The 10 worst therapists…

Inspired by some recent discussions and blogs that have taken a critical look at their own professions and some individuals in it, such as this on personal trainers by Bret Contreras, I thought I would do the same and reflect on some of the worst types of therapist I have had the misfortune to come across in my career. But, a word of warning, if you are the sensitive or easily offended type, then you may not want to read on as you may find yourself becoming the worst types of therapist, an angry one.

If you do read on and you do begin to feel angry or agitated, then you may want to ask yourself why? Is it that perhaps some of these traits are uncomfortably familiar in yourself? If so, don’t panic, there is some advice on what to do at the end! Let me also make it crystal clear that I am addressing all the professions here, physios, osteos, chiros, sports, remedial, soft tissue etc, I refer to you all equally and cast you all under the same scrutiny, in equal measure.

So without further ado, let’s get started and look at the 10 worst types of therapist…

No 1: The ‘my therapy is better than your therapy’ Therapist

Like it or not, there is a hidden, and sometimes not so hidden, hierarchal war between the therapy professions that makes ‘Game of Thrones’ look like a child’s nursery rhyme. Many therapists can often be heard bitching and slagging off other professions, claiming that the way they have been trained is far more superior and far more ‘sciencey’ than the others.

These therapists pontificate about how their methods and approaches are more effective in getting patients better, quicker, easier than others, and because they have been established since 1463 during the reign of King Archibold III they are the senior profession and so, therefore, the best!Bullshit! There is as much of the good, the bad and the ugly in all the therapy professions.

Bullshit! There is as much of the good, the bad and the ugly in all the therapy professions. None can claim any superiority or moral high ground over any other. All have their merits, all have their embarrassments. As a physio, I am clearly biased to the physio profession, often finding myself immensely proud to call myself one. But unfortunately, I am also just as often embarrassed, ashamed and disappointed to call myself a physio, as some muppet goes and says or does something stupid, gimmicky or pseudoscientific.

No 2: The ‘latest fad’ Therapist

Fluorescent stretchy tape, metal massage tools, electro acupuncture, myofascial release, anatomy trains, thoracic rings… you name it these therapists will claim it is the best thing ever to happen to the profession and that it is the most effective, useful, wonderful method for fixing patients ever… until next month when the next sparkly gimmick comes along!

These therapists will jump from fad to fad, they will buy the gadgets, they will ask their patients to buy the gadgets, they will defend the gadgets and the guru teachers of these wonder cures from any skepticism and critique.

But more importantly, they will lose sight of what they should be doing with their patients. The giving of simple honest advice combined with progressive movements and exercise. These therapists stop thinking for themselves, instead of letting some guru infest their own clinical reasoning with their distorted profit driven bullshit.

No 3: The ‘guru’ Therapist

Eloquent, confident, witty, and usually good looking, the ‘guru’ therapist is able to enthrall and dazzle audiences with their charisma and charm. They show therapists the errors of their ways and how they have been doing it all wrong for so long, and how if they do it their way it will be better.

The guru therapist has a slick website and marketing image, they develop a loyal following and surround themselves with sycophants who hang off every word they say. They reject and attack any skeptisim or critique as being disrespectful or having an impolite ‘tone’ and so refuse to debate with any impertinent up start who has any opposing views.

The ‘guru’ therapist will have many, many anecdotal stories, pictures and videos of patients demonstrating amazing instant improvements, they may even do live demonstrations of these impressive feats during their courses ‘shows’ and book launches. What they won’t show you is any peer reviewed evidence or be able to explain why these methods are not repeatable in other situations/environments, blaming the therapists for doing the method incorrectly, rather than let the method itself come under scrutiny.

No 4: The ‘celebrity’ Therapist

More concerned about WHO they treat than HOW they treat, the celebrity therapist will attempt to prove their credentials and skills by showing photos of them standing next to, shaking hands with, hugging, or even posing in a cheesy thumbs up position with a ‘celebrity’.

The celebrity therapist will boast about their status and their famous friends as often and as vociferously as they can, claiming that they were hand picked to support the celebrity due to their reputation or skill set, when in fact it is usually only due to a friend of a friend pulling a few strings to get them connected.

And when I say ‘celebrity’ therapists I am very much including professional sports therapists here. Despite it being a very popular career choice, working as a professional sports therapist is NOT the pinnacle of the skill tree or the clever ladder. Just because a therapist has worked in professional sport does NOT automatically make them more skilled, more qualified, more intelligent, than any other therapist, they are simply more used to working with a different client group, which has its pros and cons for them.

