More Gordon Ramsey than Joey From Friends! This one is on physio...
One of the significant limitations of learning (and teaching) Physiotherapy at university is the fact that it encompasses so much, that it allows little time and guidance to critique each area in great detail.
For example, a 45-minute lecture on exercise prescription and strength training doesn’t exactly make you a “movement expert”. That’s like filling a pot noodle up with hot water and say you’re an expert in Asian cuisine.
It seems to me, that the primary focus is more on “what” to think and less on “how” or even “why” to think. Recipes on how to help people get home from the hospital without doing any harm.
As a result, it can be tempting for a lot of Edinburgh Physios to fill their arsenal with lots of tools, such as needles, manipulations, electricity and fancy massages etc. etc. As a fresh graduate, it can make sense that these passive therapies will arm you enough to help you to treat anything that walks through the treatment room door.
However, you should be very sceptical of anything you believe simply because it “makes sense”. It makes sense that the earth is flat (when I look out my window, it is!), it also makes sense that the sun orbits the earth (when I look out my window, it does!) (the example is stolen from Erik Meira’s Hip course).
Science is the best tool for enabling us to acknowledge that many things which “make sense” are in fact incorrect. In fact, science is the most valuable and essential tool in any competent Physio’s toolbox because science helps us see things for what they really are without dangerously relying solely on our senses and what makes sense. (Discover our services)
Ok, so what’s Joey from friends got to do with Science? Surely I should be talking about Ross…
Joey doesn’t share food, but Joey is also not the fussiest when it comes to preparing food.
We might not expect Joey to do very well if he owned his restaurant because he’s not a chef and just because something tastes good to you doesn’t mean you should use it in any recipe.
I would argue that becoming an excellent Physiotherapist is a lot like becoming an excellent chef, who makes delicious nutrient dense food for their customers. Check out the physiotherapy Edinburgh tweet from Health by Science.
When you start out you need a supervisor to navigate you around the kitchen (different body parts), to teach you about how different ingredients work with each other (tools) and also which ones don’t. You then need to know how to put these all together in a skilful way which the consumer will not only enjoy but will get long-term benefits from (a person-centred approach/therapeutic alliance).
Now to begin with you might need to follow a few recipes under the guidance of your sous-chef or maybe even head chef. But if you want to become a better cook then you’re going to have to start learning “how” to cook and “why” certain ingredients work well together and also “why” some ingredients are harmful to our long-term health and some are very good for our long-term health.
In this example let’s assume that the customer who’s walked into your restaurant wants a delicious dish that not only makes them feel good but also helps them to look better and perform better, long-term.
In the world of Physiotherapy, there are only three ingredients that have the efficacy to achieve this as outlined in Adam Meakin’s and Erik Meira’s Hip and Shoulder course, and they are:
Advice and education
Load management
Get strong
A contentious issue is a use of massage, which is kind of like sugar. It’s not inherently evil and in the fact can be quite useful if you’re doing a lot of exercises. If you’re not exercising, however, then while it might make you feel good short-term, it’s doing nothing for your health and performance goals long-term.
So while you might sprinkle a little sugar in the dish, to sweeten it up or maybe make those veggies in the stir fry taste a bit better. Without the three main ingredients, you are being robbed of any long-term sustainable improvements in your health and wellbeing.
So why be more like Gordon Ramsey? He’s a dick, isn’t he?
I’m not sure because I’ve never met him. Whether you like or loathe his approach to training and critiquing other chefs or not, the healthy scepticism used is essential if any chef is to help other chefs, sous chefs, and trainee chefs to create a better food industry.
Of course, there are many ways to critically evaluate someone’s work, but I guess when things are that bad, some individuals can’t help but use the odd profanity now and again.
You might not like Gordon Ramsey, but he’s an incredibly accomplished chef who has helped an enormous number of other chefs. Instead, you might prefer Jamie Oliver or John Torode (who? exactly).
The one thing they all have in common is that they critique each other’s work using science-based principles to develop their own and others culinary skills.
If we don’t take this approach, then we’ll end up with a bunch of Joey’s in charge of a restaurant with a long history and good reputation. Funny for a short while but an absolute shambles if we don’t let the Gordon Ramsey’s in to stir some much-needed thought and debate.
Think of this clip below as Adam Meakins with Critical Thinkers Vs. Pseudo-science Physiotherapists.