us almost the whole of its solution. So that quote to me means that even if you don't find the holy grail answer to a problem or solution to a problem, by grappling and wrestling with that problem, which I've done over the last seven years, I've made progress towards answering that problem towards a solution of that problem. I think I've even changed the way we, we look at the problem.
Jared Powell:
So I've kind of reformulated the problem and I believe I've done that with the last paper of this thesis, which hasn't been published yet. I've cast a critical lens on the, on the, on the evidence and evidence base as it stands at the moment. So I think I've made progress towards answering this question of how and why exercise is effective without actually coming up with, okay, this is the one causal mechanism that's responsible for everybody's improvement with an exercise program. Now I don't think that solution even exists, so I can't be too ashamed of not, not finding that that invisible solution that doesn't exist. So I'm happy with the progress that I've made over the last seven years, although we haven't come out with a magic bullet solution to it.
Tara Powell:
I was gonna ask you what's the next extension, but it's of the research, but it sounds like the randomized control trial, is it, is there anything else that you, you, you know, if you had infinite time, you never, ever had to work again and your whole life was dedicated to research. Is there anything else that you would have liked to have done as part of this body of work?
Jared Powell:
Yeah, we need better, we need more robust randomized control trials with an attached mediation analysis to it. So that is a second study that doesn't just test if exercise is effective, it tests how and why and through what mechanisms exercise is effective. So a mediation analysis of is a very specific statistical approach for partitioning out the effect of a treatment. So what I mean by that is we see that exercise is effective, it works, it decreases somebody's pain compared to a control group, but we need to understand all the different channels that combine or that make up that effect. And that's what mediation analysis allows us to do. And the entire history of, of evidence-based practice for exercise for shoulder pain, we have two mediation analyses only. And so this is quite a, this is a field that's naive and new and growing and we still have a ton of work to do. So it's quite exciting really over the next 10 to 15 years. We might have some more robust answers coming out with some research.
Tara Powell:
I guess now's the time, I admit that I have not read your thesis , which might be kind of shameful, but I'm putting myself off the hook because I barely understand like half the words, maybe even less than half. But what about your audience and the listeners who know a lot more about these medical terms than I do? Like should they bother reading your thesis? Is it just gonna be a snooze fest or is it actually gonna be helpful to people? Oh,
Jared Powell:
I wouldn't mandate that everybody goes out and reads the thesis is it's 80,000 words and 250 pages. Don't put yourself through that. You've probably, most people who listen to this podcast has probably read the individual studies that make up this thesis. Although like the introduction and conclusion of the thesis, I think is interesting. I get a bit creative with using quotes and mentioning philosophy and doing this and that to, to satis to satisfy my armchair philosophy leanings. So if you're into that, go give it a read, but you're not gonna get anything out of it that you wouldn't get just by indi by reading the individual studies which are freely available. All of them are open access. If you can't get them, send me an email and I'll send them too free of charge.
Tara Powell:
Okay. We might find another way to like make that easier, even easier for people. So we'll put it in the show notes, perhaps says the COO of shoulder physio . Okay. What's next for you? Are you finished with academia?
Jared Powell:
Yeah, I'll never be a full-time academic. I, I will continue to have academic associations. I, I will remain visiting lecturer at Bond University on the Gold Coast where I've done my PhD through and I've went to physio school there 15 years ago now. So I've got a strong relationship with Bond and I'll remain there as a visiting lecturer. So that'll be fun. But I'll always be involved in research and I'm doing that through different research groups around the world. And so that's really important to me that I remain in research 'cause it's a huge passion of mine and it's been cultivated substantially over the last seven years and I don't want to just give that up. However, I'm really looking forward to getting back into seeing patients and helping people at the coalface with debilitating shoulder pain and helping them find an answer or a solution to their situation and getting them back to valued activities. I've really missed that 'cause I've dialed back on that over the last three to four years. So I'm really, I'm looking forward to getting back into that to supplement my research activity because I think the best researchers are those who are still engaged. We're seeing patients because that's, I get all my inspiration from patients to, in terms of research. So being a clinician scientist is something that's very important to me.
