It blows my mind what therapists consider to be skilled physical therapy. Our profession is so bloated with garbage interventions and a perception of self-importance. So many, including myself when I first graduated, believe that our “hands on” treatment is the vital part of recovery for a patient. I am not discounting the potential benefit of the basic benefits of human touch, but those values offer little to actual recovery. I have and do put my hands on patients but in a limited capacity and with the full intention of using it to progress a patient to self-management.
Many therapists who “specialize” in manual therapy will all have their hackles up by now, getting ready to fight. They are welcome to attempt to defend their opinion, however it does not negate the fact that research does not validate their claims and beliefs. Manual therapy is such a massively subjective interpretation of a problem. It is merely what they think they are doing, or perceiving.
It has been proven through studies, that “feeling” a problem is a horrendous technique for truly assessing a problem. It is unrealistic and illogical to believe that someone can identify a taut band, trigger point, or misalignment. You mean to tell me you can detect a 2-3 mm deviation through 2 or more inches of tissue. No freakin’ chance. I don’t want someone making decisions about my health based upon what they think they can feel.
Academic institutions and the “old guard” are a major component of continued propagation of garbage techniques. Institutions need to understand that they are the most important variable that influences how a PT practices. Instructors add their own bias into the curriculum, intentionally or not. Depending upon the school, graduating PT’s have a whole variety of biases. Some are manipulation heavy, some are soft tissue heavy, and a variety in between. Clinical instructors during practical experience further influence the practice of future PT’s. Much greater care should be provided in assigning a student to an instructor. Until the federal boards demand a standardized national curriculum, and actually start to actually follow and implement evidence-based practice, and encourage some good ol’ common sense, PT will continue to be a hit or miss treatment option for patients.
I hope that you share this with as many people as you can.
PHYSICAL THERAPY IS NOT ULTRASOUND, STIM, HOT PACKS, COLD PACKS, MASSAGE.