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Was that me?
Not you, it was TJ. I'm not being stalkery, and not even to you, sorry.
I don't get wound up very often on here, and it tends to stick in the mind. And sticking 3 words in google to find a thread on here is hardly stalking.
"I'll always say you should see a medical professional"
Physios aren't medical professionals, they're health professionals as recognised by the NHS, alongside osteopaths
"but they're not regulated by a legally recognised body"
yes they are
"it doesn't count if it's got the same name in the title - self regulation doesn't count"
You'll be dismissing all of these out of hand then:
Health regulators
The General Dental Council (GDC)
The General Medical Council (GMC)
The General Optical Council (GOC)
The General Osteopathic Council (GOsC)
The Nursing and Midwifery Council (NMC)
General Pharmaceutical Council (GPhC)
Pharmaceutical Society of Northern Ireland (PSNI)
The Professional Standards Authority (PSA)Social Care regulators
Social Work England (SWE)
Northern Ireland Social Care Council (NISCC)
Social Care Wales
Scottish Social Services Council (SSSC)
Again, I have no problem with any criticism if it's fair an even-handed, but yours isn't. Absolute statements are very rarely correct. "Every physio is better than any osteo" is nonsense, and what you are backing it up with flaps in the wind. If you want to back up your absolute statements and potentially deprive people of well-needed reprieve from pain, you need to show why NHS, the Health and Care Professions Council, the General Osteopathic Council, the NI Department of Health, the Welsh Government and the Scottish Government are all wrong, and you're right.
Its really very simple - osteopathic is not based on any science. Osteopaths continually make claims for which there is no evidence such as treating babies for colic using cranial osteopathy. Almost all the claims have been comprehensively debunked by real medics and scientists, the only benefit that has been shown is for mild lower back pain there is a possible slight benefit.
None of the rest of the claims make any sense or have any evidence for them
Its not me making these claims - its a whole raft of scientists and medical professionals that have comprehensively debunked spinal manipulation and cranial osteopathy as nonsense and spinal manipulation as dangerous especially on the neck
the roots of osteopathy are classic quackery
My aim here is to provide the information people need to stop them wasting their money on pointless and dangerous treatments
if there was any evidence base yo would be able to point to proper studies showing benefit. the fact you cannot is very telling
Evidence based pratise is the key and the basis of osteopathy has no evidence base underlying it
https://www.badscience.net/2004/09/cranial-osteopathy/
https://quackwatch.org/consumer-education/QA/osteo/
Etc etc etc
the really scary thing is in the US a osteopathy is given similar rights and protections as a medical doctor
So when you jump on threads on here, people should see any physio over any osteopath, is it when people are asking about their baby's colic? Or Asthma?
Or is it invariably people asking about bad backs, shoulders, cycling injuries?
And when you make your blanket statements that people should see any physio over any osteopath, regardless of specialisation or recommendations, are you careful to warn them of the potential dangers of spinal manipulation techniques that both professions often use, and to ask them in advance what techniques they use?
Osteopaths continually make claims for which there is no evidence such as treating babies for colic using cranial osteopathy.
A fact the NHS link on osteopathy agrees with, along with other things they don't think it works for.
But the NHS does seem to think osteopaths can help with other conditions.
As ever, it's the belligerent absolutism that, if anything, undermines your argument.
But it's great to have the real TJ back again. 👍
Not quite true More cash
read the research quoted here
https://www.evidence.nhs.uk/search?q=osteopathy
ie "Collectively, these data fail to produce compelling evidence for the effectiveness of osteopathy as a treatment of musculoskeletal pain"
cranial osteopathy does nothing. No evidence that is of any good quality for spinal manipulation
Yes some osteopaths may use physio techniques - which are properly researched evidenced and effective but you have no way of knowing if you are going to end up with an osteopath doing physio, a quack who will rip you off with useless treatments and a dangerous quack who will damage your spine
Osteopathy is based on pure bunkum
None of us actually wanted to discuss treatment for RC injuries then?
