Everything thats wrong with elite sport physios…

I have just read this interview with Paula Radcliffe’s physical therapist, and to put it mildly I am shocked  at what he describes as his usual care and routine daily ‘treatment’ of this phenomenally talented, truly dedicated, hard working elite athlete.

In the interview Paula’s ‘physio’, and I use the term ‘physio’ carefully here as really this is only allowed to be used by those suitably qualified, and I am informed he is not actually a qualified physiotherapist. In fact I have been reliably informed that his only offical qualification is one he obtained in the USA in the early 90s in soft tissue massage. This means he has no other qualifications that allow him to assess, diagnose or treat musculoskeletal injuries. So it does surprise me to see him doing just this with Paula in this in his interview, but thanks to a legal loop hole in Ireland where he works he can can call himself a physical therapist.

Anyway, thats beside the point, my main issue is what he goes on in this interview to describe as a daily routine of hours and hours of hard, aggressive, soft tissue massage on Paula that she apparently asks for and needs. He talks about realigning her joints and bones, fixing and correcting muscle imbalances and imperfections, and a pre race routine of acupuncture and joint adjustments that would make the Spanish Inquisition proud, he goes on to explain how this is “no stress for me, and no stress for the athlete”

As I read this article I feel my jaw opening wider and wider, not just at the shear amount of over unnecessary over treatment and out dated, incorrect clinical thinking and reasoning he displays, but more imprtantly I keep thinking how this therapist has probably, without even knowing it, adversely affected this awesome, talented, incredibly passionate, dedicated and hard working athlete he has the honour and privilege to work with.

How has he adversely affected her you may be thinking? Through implanting and infecting her thoughts and beliefs with outdated biomechanical reasoning and pseudo scientific advice, and by reinforcing a reliance on painful manual therapy, and negatively influencing her with over treatments. 

Its such a shame, such a waste, such a tragedy that a therapist like this has probably adversely affected a top level athletes performance. In my expereince therapists treating like this end up instilling negative attitudes in an athletes, causing a lack in self belief and a notion of fragility and vulnerability, reinforcing doubt, uncertainty in their ability and performance, and this can follow them around for life.

I see and hear this a lot in many elite sports, and it seems the more elite the sport, the more often I see and hear it, and the more elite the sport the more extreme these beliefs and rituals seem to get. 

For example I have seen first hand professional athletes think that they need this part of their body rubbed, pulled, poked, cracked, taped, needled before a game or competition, and if they don’t then it will in some way adversely affect their performance.

This is simply not a good place for anyone to be mentally, let alone a professional high performing athlete, and its about time it stops, and it needs to be the therapists and medical staff/teams that need to to change, not the atheltes, its not their fault.

If you want proof that its the therapists and medical teams that create this unique situation, then consider why this behaviour doesnt occur in amateur sports when there often is no therapist or medical staff.

You never see or hear of anyone who plays weekend amateur sports needing a 45 minute pre match rub, or tape applied anywhere or everywhere, or some joints to be ‘realigned’. Can you imaging Dave having this kind of treatment before a Sunday league footie match, if he did he would get laughed out of the dressing room by his team mates and told to ‘f**k off Dave you muppet’, yet in professional sport it’s seen as ‘normal’ behaviour… It’s not!!!

Now many argue that its different in professional sport, the demands on the body are higher, the recovery times shorter and so the risk of injury is higher. And I agree, sort off, but this is not an excuse for over treatment or reinforcing beliefs of fragility or higher risks of injury.

Most of these ‘pre comp’ routines and injury preventative rituals that infiltrate elite sports are complete and utter nonsense, and formed on nothing more than either superstition, out dated thinking or some misunderstanding or miscommunication that an athlete has picked up from somewhere or someone.

