The Rehabilitation Medicine Group

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The Rehabilitation Medicine Group

The Rehabilitation Medicine Group develops evidence-based online pain rehabilitation programs for people whose pain persists longer than expected.

Evidence-based online pain rehabilitation programs for people whose pain persists after knee replacement, spinal surgery or due to non-surgical back conditions. Our programs are designed to help people understand persistent pain and use safe, research-informed strategies to reduce pain, improve function and regain confidence in everyday activities — at home and at their own pace. The RMG was foun

ded by Dr Nathan Johns, a specialist Rehabilitation Medicine Physician. Our flagship program, Kneed, was developed during doctoral research at Monash University and evaluated in a randomised controlled trial. This research-led approach underpins all programs developed by The Rehabilitation Medicine Group. We provide education and self-management programs. Our online programs do not diagnose conditions or replace individual medical care.

12/05/2026

Understandably, when back pain persists, many people become cautious with movement.

It can feel safer to avoid activities that might trigger pain or damage the spine.

Rehabilitation should focus on learning that the spine is designed to change as we age and designed to move. Normalising movements is an important step in recovery.

Normalising movements moves to normalising activity, rebuilding confidence and getting on with life.

Progress gradually with a goal in mind.

If your back pain persists and you want a change of approach, you can find more information and a free educational program below:

https://thermg.com.au/spined/

05/05/2026

Many people with persistent back pain have already tried several treatments:

- Physiotherapy.
- Medications.
- Exercises.

Sometimes improvement stalls and this can leave people feeling unsure of what to try next.

Rehabilitation medicine should take a broad approach - looking not only at the spine but also at movement patterns, nervous system sensitivity, sleep, stress and activity levels.

Research shows that recovery starts when pain is understood as danger rather than damage. This allows for reduced protection of the back and restoration of normal movement patterns.

To find out more and understand why pain persists and what to do about it, click on the link to a free program below:

https://thermg.com.au/spined/

28/04/2026

Many people assume: “If my back still hurts, something must still be damaged.”

But the relationship between pain and scans is not always straightforward.

Changes such as disc bulges and degeneration are commonly seen on MRI scans - even in people who have no pain at all.

Pain is produced by the brain after it receives and interprets signals from the body.

When pain persists, rehabilitation focuses on helping the body and nervous system become less sensitive to movement again.

Understanding this can change how people approach recovery.

For more information, click on the link below:

https://thermg.com.au/spined/

21/04/2026

Back pain is expected to settle.

And often it does.

But for some people, pain continues for months - sometimes years, even when scans look reassuring.

This can be confusing.

The explanation lies in pain being produced by the nervous system to protect the body. Over time that system can become and remain increasingly sensitive, even after tissues have healed.

When this happens, rehabilitation needs to focus on reducing sensitivity and reducing the protective response to allow normal movements and activities.

Understanding why pain persists is often the first step toward moving forward.

That's why we've created a free educational program available here:

https://thermg.com.au/spined/

16/04/2026

This might sound familiar...

You developed back pain.
You did the right things.
You saw your doctor.
You tried physiotherapy.
And yet the pain is still there.

Often a scan report says something like:
“degeneration”
“disc bulge”
“facet joint arthritis”

It’s easy to assume that these findings must be the cause of the pain.

But here is something that often surprises people.

Many of these same changes are also seen in people who have no back pain at all.

The relationship between pain and what appears on a scan is not always straightforward.

When pain persists, rehabilitation focuses less on the scan itself and more time focussing on what actually leads to persistent pain.

Understanding this difference is an important step forward.

If you would like to explore this idea further, you can read more about it below and enrol in a free educational program.

https://thermg.com.au/spined/

01/03/2026

It’s estimated that 70% of people recover well from an episode of back pain in 12 weeks.

But that still leaves 1 in 3 people with pain.

And often this pain is associated with difficulty sitting, walking and bending.

It can interfere with exercise, sleep and other activities.

When we look at MRI and CT scans, the way the back looks usually doesn’t tell us who will get better and who won’t.

Unlocking why and how people recover well informs our pain rehabilitation programs.

18/01/2026

Welcome to The Rehabilitation Medicine Group.

This page is for people whose pain has persisted longer than expected after knee replacement, spinal surgery or due to non-surgical back conditions.