TJ is 100% correct as far as it goes, in that Osteopathy is founded in little more than witchcraft. However, I'm a very black-and-white person and TJ is worse than me. Ultimately, does it really matter how it was founded so long as it works? Or an argument beloved of homeopaths, does it matter if we don't understand how it works so long as it does work?
And at this point, TJ is bang on the money because this is what boils down to and it really is this simple: "Prove it."
One could argue that cumin cures cancer (and will have a promising career ahead of them writing Daily Mail headlines) and a perfectly valid counter-argument may be "well, how? That makes no sense!" But does it matter? Worrying about the mechanism is secondary to worrying about the efficacy. Is it efficacious? Is it efficacious beyond placebo?
Which brings us worryingly back to homeopathy. You'd have to be off your gourd to think that homeopathy is anything other than a placebo treatment. But the elephant in the room here is, so long as people aren't forgoing actual medical intervention* is a placebo treatment a bad thing if patients feel it helps? I honestly don't know the answer to that.
(* - there seems to be a move away from terming pseudo-scientific horseshit unproven treatments "alternative medicine" and instead referring to them as "complimentary therapy" and I think that's a good thing. You can have whatever voodoo you choose alongside chemotherapy rather than instead of it.)
None of us actually wanted to discuss treatment for RC injuries then?
New here? (-:
None of us actually wanted to discuss treatment for RC injuries then?
Some of us had a go on the first page, TJ and Cougar have derailed it by getting on their poorly considered hobby horses. Unfortunately for me, I've weighed in, when I told myself I wasn't going to. Again.
I'm not an osteopath. I've seen 4 in the last 15, 18 years. 2 were underwhelming and I wouldn't see again, 2 were excellent and have helped me a great deal. That's as much skin in the game as I have. I'm not defending osteopathy, I'm attacking TJ and Cougar's "belligerent absolutism".
.
TJ and Cougar do not understand what they are talking about - on this topic. Their arguments make it clear they don't know much about Physiotherapy or Osteopathy.
History they constantly point at the origins of osteopathy as proof that a well recommended osteopath cannot help you. Have they examined the origins of physiotherapy in the same way and hold it to the same standards? Clearly not. snippets below.
"Physicians like Hippocrates, and later Galenus, are believed to have been the first practitioners of physiotherapy, advocating massage, manual therapy techniques and hydrotherapy to treat people in 460 B.C.[4] After the development of orthopedics in the eighteenth century, machines like the Gymnasticon were developed to treat gout and similar diseases by systematic exercise of the joints, similar to later developments in physiotherapy."
"Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s.[9][10] Later that decade, PTs started to move beyond hospital based practice, to outpatient orthopedic clinics, public schools, college/universities, geriatric settings, rehabilitation centers, hospitals, and medical centers."
https://www.physio-pedia.com/Physiotherapy_/_Physical_Therapy
regulation - they do seem to have backed off this point, but I imagine it'll be back next time.
scientific background/training - have they looked at the course syllabuses of physios and osteopaths to establish the scientific content? Obviously not.
evidence base - this is the really big one. asking for evidence that osteopathy works - blind to the oft-repeated facts that it's a diverse selection of techniques, much like physiotherapy. The individual techniques are studied, not the entire profession. "Has "physiotherapy" been proven to work" - what a silly question that would be! - which bit?
Last time round, the main argument was around studies of spinal manipulation - presented as proof that osteopathy was rubbish, ignoring the fact that the studies took account of many patients of physiotherapists who had used the very same techniques.
Have they even looked into the evidence base for "physiotherapy techniques"? Do they know how long evidence based practice has been a "thing" in Physiotherapy? Do they even know what the profession's view is of EBP? Very clearly not!
A recent systematic review analysed "What do physical therapists think about evidence-based practice?" [12] and concluded that the barriers most frequently reported were:
lack of time,
inability to understand statistics
lack of support from employer
lack of resources
lack of interest and
lack of generalisation of results.
