Is physiotherapy a waste of time?

To me, anyways, a physiotherapy is just a fancy word for "massage" ... which allows for insurance coverage.

Obviously, YMMV.

 

Note: physical therapy is different than physiotherapy. The first includes exercises chosen to rehab/rebuild injured parts. Assuming you have the motivation, once you have learned the exercises, you can do them without the therapist but they are good to get you started. The later is close to massage, as discussed above.

 

This is almost an apples vs pears discussion. Physio therapy can be a family name for all sorts of various treatments. I would say it varies a LOt with your actual therapist.
My injuries are mostly sports and build related so a great therapist/spinal expert is a must for me.
Or try to go for a good manual therapist, not sure how these are called in the US.
I would ask around/google around for references as the good ones have more knowledge of the human body then most doctors.

 

I think you are talking about a chiropractor and yes, the good ones know more about the physical structure than most MDs. Unfortunately many (most) of them are pretty fluffy and new age, they are not science based in their approaches and methods. That has given them a bit of a reputation, not always good, here in the US. I am fortunate to be married to one that is a scientist at heart. She has helped me a lot over the years. Though I almost never see him, I also have a sports medicine doctor as my primary care doctor.

 

I think the wording is a bit different, but we both refer to more or less the same practitioners.
I'm indeed not talking about the 'quacks' that make you do 10 air squats and have you on your way.
A chiropracticor is also not what I mean. There's a whole host in between of qualified professionals that actively try to influence our movement patterns and system.

I would search for someone that has a good track record and is working with professional athlete's. They are always the best.
I swear by mine.

 

I see a physical therapist/phisotheropist.

Shes awesome. Doctors wanted to do surgery. She stretched and exercised and massaged my way out of it.

Best ****ing thing I ever did was try it.

Here is the failure point. YOU. YOU have to do the take home exercises. You have to take it seriously. They don't just move you around once a week and once a week for an hour you magically get better.

I'm actually pretty much all better now and I go for stretching and some exercises as more of a preventative for injury because I work out pretty hard.


If you get the right person and you do what they tell you. It's amazing.

What I would recommend is find someone and pretty much only accept someone who is physically fit. These people understand the body fsr more than the people who just took the test to get a job.

 

Physiotherapy healed my torn rotator cuff and torn ACL. No surgeries needed.

However, for my shoulder, there's a lot of difference. I can still lift heavy weight, but i don't do much with an olympic car, and sometimes, I can't hold a even a bag for longer periods, before my shoulder start tiring out.

For the ACL, i hike, swim, run, football without any issues,

 

After dealing with shoulder pain for a while, I decided to try it out, and it helped me. One thing that made a difference for me was TENS, which stands for Transcutaneous Electrical Nerve Stimulation.

TENS uses this little machine to send tiny electric shocks to your skin where it hurts. These shocks mess with the pain messages your body sends to your brain. Usually, when you're injured, your body usually sends a lot of "ouch" signals to your brain, making you feel pain. TENS interrupts those signals, so your brain gets fewer "ouch" messages, and you feel less pain. So, from what I've seen, physiotherapy, especially with stuff like TENS, really does work. TENS is effective because it goes straight to the source of the pain and calms it down.

 

A friend has, I mean had some back trouble recently.

Docs looked at him and said he would benefit from visiting a Physiotherapist and it took some time, around 8 months all up, but it actually fixed him.

He kept telling the Docs he wanted surgery, but they said surgery is last resort and to try seeing a Physiotherapy first and he did, he took it seriously and did the work at home and it helped him.

 

What is your basis for this assertion of yours? What kind of MD were you referring to?

 

MD, a DO has similar knowledge. I am talking skeletal and muscular.

 

I meant what specialty of MD you were thinking about?

 

My wife is a chiropractor and my primary care is a DO. They have similar training in muscular-skeletal function. The standard MD know many things they do not but they also don't have the education in muscular-skeletal structure & function. And of course, specialists in various functions like gastrointestinal are far behind a chiro in muscular-skeletal function. That isn't to say that they are stupid, they just aren't specialist in the same areas. The same is true for general practice doctors.

 

I see. There are three different specialties that allows a doctor (MD or DO) to sub-specialize in sports medicine - family medicine (your primary care doctor), emergency medicine, orthopedic surgeon. Medical students have to choose the specialty they want to practice by another round of application. Orthopedic is considered the most competitive residency to get into. Family medicine is for those who ranked the bottom in medical school.

Within Orthopedic, there are few subspecialties, sport medicine is only one of them. Spine surgery is another one.

To all physicians out here including myself, no other physician will know more than a spine surgeon (both neurosurgeon and orthopedic can specialize in spine) about anything about a spine on earth. If your impression that some chiropractor would ever know more than a physician about spine is based on your experiences with your DO family medicine, I am sorry, your opinion will be considered grossly unfounded.

Chiropractor is not a physician. They have a doctorate in chiropractic which is an academic degree. Chiropractor cannot operate, prescribe. Only MD, DO and Doctor of podiatry medicine can legally do it in USA.