Tara Powell:
So I hope our listeners will indulge me a little bit because I just wanna talk about how you actually managed to even get this done. Like when I met you, so this was, you started this PhD like seven years ago before we even met. And you were just a single man working in a clinic full time or maybe 80% workload and you know, work had all the time in the world to work on this academic pursuit. And since then you've had two kids you know, had a family, you've started a business, you've created a social media following with like 70,000 followers. You've still seen patients the whole way through in the last, you know, 18 months or more. You've been the predominantly the primary carer for our second son working like one and a half days a week to devote to this, you know, how have you managed to get it done? I think that when you look at it like that, it's an incredible achievement.
Jared Powell:
Thanks. There's no, there's no hack, unfortunately. It's a lot of, it's persistence and having a plan and, and sticking to it. Something I'm good at is showing up day in and day out despite external circumstances. I'm pretty good at just not giving up, I guess. And that's something that there have been moments where I've wanted to give up. No doubt. I've, I've taken two leaves of that leaves of absence within the PhD. So that was like 18 months and it's, you get used to not doing the PhD and it's quite hard to get back into it. But somehow I did, the advice that I have for a prospective or early days PhD student is to take more time at the start of a PhD to get a really solid plan of firstly the question or the niche that you want to fill or the gap in the literature that you want to fill.
Jared Powell:
And then have the requisite steps that are gonna get you towards maybe not answering that problem, but making progress towards answering the problem and having the, the papers and the studies in mind that are gonna get you towards that solution. In the end. And remember, it's something that I got lost is that a PhD is not just a succession of random papers. The papers all have to be cohesive and talk to each other and tell a story. And the thesis has to tell a story. So in order to, a thesis has to be 80,000 words. So in order to tell a story 80,000 words, it needs to be coherent and logical and it needs to, it needs to follow. So take the first year or six months of your PhD to figure out the question that you wanna answer. Read, read liberally, read hundreds of journal articles and you know, from d like different types of journal articles.
Jared Powell:
I'm talking quantitative journal articles, qualitative journal articles, basic science articles, different types of methodology as well. Find a question that you think needs answering and then map out how you're gonna make progress in different studies towards achieving that solution. And then, and then as you are doing these studies over the years, make sure they're relevant to each other. They talk to each other, they're connected, they form a cohesive body of work. 'cause Then writing the thesis up shouldn't take too long. I know some people that get really stuck trying to write up a thesis and it can take a year or more. Whereas I was able to put my thesis together in a, in a month or two because all of the studies really followed nicely. And so that's something that really helped me towards the end. It was a really cohesive body of work that came together almost organically in the end without too much effort.
Tara Powell:
Yeah. So you did a thesis by publication, is that or PhD by publication? Is that what that's called in compared to, you know, you just work on things for three years, six years and then you have to sit down and write the 80,000 words from scratch?
Jared Powell:
Correct. Yeah. So mostly in, in medical science or in the school of medicine and health and science, a PhD is done by publication or research where you're expected to conduct research and publish a certain amount of articles in peer reviewed journals. And they form the bulk of your dissertation or thesis.
Tara Powell:
Okay. And as I understand it then, I mean, I saw you going through the process, you know, each of those articles as you put them together for publication, you know, were highly scrutinized by the editors or the reviewers from each journal. So you sort of spread the, the pain of getting that review and that feedback over the life of the PhD, right? Because I remember some of them, you know, you'd get the feedback and they'd say, oh, this wasn't clear or this, you know, and you'd have to negotiate the changes and edits that they wanted based on where you were trying to take your whole thesis. But it kind of meant like the pain was sort of spread out rather than all at the end,
Jared Powell:
Correct. Well, I knew where my work stood in terms of the, my colleagues and that was helpful. Instead of you're in a dark room for seven years writing 80,000 words, nobody's seen it, you become attached to it and then you throw it out there to the world and it's either a piece of or it's a work of genius.
Tara Powell:
I mean, I I think we, I just wanna say, you know, like your PhD was approved without amendment, which I also understand is quite rare. But it sounds like not to, not to diminish that accomplishment, but it sounds like because you had the five, did you say five articles,
Jared Powell:
Five published articles, and one more under review. Okay.