This needs to be addressed and re-educated, not encouraged, ignored or glossed over. Yes it needs to be approached carefully, tactfully and sensibly, not like a bull in a china shop that I am often guilty off. But the excuse that “if it helps them then where is the harm” is also not an excuse, the harm comes from reinforcing a sense of dependance and fragility on bullshit treatments and therapists.

All healthcare professionals need to be aware of an athlete (or any of their patients) passing control of their performance over to someone or something else. Instead they should be comfortable, confident and assured that they alone are in control of their own outcome.

Yes healthcare professionals are there to assit and help athletes, but their primary responsibility is to instill a sense of robustness, toughness, and strength, both mentally and physcially with all they they work with. 

Simply put therapists should try to make everyone they work with feel strong, robust, invincible, impregnable, indestructible, basically like f**king superheroes, whether that’s helping them run a marathon, or just climb a flight of stairs.

So physios, lets get our acts together, and make these amazing people we have the privilege to work with feel unstoppable, unbreakable, and downright awesome. 

Make them feel in control of their own performance. 

Make them feel in control of their own future.

Make them believe in themselves, not in you!

 

 

40 thoughts on “Everything thats wrong with elite sport physios…

  1. Well said Adam and something that needs saying! It’s seems I spend most of my time trying to undo the mess left behind by this so called care. No one seems to be able to see the negative effects this has on athletes, IMO Paula would of won an Olympic medal but her perceived fragility couldn’t handle the pressure and she ‘broke’, her magnets and other voodoo providing no help when things really mattered. I see this all the time: the best athletes have no shackles to stop them flying.

      • Thanks Paul

        I must admit you where definitely an inspiration for this article, following your pearls of wisdom and experiences of working with triathletes has reflected my own of working with ‘softer’ athletes from various sports and have followed you in your quest to instil robustness and self belief in those we work with, athlete to average joe

        Cheers

        Adam

        • Appreciated Adam… I feel honoured! Sincerely. πŸ™‚ I feel that physiotherapy can offer so much more to athletes and peoples lives than it presently does, thats my mission I guess. Gold Standard.
          I’ve had quite a few questions myself regarding Paula and such methods of PT care… I’ll see if I can scrawl down some thoughts.

          Westy

  2. I lOVED this article! I’m a physio, don’t work with elite athletes at all, but do as a Lymphatic Drainage Therapist work with clients with lymphoedema, a long term condition that requires long term management. I do know that there are therapists out there that thrive on building similar dependencies to those you’ve described in the ‘elite athlete’ world. I’ve never subscribed to that, I believe that it’s all about empowering the client to manage their condition and giving them the confidence to do so with guidance from me as and when needed, not to become so dependent on me that they feel powerless themselves, so your final 2 paragraphs I think are completely relevent to me and my clients and in fact to all physio’s everywhere. Thanks a million for writing it!

  3. Here, here Adam. It would seem Paula has unfortunately surrounded herself with a poor pit crew. But on the other hand maybe she chooses them. Smacks a bit of the Tiger Woods displaced sacrum saga and the idiots he had “helping” him. Not having ever met the woman I can’t comment on her personality, nature etc. Paula is obviously a phenomenal athlete. I liken her 2.15 marathon to a male sub 2hr marathon. But her psyche is something I’m not aware of. Even though her treatment protocol is maddening, maybe she wants that safety net even though I’m sure it has a negative impact. I was reading an article yesterday about Paula’s final marathon preparation for London and her pathway back. There was a period it said of training in Kenya where she got some Achilles soreness. Now blind Freddie would have just calmed her down, looked at the current training volume, adjusted things a little, eased her back in. But no, they threw everything bar the kitchen sink at her from all over Europe. On a side note I was listening to the radio on the way to work this week and the airwaves were awash with Anzac news as it’s the 100th anniversary today of the infamous battle. The particular radio announcer (who I normally don’t agree with much), was lamenting that Australia has lost its way a bit and we need to get back to old values and in particular “call bullshit when we see it”, I found myself quietly nodding in the car. This article resonates well with me. Let’s all start calling it when we see it ,and in a controlled, intelligent way.