Continuing pain can impact on walking, sleep, confidence or daily life.

This experience is more common than most people realise.

Persistent pain does not necessarily mean that something has gone wrong.

Often, it reflects how the nervous system and body adapt after injury or following surgery, becoming more sensitive and protective over time.

At The Rehabilitation Medicine Group, we focus on pain rehabilitation:

- understanding why pain can persist
- explaining pain in clear, non-alarming ways
- and sharing evidence-based strategies used in rehabilitation medicine when recovery has not followed a straight forward path.

Our programs are developed by Dr Nathan Johns, a specialist Rehabilitation Medicine Physician and are based on contemporary pain science and clinical research.

If you’re here to better understand pain, you’re in the right place.

Th page is educational only and is not intended to provide individual medical advice, diagnose conditions or replace care from your clinicians.

28/10/2025

The Kneed trial results:

Now available to the public: https://thermg.com.au/kneed/

26/10/2025

Should you push through pain after a knee replacement?

For as long as I've been practicing in rehabilitation medicine (25 years), patients have been encouraged to push through their pain (keep going despite increasing pain) after surgery to achieve a better knee bend (range of motion).

But is this the right thing to do? 🤔

There are 3 different strategies for exercise and pain...

(i) 😣keep exercising even though pain is increasing (no pain-no gain)
(ii) 🐢stop exercising before pain increases (pacing)
(iii) 🙈 don't exercise if you have pain (avoidance)

This has not been studied after knee replacement, but has been studied with chronic pan conditions:

🙈 The avoidance strategy (iii) is the least successful and should itself be avoided.

😣 The no pain - no gain strategy (i), whilst better than avoidance, may contribute to muscle inhibition (reduced range of motion due to pain) and the learning that exercise leads to pain. This may lead to sensitisation and persistent pain.

🐢My preferred choice is pacing, especially if pain lasts more than 3 months after surgery. This is to keep exercising, but stop before pain increases. This means that you have to do multiple exercise sessions rather than doing it all at once.

💻The Kneed online pain rehabilitation program teaches the pacing strategy and this, I believe, is one of the fundamentals to reducing pain after knee replacement.

🎓Further studies on Kneed will investigate whether people who successfully reduced their pain used this strategy.

Learn more about Kneed 👉 https://thermg.com.au/kneed

24/10/2025

🦵Why does pain persist after knee replacement?

Knee replacement surgery can be life-changing — but for some people, pain doesn’t fully go away. In fact, around 1 in 4 people continue to experience moderate to severe pain months (or even years) after surgery.

So why does this happen? 🤔

Persistent pain isn’t just about the knee joint itself. It’s often the result of a mix of factors that interact in complex ways:

🦠 Osteoarthritis pain before surgery: the longer you’ve lived with knee pain, the more sensitive your nervous system may become.

🧠 Sensitisation and personal risk factors: things like long-term pain, stress, poor sleep, or anxiety can make the body’s pain system more sensitive.

🔪 The surgery itself: even when surgery goes well, the body and nervous system can experience significant changes.

⚠️ Post-operative complications: our research found that this increased the risk of severe pain

⚡ Neuropathic pain: nerves themselves can be injured or sensitised, leading to burning or shooting sensations.

Persistent pain doesn’t mean your surgery “failed” but it means that your pain system has changed and it needs extra care and retraining. 💪

The Kneed pain rehabilitation program helps people understand and reduce their pain safely and from home.

You can learn more about pain rehabilitation approaches here: https://thermg.com.au/kneed/

23/10/2025

😴💤 Is poor sleep making your knee pain worse?

If you’ve had a knee replacement and still find yourself awake at night — you’re not alone. Many people experience sleep problems before and after surgery, and here’s the problem:

👉 Lack of sleep can actually increase pain sensitivity, making recovery even harder.

Research shows that pain and sleep are closely linked — when one gets worse, so can the other. It can become a frustrating cycle: pain keeps you awake, and being awake keeps you in pain.

💡 The good news?
Small changes in your sleep routine and how you think about pain can make a real difference.

That's why Kneed, our online program for people with pain after knee replacement, includes modules on sleep, relaxation and understanding pain.

👉learn more at: https://thermg.com.au/kneed/

Address

441 Bay Street, Brighton
Melbourne, VIC
3186

Website

http://www.thermg.com.au/

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