musculoskeletal system physiotherapy and I

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 10^th or 5^th .

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