    • Hi Nigel

      Thanks for your comments, and I dont think its just Australia that has lost its way and needs to call bull shit when it see’s it, it seems to me that at times political correctness is handicapping us all

      Cheers

      Adam

  4. My team work a lot with professional dancers, and try really hard to play as little a part in their lives as possible, and it’s an approach that works well and sees great results, with them taking responsibility for their own maintenance as far as possible. Often see some who have been elsewhere and sold courses of realignment etc, and are told they ‘must’ have this or that done pre-performance and you’re right, it just fosters dependency and is more for the therapists benefit than the patients. The human body is tough, and needs a little help now and then, not constant sham nursing.

  5. I enter this debate with caution as I speak as arelative layman here, with an amateur background in athletics, some training in basic physiology, and experience of lots of injuries. I know from recent personal experience how difficult it is to find someone who can help with a difficult injury problem. I hear what you are saying but there are a couple of things which make me want to know more.

    Firstly, the article states he has worked with 73 Olympic medallists. Surely this must be somewhat due to his reputation! I believe he was sought out by Kelly Holmes prior to her double medal runs in Athens when she was having injury problems. He played a small part in her success too. Is he still sought out by athletes as someone who gets results, as that is what it is about ultimately?

    Secondly, I’ve just scanned the article again and he seems careful not to refer to himself as a physio. Sure he may be blurring the line by a single use of the word physiotherapy in response to a question about his work, but does he claim to be a physio? Maybe I am splitting hairs here.

    Also, Paula seemed pretty empowered in her sessions with him and in total control. Paula clearly has as unbeleivably strong will power and I speculate that may have been her downfall in some instances. Therefore, it is all very well making an athlete feel feel ‘invincible, impregnable, indestructible, basically like fucking superheroes’ but the reality is that we are all human and definitely not super heroes. This notion instilled in Paula Radcliffe may have been counterproductive when it comes to training. Each athlete needs to be treated as an individual and may need to be protected from overtraining in some instances. Is not the notion of a blanket feeling of being invincible a danger? It is necessary for competition but may not always be relevant to training.

    Paula Radcliffe’s achievements relative to her peers are amongst the best in the history of athletics. There are very few that can match what she achieved. She must have been doing something right, and therefore so must he.

    • Hi Andrew

      Thanks for your comments, you raise some good points. First who therapists treat is more due to where they work, not on results. Therapists who work in elite professional sports have access to a lot of elite professional athletes, just because he has worked with many doesn’t to me mean much, its simply due to the circles they work in. Also working in elite professional sports is NOT the pinnicle of the career ladder or skill tree, far, far from it in a lot of circumstances

      Also is he sort after because he gives the athletes what they want rather than what they need? Its very easy to do what an athletes asks for, not so much when you know its not what they need or that there is very little it will do or offer them and have to challenge their beliefs and demands.

      Im not that fussed about the physio title thing to be homest, more about the content of what he thinks is good management of an athlete. However the public needs to be aware that physical therapists in Ireland are not trained in the same way, at the same depth or level as physiotherapists, it seems physical therapy is more a set of weekend courses that have little to no accreditation or assessment, more that you pay your money and you get your title… Which is just complete and utter BS

      Lastly the idea that all need to be treated as individual is of course a great point and I totally agree. And yes caring support and compassion are needed at times. However looking at the bigger picture over a longer time frame, too much passive treatment with silly pre race rituals and routines with beliefs that joints are being realigned etc is just NOT helpful for an athletes psyche in my opinion and shouldnt be inforced or allowed.

