Connective Issues — Introduction to Louis Gifford – Aches and Pains – Part 1

I will not let anybody walk through my mind with their dirty feet – Mahatma Gandhi

Happy anniversary. A sequence of events that has happened to me (and most likely, you) over the past year is that in March last year I got shut down for 15 weeks, I reopened in July, I taught a manual trigger point therapy class in August and decided to suspend all teaching soon after. What with the masks, the distancing, the two-person bubbles, the constant sanitization, the open windows with traffic noise and the inability to have all the students feel my hands, it just didn’t work for them or for me.

I don’t know about you, but I’ve really gotten to enjoy treating patients in my clinic with a renewed enthusiasm. Numbers are down a bit, but that gives me more time to think. I get a new interesting patient every week. Funny thing is that I’ve never seen their faces. I could pass them in the street later in the year and not recognize them. My thoughts are that pain may even be exacerbated in the pandemic. What do you think? Because of masking-up I’m not treating in prone, but that’s made me quite inventive.

As you’ve known by my previous thoughts and writings I have a belief that there is not just one way to view treatment of pain and dysfunction; assessment, informed decisions, treatment plans, implementation and homecare. Many times all we are doing is buying time while the patient figures out how to be well, themselves. This blog is the first of three; Introduction to Louis Gifford, the Mature Organism Model, and lastly the Shopping Basket Approach.

There are many pain models in the literature to help people understand aches and pains. Among them we could include the ‘Biomedical Model’, the ‘Vulnerable Organism Model’, ‘the ‘Fear Avoidance Model’ and the ‘Biopsychosocial Model’. They all have their merits and I’m sure you have used some or all of them to help educate and treat your chronic pain clients.

I want to bring to your attention one writer on the subject of pain in particular. Louis Gifford (1953-2014)  was a UK-born physical therapist hugely respected around the world who amassed a huge collection of material; lectures, youtube videos and writings that are mostly free to download.


In 2007 Louis was diagnosed with prostate cancer. He lived seven more years and during that time wrote the 3-book collection that he called ‘Aches and Pains’, published posthumously. What a perfectly titled set of books. That’s what we therapists deal with, right? The Aches and Pains trilogy comprises 1. Aches and Pains, 2. The Nerve Root, and 3. Graded Exposure and Case Histories. The three books amount to over 1300 pages of page-turning material.

Gifford’s writing style is highly individualized, thus defying traditional classification. You get a real insight into the whirring cogs of his curious mind. Sections are written quite idiosyncratically, making them very interesting, quite personal, including many case studies, and can be used by any type clinician working in the pain relief field, not just physical therapy.

I also have in my library a densely written book called ‘Pain Models’ by Handwerker and Arendt-Nielsen. It mentions none of the Gifford concepts above in its four hundred plus pages. It does mention trigger points just the once, unlike any trigger point references in Aches and Pains that I’ve come across.

Cheerio for now,


Louis Gifford – Part 2 – The ‘Mature Organism Model’

What is this ‘Mature Organism Model’?

The one model that I like to use often is the ‘Mature Organism Model’  (MOM), as promoted by the British physical therapist, Louis Gifford. From 1978 to 2013 Louis studied with the best therapists (Maitland, et al), practiced in rural England, and taught world-wide. He was friends with legends in pain models like Pat Wall, David Butler, Lorimer Mosely and Mick Thacker. He was a thought sampler – never believing that there was just one way to treat pain.

Louis Gifford – Part 3 – The ‘Shopping Basket Approach’.

Cheerio for now,