MECHANICAL MEDICINE Exploring the History of Healing by Exercise, Manipulation and Massage. 23 May 2019, Science Museum, London. A symposium at the Science Museum, London, organised by Dr Kay Nias (Medicine Galleries Research Fellow). ‘Physical medicine’ or ‘physical therapy’ has ancient origins. For thousands of years, people with illnesses and disabilities have been treated with physio-therapeutic techniques including exercise, manipulation and massage, as well as air, water, heat and cold, electricity and light. These various healing methods have rich and diverse histories that span time, cultures and medical traditions. While documentary evidence representing the … [Read more...] about Call for Papers: Mechanical medicine – Exploring the History of Healing by Exercise, Manipulation and Massage.
The idea that one approach to practice is superior to another is a powerful discourse in physiotherapy today. Last week I was talking with a colleague who thinks of himself as a 'critical thinker', and we were debating the merits of active rehabilitation over passive treatment. So called 'passive' treatments (some forms of massage, manipulation and electrotherapy, for example), in which the patient has treatment done to them rather than taking responsibility and actively engaging, have been the subject of much criticism in the profession for some time now. There is, I was told, indisputable evidence for the benefits of active approaches over passive treatment, and that those who … [Read more...] about Going beyond good and bad practice
There has been a flurry of interest in the value of exercise as a therapeutic remedy in some sections of physiotherapy social media in recent months. Some of this, at least, appears to be a reaction to what have been called 'passive' treatments, and a neoliberally-inspired desire to see people take more responsibility for their future health and well-being. Exercise is clearly a very valid and appropriate intervention for some people. It has been for as long as human civilisation has walked erect, and it almost certainly will continue to be useful into the future. But a recent special edition of the journal Qualitative Research in Sport, Exercise and Health has cast doubt on some of … [Read more...] about Exercise is medicine
A report in The New York magazine last week speculated on the likelihood that President Trump might die in office because he is one of the least active presidents in human history (link). How, you might ask, has this got anything to do with physiotherapy? Well, the President of the United States, it seems, holds a view about the body, and the detrimental effects of exercise, that was popularised by some of the same 19th century physicians that made physical therapy popular. It seems President Trump 'considers exercise misguided, arguing that a person, like a battery, is born with a finite amount of energy' (link). There's a lovely historical overview in The Guardian about this … [Read more...] about Assault and battery
I posted a tweet about a small bit of news from the Chartered Society of Physiotherapy (CSP) that had caught my eye yesterday. It was about 'A telephone assessment service in Cambridgeshire [that] is helping more than half of its physiotherapy patients to self-manage their conditions' (link to the full press release here). It featured an image that I thought was interesting and just a little ironic. Here is the image. My comment on Twitter was that this was 'a thing of postmodern beauty', and both the picture and the full report raised the ire of some in the Twitter community. There were a number of things going on in this report that I think said some important things about the … [Read more...] about “Seated physios giving advice on exercise to patients over the phone” – a follow-up
There was an interesting collaborative blogpost by Jarod Hall a few days ago. Titled 'Knowledge Bombs for a Successful Clinical Career' it summarised a great collective effort by a number of experienced clinicians looking to summarise some of the key tenets of current clinical practice (link). Some of the summary points were that good clinicians build therapeutic alliances and actively ('truly') listen to their clients; that clinicians are experts at the basics and should not take the blame for patients not getting better; and that education and exercise are key. There are many things to like about this blogpost, not least the collaboration between colleagues and the earnest attempt … [Read more...] about How to be an expert in physiotherapy today
Sadly, it seems we cannot escape the fact that many physiotherapists now believe that part of the answer to the problems now facing the profession can be resolved, at least in part, by telling people to lose weight, stop smoking, and get more exercise. The need to feel part of the move towards population-based primary health care has induced many traditional and orthodox health professionals to scratch their heads and ask what their social function will be in the future. It seems reasonably clear that traditional sources of work, like the specialist care that once took place in large hospitals, and the routine self-limiting, acute musculoskeletal disorders that made up significant … [Read more...] about Stop telling people to lose weight and get more exercise