So these are my take on musculosketal-physiotherapy without much of explanation
1.
There is no mechanical pain- all pain or bio-psycho-social
2.
There is no core- all muscles are vital and they
all work for a context- so stop calling a group of muscle as core. It also
makes us look uneducated when we say one group of muscle is important.
3.
Difficult to predict or prevent injuries (including
sports).
4.
Ergonomics consists of nonsense and some good
science- difficult to differentiate, so start afresh. Leave the designer chairs,
mouse and other animals and come up with ideas based on science – not what you
observe.
5.
Impairment exercise seem to be the norm- so PTs
who want to start a career in musculo-skeletal PT should start from Motor control and motor
behaviour not from pain science
6.
Fascia, muscle and other soft tissues are nearly
difficult to stretch and change its length, so don’t over claim and over do
them
7.
Learn plasticity
of brain before – pain science
8.
Learn brains-on treatment rather than hands-on. Any
monkey can learn to stretch but only humans can understand complex interactions
of many sub-systems- so go to a course were they teach you to use your brain
9.
Craniosacral therapy, needling cupping are not
concepts- they are faiths, please don’t insult Physiotherapy science or the
word concept
10.
Shut up and teach exercise for all patients on
the day of their first visit – not the 10th or 5th .
11.
Tools in my tool belt is one of the often repeated
sentence -you are not a mechanic you don’t need more tools- you need better
understanding of the human body- so learn- bio-psycho- social issues is the
next step, not putting sticker or needle or a tea cup or screw driver
12.
All exercises are good no exercise is superior
to another (for all those people who are experts in pilates, etc (as I can’t
remember the myriads of names)
13.
Don terrorize the patient – so stop saying – don’t
ride the bike or riding bike lead to back pain, don’t squat, don’t sit on the
floor etc. he or she came to improve his activity limitation not increasing it.
14.
As an
addition note to the earlier point- leave the posture alone, stop making
religious statements like good posture bad posture and evil posture. Remember no
one change posture and all postures are good (well that looks like a Buddhist
theological statement)
15.
Learn the difference between impairment and causal
relation. Example multifidus not working in LBP is an impairment- it did not
cause back pain, hence improving multifidus will not lead to betterment of back pain (this
is been proved again and again by 100s of trials on back pain)
love
K. Hariohm