Tara Powell:
Yeah. So, so you, so you had the six, it, it was really like, based on this framework of five published, five settled, approved, like your PhD reviewers are not going to go and critique the sections or the chapters that were published already because they understood it had already been through a rigorous review process.
Jared Powell:
Yeah, yeah, exactly. So once, once a, an article is published, yeah, it's been reviewed thoroughly as you said, in terms of peer review. So, so those articles kind of speak for themselves. And so the more you can get published in a thesis, typically the smoother it tends to go in terms of getting your PhD over the line. I
Tara Powell:
Know you were anxious about awaiting the results, but I was pretty confident, not that I had any ba like basis of being confident, but just, you know, on its face knowing that like the bulk of the thesis was based on these published papers already and then the work that had not been reviewed by anyone, it was actually a small part of it by the end. So anyway, I just wanted to say that any other tips or advice for people looking to do a PhD in this area or would you even, would you recommend people do a PhD if they're sort of thinking about it or tossing up the idea now that you're on the other side?
Jared Powell:
It really depends. It's, you have to be a certain disposition, I think to do it. You have to, this is gonna sound wrong, I think, but you have to be really curious about solving problems at, at a higher level. And then that's one part of it. A lot of physios are curious, we're clinically curious, we wanna solve the problem of a patient in front of us, but then to like go through the sometimes laborious process of doing a PhD can sort of dampen that curiosity at certain stages of it because it's quite bureaucratic, you know, there's things you have to do that aren't related to your PhD along the line and do, you know, doing this, the genius research that you've got mapped out in your mind often doesn't really come to bear and you, you're sort of stuck doing secondary things that you wanted to do just to get it done.
Jared Powell:
And that's not really been my experience, but that can happen to a lot of PhD students. So would I recommend, if you have an interest in a clinical question and then you've got the time and the, like socio ecological context is right, meaning your family situation is right, your lifestyle is right, you can afford to maybe do part-time PhD, part-time clinical work, or you get a scholarship to do, to do full-time PhD, then, then it can definitely be a really a really rewarding thing to do because you, you do make you produce a legacy in terms of you've got a question you've set out to answer it, you publish studies that don't go anywhere unless they're retracted. They're for the forever for as long as the internet exists. And so you're really making a contribution towards advancing the profession. So I feel really good about that.
Jared Powell:
I also feel really good about the research that we've done is actually gonna change practice. And so changing practice for the betterment of a patient or the betterment of a physio as well or the clinician is, is immensely gratifying to hopefully make that whole experience better for both patient and clinician. So that's perhaps an egotistical reason to go into doing a PhD. But doing a PhD can do all of those things. So if you're curious, if you've got the family situation right and, and you've got a question that you want to answer, you can really, it can really be a rewarding thing to do, but it's gonna take a ton of time. It's gonna put a fairly large burden on your family life and your relationships maybe, which I don't know if you wanna talk about that, but it's, it's a huge thing that will hang over you for, if it took me seven years, I did it part-time. If you do it full-time, it's still four years and there's a whole lot of depressing data out there on the mental health of PhD students and it doesn't make happy reading in terms of like suicide rates, depression, et cetera, et cetera. So that's a bit of a neg vibe to put on this at the end, but it's something that you should probably consider. I don't think you should go into it too naive. Yeah, I'm
Tara Powell:
Just trying to think of what to say. , I don't know. I mean, your whole life circumstances changed from darting it to finishing it, including, you know, you really did. I mean, we had a pandemic in the middle, which also changed a lot of things. So it's hard to say without the pandemic what changes you would've made. But you know, you went from being like in the clinic four days a week working long hours till, you know, offices back to back. We've got his and hers office stream offices right next to each other. Yeah. But I think now that you've done it, like thank God you've finished it, but now that it's finished, I think neither of us would regret anything that we did or change. And I think, you know, if you hadn't been in that situation and, and we hadn't had to adapt to a pandemic and children coming along, shoulder physio wouldn't exist, I don't think.