No 5: The ‘I’ve got more qualifications than you’ Therapist

These therapists are easy to spot, they are the ones who always place the full 26 letters after their name on every single letter or email eg Dr A Noying BSc (hons), MSc, PhD, MACP, SRP, CSP, CSCS, NASA, ASAP, PDQ, JLS, DFS… FFS!

They think these initials are like medals to be displayed and the more the better. They also tend to go to great lengths to introduce themselves by their qualifications when you first meet them, telling you very quickly which university they are associated with, and will soon ask you for your affiliations and qualifications to decide if it’s worth talking to you any further.

They seem to think qualifications are all that’s needed to make a good therapist, they think reading the research, or staring down a microscope, or working in a video analysis lab tells them how best to manage patients, not that many of them have actually managed a patient for many years, if at all. They have forgotten that being a therapist isn’t just about treating pathology, it’s about treating PEOPLE with pathology.

No 6: The ‘I’ve got more experience than you’ Therapist

Thirty-eight years doing this job and these therapists have been around since the dawn of time. They are the Yoda’s of the professions. They can be spotted by the wise forlorn look in their eyes, the weathered and worn hands from years of manual therapy and are often seen flicking through the current pension investors handbook.

Although immensely wise and experienced in the art of dealing with people, most of these matriarchs are now unfortunately hopelessly out of touch with current practice, having long ago becoming tired of the constant change in practice and methods, and so have given up.

They have not attended a course since 1986 which was on current concepts in Faraday bathing, and the last journal article they read was on how friction massage breaks adhesions and increases blood flow. They think the profession is on a merry-go-round and if they stay still long enough it won’t be long before what they have always done comes back into vogue. They are now quick to crush new ideas and thinking as youthful exuberance and inexperience and are keen for younger therapists to learn from them and follow in their ways happy now to trust their years of past experience rather than current research or evidence.

No 7: The ‘lazy unfit’ Therapist

The lazy, unfit therapists are easy to spot, they happily give out advice and education to patients on lifestyle and exercise left, right and centre, yet it is clearly obvious they do not follow their own advice. They are the ‘do as I say, not do as I do’ therapists.These couch potatoes are quick to advise patients do more exercise, get fitter or stronger yet look like they haven’t run to the end of the street since they were a kid, or lifted anything remotely heavy repeatedly apart from their own fridge door. They will often ask a patient to do an exercise that they themselves have never done or are unable to do, and when on the rare occurrence they do attempt to demonstrate an exercise they tend to look like a drunken walrus… on roller skates… with bad asthma!

These couch potatoes are quick to advise patients do more exercise, get fitter or stronger yet look like they haven’t run to the end of the street since they were a kid, or lifted anything remotely heavy repeatedly apart from their own fridge door. They will often ask a patient to do an exercise that they themselves have never done or are unable to do, and when on the rare occurrence they do attempt to demonstrate an exercise they tend to look like a drunken walrus… on roller skates… with bad asthma!

No 8: The ‘functional movement’ Therapist

These therapists are also easy to spot, they will be wearing Vibrams, or worse walking about in bare feet, carrying a copy of ‘Become a Supple Leopard’ and tend to say tri-planar, or 3D in every other sentence. These are the disciples of Applied Functional Science. They insist all must do backward lunges with trunk rotation and a contralateral shoulder driver. Poor old Ethel only came in for some exercise after her knee replacement!

The functional movement therapist has no time for frivolous nonsense like squats, deadlifts or shoulder presses, instead insisting they work on floor mats with grids and crosses marked out all over it, Kaiser cable machines and voodoo bands. The functional movement therapist also has no time for any exercise that involves standing on two legs or moving both limbs together. Simply put if you ain’t standing on one leg, on a bosu whilst waving a limb about you just ain’t functional bro!

No 9: The ‘alternative’ Therapist

These therapists are often seen munching on some vegan lentil soya bean salad whilst discussing how their chakra is off centre due to some misalignment in the planets this week. They will consult the horoscopes and astrology charts rather than research journals and has an array of strange shaped rocks and lumps of coloured glass on their desks that they occasionally rub over patients, thats if they touch them at all, usually preferring to work on patients auras and energy fields.