      Thanks again for some great comments

      Cheers Adam

      • I believe the physical therapist you’re referring to has a wealth of experience working with elite athletes from Sonia O’Sullivan to Usain Bolt. Therefore, it stands to reason that he has a fantastic reputation in the upper echelons of world athletics for the work he does. You have raised some interesting ideas regarding the nature of that work and whether or not it is ultimately helpful to the athletes who he ‘treats’. It’s clear from reading your piece, however, that there is a (not untypical) air of the ‘chartered’ physio looking down on the qualification of the physical therapist. The distinction is a laboured one in your piece. It’s actually quite plain the contempt you show for the profession. However less difficult, demanding, or in-depth the rigours are to become a physical therapist, the real-world, and in Ger’s case, the real ‘elite’ world, will require more than guile, charisma and compassion for his athletes; he has learned ‘on the road’ and has risen to become one of the best physical therapists around. Questioning practices plays just as much of a role in his work as yours.
        Athletes at the elite level engage in neurotic behaviour during training and competition as a function of their personalities; in other words, they would not logically be ‘elite’, putting in inhumane hours of practice, without some degree of neurosis. Individual athletes need support staff with whom they can develop a relationship above-and-beyond that which could be considered professional; moral support is important and, obviously, some are better at giving it than others. It’s patronising to question whether Paula’s mental health is compromising her ability to see through Ger’s ‘mask’ and ‘silly’ therapies. She, and several others like her, have enlisted his support for reasons that you may not fully understand, but should respect IMO.

        • Dear Mas

          Thank you for your comments, however I’m afraid you make some gross assumptions that are untrue, and that I take exception to, not to mention making many logical fallacy’s

          First your appeal to authority is a classic fallacy. Just becuase this therapist is in a position of authority and working with professional athletes does not make him or his approach or methods any better, in fact as I have argued it makes them far inferior

          Next, there is no ‘air of typical chartered physio here’ as you rather patronisingly state. If you bother to read more of my work or follow me on social media you will see I am just as critical of chartered physios as I am of other therapy professions, for example read my 10 worst types of therapists blog from a few months back.

          Next I am not questioning Paula’s mental health, rather her state of mind after it being infected by this biomedical nonsense, a completely different premise and arguement and another logical fallacy you make.

          Finally your plea’s that I should respect this therapist due to the fact that he works with elite athletes is simply ridiculous and again another logical fallacy.

          Please learn these, it will only help your debating and discussion skills in the future should you comment further on any more blogs

          Regards

          Adam

    • Not Irish, not googling, not sporty or treating many sports injuries: I would guess that he played the match and went for surgery very shortly after.
      Hilary

  6. Do you have a link to the original article? The above said I get the impression, and it is only that, from watching her Husband, Gary, he is very much on the anti ‘woo’ side. Watching ‘My Sporting Life’ ITV4 my thought is that he is very driven and takes a no bullshit HTFU attitude. This would be in complete contrast to the ‘Physical Trainer’. Therefore it would appear, to me, that it is strange the two would work together?

    • Hi Tim

      If you click the blue here button it will give you access to the full article. Interesting comment about Paulas husband, and I also get this impression from Paula as well, well I used too until I read this. Maybe this therapist is just embeleshing for thr media article, maybe Paula is requesting all this passive treatment herself, still the jist I get from this is this therapist is not helping psychologically by performing or doing all this realigning of bones ans joints and soft tissue work, especially if he is using terms and descriptions like he uses in the article

  7. Interesting stuff but probably worth pointing out that physical therapy in Ireland is a 3 year Bsc which is very much externally accredited and verified by the national Higher Education and training accreditation committee. Classes are at the weekend but the course is directed towards mature students. The course only addresses one aspect of ‘physiotherapy’ that being msk so the students 3 years are dedicated to this alone. Actually I suppose as physiotherapy students have numerous other areas to study in I’d imagine lecturer contact hours for both in relation to msk might be similar but I would say with confidence that outside lecture study time on msk is much greater for the physical therapist. As regards the quality of the course versus physiotherapy I can’t comment as I have not trainied in physiotherapy.
    One would have hoped before publishing the least you would have done was verified your information rather than putting your name to something so incorrect and ilinformed. Do all the rest of your facts get so poorly researched

    • Dear Dave

      I assume from the disdain and angst in your comment that you are an Irish Physical Therapist and have taken my critique of this individual personally!

