Practical Communication Strategies for Physios

Most physios care deeply about helping people make positive change.

We want our patients to feel better, move better, and get back to what matters to them. Sometimes, we care even more than our patients do! This blog is for every physio who’s ever left a consultation thinking, “I explained that really clearly and the message seemed to get across, so why hasn’t anything changed?”

Communication is one of the biggest drivers of outcomes. But because of that influence, it’s also one of the easiest areas to unintentionally slip up. We’re trained to assess, diagnose, and solve problems, so it’s no surprise that our natural instincts can sometimes get in the way.

We’re often told that communication is key, but how often are we actually given practical skills to implement it? That’s where Dr Alison Sim’s Communication Masterclass fills an important gap. She shares communication strategies that are immediately applicable in the clinic. This blog highlights three common traps even experienced physios fall into, along with some implementable strategies to shift your approach.

If you want to learn all the communication tips and tricks to not only help your patients but also help you become a better clinician, watch Dr Alison’s Communication Tools for Treating People in Pain Masterclass here.

Trap #1: The ‘righting reflex’

When someone describes a problem, it’s natural to want to fix it straight away. This “righting reflex” is part of what makes us good clinicians, but it can sometimes shut down exploration and cause patients to disengage, even if they’re nodding along.

Jumping straight to solutions can mean we miss important context about a patient’s beliefs, worries, or goals. It can also shift the conversation from collaboration to instruction. This is where Motivational Interviewing (MI) skills can help, enabling patients to explore and strengthen their own motivation to change. First, for a little background, watch Alison explain some of the evidence regarding the efficacy of MI in this clip from her Masterclass:

Practical strategy to avoid this trap:

A helpful way to shift this dynamic is to lean into curiosity. Alison introduces OARS as a simple framework to guide conversations: Open-ended questions, Affirming, Reflecting, and Summarising.

In this context, open-ended questions are particularly useful. Instead of steering questions towards your preferred answer, ask questions you genuinely don’t know the answer to. Approaching conversations with real curiosity helps build trust, deepen rapport, and uncover context you might otherwise miss. Importantly, a common concern is not having enough time in a consult, but Alison emphasises that these communication strategies don’t actually lengthen appointments.

Trap #2: Assuming knowledge = change

It’s easy to assume that once a patient understands their condition or treatment plan, change will naturally follow. But behaviour change is rarely that straightforward.

Change is driven by personal motivation, and patients can hold conflicting thoughts at the same time. They might want to exercise more but feel worried about pain. They may believe activity is helpful but still fear flare-ups. Understanding doesn’t always translate into action.

Practical strategy to avoid this trap:

Recognising ambivalence is key, it helps you identify when a patient may be ready to consider change.

These are the patients we are best placed to support to change. If the patient is in the pre-contemplative phase, pushing the conversation can simply lead to resistance.

Reflective listening can be useful here. By reflecting back what you hear, you show that you’re present and understand their experience, which often encourages patients to expand on their thoughts. This deepens the conversation and strengthens the therapeutic alliance, which is linked to better outcomes.

Trap #3: Trying to persuade

When a patient seems stuck, it’s tempting to explain more.

We might offer more evidence, or more reassurance in the hope it will convince them. We might even try to counter their concerns with evidence-based rebuttals, trying to challenge the unhelpful beliefs they may have around change.

This usually comes from a genuine desire to help, but trying to persuade patients to change is often ineffective, and focusing on the negatives (i.e., the reasons not to change) can be detrimental. Alison highlights that people are more likely to be influenced by what they say themselves. Rather than trying to talk someone into change, the aim is to help them talk themselves into it by promoting discussion around the reasons to change, rather than the reasons not to.

Practical strategy to avoid this trap:

One simple tool is the Importance Ruler. Watch Alison explain how this tool can be applied to address both trap #2 and trap #3 in this clip from her Masterclass:

Wrapping up

Most physios genuinely try their best to communicate effectively, and we have many strengths in this area. But while we’re often told communication is important, we’re rarely taught how to implement it in practice.

Behaviour change is challenging for physios too, so starting small and experimenting with individual skills can make it feel more manageable. When we slow down and stay curious, communication becomes a big part of our intervention. It creates space for patients to feel heard, and ultimately supports better outcomes.

If you want practical tools to refine your communication and support behaviour change more effectively, watch Dr Alison Sim’s full Masterclass now.