There has been a lot of interest on social media over the last few days in this promotional video from the Physiotherapy Associate of British Colombia (PABC) called Choose to move (see below).
What’s really striking about this video is that it’s all about movement; not the kind of movement defined by the American Physical Therapy Association as “a system of physiological organ systems that interact to produce movement of the body and its parts,” but rather a humanistic, social and deeply personal experience. As @AdamMeakins opined on Twitter, [this is a] ‘f**king awesome advert… No tape, needles, machines or manips in sight!’
The advert does a wonderful job of connecting physiotherapy to the bigger issues that really motivate people to make use of our experience and expertise. It makes extensive use of metaphor; ‘What moves you?’ and uses powerful visual images and sound to evoke the idea that movement is for everyone regardless of ability, gender, age, ethnicity, or any other cultural positioning.
But this raised an interesting question for me. Adam is right that there are none of the traditional markers of physiotherapy practice in the advert. All it states is that physiotherapists can help you move. But what specifically identifies physiotherapists as the agents people should turn to here? Why would someone look at this advert and think that a physiotherapist has something to offer? Why would they turn to us and not a personal trainer or practice nurse?
I find the same question when we teach primary health care and population health to our UG students. We do a lot of work to explain all the reasons for the shifts taking place in modern health care, but when it comes to how physiotherapists might take an active role as agents of change in this new world, we’re often left with the trite and simplistic message that people just need to lose weight, stop smoking and get more exercise.
We know that it doesn’t take a four year undergraduate training to tell people to lose weight and get more exercise. And equally, it take an extensive background in anatomy and physiology, differential diagnosis and the management of complex health problems to encourage people to move.
So what is the role of the physiotherapist here? How do we distinguish ourselves as experts in empowering people to move if we take away the traditional trappings of our practice?
My personal view is that there are a lot of people trying to position ourselves as experts in human movement on the basis of our knowledge of the body as machine (see, for example, Shaun Logan’s piece on ‘Physical therapy and the human movement system‘). But these offers a very paternalistic, reductive view of movement that situates the patient as a passive recipient of treatment – more of a 19th century idea of practice than a message for the 21st century.
So while I applaud the PABC for it’s humanistic and holistic interpretation of the importance of movement for physiothearpy, I want to know what the next two minutes of video might include; the part where they say exactly how physiotherapists will help to ‘move you.’