      I get this a lot, and I will say to you excatly what I say to any therapist who seems unable to take critisim of their profession or other individuals in it.

      Basically if you cant read a critical review of your profession and be secure and confident enough in your own conduct or behaviour to know that it doesn’t apply to you, then you may want to reflect on why and perhaps take a long hard look at your practice.

      Yes I have done my ‘research’ as you say, I have many colleagues who practice in Ireland who have told me the situation regarding the turmoil over protected titles etc! Most have told me that the courses are poorly accredtited and the syllybus outdated.

      The fact that these Physical therapy weekend qualifications do seperate MSK from the other areas of the human body is not a positive. It is a reason why so many who do them have such a poor understanding and knowledge of how the MSK system works in conjunction with all the other systems especially the neural system and so it just can not be isolated in Ax or Rx.

      I am well aware that there are good, bad and terrible therapists in ALL professions and I do not just pick on Irish Physical Therapists. I have mentioned this before in my other blog on the 10 worst types of therapists here https://thesportsphysio.wordpress.com/2015/02/18/the-10-worst-types-of-therapist/

      So I stand by my thoughts and opinions in this blog, and as I said earlier if you can NOT seperate this individuals practice from your own then thats your problem, not mine

      Adam

  8. That’s a pile of bullshit…. To summarise, you were factually incorrect… Opinions, feelings, thoughts, notions, urges, others opinions or anything else you might have are irrelevant. Who were these people you spoke to, any Irish physical therapist? Let me guess, a few charted physios maybe.
    I have spoken to numerous charted physios who didn’t have any knowledge of some of the most common msk conditions. Actually stunned me. You see it’s an easy game to play. Yours was a petty, ignorant attack on a specific group u know absolutely nothing about. Easy to claim it relates to all therapists now but that wouldn’t have happened if you weren’t challenged on it..

    • Did you bother to read my other blog on worst therapists Dave, the one I wrote a month before this one, the one where I ‘attack’ ALL therapists without prejudice… Good bad and ugly in all…

      I think you need to relax a little Dave, and reflect for a while on why this is winding you up, and as I said you should not take critique directed at others personally!

      And watch your language on my website!

  9. Your ability to judge those you don’t know knows no bounds. You might be amazed at how unwound I am. The month old blog is irrelevant other than to allow you to make a valiant attempt at being a type 1 with your attack on the Irish physical therapist. And the irony of the language warning. Angst seems to be catching. I didn’t lick it off the ground… Always thought ‘bullshit’ was the preserve of those who’s opinion is not to be questioned. Thought I’d see how it worked. At the end of the day you attacked a specific group using factually incorrect statements proving either you or your sources basically don’t know what you are talking about. And there was no need for the attack at all as you confirm by posting your other blog. Of course the best option would be for a good old pat on the back for a job well done and ignore this…. Funny enough I don’t think thats your way either…..

    • Dave, Dave, Dave… you obviously are bothered or you wouldn’t have replied three times now with sweary ad hom laced comments to a 500 word blog, bless ya!

      My 10 Worst therapist blog is irrelevant? Most of my blogs are irrelevant!

      However you did accuse me of ‘attacking’ Irish physical therapists, I therefore choose to show you that I attack poor practice, dubious conduct and misguided thinking regardless of profession, I couldn’t care less if this Hartmann character is a physical therapist, physiotherapist, osteo, chiro or anything else to be honest, I would still highlight and write exactly the same thing.

      And you accusation of attack is simply wrong. I highlight poor practice, flawed thinking and erroneous reasoning is more like it, but I guess this isn’t seen this way by all, especially those who’s income is solely based on developing dependency and a reliance on passive treatments.

