I often get accused of not being a ‘proper’ physiotherapist. Many call me a glorified personal trainer in some misguided, delusional, laughable belief that this is an insult to me. Many think that because I don’t use manual therapy, or electrotherapy, or dry needling, or taping, or any other crappy adjunct to help people in pain or with disability, preferring to only use education and exercise that I am not fit to call myself a true physio.
This makes me both laugh and cry at the same time. First it makes me laugh that many physios have the arrongant belief that personal trainers are beneath them. Even though personal training is an unregulated profession and anyone can claim to be one, from the snot nosed teenager with a shitty weekend course to their name to the highly experienced and extremely qualified ex-pro-athlete, most physios could learn a thing or two from most personal trainers, with the exception of that snot nosed teenager.
The uncomfortable truth for most physios is although they love to ridicule personal trainers for their lack of knowledge on anatomy, biomechanics, professional qualifications, or protected titles, when it comes to exercise selection, prescription, and planning many personal trainers put many physios to shame.
Physios are supposed to be the experts of exercise but I personally know most physio training does a really shitty job at educating physio’s on exercise prescription. Many physios simply do not know how to prescribe, dose, progress, regress, and execute exercise well at all. Most physio training on exercise reaches the dizzying heights of how to use a theraband safely and teaching someone how to walk up and down the stairs, which of course is important, but lets not forget that without sufficient leg strength no one is walking up or down any stairs, anytime soon.
So you would think it would also be a good idea to teach physios how to develop sufficient leg strength in their patients. You would think it would be a good idea for the universities and physio schools to educate physios how to perform exercises such as the squat, the dead lift and many of the other simple and effective strengthening exercises. Yet most physios could not tell you the difference between a front squat, back squat, hack squat, pistol squat, or split squat let alone demonstrate them. This makes me want to cry.
What also makes me want to cry is that for most physios it seems that their focus is not on exercise but rather the crappy side interventions of our profession like manual therapy, dry needling, taping etc. Many physios believe these techniques justify their existence, and their place in the healthcare system. This makes me want to cry. Interventions are NOT identities as well explained by the excellent young US physio Kenny Venere in his blog here go read it.
Unfortunately most physios seem to think if they are not doing something to someone then they are not true physios. It appears that most physios suffer with inadequacy issues, inferiority complexes, or small man (or woman) syndrome. Many physio’s feel the need to exaggerate and inflate what they do to make themselves feels more important and more worthwhile in the eyes of their patients, peers, and other healthcare colleagues. Most physios do not see the value in education and exercise nor what they do or how they do.
This again makes me want to both laugh and cry. Why most physios feel inadequate to simply say that their job involves motivating, encouraging, and cajoling people in pain to move more and return to function is beyond me. Why many physios feel the need to justify their existence by saying they can correct faulty biomechanics, fix movement abnormalities, release stiff joints and tissues such as fascia, knots, scar tissue, etc again is beyond me.
I try to help people in pain, disability or injury move and function better. I try to do this by getting people fitter, stronger, robuster, both physically and psychologically. I try to do this with advice, education, activity and exercise, NOT rubbing, poking, prodding, or taping. I can’t and don’t correct faulty biomechanics. I can’t and don’t change joint or tissue stiffness. I can’t and don’t miraculously cure or remove pain.
I am just a physio.
So my plea to all other physios is this, be proud and confident in providing GOOD effective education and exercise. You don’t have to do or throw everything an anything at someone in pain to help them, and you don’t need to exaggerate and inflate what you do. Finally please for the love of Jehovah and my sanity please go and learn how to teach squats and deadlifts better.
As always thanks for reading