Although the majority of physiotherapists have a positive opinion about EBP, they consider that they need to improve their knowledge, skills and behaviour towards EBP.Limited research in some areas of physiotherapy also constitutes an obstacle to practising evidence-based physiotherapy (Fruth et al 2010).[13]
And despite, or rather because of, this absolutely terrible thinking, research, ability or inclination to learn, they jump on every thread like this, stating all physios can be recommended unreservedly, and all osteos are quacks, potentially depriving someone in pain of their best option for care and therapy.
Ned
Unfortunately its you that do not understand at all here
Osteopathy is pure bunkum. Proven fact. It has no evidence base worth talking about, it has no validity and its not based on science
I never stated that all physios can be recommended unreservedly however "evidence based practice" is the gold standard and physiotherapy is based on that.
Really dude - this is something I know a bit about. I have had osteopathy - damaged my back permanently. I have seen osteopaths taking eyewatering sums for known useless treatments from vulnerable people. I see them still advertising they can do things that are proven bunkum
,
potentially depriving someone in pain of their best option for care and therapy.
NOpe - potentially stopping them wasting money on useless snake oil and potentially stopping them being crippled by it
I do not control what others do with the information. all I can do is give the information.
the end of it is really simple. Osteopathy is dangerous and is not effective apart from a [possible slight reduction in lower back pain and even that is unproven. Every other claim for it has been solidly debunked by proper science
Do you know how long evidence based practice has been a “thing” in Physiotherapy?
Do you even know what the profession’s view is of evidence based practice?
Yes - I know the answers to both of those things.
However this discussion has reached the point of futility.
apparently so.
I think you (cougar,ned,tj) should just agree to disagree ....... please for all our sakes
TJ and Cougar have derailed it by getting on their poorly considered hobby horses
That's rich! 😂
Can I just ask (I think flaperon gave some good points) is it better to just carry on and not rest an injured shoulder.
My job has been hard going (curtain maker wrestling with heavy velvet fabrics), which has aggravated my old 'neck of femur' injury. Is it better to do my physio exercises and carry on with the work, or rest the arm as much as possible, but still do the exercises?
I've had both osteo and physio treatment for shoulder injuries, and if you gave me a blind test and asked me, when I was on the table being managed and manipulated, which practitioner was working on me I couldn't tell you. Osteopaths probably have a better knowledge of the structure and mechanics of the body - the training is very thorough. Yes, some osteopathic techniques are bunkum - cranial, and some of the 'crunches' they used to do - but I've not had an osteopath suggest either to me for years. So my personal experience, which is obviously not a scientific study, suggests that both physio and osteo can be useful to someone in the OP's situation.
For @convert
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004258/full
TL;DR:
There is some evidence from methodologically weak trials to indicate that some physiotherapy interventions are effective for some specific shoulder disorders. The results overall provide little evidence to guide treatment.
Worth a ctrl+F for "rotator cuff." Apparently, mobilisation/manipulation plus guided exercise might help, but a corticosteroid injection might help more, although ibuprofen might help just as much.
Most up to date study for shoulders suggests advice is just as good as exercise interventions (with or without cortico-steroid injection).
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00846-1/fulltext
FWIW I am a physio, I am a researcher, I also know a fair amount of what the professional body wants. The above study was a robust investigation delivered by an awesome team out of Oxford. So the hands on stuff isn't always any better than a leaflet or a bit of a chin wag...
There is a paucity of robust evidence to support a number of things we as physios do in our day to day practice (same can be aimed at many AHP's including Osteo), however, due to our breadth of specialities we work in we have some fairly decent evidence too in specific areas of practice (respiratory). I think the evidence for any intervention for musculoskeletal issues is less robust.
We as AHPs have a responsibility to provide clinically reasoned, evidence informed practice (as do all the others), and we follow the evidence where available and our clinical reasoning to determine the best approach from what we assess.
