This is a production of Shoulders of Giants with Jared Powell, the shoulder physio. Jared is a senior physiotherapist with a special interest in shoulder pain and pathology and is currently enrolled in a PhD in this area.
Jared will use this platform to chat with interesting people about interesting things in the health and fitness sphere. The focus will be on the hard science and evidence behind the topic at hand and will aim to avoid sensationalism and opinion to the best of Jared's ability. Another aim of this channel will be to broaden the horizon of physiotherapists and musculoskeletal clinicians to include areas of science such as; neuroscience, philosophy, evolutionary biology, physics and psychology.
We are, after all, in the game of behavoiour change. Enjoy!
Interesting Idea, that Physios can choose, If they want work with their hands and specific techniques. Because we mustn't forget, what does the Physios feel? It's not only about clinical outcome, but also about Humans having fun and a good Feeling by touching other Humans.
Excellent information. I’m currently learning MT and more general MSK management in my DPT training and having this perspective is invaluable. Big thanks to everyone involved!
An ad hominem is technically when you conclude your opponent’s wrong because of their poor character etc. Simply insulting someone is not an ad hominem.
Hi, I respect and very much agree with the fact that a lot of manual therapy "teachings" reffer to palpation or to specific applications but not all of them Have you heard about the maitland concept or more than that have you ever done the course, Adam? A quick example is that in the maitland concept palpation is something that sits at the bottom of the asessment and is used because it might give you some more relevance to the component that you suspect, you disagree with that? So then again maitland doesn't use palpation as an primary asessment tool, it might only give you more reason to think about a more specifically region or joint. Then if you agree with this, how can you say on the network that palpation is irrelevant or bullshit? Instead of saying this, show you are more open minded and teach the people that look up to you, how to use all the tools that are possible in which situation, because that might make a difference to a patient, and we all aware of the fact that all patients are different, so how can we make even the assumption that palpation might never be relevant, or other manual therapy things? Again maybe they are not the answer, but sometimes they might give better quality to the patient recovery, so another question comes, does it matter how you do it?
Wow, this was an epic intellectual battle between two professionals. I'm agnostic on who won the debate but as a lifter I tend to listen more to practitioners who have the education plus are also world-class athletes. Although academic research papers have their place, to me they are inferior to practitioners who also can demonstrate the efficacy of their opinions through feats of physical performance. In the Marine Corps we had a saying that if you are explaining you're losing - specifically by promoting your academic credentials over your accomplishments.
Had an ACL tear (and some damage to the bone, meniscus was ok) in January 2022 at grappling (mri and physical tests done by 3 doctors). Did not get surgery, researched online and decided to just do physical recovery. Did the kneesovertoes guy recovery exercises plus others I found online (am still doing them once a week) and came back to grappling after 4-5 months. I have not had an mri on the knee to see if any healing occured but either I am a coper or the acl healed somehow at least partially.
@@VarunBatraIT That is what the doctors said after the manual tests and the RMN showed a full tear... I am not lying, I went to 3 doctors and they all said the same thing. But from the injury during jiu jitsu sparring I had only some cracks in my femur next to the knee and the full acl tear, very little meniscus damage. So I guess that helped, it was not a full knee injury, menisc+ all 3 ligaments.
@@dodolino99 I trust you. I was just trying to evaluate my chances without surgery. One theory is that it can grow back in 2 years or so. So I asked if you later did an MRI. I just can't believe that body can't heal itself. It's biological being want to survive and repair is priority
I believe PTs have caused more harm than good by telling clients with LBP to not bend their spines. Its insane. The spine flexes and if you dont use it, you lose it. The big guy is very confrontational, unfortunately. It shows poor tolerance to open mindedness.
Second year of physio school I thought Locke was super cool. Bit embarrassing in hind sight to think I ever gave the guy credit. Absolutely love how capable of ambivalence Lehman is. Always measured and contextual. The script by Locke shows just how boxed in, uncontextual and rigid he is. All the ad homs he pulls out of those scripts shows just how personal he takes this. Just makes me want to scream: It's not about you mate, it's about real people with real pain and doing the best we can for them.
