Really you thought the blog was real 

 love 
hariohm

where are the women?

Where are the women?

When I went to college- the TN Government had a quota system of 12 girls and 12 boys in each class, later on the ratio skewed more towards boys. In the last 10 years the number of girls pursuing PT is more.  Well this is not a blog on the gender ratio in classroom but in research.
Few years back we wanted to know the research production of Indian therapist and we did some research to unearth it.  But when I was going through the list of first authors- to my surprise most of them are men. I would like to add we did not do any gender analysis, so my saying “most of them” is just informal guess.
When I look around I hardly see women in research in Tamil Nadu and probably in India. I can understand woman don’t sell products like NDT, K-tape and others (I know some use to) as there may be some issues with travelling etc. I understand there are some women in research and the sports therapist in Guru Nanak university come to mind immediately - but where are all the brilliant hard working women? I am assuming many of them have let the country (like cynthiya kesevan) or they are trying hard to leap out in the man’s world. 

Any how I just hope our research scene get more of the brilliant women we see in our class room.
I would also be happy to get a women’s perspective on this – anyone?

Love
K. Hariohm

When you play with pseudoscience- one day we will become one.

The UGC under the direction of PMO has said yoga should be in PT curriculum.  Some time back there was talk we are part of AYUSH (the department of fairies for medicine) and some of the PTs also thought it is good idea.

Even though I think the idea of yoga in our curriculum should have come from some right wing nut, I also blame this on us. For the last 3-4 decade we have been running bachelor course and in the last 5 years every idiot with master’s degree (which most of them got it by not stepping into the collage) is doing or finished Phd (again most of them, without doing the actual thesis).  But we have not done anything to promote our worthiness as serious people of science. We have sporadic diligent people doing good work- shut down by other – and serious research. As noted earlier our MPT went from the toughest course to pass to the easiest course to pass in less than 5 years (well you don’t even have to come to collage what more to say) and we are using the same model for Phd.

The course done outside the college- those “workshops” are just flourishing which you would think would have made us all smarter. Well hell no one idiot is teaching the whole of India to put needles, other one is selling stickers and we have my perennial favorites- NDT (the treatment which never works but it cost 4 lakhs- when taught by vellakaran and 25 thousand when taught by your neighborhood Indian therapist). Add to this we are the growing market for the junk of the medical world like osteopathy and chiropractic (which I am pretty sure is illegal to practice in India) and experts in this crap (home grown and vellakaran).

Well all this leads to a big bullshit that is PT education today.  if you have any doubt search for sticker (k-tape), NDT, chiropractic and any other bullshit which is trough at us- the answer is always same- these are outdated science, these are not science these are not legible sentence will be the answerers. We have not promoted science, we have not promoted motor control, learning etc in neurology, and we have not promoted pain science in ortho and what we are left with people selling snake oil.

The newest threat to my beloved science is introducing yoga- not just the postures which are exercise but the philosophy – including study of Bhagavat Gita, Upanishads and what not.  Well happy to have known you all folks as PTs folks in the next few years we will be treating imaginary disease with imaginary breathing power. Come to think about it we are already doing it.

Love

K. Hariohm

I have seen it in my practice

Galileo's Leaning Tower of Pisa experiment and clinical experience

One of the common arguments I encounter from PTs (probably also from patients and others) is personal experience and “i have seen it” argument.

Why is I have seen it argument flawed most of the time:

One of the common notions in Indian and eastern philosophies is the idea of “mayai” or illusion.  An illusion as we are well aware is – what you see is not the truth. I am not going in the philosophical arguments (you may read J. K if you really want to understand) but the scientific one.
I am going to use a simple example which we all learn in school

When you drop a feather (a lighter object) and a ball (heavier object) you will see the ball dropping to the ground faster than feather. The observer may conclude the heaver object falls faster than a lighter.  However anyone who has done 6^th standard physics will know the gravitational force is a is a constant- hence the above statement cannot be true.
So you end up tearing yourself- whether what I have seen is untrue or whether the physics I have read has an “alternative”.  Well the physicist does not tear themselves- they look into the flaws and the confounding factors in the observation – they just don’t say- sometimes the G force is behaving badly.

 Well the physicist do not tear themselves- they look into the flaws and the confounding factors in the observation – they just don’t say- sometimes the G force is behaving badly (for this observation)

Well when the same thing happens in clinical setting to most of us. We see our patient getting better with IFT, traction, the K-tape, SI and all the other one hundred things people are selling. But most of the time the justification for all these treatments are flawed, pseudoscience or plain ridiculous.

In medicine most of see something happening to our patient and when it is good, we look for justification. When the physiology or the science is not able to justify we fall back on the alternate ridiculous answer.