Tara Powell:
I think you would've stayed just within the clinic and devoting all your energy to that. So yeah, I, I think overall it's been the best thing ever, but it hasn't been without its challenges and there's definitely been times when I've resented, you know, you doing or, or feeling like it was a passion project for you and I've had more pressure than I wanted and things like that. But, you know, I think that's just relationships too in, in that now now's your time to shine babes. So , the world's your oyster and might be my time to just step back a little bit. So, you know, that's relationships, just sharing the load and different people have got different things that they're prioritizing in the family. I mean, I'll have to say I think it's been incredible how you've even achieved it. It's not like you've been burning the midnight oil in your office or, or doing anything.
Tara Powell:
You know, you've been like caring for our boys first as your priority and then in a little bit of downtime producing this incredible body of work. Like I think the discipline that you've had and the focus that you've had on actually getting the work done. I have seen like very rare instances of you procrastinating or I don't think you've printed out a single piece of paper for this PhD, which as a lawyer like amazes me, like back yourself. You've had total focus and discipline the whole time, and I think you've just got things done in such a short amount of time by believing in yourself and just the necessity of having to get it done to a timeline, which I think is amazing. Thank you.
Jared Powell:
Yeah, it's certainly been full of ups and downs and side turns and tangents and everything. But no, i, I pride myself on, on setting a task and a goal and, and getting towards that. I don't think I, I would accept failure too often and, you know, this is my, I've done a bachelor's degree, I've done a double bachelor's degree and then a doctor, a physio, and now I've done a PhD so I can kind of finish a degree. And that's, seeing that I've done that in the past gives me confidence and I, I can do it in the future, but also don't forget that I'm extraordinarily passionate about shoulder pain and helping people with shoulder pain. It's been pretty much my life for the last seven years of, of reading and understanding the shoulder literature. And so putting that into a thesis has been a pleasure and a joy. It's been really fun and it's something that, and I created shoulder physio as a, as a medium and as a vehicle to express that I was learning and the knowledge that I was garnering from reading all of this literature and then ultimately generating knowledge by doing the research as well. So it's, it's been an endeavor that's all been quite connected and it's, it's all supported each other and helped each other in this journey. I'm really happy that I've done it. I do not regret it. May even do another one in the future. Pardon?
Tara Powell:
. Sorry, what?
Jared Powell:
I'll talk about it, I'll tell you later.
Tara Powell:
All right. Yeah. All right. When you're a man of leisure in your retirement, that sounds fine. So what's next for shoulder physio? Because I asked you what's next for you, and you didn't really mention shoulder physio, but are you planning on incorporating everything or, or, or revisiting the messages from your shoulder physio course For anyone who's, doesn't even know. I mean, we've had thousands of practitioners all over the world do your complete shoulder online course. So if you're new to the podcast, that's the sort of cornerstone of the shoulder physio solution, the online course by Jared. So yeah. What's next for the online course now that you've finished the PhD?
Jared Powell:
Yeah, so the online course is gonna get a complete revamp over the next half a year, three to six months. It's been subtle tweaks and alterations and updates to it over the last four or five years. I think it came, came out just before the pandemic, the first part of it, and then the second part of it came out just a few months after the pandemic. That's
Tara Powell:
Almost five. Yeah,
Jared Powell:
It's I mean, I stand by every single slide and second of audio and video in that course. It's actually all stood up to testing over the last five years, which is, yeah, it's a nice verification of my, of my principles and, and methods, but I've got a a lot more to include in terms of all of my research and other research that has come out. It's all gonna get a complete upgrade and revamp, so, so keep a lookout for that.
Tara Powell:
Yeah, I mean, I'm involved behind the scenes in shoulder physio too, and I, I just think it's really exciting now that you've got all this energy to devote to leveling it up and, you know, yeah, five years old, all that material and around for five years, which is great. But yeah, I think you've got, you're a different person than you were five years ago as well, and you've obviously learned so much. So I think that's really exciting. And you know, in, just in terms of like all your output, you've been channeling that into the PhD also, our little baby is not so much of a baby anymore, and so you've got a lot more time. You're not like the main carer of him. So yeah, I think it's gonna be so exciting to see everything you do in shoulder physio.