They will also constantly talk about the life force that flows through all of us, yet have absolutely no idea who Obi Wan Kenobi is or understand you when you tell them “these are not the droids you are looking for”

No 10: The ‘profit driven’ Therapist

I saved the worst type of therapist for last. The profit driven therapist is a cancer in all of the therapy professions and needs to be hunted down, exposed, and then eradicated. These therapists are more interested in patient retention than turnover. They are more interested in cross sales than the outcome. They are more interested in money than patient welfare. Don’t get me wrong I am all for people making an honest living and fair payment for professional services, but there are some therapists that have NOT got their moral compasses set straight.

These therapists scumbags will often get patients to sign up to expensive, extended treatment plans, requiring multiple visits, by instilling fear and selling sickness, they depend on patients developing a sense of trust and need on what ever pseudo scientific bullshit they are pedalling in a belief that it is fixing or curing them. They will also ensure patients have brought orthotics, tape, braces, foam rollers and any other add ons that they can push onto the poor patient regardless if they need them or not.

They advertise their services anywhere and everywhere, rather than rely on word of mouth, as they have none. They are usually in collaboration or partnership with other likeminded businesses scumbags and all tend to promote each other and form groups that self-feed referrals and so more profit for each other. These are the worst type of therapists and need to be pushed out of the profession.

Conclusion

So there you go, that’s my look at the worst types of therapists. If you do recognise a few traits here in yourself, don’t be mad, and don’t panic, none of us are perfect, me far from it, I’ve been a good few on this list during my career. However, if you do recognise a few things in yourself, whats more important now is what are you going to do about it?

Remember making mistakes isn’t a crime, not learning from them is…

Learn, improve, and become the best you can be to help those that matter the most, our patients!

As always

Thanks for reading

Adam

54 thoughts on “The 10 worst therapists…

  1. Thanks for this article.

    I am seeing a private physio for Haglund’s Deformity which is causing insertional achillies pain.

    After 4 weekly appointments the pain is still there.

    I don’t think I am being milked for my money but I am concerned about the cost.

    As well as getting rid of the pain I also need to gain calf flexibility – I can’t hop on my injured leg.

    Can you give me some indication as to how long this kind of condition requires treatment?

    Thanks.

    • Hi, im afraid it is impossible for me to give any personal advice online as I really need to take a history and assess you!

      But on average insertional Achilles tendinopathy can be tricky to manage, and can take 3-6 months to settle!

      The key to successful outcome is appropriate management of activity, enough to load but not too much to aggravate significantly, and I usually don’t advise stretching as this tends to aggravate and not help insertional tendinopathy as it contributes to compression forces!

      Instead a heel raise to help off load and regular and steady calf strengthening which needs to be tailored to your ability and pain

      Regards

      Adam

    • I generally say to clients if I cannit sort out your problem within 3 weeks it is not what I thought it was I thjnk you need to ask the question has your therapist established what is wrong what has caused the issue.

  2. What about Diane Lee and her daughter and their fantastical approach to magical pelvic dysfunctions. Thoracic rings an all there has to be some truth in it. I can’t wait for their next book is it called the Hobbit??

  3. Awesome read, I wish everyone took this down to earth approach to manual therapies! The one thing I disagree on is anatomy trains being a fad… I would swap these for the ‘kinesiology tape’ fad hands down haha. Well done

    • I can tell you that anatomy trains is one big pile of Bullshit ! imo. way worse than K-tape. I’ve been to one of their €800 4-day courses, after being convinced by some of my collegues. I didn’t make it past day 1. I never imagined that it was possible for someone to tell (and demonstrate) so much BS in such a short period of time. The naivity of 90% of those present was even more worrying.

      Love the anatomy and biomechanics of the myofascial system, hate the non-scientific, commercialized, look-at-me-I-do-complex-stuff, arrogant, exploitation of it by this anatomytrains assessment and “treatment” concept. You shouldn’t even need to be a physio to realize it’s BS, just some common sense (and a bit of criticism) will do. If you try to be an evidence based practicioner don’t even think about it, as you’ll hardly find any references in the back of the course, instead you will find a pricelist of their products you can waste some more money on.

      If you really want to waste your money, you’ll be better of buying some K-tape, as that can be useful for markings on your gym floor for some skipping exercise or something.

      Excuse me for ranting, frustrations are still fresh

  4. Hi, there’s one more type of therapist you must know, that is workshop driven therapist. These people spent their life only to conduct workshops. They won’t be having any experience or publications work in their so called workshop topic.