These are the top 5 ridiculous statements i like:

1.       Jane Ayres – sensory diet- can’t stop laughing even now

2.       The internal organs are all in the hand and feet- just a insult to one’s own brain

3.       K-tape will facilitate muscle action- really the brain, the psychological factors, the social factors etc is just a joke?

4.       Hands are the physiotherapists most important organ- he touched the patient and he got better- really?

5.       Last but the most ridiculous – Cranio-sacral therapy- should check with your neurologist if you think this is “therapy”

I can hear people screaming- I have seen these being done, seen patient getting better with these magic (could not get to type therapy). Remember the G force is constant – lighter objects don’t fall slower; it is just that we have not controlled the n- number of factors in our observation. That is why you need experiments- with controlling all these parameters in medicine and science in general. Don’t take the easy route in finding alternates to why it happened- rather question first did it happen?- that is did my patient get better or is it an illusion because of the “n” factors- including natural recovery, fooling your brain, fooling patients brain or just wishful thinking. Then think of explanation for what you have observed and not the “alternative one”- the real answer which is hard, cumbersome and hard to come by. Then we will call ourselves as practitioner of science we call Physiotherapy.

PS- the Galileo thought experiments and the moon experiments gives us the right answer why the feather falls down and the remove the illusion and help us see clearly

watch the hammer and feather drop experiment on the moon: https://en.wikipedia.org/wiki/File:Apollo_15_feather_and_hammer_drop.ogg

one of the most interesting videos

love
Hariohm

Wish list for 2016- My positive blog

what I think will take us take the next step:

1. Move from movement specialist to rehab of whole person specialist
2. Move from reductionism to complex systems paradigm
3. Move from calling “clients” and call them as “patients”- you are running a health care centre not a grocery store
4. Move from biological model to complex models in pain and neuro-rehabilitation
5. Move from named course to science based course- call our course as cerebral palsy rehabilitation or back pain management course (the experts should grow some balls)
6. Course on how to convey difficult news to patients
7. Move from osteopathy and other s!@# to physiotherapy (there is a huge science we have no clue- why go behind grocer techniques)
8. Move from distant education to education (the colleges should grow balls)
9. Move from cult organization to patient interest groups
10. Move from publishing in throw away journals to indexed journals

What is in store for physiotherapist in 2016?

What is in store for physiotherapist in 2016?

1.       Jokers will teach NDT, SI, carnio-sacral therapy and gullible PTs will still do it

2.       The IAP and other millions of associations will think they are still relevant

3.       PTs will think these associations can change their lives and call for “unity”

4.       Bunch of dedicated PT s will get disillusioned and will go into their shell

5.       We will still teach the same nonsense they taught me in 1990 and think that is good science (our new syllabus proposed is a great example)

6.       PTs will share more pseudoscience than real information in social media

7.       Collages will “make” the students attend workshops and conference

8.       Clinical therapist will still say- “you can’t exercise with pain”

9.       More self proclaimed experts (jokers) will –teach pseudoscience and ruin as more (examples- osteopathy, chiropractice and dry needle)  

10.   We will still think evidence is for losers and uneducated slobs not for intelligent people like us (and practice the same thing)

Well in 2 words “no s!@#
                

Happy new year folks

Speak up against pseudoscience series - Part I

These are course we think intelligent therapist should shun, So we are starting with the current fad- dry needling

Dry needling- well because it is reinventing the wheel. A group of intelligent people thought- how can we sell our crap? We they were lazy and so they just rehashed some already available assumption with poor science- ie- trigger point and mashed it acupuncture. In acupuncture they have this idea called- ashi point, if I can remember correctly, which are tender points or as they renamed it trigger points with some modifications.
In the last decade they have done thousands studies on acupuncture and it has been found it works only in china when done on Chinese people. So these intelligent people took the lessons from a marketing guru and did what any good execute will do- rebrand it. So as a first step like Airtel called there 3g as 4g they called acupuncture which has lost some credibility among proper medical professionals- they called it dry needling. ( for PT who want to learn wet needling you need to contact Gowdhama Kumaran )

Major problems in this area-

·         No research evidence- that is natural. I know people who teach this will say it is evidence base- don’t worry they have not know clue what is evidence is like most of our us- making it easy to fool us.

·         no physiological sense-  Trigger point is not science as people are made to believe (you can do your own research to learn about it, but start with https://www.ncbi.nlm.nih.gov/pubmed/1404132 done by the people who wrote this )

·         also remember the map they show for trigger point- pulled out of there ass rather than from any study

·         latent trigger point- well, you want to believe this kind of shit no amount of evidence to the contrary is going to shake your faith

·         Remember we have good evidence for multifactoral pain management in chronic low back pain- hence you have to prove it is good than that rather than doing nothing.

Next time i hear someone says i am a expert in this crap i am going to give them an award for being the best therapist in the whole word with my own money