Just A Physio!

I often get asked by other physios ”what kind of physio are you?”. Often I reply 'just an average one'to wind them up because I know what they are really asking me is what are your qualifications andallegiance to a specific physio method or treatment?

Now there are many kinds of ‘method physio’ such as McKenzie physio, Maitland physio, Mulligan physio, a Cyriax physio, even a Cognitive Functional Therapy physio. And there are many kinds of ‘treatment physio’ such as a manual therapy physio, a pilates physio, a dry needling physio, a cold laser physio, a myofascial release physio, even intergrated functional systems physios.

Well, I am now proud and happy to say I am none of those, I’m just a plane boring bog standard physio. I’m not accredited, affiliated, or aligned with ANY specific methods, treatments, groups or gurus, and personally I don't think any physio should be.

Now don’t get me wrong I think we can all learn some stuff from many of these methods and treatments, and I have! I’ve personally done many of these courses, jumped through their hoops of assessment and passed their pseudoscientific exams to earn post graduate ’qualifications’. But I don't align myself with any of these methods or treatments when it comes to doing my day to day job seeing people in pain or with disability!

Personally I think most if not all of these groups, clans, and tribes within our profession cause more problems than benefits producing more bickering, backstabbing, infighting and endless pathetic claims of superiority over each other.

For example, when I was a young naive and impressionable physio I did my first MSK orthopaedic post graduate course with the Cyriax affiliated ‘Society of Orthopaedic Medicine’ or SoOM as its called, I was consistently belittled and looked down upon by those in another MSK orthopaedic special interest group called 'The MACP' which used to stand for 'The Manipulation Association of Chartered Physiotherapists' but changed its name to the ’Musculoskeletal Association of Chartered Physios’.

Because of this I then started to do my MACP post graduate training but kept coming across so much ego and elitism in their members and tutors that I left half way through my training unable to stomach it or them anymore. Still to this day because of these experiences I hold the MACP and most of its members in low regard. I have also had some personal and professional disagreements with some of their senior members and have found the MACP to be a seething nest of spiteful, vindictive, and narcissistic attitudes and actions.

The MACP often try to promote they are working hard to improve the standards and advance MSK physio, but in my opinion this is just a thin disguise for their real motive which is to get as many physios as they can to join their clan, pay their subscription fees, do their training, jump through their hoops of assessment and accreditation, and ultimately think and act exactly like they do.

I've lost count of the number of times I've seen or heard MACP physios thinking and acting the same, often claiming that they are better trained, better skilled than other physios because of their membership. Many think and have told me that because I haven't completed the MACP training brainwashing or jumped through their hoops of accreditation that I am somehow less skilled, less capable, less of physio

I often get called by many MACP members in senior ESP, APP, FCP roles a 'glorified personal trainer' in some misguided and laughable belief that this is somehow an insult to me. Many think that because I dont use manual therapy, electrotherapy, dry needling, taping, or any other adjuncts to help people with pain or disability, preferring to use advice, education, movement, and exercise that I am not fit to call myself a physio.

Many think that because I dont use any passive treatments, tricks, gadgets or gizmos then that makes me less of a physio! This makes laugh and cry at the same time

For example, when some physios call me a glorified personal trainer it clearly shows their arrogance and ignorance in thinking that personal trainers are somehow beneath them. Even though personal training is largely an unregulated profession I think many, many physios could learn a thing or two from some personal trainers.

A lot of physios like 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 prescription, planning, and programming most personal trainers put most physios to shame.

Physios are thought to be the 'experts' of exercise but I know first hand that most physio training does a really shitty job at educating and equipping them to understand, prescribe and program exercise effectively. Most physios training on exercise and rehab tends to reach the dizzying heights of how to prescribe safety googles before using Thera-band and how to walk up and down a flight of stairs, which can be 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 be a good idea for physios to also learn how to develop sufficient leg strength in their patients. You would think it would be a good idea for the universities or special interest groups like the MACP to teach physios how to perform and teach exercises such as the squat, the deadlift, the overhead press, and many of the other basic strengthening exercises. Yet they don't!

Most MACP or other accredited method/treatment courses couldn't teach 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. Most physios training does not teach them how to prescribe, dose, progress, regress, or execute exercise well.

Most physios training is just not focused on exercise or rehab, but rather on modalities and adjuncts like manual therapy, dry needling, and taping etc. Many physios are lead to believe that these treatments justify their role and their place in the healthcare system, and exercise is the simple easy bit that can be done at the end, or worst not at all!

This makes me both mad and sad. Physiotherapy is so much more than its treatments of manual therapy, electrotherapy, needling, even exercise.

Many physios feel the need to justify their existence by saying things like they break up scar tissue, release stiff joints, free fascial adhesions, or correct muscle imbalances or faulty biomechanics. Many physios just don't feel confident to explain that what they do is assess, reassure, advise and try to get people moving more.

Many physios feel the need to exaggerate and conflate what they do to make themselves feel more important and more essential in the eyes of their patients, their peers, and other healthcare colleagues. Many physios just do not get taught or encouraged to see the value in simple, honest, things they do.

This is again both sad and maddening.

So I will try to change this by saying that as a physio I try help people in pain or with a disability to move and function better. I do this by assessing for any serious or sinister stuff, then advising and reassuring patients that its safe. I then try to look at ways to get them to move differently, get them a little stronger, fitter, and more robust both physically and psychologically.

I do this without any gadgets, gimmicks, magic tricks, or bull shit. I don't correct faulty biomechanics, I don't release fascia, I dont alter soft tissue tightness, spasm, tone, or flexibility, and I don't miraculously cure or remove pain.

In summary, I'm just a physio!

As always thanks for reading
Adam