 

I agree that specialists have far more knowledge in their target field. I also agree that many chiropractors are one step above snake oil salesmen. But comparing a specialist to a general practice isn't a useful comparison. With that argument I can easily support that chiropractors know MUCH more about muscular-skeletal structure & function, I just have to compare them to something like a gastroenterologist or optometrist.

As to "academic degree", a Doctor of Medicine is also an academic degree; pretty much all degrees are academic degrees. I understand that MDs often don't like chiropractic and there is a long standing feud between the AMA and ACA. I also know that operate & prescribe are often used as talking points about 'why we are superior' but feeling superior doesn't change that both have expertise in their specific areas. None of that is a dis to MDs nor was it intended to be one.

For the record, my DO has a sports medicine practice, I just happen to use him as a primary care. He is very knowledgeable in these areas.

 

When I mentioned chiropractor has a doctorate in chiropractics which is an academic degree, I meant they are not doctor which is the word that can be used for MD, DO, and DPM. Many people wanted to be called a doctor as a profession because they have an academic doctorate degree. It is unprofessional and dangerous to the public, and that is why Multiple states have laws to prohibit anyone to call themselves doctor in clinical setting when they don't have MD, DO and DPM. There are nurse practitioners with doctorate degree in nurse practice calling themselves doctor in hospital which causes confusions among patients. We are called doctor not because we have a doctorate degree in medicine but because we are doctors in profession.

Chiropractor love to call themselves Dr. So and so with patients. Many patients do not know that chiropractor did not go to medical school at all.

Being able to prescribe medicine and operate is not talking points. They are indeed the result of us being a healer via over decades of additional training after undergraduate. 4 years of undergraduate, 4 years of medical school, 3 to 7 years residency training, and additional 1 to 3 years of fellowship on top of that.

I never stated what chiropractor are, and I only pointed out what they are not.

When your car is broken down and you take it to a mechanic. You want that mechanic to be what he claims to be. That's all.

 

@iloveferrari Clarification: states do not tell chiropractors that they can not say doctor, several do say that you must specify that you are a Doctor of Chiropractic or show Name D.C. Undergrad, post-grad, and clinical are required for DCs as well as MDs. BUT when it comes to spines, the data isn't good for surgery. There are few studies and those that exist show that non-surgical methods produce similar results. Below are clips from a couple of studies on the NIH site. Obviously, there are many potential spine issues and many that Orthopedic doctors are excellent at handling. There are also several that are best handled by Chiropractor. Each is a specialist for a specific thing.

The role of spinal surgery in the treatment of low back pain - PMC (nih.gov)

• Acute LBP is frequently self‐resolving, but recurrence is common, and a significant proportion of patients will develop chronic pain. This transition is perpetuated by anatomical, biological, psychological and social factors.
• Chronic LBP should be managed with a holistic biopsychosocial approach of generally non‐surgical measures.
• Spinal surgery has a role in alleviating radicular pain and disability resulting from neural compression, or where back pain relates to cancer, infection, or gross instability.
• Spinal surgery for all other forms of back pain is unsupported by clinical data, and the broader evidence base for spinal surgery in the management of LBP is poor and suggests it is ineffective. Emerging areas of interest include selection of a minority of patients who may benefit from surgery based on spinal sagittal alignment and/or nuclear medicine scans, but an evidence base is absent.

Effectiveness of Surgery for Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis - PMC (nih.gov)
The relative efficacy of various surgical options for treatment of spinal stenosis remains uncertain. Decompression plus fusion is not more effective than decompression alone. Interspinous process spacer devices result in higher reoperation rates than bony decompression.

 

I am sorry, I think you are out of your lane when you are citing literature. I am an editor for research text book and grant review committee chair for different organizations. When we cite studies, few important criterions must be paid critical attention too. Rule #1. Open access journal has very low regards because you can simply pay to publish while going through dubious review process. Rule #2. Impact factor of the journal itself i.e. how impactful the journal the paper was published in. Your cited examples fall under these. Also pubmed is simply a library service under NIH. It does not by any means imply the quality of the works. Any medical journal once indexed. Also Google predatory journal from India. You would get an idea.

Let me put it this way. A PhD student should not quote any study falls under the above criteria in their graduating PhD thesis, or the PhD mentor would be talked to. I know because I was in a PhD thesis review committee.

You can defend chiropractor practice as much as you like because your wife is a chiropractor. But the evidence behind it is sorely lacking therefore the medical community at large does not accept it as conventional methodology. The current social media including the animal chiropractor and chiropractic practice for baby definitely add to it.

Last post from me on this discussion. The truth is if you know you know, if you don't know you never need to know to begin with. My post is not to put down chiropractor but to let whoever read it have fully informed information about what it is not despite what the wishful thinking chiropractor have.

Of course, if you care, Google the origin for the chiropractor which is about a guy talking to the ghost of a doctor. Lol

 

The fact that I pulled them from an open access library doesn't mean the library is the author. I see a lot of dissing on studies but I don't see anything supporting your claims. IE: the only thing we have from you is 'your word'. Then again, the studies I referenced were authored by the people below. Then again, what do universities in many countries know about anything. Never mind you reference India but the studies were from Australia, oops.