I think putting physios on a pedal stall and taking aim at Osteo / Chiro is a bit unfair. Sure they come from rather peculiar beginnings, but so did physio - remedial gymnastics anyone? Physiotherapy came about as an offshoot of nursing when they were provinding massage therapy and didn't want to be thought of as offering 'other' types of massage...
I think there are good and less good practitioners in all professions, and that's why a number of people get hauled up before the HCPC, GMC, NMC etc for fitness to practice hearings and that's why our professional bodies pay out a huge amount to provide personal liability insurance to members.
I think this is the study I found before (review of databases rather than a new study) but more recent.
https://www.csp.org.uk/frontline/article/effectiveness-exercise-rotator-cuff-related-shoulder-pain
Resisted and progressive exercise provides an uncertain clinically meaningful improvement in pain and function compared to no treatment or placebo among people with rotator cuff related pain. In contrast, there is low certainty evidence of no benefit in all outcomes with non-resisted or non-progressive exercise.
TJ and Cougar do not understand what they are talking about – on this topic. Their arguments make it clear they don’t know much about Physiotherapy or Osteopathy.
I was at odds with TJ. Are we both wrong whilst disagreeing with each other?
[lots of typing basically saying physios are also quacks]
At the end of the day, if you're a practising whatever-you-are then you need to back up any claims to efficacy that you're making. If physiotherapy should be in the same bag as the others then I hold my hand up, I did not know that. Do you know of many physios claiming that they can cure asthma or colic?
they jump on every thread like this, stating all physios can be recommended unreservedly, and all osteos are quacks, potentially depriving someone in pain of their best option for care and therapy.
I find this a weird coda. I've never stated that "all physios can be recommended," I wouldn't be rash enough to say that about "all" anything. All GPs? All plumbers? I know plenty of shit technicians and engineers in my own fields.
And, "best option"? Is it? What you've just described there is at best "least worst."
n=1 and all that, but the stupidest* person I have ever met** has wound up as an osteopath after various failed careers.
*As in dangerously stupid. As in has been a member of various religious cults in the past, believes every single conspiracy theory going etc.
** Met while we were both studying for bioscience PhD's - the PhD which they proudly display on their website as some kind of proof of not being a quack unfortunately.
Sorry, Cougar, I might have got a little sloppy with my language, but after a few of threads trying to get across what marp said above, with no success, I'd got a little frustrated.
lots of typing basically saying physios are also quacks
That's not what I said at all. I've not leveled blanket accusations at anyone.
All I've ever said is that some manual therapists are good and some are bad, people should ask for recommendations for someone who's good at dealing with the issues they have.
I've been frustrated at blanket accusations thrown at one field on the basis of evidence, history, regulation, and scientific basis without much attempt to view the other field through the same lenses.
Edit: And you're still shit at even basic checks of your position, even after the abuse I gave you earlier?
Do you know of many physios claiming that they can cure asthma or colic"
Google "physiotherapy colic" how many pages before you find one? 3rd result down in the first page for me.
Where's wanmankylung when you need him lol
Lol... you lot!!
As per post number 3... if you have sore shoulders then go and do some "Face pulls"*
In fact, go and do some even if your shoulders feel ok.
Do them properly. Just one or two sets of these will help restore function, coordination and joint space. But you have to do them properly.
*Don't do these if it make the impinging pain worse.... this is highly unlikely 🙂
Reading this with interest as I’ve got a rotator cuff injury too, through a combo of doing ninja warrior locally and also via Ferrata clinging to a rockface!
It doesn’t affect my riding at all at the moment but can I reach a glass from when in bed, not easily!
Trouble is I am quite bad at doing my physio exercises and I guess I need to be better basically! I am 10 weeks into MTB Fitness too and thinking some exercises I really shouldn’t be doing like pull ups! Did I read that so long as the shoulder is down and back then it’s better? So for example deadlifts so long as I’m not trying to lift a very heavy weight. Resistance bands seem to be the best by the sounds and I’ve got a few exercises with those to do from the NHS. Might be worth me seeing a physio though!