Jared Powell:
Yeah, crucially, our not so little baby is now sleeping through the night and for a couple of hours during the day. So that's another thing that I've achieved over the last couple of years. I've been the resident sleep trainer within the house, and the trainee is now fully trained and he can put himself to sleep and he sleeps for 12 hours at night, which is unbelievable and I feel like a different human. So that's, there's that too. I
Tara Powell:
Mean, I really hope you didn't just jinx us now guys, you do not know how bad it was. He was waking up for like three hours at a time, starting his day at four 30 after being awake like 4:30 AM after being awake for three hours and then also waking up every 90 minutes like you were operating on next to No, so
Jared Powell:
Onwards and upwards. So 2025 is gonna be the year.
Tara Powell:
Okay, well, let's just put that all behind us. Yeah, 2025 is looking very shiny. Are there any people who have been an influence on your work or your journey besides myself, who you want to give a shout out to or a mention?
Jared Powell:
Well, firstly, you, you've been unweight in your support and couldn't have done it without you. And you know that I don't need to put on a show for you here publicly, but I will. So thank you for all your help. From a professional standpoint, it's like Jeremy Lewis was one of my supervisors, and he is, he is one of my, he's a friend and he is also like my intellectual hero in physiotherapy. He's been so gracious in, in giving me all of his time and feedback on i, my wacky ideas and he tends to not just support my wacky ideas, but give them a life too. So that's been really been amazing as well. Ben Schram, who was another person, a supervisor for my PhD associate Professor Ben Schramm at Bond University has been amazing as well. Just there for me every step of the way.
Jared Powell:
And this might be something guys that you need to consider if you're gonna do a PhD, pick your supervisors because they really can make your life better or worse. So pick your supervisors really carefully, and then I've got a bunch of like, so Tara, as you may know, I, I'm interested in philosophy and Carl Popper, who I've mentioned a moment, a quote before, I've read all of his books. You can see behind me this orange book is Papa Conjectures and Refutations. And a lot of his philosophy is to do with kind of the stuff that I've investigated in this PhD. It's, he believes the aim of science is to find satisfactory explanations of worldly phenomena. And that's been the aim of my thesis. My, the aim of my thesis has been to find satisfactory explanations for how exercise works, people with shoulder pain. So I've drawn a hell of a lot of inspiration and knowledge from the philosophy of Carl Pop and a bunch of other contemporaries of his, which I won't name, so, but they're the, they're the key influences over my PhD journey. How
Tara Powell:
About the statistics lady? I think she helped you a lot when you said before about the bureaucracy of doing a PhD. I mean, I saw you banging your head against a wall a lot of times about references, statistics, or research methods, all of that stuff.
Jared Powell:
Yep, a hundred percent. Yeah, I've been helped by a lot of different librarians and, and statisticians. And Natalia Acosta actually was really, really important for helping me learn qualitative research, which, which is a method that I hadn't done before. So yeah, I've been too many to name, but definitely been helped by a lot of people.
Tara Powell:
Okay. Well, I guess we're wrapping it up. I just wanna say, you know, on behalf of our family thank you for finally getting this done. Thanks for making me a doctor's wife, but on behalf of the boys and I, we are just so proud of you. And yeah, I think this is just the beginning. Congratulations.
Jared Powell:
Thank you. Let's go out and have a few drinks. Thank you for listening to this episode of The Shoulder Physio podcast with myself, Jared Powell and my amazing wife, Tara Powell. If you want more information about today's episode, check out our show [email protected]. If you like what you heard today, don't forget to follow and subscribe on your podcast player of choice and leave a rating or review. It really helps the show reach more people. Thanks for listening. I'll chat to you soon. The Shoulder Physio Podcast would like to acknowledge that this episode was recorded from the lands of the Ang people. I also acknowledge the traditional custodians of the lands on which each of you are living, learning, and working from every day. I pay my respects to elders past, present, and emerging, and celebrate the diversity of Aboriginal and Torres Strait Islander peoples and their ongoing cultures and connections to the lands and waters of Australia.
