Physiotherapists are well known for confident physicality. A friend of mine used to say that you could always tell the physiotherapy students at university because they'd be the ones walking around with hardly any clothes on. Happy are we it seems, to betray our confidence in our understanding of the body and how to 'work' it, taking every opportunity to thrust our bodily ideals on others. Often, physiotherapists' projections of the idealised normal and able body cause little offense, but their approach can also cause a great deal of hurt and frustration in the very people they claim to be helping. It would be nice to think that physiotherapists would be united in their opposition to … [Read more...] about Work for it – fitness, female and fascism
A few days ago, I responded to a Tweet from Glyn Blakey (@saebouglyn) and Mary Banks (@MaryBanksy) after Mary had posted up a paper suggesting that the Saebo Mobile Arm Support (SaeboMAS) had reduced tonic muscle activity across all muscles, and that this had had a positive influence on corticomotor selectivity of biceps brachii during a counterbalanced movement tasks. This all sounds very fancy, but what it basically means is that if you support the arm, the patient who is having difficulty moving, can concentrate on one joint activity while the rest of the limb is supported. You'll get a better idea if you see a picture of the SaeboMAS at work: Seeing the paper made me wonder … [Read more...] about There are no new treatments in physiotherapy
I’ve just returned from the biennial NZSP conference held over the last two days in Auckland, and I find myself, once again, disheartened by some of the ideas my colleagues are promoting. Years ago, when I was a junior practitioners and an even more novice qualitative researcher, I would go to physiotherapy conferences hoping to hear the brightest and the best, speaking about cutting edge practice. But rarely did I hear anything about people as people, social theories, politics, disability rights, gender issues, etc. There was never even the slightest mention of anything qualitative to break up the dry diet of quantitative facts and figures. (Those were the days when physiotherapy was … [Read more...] about Exercising our demons
One of the biggest growth areas for physiotherapists in the coming years years will be the management of chronic illness. The numbers of people now living with conditions that were once relatively rare is quite staggering, and they are becoming more complex. A report released last week by the Australian Health Policy Collaboration (link) has once again highlighted the need for us to take a society-wide approach to managing the threats posed by conditions like heart disease, diabetes, cancer and respiratory illnesses, through a concerted effort to tackle the 'upstream' causes: alcohol consumption, sedentary behaviour, high salt intake, smoking, etc. Obesity, diabetes, hypertension and … [Read more...] about Do you need a four-year degree to tell someone to stop smoking and do more exercise?
Sanitary Systems Dumoulin, the physician, observed at his death that "he left behind him two great physicians, regimen and river water." Villars, the French quack, who, before the middle of the last century, made a fortune by an almost justifiable fraud, kept thousands of patients in good health by administering to them nitre dissolved in Seine water (sold at five francs a bottle), eat moderately, drink temperately, take plenty of bodily exercise, go to and rise from bed early, and avoid mental anxiety. And in the same way the English quack, Graham, whilst he presided over the "Temple of Health," prohibited to his patients the use of the "deadly poisons and weakeners of both body and soul, … [Read more...] about Staying healthy in the 18th century
Physiotherapists are very interested in fitness, leisure and sport, but they rarely discuss the history of these ideas, or the place of physical therapies (massage, manipulations and mobilisations, remedial exercise, electrotherapy, hydrotherapy etc.) in the promotion of the health of the population. There are a number of reasons why I think we should pay more attention to this specific history. Firstly, it's one of the few areas where physical therapies have made a genuine contribution to the health of the population. I don't mean the health of individual patients that, taken together, amounts to the health of the population, but rather an approach applied to the population as a whole - … [Read more...] about Strong and modern – physiotherapy and physical culture
Yesterday, I took part in one of the regular and always enjoyable Physiotalk Tweet Chats (#physiotalk). This one was on the role of physiotherapy in exercise prescription. As usual, the discussion ranged widely over all sorts of topics: whether physiotherapists were experts in exercise prescription and what needs to be taught in the UG curriculum not being the least of them. One thing that came through strongly was a desire to manage the client/patient's behaviour. Words like adherence, compliance and motivation kept coming up and people seemed to recognise that all the skill in the world wouldn't matter to the therapist if the patient didn't engage. As someone who's read their fair … [Read more...] about Is behaviourism the future for physiotherapy?