1 Royal Melbourne Hospital, Melbourne VIC
2 University of Melbourne, Melbourne VIC
Katharine Drummond, Email: [email protected].

1 The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
2 Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
3 South Western Sydney Clinical School, Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia
4 Department of General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands
5 Department of Health Sciences, VU University, Amsterdam, The Netherlands
6 Institute of Bone and Joint Research, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
Toronto Western Hospital, CANADA

 

Good. We are not talking about chiropractor anymore. If you are genuinely interested about the merit of academic publication, I am happy to share with you how the academic world look at things, and they are not my opinion. I of course welcome anyone who sits on promotion and tenure committee of any university and medical school to share their experiences and you will soon realize they are not opinions and experiences are very similar.

Nowadays anyone can publish in hopes to satisfy the promotion requirements of professor rank. It is the onus of the department chair and P&T committee to sort through trashes and fillers. Author having a university affiliation cannot be more basic. It is as basic as putting toothpaste onto a toothbrush in the morning. It does not provide any validity whatsoever to the trained eyes. We look at biosketch (you should Google biosketch) when deciding grants (you can also Google what it means when I said I chair grant review committee) I also evaluated DoD grants, so this is not something you see often in Ferrarichat.

All in all, the point about India predatory journal is to undermine your implications of having published means something. In all honesty, it does not mean anything to the one that you should be glad are responsible of deciding on funding how and what research are done.

As a layperson, it is important to learn that whatever is published does not mean anything at all. Now you have learned that 1. Open access is almost as useless as an opinion piece on a blog. 2. Impact factor of a journal is very important to consider in terms of gauging the merit. 3. Having university affiliation published in any journal should not imply any blind confidence. The key is the rigor of research methodology, results and its interpretation and conclusion. An extremely famous author from Harvard can still publish something in some second or third rated journal and there are so many reasons for it.

There are reasons why someone is sitting in P&T or grant committee and why someone is being reviewed.

Before you post, really send my post to those you know are high enough in academic medicine, then you will know who you are debating with and you likely would be able to reply with intelligence expected at this level of conversation.

Have a good day sir.

 

I am very familiar with DoD grants (prior life), and I know several people with PhDs in biology fields and medicine. Open Access only means that anyone can access the data, also anyone can post, so you need to be discerning. The fact that something is available on the NIH database, open access, doesn't mean it is not pier reviewed nor does it mean that the data is faulty. Your likening the NIH, Australian universities, and several universities in the Netherlands to some random India website is, at best, insulting.

I agree that anyone can publish in hopes of getting a promotion, it is kind of the minimum bar in academia. I agree "The key is the rigor of research methodology, results and its interpretation and conclusion." People frequently draw false conclusions, confuse correlation with causation, and introduce their own bias.

YET, you have not posted any studies or research supporting your claims. One has to wonder why, or they know why. It is easy to throw stones, much more difficult to support your claims. You persist with pushing 'I am so superior that my word is fact' but you won't provide any support for your claims. That tells me that you don't actually know and can't support your position with any facts.

I know that many here are experts in different fields and I am not an expert in those areas. My lack of extensive experience doesn't make someone's claims valid unless there is data/proof. Particularly when I have provided evidence. You want me to believe you blindly? Post up some proof/studies supporting your claims.

I am not saying you are stupid. I am just asking for evidence for your claims. That shouldn't be hard.

 

You also insinuate that you are a spinal surgeon. Then you say you are an editor. So what is it?

Post #16 - To all physicians out here including myself, no other physician will know more than a spine surgeon (both neurosurgeon and orthopedic can specialize in spine) about anything about a spine on earth.

Post #21 - I am an editor for research text book and grant review committee chair for different organizations.

 

You have mistaken my position sorely. I never was in the debate of chiropractor efficacy, ergo there was never a need for me to provide any study to support the position that you assumed I had. Reason you you thought I had was because you were in the defensive mode already due to your wife is a chiropractor.

I think you still miss a point about my mentioning of Indian predatory journal exist in academic world. Can someone else take my place to explain to this guy, please, I am getting tired.

I never insinuate I am a spine surgeon. You need to read what I wrote on the surface and not between the line that you obviously have shown reaction to. Be objective. Be analytical.

I already told you to show my post to those higher up in academic medicine, they will then explain to you. All physicians (MD or DO) who are professor of medicine are required to show their merits of teaching, contribution to progression of science in their own field. Therefore, my being a Editor of a research book as a physician is exactly expected at elite medical school and hospital. However, being the editor of a major text book could potentially backfire due to the time and effort it took. Published an article in NEJM will carry anyone much farther than being a textbook editor. My point of telling you that is to let you know that the publisher will only agree to publish a book after the editor name is that famous in the field and can guarantee the sales of the book.

It is obvious beyond your capacity to understand and accept how poor of evidence you provided when you are repeatedly educated by someone who knows what they are talking about.

If you have no one that you can rely on to learn how it is in academic medicine, let's stop right here because I find it embarrassing enough to educate a random stranger on a car forum. Boredom got the best of me.

Bye. This is my last post to you.