MusculoSkeletal Physical therapy Vs Physiotherapy..?

bo0li5eumx12kp

I'm gonna put forth some ideas - and I'm looking to be challenged on them.

I developed an interest in hands on style physical therapy a while ago - primarily via having work done on myself.

So - I, like half the country - did a part time course.

Very enjoyable.

Then I did a bunch of additional courses.

Then I contemplated the "ifs";

Go back to uni and study physio - or just shoot from the hip and open up my own musculoskeletal physical therapy clinic.


See - long since has been the idea that, non uni based physical therapists are, how you say - imposters?

Chiros, osteopaths, physical therapists - basically - masseuses without the hot oil.

But - since having become involved in the area - these are the facts as they appear to me;

Musculoskeletal is but one are of physical therapy.

Hospital based physio's, i.e. uni graduates - are by far far far and away most concerned with orthopedic rehabilitation, and often liaise closely with Dr's in this capacity.

You regular physical therapist - imposter types - they are concerned almost exclusively with muscle spasming, the complications that can come about as a result of that - and joint mobility.
Thus - this is largely considered "complimentary therapy".

Muscle spasming and joint mobility - are obviously intrinsically inter-related - as muscle connects to bone, and when it tightens, in inhibits said mobility.

The modalities to treat this - are, well - extremely straight forward.
Thus - they can be covered on a part time study/weekend study basis.
Well - chiro and osteo is obviously full time but - there's much hyperbole in them fields - dieting etc.


In any case - the point here is that - is it necessary to study 4 years at uni to treat muscle spasming??

lolwut?

Obviously not.

The hilarious thing is - uni based physio doesn't really cover muscle spasming - or certainly not manual soft tissue techniques associated with treating it.
They do some mobilizations - which again - can be learned over a weekend - easy.

But they're concerned more so with, multiple bone fracture rehab, stroke recovery, neurology - seriously complex rehab.

You average dudes limping into your clinic after a tough rugby game, well - he don't have these problems.

Therefore, in many ways - your weekend program "imposter" - may well actually be more qualified, experienced, and competent, in treating these types of cases.

Tell me I'm wrong.

bo0li5eumx12kp

What it is?

Did I stun ya'll into silence with them brash statements?

Or is this just not being dignified with a response?

St.Brigids

I agree.

Spoke to a women today who has had her knee done 3 times. She said the best person she had treatment off was a physical therapist. Far far better then any physio.

RoamingDoc

I don't agree.

I spoke to 2 women today and yesterday, who said that physical therapists are actually werewolves. Far far worse then any physio.


^ This is why anecdotal evidence doesn't count as evidence....

Tiddlypeeps

The problem with most forms of "complimentary therapy" is that they are generally fairly unregulated, or "self regulated" for whatever that is worth. Physio is a protected term like doctor, it means if you are seeing one then you are assured of a certain level of education and competence unlike other forms of "complimentary therapy".

I can say with certainty there are some chiropractors or osteopaths etc out there that are better than many physio therapists. They may have picked a niche and really doubled down on educating themselves on how to treat it and and are now the best person ever to see for that particular issue. The problem is the average joe trying to pick at therapist of whatever type to see has no way of knowing if they are going to see one of these amazing people or a quack who barely scraped through a weekend course and is now "qualified". The major issue is the latter is outright dangerous. A chiropractor or osteopath performing manipulations incorrectly can leave you with significant injuries, and this happens to people often enough that it's a legitimate concern that should be considered when choosing a therapist.

The human musculoskeletal system and the many many ways it can be dysfunctional is an extremely complex subject. One that is still surrounded in many questions and still has lots of research ongoing. The fact you think taking 4 years to study it is laughable suggests you are in the "knows just enough to be dangerous" category.

bo0li5eumx12kp

Tiddlypeeps wrote: »

The problem with most forms of "complimentary therapy" is that they are generally fairly unregulated, or "self regulated" for whatever that is worth. Physio is a protected term like doctor, it means if you are seeing one then you are assured of a certain level of education and competence unlike other forms of "complimentary therapy".

I can say with certainty there are some chiropractors or osteopaths etc out there that are better than many physio therapists. They may have picked a niche and really doubled down on educating themselves on how to treat it and and are now the best person ever to see for that particular issue. The problem is the average joe trying to pick at therapist of whatever type to see has no way of knowing if they are going to see one of these amazing people or a quack who barely scraped through a weekend course and is now "qualified". The major issue is the latter is outright dangerous. A chiropractor or osteopath performing manipulations incorrectly can leave you with significant injuries, and this happens to people often enough that it's a legitimate concern that should be considered when choosing a therapist.

The human musculoskeletal system and the many many ways it can be dysfunctional is an extremely complex subject. One that is still surrounded in many questions and still has lots of research ongoing. The fact you think taking 4 years to study it is laughable suggests you are in the "knows just enough to be dangerous" category.

I like this post because - it's pretty much spot on (except for the last part :pac: )

I've always weighed the balance between weekend studied physical therapist, and uni graduated physiotherapist, as a trade off for what you get in professionalism, made up for with personality.

That is to say, most charge effectively similar rates - well, physio maybe a little higher, but not too dis-similar.
Most are gonna take 50 euro a session - be it 30 mins, or 50 mins.

However, what seems to predicate actual success, is the reputation one garners.

So basically - my contention is, if you're a weekend qualified job style physical therapist - success, and the personal ability to apply oneself in the way mentioned above (developing a niche), as well as gain a positive reputation - will be largely predicated on personality.

i.e. people going to see you, better damn well like you - cause you don't have the job title and associated professionalism to fall back on.

i.i.e you may well acquire the reputation of "quack", with the quickness.


MSK and complex array of dysfunctions it can develop?

Well - let's face it.
90% of the time your gonna be dealing with muscle spasms of one incarnation or other.

"Physiotherapy" - they prescribe primarily evidence based exercises.
Additionally they might do some electro stim and maybe needling, mobilizations - but their professions reputation, as far as MSK is concerned - seems to rely largely on exercise prescription.


What's the bottom line here....?

I guess the bottom line is, there's a long string of people that attend physiotherapists and come away no better, with some bogus exercise that changes little - but feel better about having attended a "real professional".

May sound cynical - but it's not 100 miles off the general feedback I get.

bo0li5eumx12kp

Okay let me take another example.

Lumbar spine disc herniation.

What's a physio gonna do?

Release the attaching musculature?

McKenzie protocol - give some spinal extension exercises?

A slipped lumbar disc is gonna come 99% of the time from a flexed (rounded) lower back, the resulting protrusion.
Nerve impingement etc - resulting problems.

Postural correction is ideally the order of the day - which is a physiotherapists theoretical approach.

lol

Do we really think some McKenzie exercises are gonna give rise to long term postural correction?

Strengthening is gonna be where it's at, let's be honest - but wait a sec;

Physio's can't prescribe weight bearing exercise.

:pac::pac::pac: