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 now 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.
First it does make me laugh that a lot of physios have the arrogance to think that calling a physio a personal trainer is an insult in some belief that personal trainers are beneath them. Even though personal training is an unregulated profession and anyone can claim to be one, in my opinion many physios could learn a thing or two from some personal trainers.
A lot of physios try to belittle or ridicule personal trainers for their lack of knowledge on anatomy, biomechanics, or because they don’t have formal qualifications. However, when it comes to exercise selection, prescription, planning, and programming most personal trainers can put most physios to shame.
Physios are allegedly supposed to be the ‘experts’ of exercise but 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 for physios to know 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, half or quarter squat, let alone demonstrate them well.
Unfortunately, these days most physios attention is not on exercise but on adjunct interventions like manual therapy, dry needling, and taping etc. Many physios are taught to believe that these shitty treatments justifies their role 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, needling, even my beloved exercise as explained by the bright young physio Kenny Venere in his blog here go read it.
Why so many physios feel the need to justify their existence by saying things like they correct faulty biomechanics, or break up scar tissue, release stiff joints, free fascial adhesions is beyond me. Why many physios don’t feel confident to just explain things clearly and simply and do the basics really well is due to many reasons.
Many physios seem to think that if they are not doing something to someone then they are not a true physio. Many physios do not see the value in simple, honest, education and exercise. Many physios suffer inadequacy issues and inferiority complexes, feeling the need to exaggerate and conflate what they do to make themselves feel more important and worthwhile in the eyes of their patients, their peers, and other healthcare colleagues. This is both sad and disheartening.
So I will start by saying here that as a physio I help people in pain or with a disability to move and function better. I try to do this by reassuring, motivating, encouraging, and cajoling them. I also try to do this by giving simple, clear, honest, evidenced based advice and education, and by getting them moving more and different ways, making 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 joints positions. I don’t alter soft tissue tightness, spasm, tone, or flexibility, and I don’t miraculously cure or remove pain.
My plea to all physios is simple… please be more comfortable in providing simple, clear, honest advice, education and exercise. Do the simple things really really well. Be confident that you don’t have to use any adjuncts to be a good physio. Finally be proud in what you do and how you do it.
I am, because I am ‘just’ a physio!
As always thanks for reading