      Finally I don’t want or need any pats on the back, nor any other form of recognition, I just decide to write as I see it, take it or leave it, I’m not bothered at all pal…

      You choose to ignore this or not, your choice, but remember this is my webpage, so I can assure you the last word will be mine… Bias is a bitch!

      • Hello Dave,

        You should have remained silent rather than bring attention onto yourself and your so called profession

        Physical Therapist education is a joke in Ireland. 3 years is pushing it.

        I will summarise the courses which enable people to call themselves physical therapists.

        The information is taking from the website of each course. There is the Sports Rehabilitors who come under BASRAT and there is a 4 year degree from DCU or CarlowIT.

        Physical Therapists (Institute of Physical Therapy and Applied Sciences limited) – http://www.iptas.ie/about/what-is-physical-therapy.
        Therapists use highly skilled, hands-on techniques to diagnose, prevent or treat underlying conditions and problems. Physical therapy is founded on a tradition which recognises and values the healing properties of touch. The course is part-time over 3 years. Students attend at weekends. They have no regulatory body or standards of professional practice. They do not publish what training the therapists receive

        Neuromusclur Physical Therapist
        The course is part- time. Students attend for 15 weekends. This equates to 30 days training in total. There is no information if they receive any training on real patients, or if they receive any clinical supervision. The course prospectus states that the majority of graduates work as sole traders in private practice. So in essence, graduates do 30 days training and then open a clinic and start treating patients with no supervision or regulation. The training is run through National Training Centre (http://www.ntc.ie/massage-courses). Their website explains the difference between a Neuromuscular Physical Therapist and a Physiotherapist
        β€˜Unlike Physiotherapy, Neuromuscular Physical Therapy has a focus on the pathophysiology, aetiology and treatment of Myofascial Trigger Points’

        Sports Massage Therapist – http://www.nsrt.ie/upcoming_courses.asp

        It is aimed at giving a comprehensive understanding of the most effective techniques leading to participants having the knowledge and skills to practice professionally as a sports & remedial massage therapist.
        ● Anatomy & Physiology, Advanced Massage
        ● Sports Massage, Soft Tissue Release
        ● Muscle Energy Technique, Trigger Points
        ● Positional Release, Differential Diagnosis
        ● Event Massage
        ● Local Muscular Endurance & Resistance
        ● Training
        ● Rehabilitation of Injuries

        The course is ran over 16 weekends, thus students receive 32 days of training.

  10. Gerry… You need to do a little more research but at least somebody is straight up about this being an attack on a ‘profession’.
    Maybe in my retirement I’ll get round to writing my memoirs. Might include some of the horrendous cases of diabolical treatment some of my patients have had at the hands of chartered physios. Some of it almost immoral. Have seen numerous cases where everyday conditions weren’t recognised. Guess the therapists in question just missed class that day. My blood has actually boiled on occasions at the amout of time and money people have wasted. Learning never stops Gerry….3 or 4 years studying is minuscule in a 40 year career….

    • Dave I really dont know how clear I can make this!!!

      There is no attack on a profession, there is strong critisim of an individual, please point out exactly where I ‘attack’ the profession please!

      • And Dave you may be surprised to hear that I agree with you there are some bloody awful physios out there, just like there are some bloody awful physical therapists out there such as this individual too busy rubbing poor Paula for up to four hours a day and realigning her bones to bother staying current with evidence and research on best practice, which is as you out it, utter bullshit

        Oh and me swearing is ok… My website, my rules!

        • Oh one last thing Dave, you really do NOT sound like a therapist with 40 years experience, more like a petulant teenager throwing a tantrum because someone has questioned his friends haircut or fashion sense… Grow up and learn to differentiate critique from critisim and not take it personally.