  5. Excellent reading Adam. Do you have a definition of : The “Expert” Therapist? Here’s what they say:

    1. The ‘Expert’ therapist works individually with clients and do not offer the same treatments as other therapist.
    2. Due to a wide range of therapies the “Expert” Therapist offers he advise you to not see other Therapist for the safety of his work.
    3. Client’s don’t realise the full extend of what the “Expert is doing or the effect of mixing different treatments.
    4. Other Therapist cannot tell or understand the type of work the “Expert” is doing with clients.
    5. The “Expert” often say your body work is not the same as my body work
    6. The “Expert” usually offer all in one session the following: psychotherapist work, bodywork, reflexologist sports therapy, reiki healing and physio exercise.
    7. He follow professional etiquette and ethics.

    Regards

    Ben

  6. Sadly the above is very true. All you can do is hope that honesty, research, knowledge and hard work wins out in the end in building a long term successful practice. The busier your practice gets, the less you tend to worry about others.

  7. Hey Adam,

    I’m just a student finishing up the program in a few months. This is something I’ve seen on every single one of my internships so far. I’ve seen it when I’ve gone to different professionals for treatments too.

    Your honesty about it all is refreshing! Gives me some hope when I graduate haha

    Cheers! Iyad

  8. Adam, I would so love to share this but number 7 makes that impossible. Equating fat with lazy is a false connection. It’s more than problematic to use a derogatory term like ‘fatties’ and imply people are large because they don’t exercise, and are also therefore lazy or a bad therapist. Number 7 takes the irreverence (thumbs up) into insulting, and in this instance you may have failed to check your own biased assumptions about being large.

  9. I recently stumbled upon Naudi Aguilar. To the best of my knowledge, I don’t think he holds any formal degrees in the health sciences. Anyone asking him questions is viewed as a threat and he quickly goes on the attack rather than answer the questions, even if innocent and well-intentioned. Your article hit the nail on the head and accurately described him to the letter. Very sad that people trust these types of pseudo gurus. I’ve trained as both a dietitian and clinical exercise physiologist and have been in the industry 26 years. Ive found that every aspect of the health industry has been overrun by this type of charlatan, especially with social media fueling the fire and fanning the flames.

    Keep up the good work amigo.
    Cheers
    Bill

      • Hi Adam, this really cheered me up! I wonder if there is another type – the humourless therapist! I once wrote an article in Frontline magazine for a new column (since dropped) about working as a (mature) junior physio on the elderly rehab wards and how some of the patients mistook me for a doctor or a consultant despite wearing a white polo shirt – I joked that perhaps they thought I had come off the golf course and was doing my ward round. This generated a very frosty letter from a (female) therapist who said consultants she worked with didn’t spend all their time playing golf and was I trying to be funny etc………..well yes! Something about stereotypes male/female!

        Keep up the good work! Phil

  10. I was laughing to myself over my morning coffee. Good article, nice to see the profession not take themselves so seriously all the time and realize we are actually human beings. My other fav is the I work for your modalities company therapist. This person comes in twice a year to lecture us on how only their NMES, SWD or US machines will give any results, based on their own corporate funded research of course.

  11. very nice to see you have a strong moral compass in the PT world. especially enjoyed your functional rotational movement therapist and the profit driven therapist. good read!

  12. Hi Adam!
    Great article – thanks for that !
    I’m desperately trying to find a second opinion about Douglas Heel and his “Be activated” – course ( http://www.douglasheel.com ) which he is holding all over the world. My physiotherapist is using Heel’s “approach” and my BS-detector is ringing like crazy. But I’m struggling with finding anything critical about Douglas Heel on the Internet – he just seems to be super succesful. Do you know anything about him ?
    I’m struggling with Patellofemoral Pain Syndrome and one particular thing my PT is doing every time is:
    He makes a strength test in my legs where i push or pull against his arm ( very much like that: https://www.youtube.com/watch?v=49CvzZW8L_U )
    Then he tells me he is gonna make me stronger and presses for maybe 10 seconds on a spot between my belly button and the rib cage and also on the psoas in my sides. It really hurts.
    He repeats the strength test , this time he tells me I’m stronger ( I’m “winning” against him ). I also can feel a difference. When i ask him what he is doing, he says he is activating my muscles through the lymphsystem , but thats it – he kinda refuses to give further explanations…
    I’m leaving him – but I really would like to understand if there is any sense or even clinical evidence for what he is doing ( and Douglas Heel ).
    If you ever have some time to answer me I would highly appreciate it !
    Thank you !

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