In this episode of the MACP Podcast, Matthew Low (Knowledge Translation Officer, MACP) speaks with Paula Bright, an experienced musculoskeletal physiotherapist whose career spans over 25 years across both public and private sectors. This episode provides a reflective and future-oriented discussion on the evolving identity of MSK physiotherapy, informed by Paula’s personal and professional journey.
The conversation begins with an overview of Paula’s early career in the NHS, including her foundational rotations and progression into musculoskeletal specialisation. Having spent time working in New Zealand before returning to the UK, she reflects on the comparative dynamics of international physiotherapy practice and the influence of cross-sector experience. Two years ago, Paula made a decisive shift to independent practice, motivated by a desire to align her clinical approach with a more holistic, lifestyle-oriented model of care. Her reflections offer insight into the challenges and opportunities of this transition, particularly in relation to autonomy, scope of practice, and professional identity.
A key thread running through the episode is Paula’s engagement with lifestyle medicine as a meaningful framework for contemporary MSK care. Drawing on a talk she recently gave for the British Society of Lifestyle Medicine on World Health Day, Paula outlines the relevance of lifestyle factors—nutrition, physical activity, sleep, stress, and social connection—in supporting sustainable, preventative health. Rather than viewing these domains as adjuncts to physiotherapy, she proposes their integration as core to an updated professional practice.
The episode also touches on broader issues including the limits of protocol-driven models, the importance of therapeutic relationship-building, and the need for physiotherapy to remain responsive to shifting social and health system pressures. Paula advocates for a practice grounded in values-based care and ecological understandings of health, where practitioners support patients in cultivating their own adaptive capacities.
This conversation offers an intellectually rich and practically grounded perspective on what it means to practice MSK physiotherapy in a changing world. Paula’s experience serves as an inspirational case example of how physiotherapists might reconfigure their work in ways that are both professionally fulfilling and responsive to emerging models of health and care.
Paula’s fantastic talk for the British Society of Lifestyle Medicine is here and I would recommend listeners to have a listen before the podcast episode.
Disclaimer:
The views expressed in this episode represent the personal perspectives of the speakers and do not necessarily reflect the official position of the MACP or its affiliates. This conversation explores varied experiences across healthcare sectors, including reflections on practice within and beyond the NHS. It is intended to provoke thought and dialogue about the evolving landscape of musculoskeletal physiotherapy, not to endorse any singular model of care.
Matthew Low - Knowledge Translation Officer MACP.