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, electrotherapy, dry needling, taping, or any other adjunct to help people in pain or with a disability, preferring to only use education and exercise that I am not fit to call myself a physio.
This makes me both laugh and cry at the same time. First, it makes me laugh that many physios have some misguided and arrogant belief that personal trainers are beneath them, and that to call a physio one is somehow an insult. 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 the highly experienced professional athlete, most physios could learn a thing or two from most personal trainers, with the exception of that snot nosed teenager.
Although physios love to belittle or ridicule personal trainers for their lack of knowledge of anatomy, biomechanics, or that they don’t have formal professional qualifications, or protected titles when it comes to exercise selection, prescription, and planning most personal trainers put most physios to shame.
Physios are supposed to be the experts of exercise but personally, I know most physio training does a really poor job. Many physios simply do not know how to prescribe, dose, progress, regress, or execute exercise well. Most physio training on exercise reaches the dizzying heights of how to use a Thera-band safely and teaching someone how to walk up and down the stairs, which of course is important, but let’s 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 to teach physios how to perform exercises such as the squat, the dead lift and many of the other simple and effective basic strengthening exercises. Yet most physios couldn’t 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 more is that most physios focus is not on exercise but rather on the crappy adjunct interventions like manual therapy, dry needling, taping etc. Many physios believe these techniques justify their roles and their place in the healthcare system. This makes me want to scream. Our interventions are NOT our identities, physiotherapy is so much more than manual therapy, electrotherapy, even exercise therapy as well explained by the bright young 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. Most physios suffer from inadequacy issues, and inferiority complexes, feeling the need to exaggerate and inflate what they do to make themselves feels more important and more worthwhile in the eyes of their patients, their peers, and other healthcare colleagues. Most physios do not see the value in good, simple, honest, education and exercise.
Why most physios don’t feel confident to 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 correct faulty biomechanics, movement abnormalities, or release stiff joints, fascia, knots, scar tissue is beyond me.
I will say here confidently, simply that I try to help people in pain, with a disability or after an injury or surgery to move and function better. I try to do this by getting people stronger, fitter, robuster, both physically and psychologically. I try to do this with advice, education, activity and exercise, but 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.
My plea to all physios is this, be confident in providing GOOD effective advice, education and exercise. Be confident in doing the simple things well. Be confident that you don’t have to use the adjuncts, and you certainly don’t need to exaggerate and inflate what you do. Be proud in what you do and how you do it. I am!
As always thanks for reading