When physiotherapist Jessica Maguire moved interstate to start a physiotherapy practice in rural Australia, she didn’t expect to fall victim to occupational burnout. But there’s a silver lining to her story.

“I was fortunate to work in a fantastic clinic after graduating from physiotherapy, where we had regular professional development and mentoring.

“This helped me develop confidence in my manual therapy skills, and I feel lucky to have felt so supported in my learning journey.

“After several years, I moved interstate to a rural setting and set up my own practice. This was a steep learning curve, and I realised that I had to play several roles: the physiotherapist, the manager of staff and business operations, and wear the hat of marketer.

“It can be challenging working in a rural setting and running a clinic without other physios to talk to or ask questions professionally.

“I was also challenged as I didn’t have the business knowledge to run a business.”

While Ms Maguire says this experience expanded her clinical skills, it was also a key contributor to her eventual burnout.

“After a few years, I hit burnout. I didn’t have the self-awareness to recognise that I was frequently over-riding my neurobiological limits and pushing myself beyond them.

“I did this so that I could manage a full patient caseload and run a business. I would tell myself that ‘it wasn’t that bad’, and ‘I could do it,’ and ‘I just needed to get on with it.’

“The reality was, the expectation I’d set was too high, and I often felt isolated and without support in this role.”

As a result, Ms Maguire reassessed her career trajectory and decided to pursue professional development in neuroscience.

“This led me down a new path, and I added education on how chronic and traumatic stress can lead to chronic pain and poor functioning of the vagus nerve to my work.”

This combination of clinical experience in neurology and musculoskeletal physiotherapy led to a fascination with the potential for the human brain and nervous system to change itself.

“I created the Vagus Nerve Workshops and now run sell-out events around Australia, in addition to working in the clinic.”

“I teach people about the vagus nerve and nervous system, and how stress-related illness such as anxiety, depression, gut disorders, autoimmune issues and chronic pain can arise from dysregulation after chronic or traumatic stress.

“When the pandemic hit, my work online grew, and this is what I now do.”

The Vagus Nerve Workshop and Masterclass helps people get to the cause of their problems, explains Ms Maguire, rather than just relying on others to treat their symptoms.

“It gives a framework to understand the different responses of the nervous system, and how to engage with it rather than being overwhelmed by emotions and physical sensations, giving them their power back.”

11 tips to beat burnout in physiotherapy

As a trauma-informed integrative physiotherapist who has experienced burnout, Ms Maguire shares her tips on beating it before it takes hold.


1. You won’t know everything when you graduate. It’s important to remember that manual therapy and clinical skills take time to develop. Lower the expectations that you should know everything once you graduate, and at the same time have regular study time.

2. If you’re a new graduate heading into private practice, you’ll also benefit by learning about business – things like re-booking patients and marketing can be challenging at first, and you may feel guilty about re-booking. Invest time to learn about marketing too. This may not be something you learnt at university.

3. Don’t be afraid to try different things to keep it interesting: you could offer new group classes, workshops and events that educate patients.

4. Build autonomic awareness so you can recognise when you are over-riding your neurobiological limits. Stress isn’t bad for you as long as you get to recover from the stress activation in your sympathetic nervous system.

5. If you don’t discharge the stress activation, you may eventually get reduced functioning of your vagus nerve (low vagal tone), and this is the beginning of your physiology moving away from its baseline. Research is showing that low vagal tone is what burnout actually is.

6. If your nervous system becomes dysregulated for hyperarousal, you may over-function, become perfectionistic, push yourself harder when you feel stressed. You may find it hard to switch off, to get to sleep or stay asleep. Long-term, it can lead to digestive issues, insomnia and even inflammation.

7. On the other hand, you can become dysregulated for hypo-arousal and under-function when you face stressors. Your physiology has shifted you into a state where you feel flat, fatigued and cynical. You may experience procrastination and find it difficult to complete your work. Long-term, this can lead to chronic fatigue and memory issues.

8. It’s important to recognise when your nervous system needs recovery, support and tools to help with regulation. Without it, these tools, stress symptoms can lead to burnout.

9. As you learn to recognise your stress reaction habits, you then have an opportunity to support your emotional and physical health with self-regulation tools.

10. Recognise that burnout shifts your autonomic nervous system away from homeostasis because of chronic or traumatic stress. This could be from your work in the clinic or other events going on in your life.

11. The antidote is improving the function of your vagus nerve to balance your nervous system.