    • Dave, I want to thank you for creating this conversation. Between the comments of you and others to this post, and the replies Adam has given, I am certainly getting a rather different sense of his perspective than that which I got from the original article. And, no, I didn’t get the sense he was attacking all Irish physical therapists; one could certainly be forgiven for thinking he was attacking Irish “physios” though (highly belabored as if this was deceptive advertising, then later dismissed as “not really the important thing” when it was gently pointed out that Mr Hartmann doesn’t call himself this at all).

      I know Adam seems to have a bit of a thing for exaggerating the controversy in his opinions, and usually I love investigating what all sides of an argument have to say for themselves – it’s a good learning tool – but given the lack of personal insight and attention to detail this blog and comments display on his part, I’m afraid I can’t see that translating to a very valuable outlook in other areas of “expertise”. There are so many experts out there that possess real insight and back up what they have to say with carefully verified facts – time is far better spent exchanging ideas with practitioners such as these. Our time is valuable, Dave; let us no longer waste it πŸ™‚ (And let’s not worry about Adam, we both know that’s hardly going to devastate him :p ).

  11. Oh Dave,

    You decided to justify the weekend physical therapy course as being more credible than Chartered Physiotherapy in the field of MSK. I posted those linked to highlight to everyone how little training you get. Β£ years training is just not true. Its more like 15 to 16 weekends with the students allowed to treat members of the public after the first few weekends.

    Its hard to believe you would try to justify that your weekend course is in anyway superior to a BSc (Hons) Physiotherapy course.

    Lets be clear,
    30 days training is not sufficient to be a therapist treating any condition. Especially one, where serious pathology masquerade as MSK injuries. SO far in 2015, I have had 3 serious pathologies present as MSK related pain.

    You come across as unconsciously incompetent, the most dangerous type of therapist.

  12. Dave,

    I’m afraid you may be a little wide of the mark here. The CAO which is the governing body for all acredifed degrees and diplomas etc which highlights there is no course that comes u see the name of ‘physical therapist’ However there is course on sports therapy, sports rehabilitation and athletic training from certified institutions or universities where by you get an actual academic award for. Physical therapy is not based within any of these institutions as far as I can see

  13. I’m not far from Hartmann, he charges a few hundred from what I know. He gets a lot of international runners and what not. I was under the impression that he trained in America so you may a US PT and not an Irish PT. Heard him interviewed in the past, he is not short on self confidence.

  14. Hey,

    Yes there is a loop hole in Ireland that allows said Physical Therapists to practice as phyisos – but what we won’t take the blame for – is that he trained in the USA!

    • Yes it is Brendan, however I am lead to believe that Hartmann has not completed a US or UK degree in physiotherapy or physcial therapy, however I cant confirm his qualifications and either way that doesnt really matter, this is in my opinion poor management and clear over treatment of an elite athlete

  15. Evening all. Off the original (and maybe the second & third/!!) topic, but I think US PT is not considered an educational equivalent – nor a pay one, PT used to be the 98th highest paid profession in the states, sorry Adam no reference for that but it might have been (back-in-the-day, FHM). They previously had Masters as entry level, but that was following 3 years of a general university education. MPT included about 15 weeks of clinical experience. The moves are now towards the Doctorate in Physical Therapy (with one whole year clinical in that) being entry level and their assistants will need a Masters instead. I have looked, but I do not think being a US PT would automatically qualify you to work in the UK – and the CSP/HCPC pretty much never say who can as they consider each case individually.

    Can’t for the life of me remember the first point………..

  16. Hi Adam, Came for the article but thoroughly enjoyed the comments as always. Im a lecturer in clinical Exercise Physiology and I suggest to all of my students to read your posts, mainly because professionalism and reflective, evidence-based practice should always transcend petty arguments of which profession someone is officially trained as. Regular readers have seen first hand the wrath that is directed to ANY profession using out-dated, ineffective techniques including physiotherapists. Thanks for making us think and challenging us to be better in ANY profession where we are aiming to move our clients/patient/athletes towards the strongest/fittest/fastest/happiest/most “functional” version of themselves.

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