I often get accused of not being a ‘proper’ physio with many calling me a glorified personal trainer in some misguided, misinformed, and laughable belief that this is an insult to me. Many think that because I don’t use any manual therapy, electrotherapy, dry needling, taping, or other adjuncts to help people with pain or disability, preferring to only use advice, education, movement, and exercise that I am not fit to call myself a physio.
It does make me laugh that a lot of physios have an arrogant belief that personal trainers are beneath them, and to call a physio one is an insult. Even though personal training is an unregulated profession and anyone can claim to be one many physios could learn a thing or two from some personal trainers.
A lot of physios love to belittle or ridicule personal trainers for their lack of knowledge on anatomy, biomechanics, or because they don’t have formal qualifications or protected titles. However, when it comes to exercise selection, prescription, planning, and programming most personal trainers put most physios to shame.
Physios are allegedly supposed to be the ‘experts’ of exercise but personally, I know most physios training does a really shitty job at educating and equipping physios to prescribe and program exercise effectively. Most physios training does not teach them how to prescribe, dose, progress, regress, or execute exercise well. Most physio training on exercise tends to reach the dizzying heights of how to use a Thera-band safely and how to walk up and down a flight of 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 and teach exercises such as the squat, the dead lift, the overhead press, and many of the other basic strengthening exercises. Yet most physios couldn’t tell you the difference between a front squat, back squat, sumo squat, goblet squat, hack squat, pistol squat, split squat, or just a squat squat, let alone demonstrate them well.
Unfortunately, most physios attention is not on exercise but on the crappy adjunct interventions like manual therapy, dry needling, and taping etc. Many physios are taught to believe that these shitty 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 as explained beautifully by the bright young physio Kenny Venere in his blog here go read it.
Many 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. Many physios still seem to think if they are not doing something to someone then they are not a true physio. Many physios do not see the value in good, simple, honest, education and exercise.
Why many physios don’t feel confident to do the simple things well and say that their job involves motivating, encouraging, and cajoling people in pain to move more is beyond me. Why many physios feel the need to justify their existence by saying they correct imbalances, fix faulty biomechanics, break up scar tissue, or release stiff joints, muscle knots, and fascial adhesions is beyond me.
So I will start by saying quite confidently, quite loudly, quite often that as a physio I help people in pain or with a disability, after an injury or surgery to move and function better. I try to do this by giving simple, honest, clear advice and education, by getting them stronger, fitter, and more robust both physically and psychologically. I do this with all types of activity and exercise-based interventions NOT with rubbing, poking, pricking, prodding, or taping. I don’t correct faulty biomechanics. I don’t change joint stiffness or position. I don’t alter soft tissue tightness, spasm, tone, or flexibility, and I don’t miraculously cure or remove pain.
So my plea to all physios is this… please be more comfortable and more confident in providing simple, honest, clear advice, education and exercise. Be more confident in just doing the simple things really really well. Be confident that you don’t have to use adjuncts, or exaggerate, or conflate what you do. Be proud in what you do and how you do it.
I am, because I am ‘just’ a physio!
As always thanks for reading