Yeah, the ignorant will view nuance and ambivalence as ignorance, not realizing that he is in fact caught in the logic of false dichotomies and absolutism. It's a shame that younger physios also look to SquatU as their hero. At least a charlatan like Locke was only a part of your learning process. A lot of physios seem to just stay in that outdated biomedical realm.
On psychological intervention: there is an average of 50% pain reduction with treatment from effective CBT - David Burns, MD. I would venture to say that between Physical Therapy and cognitive therapy, pain reduction has extremely favorable chances.
Could this profession become any more clogged with Self-aggrandizing male egos? Truly a profession on its way out, defensive, parochial, under-educated, over-credentialed & yet incapable of critical thinking. But mostly, ineffective. Time to retire this White privileged mob to pasture.
Locke's "don't trust a non-lifter who researches lifting" is such an insanely weird argument. What about biologists who research bird migration, astronomers who research solar systems, and physicists who measure quantum phenomena... are these scientists any less legit because they themselves dont fly, appear in space, or wiggle like strings?
My university SOMT of the manual therapy master dergree recommended to watch this video before our course of manual treatment options of the thoracic and lumbar spine. They also added some SI joint manipulations, but I feel like that would only cause a manipulation of L5-S1 or above.
The big assumption here that neither speaker touches upon is why exactly does society need the profession of PT? Separate the professional designation from whatever good might be done using these (lower case) physical therapies and then begin the convo. You are both entering the discussion already accepting the existence and need for the PT profession. I question such an assumption as the quintessential issue here. People don't need PTs, period. People don't need to be told what to do, rather, PT needs people to tell what to do in order to bolster ego. PT has assumed that its place in society must exist because its proponents believe people need it. Yet that is marketing, not truth. If PT disappeared tomorrow, NOTHING BAD WOULD HAPPEN.
This term, "therapeutic touch" means what? Here is another example of absolute bullship. Who gets to claim such a term? According to who? So much intellectual vomit.
This entire conversation is an illustration of narcissism, nothing more. Male egos pretending to be important. News Flash! PT (incl Chiro) is nothing but pseudoscience packaged and marketed to make it look like these professions are relevant. Both these individuals are bloated, arrogant and offer nothing new. EGO
This video should be included in every undergraduate physiotherapy course! Not just for the argument on manual therapy but also HOW to think as a therapist.
Such conversations are avoided because they represent existential threat. The reason PT is in such a mess is because it is a cult, clutching and clinging to anything and everything that will reinforce the fragile collective egos of those who seek membership in a group they see as "elite".
I'm on line with non surgical rehab. Just tore my left acl completely playing soccer. If my knee gives up after months of rehab, I would then opt for surgery. I feel I could cope with braces and crutches for few months and work my knee off to recover.
This is painful to watch. Greg Lehman published at least 5 studies with Dr Stu MgGill and Andrew Lock is arguing semantics that he never studied "under" McGill. And I'm only at 7 minutes in... Let's see what other gems this provides!
I would be interested to know if Adam would seek manual therapy after he's sustained an injury and been in severe acute pain. My thoughts are that acute injuries occur due to tissue failure from acute overload or repetetive microtrauma inducing overload. Exercise is required to protect that tissue from future overload and to deal with the loads required of it. However, Pain is amazing at inhibiting muscle function and overall function so manual therapy therefore shines in allowing for exercise based therapy by pain inhibition/modulation. Manual therapy should not be seen as a cure but it certainly helps with correcting movement, as well as gaining buy-in/trust from the patient to work through the required strengthening in the future :D
I made one comment on Andrew's Insta, asking why he wouldn't talk to someone who disagreed with him, and he blocked me instantly. Bit of a weak move from a strong man 🤷🏻♀️
Really interesting and informative video, thanks to both of you. Tore my left ACL end of March and currently 2 months into rehab with the hope of being a 'coper'. So far ok but very early days! This was reassuring as like you both discuss, the surgery route is so engrained into us, I was hesitant when the non-surgical route was recommended to me. Thanks again.
