Neurodiversity
in Practice

This series — Exploring neurodiversity in MSK practice — is published on Substack and explores what it means to work in musculoskeletal (MSK) practice within a neurodiverse world—not as an abstract concept, but as something that shapes everyday clinical encounters.

Across each part, I’m trying to think more carefully about:

• how neurodivergent patients experience MSK care  

• how clinicians interpret (and sometimes misinterpret) behaviour  

• where breakdowns in understanding occur  

• and how we might practise in ways that are more affirming, more accurate, and more humane  

The series is structured across a number of parts, each exploring a different aspect of neurodiversity in MSK practice.

Part 1 —

The Pathology Paradigm vs the Neurodiversity Paradigm

What if many of the problems we locate in patients are actually products of how we frame difference in the first place?

Part 2 —

The Social Model of Disability: What It Means for MSK Clinical Practice

What we often call “non-compliance” or “avoidance” may be less about the person—and more about environments that don’t fit.

Part 3 —

Ecological Diversity & Neurodiversity: Why Context Shapes Everything

If behaviour changes across contexts, what does that tell us about where the “problem” actually sits?

Part 4 —

The Double Empathy Problem

What if communication difficulties in clinical practice are not one-sided, but emerge from a mismatch between different ways of experiencing the world?

New parts will be added here as the series develops.

In MSK settings, we often rely on subtle interpersonal cues — body language, tone, narrative coherence — to guide clinical reasoning.

But these cues are not universal.

If we don’t account for different ways of communicating, sensing, or processing:

• we risk misunderstanding patients

• we may pathologise difference

• and we can unintentionally narrow what “good engagement” looks like
  
  

Thinking about neurodiversity isn’t an optional extra. It’s part of practising well.

This series is ongoing. Future parts will continue to explore how neurodiversity shapes clinical practice — and how we might think more carefully about communication, difference, and care.

Areas I plan to explore further include:

• sensory processing

• executive function

• communication across neurotypes

• masking and burnout

• co‑regulation and safety

• practical environmental adaptations

Each part draws on a range of perspectives across neurodiversity, disability studies, and cognitive science. A fuller set of references is included within individual articles in the series.

If any of this resonates, you can follow the full series on Substack, where each new part is published.