The biggest mistake therapists make is

willy waving on a bike forum?

[video]http://www.youtube.com/watch?feature=player_detailpage&v=dJmg-879j5o[/video]

Podium – what on earth are you talking about? What qualifications does a body worker have?

Stoatsbrother – fair point well made. Probably is as good as diagnoses get though.

I know it’s wiki but this description on “Bodywork” is probably all you need to know.

‘energy medicine’

is this invisible snake oil?

The Medi profession is absolutely clueless re “Carpal Tunnel” they continue to do unnecessary surgeries that don’t make a difference.

Well that’s a load of bollocks.
I had my right CT done 15 years ago and it’s fixed. Perfect ever since.
I’m just waiting for a date to have my left one done. I’ll report back in another 15 years about that one….

Podium – what on earth are you talking about?

he went away after I asked him what his medical qualifications were 😛

Some of what podium says makes sense and what I think he is talking about (in a rather obnoxious and arrogant way unfortunately) is related to the works of Janda and postural syndromes (upper crossed in particular) and the law of reciprocal inhibition in muscles. In other words you can’t simply stretch a muscle which is weak and inhibited by other neuromuscular imbalances and faulty movement patterns (such as postural issues). The issue will just return again. You need to address the other factors also.

How he can claim to fix this ‘in minutes’ and diagnose someone on a forum is highly questionable. To dismiss physios as not being highly qualified enough and unable to treat stuff like this is also laughable (and no I’m not a physio).

mulv1976 – I’m not a physio either and my medical knowledge is limited to my own body failings 😆 I do however rate the physio’s I have seen over the years. Sure some are better at getting to the root of an issue and helping than others, but all have been professional

Wow a moshpit in my topic 8)

Sadly I cant rough-house as my hands are **** 😆

Did 2 years of a physio degree. That didn’t remotely give me the answers I was looking for.
Changed to Sports Therapy. A bit better but I was still looking for a eureka moment [in terms of problem solving knowledge]
Was going to train as a surgeon but jumped into a different frying pan – that of Structural Osteopathy. Getting there..
You’ll love this bit – taught soft tissue techniques on a Physio Degree! That was very stifling as I wasn’t allowed to teach the students to think outside the box, which you need to do to solve complex musculoskeletal problems.
Went to America to train in various Bodywork modalities. Bodywork is something of a generic term and a universally acknowledged umbrella term over there. Most are trained in different stuff, wether from a Chiropractic background, Physical Trainer [similar to our Physios] Rolfers etc.
Last 10 years spent doing more obscure post grad quails.

All of that goes into the melting pot, I use very little of the original trainings in the trenches these days which I feel only teach you to a level of basic competence.

I Work on Bodies using various skills and knowledge.

Defacto i am a BodyWorker.

But you can call me a complimentary therapist 😉

You sound more like an insulting then a complimentary therapist. (sorry couldn’t resist)

There are some great physios out there btw.
It’s all STW banter hels.
I’m actually a dustman.

Went to America to train in various Bodywork modalities

Last 10 years spent doing more obscure post grad quails

Could you be more specific as to the training and the qualifications?

My missus, who is actually a physio keeps hitting me…says stop annoying the SingleCrackers.

Obscure stuff not many have heard of. Much better than all the other stuff put together. Top secret sauce, if you will.

Sounds like a good dose of reflexology would sort you out.

Pinch the skin behind your big toe, the left one. Does your hand feel any better?

If that doesn’t work, I can put you in touch with a vibrational therapist.

says stop annoying the SingleCrackers

.

Um, I don’t think you’re annoying anyone, I waiting for the information regarding your training and qualifications, so I can have a chuckle before bedtime.

There’s good and bad practitioners in all types of health care (I’m a chiropractor btw) but I don’t agree with the general medical approach to musculoskeletal conditions, which seems to be to react to pain by masking it with pain killers or by hacking bits off. Surely it is better to identify and deal with what may be causing it in the first place e.g. functional issues. Structural issues or pathology are a different matter.

It makes me laugh when medical doctors are held in such high regard just because they have a medical qualification. In my experience, most GPs wouldn’t have a clue how to treat a musculoskeletal problem (and I’ve had one as a patient who admitted as much). The majority are just a gate-keeper for referral or basically to triage any red flag cases. Don’t get me wrong, there are some great GPs out there and I respect medical doctors but I think the westernised medical system is all geared towards targets and £££ and not about the well-being of the patient at all.

Case in point – a recent patient with a 20 year history of disc prolapse and degeneration was fobbed off with pain killers and NSAIDS for all that time and is now left with massive structural changes, chronic pain and neurogenic claudication which (surprise, surprise) won’t react to medication. Now, if this condition had been dealt with properly 20 years ago (ergonomic, lifestyle, postural, functional, stability advice, exercises etc), they would have had a decent chance of a fit and active, pain free life. To me that borders on negligence, but it is all too common nowadays. I see it time and time again.

People want a quick fix to be pain free i.e. pop a pill (‘evidence shows it’s just as effective’ blah, blah). That’s fine in some cases, but in others it won’t prevent degenerative processes if the underlying functional causes aren’t identified and addressed! Sorry, bit of a rant, but there you go…

‘Medical’ qualifications: Masters degree in Chiropractic (4 years full time undergraduate training, including 12 months in a clinic environment) for those who want a ‘chuckle’ 🙄

so not medical then…

as for your example – frankly fatuous. as i was working in hospitals 20 years ago and trying, with some lack of success, to get complementary therapies introduced the notion that any of these things would’ve been taken on board would’ve have been rare indeed.

as for gps, well there’s good and bad but i note none of you have managed anything like a differential beyond ‘something neckish’ so really i don’t think anyone should be throwing stones in that respect.

the ‘i know best’ model, amply demonstrated in the above, is one in which not only can clinical error thrive but also removes the person concerned from the centre of the picture in favour of the practitioner.

patient first, ego second seems to me to be a pretty decent way to work as well as assessing the type of person looking after you.

A simple search for “singletrack forum chiropractic” will turn up ample evidence of the previous threads on this subject.

Case in point

Anecdote, compelling though it may seem, is not the equivalent of data.

How much do you charge?

so not medical then…

What does that even mean? What do you see as a ‘medical’ person? NHS? No offence but that’s opening a whole can of worms.

as for your example – frankly fatuous

Really? Try telling that to my patient and the many others I see in the same boat. My approach is biopsychosocial ie holistic, where the patient is at the centre. I will try to address all aspects of their life which may be affecting their health.

as for gps, well there’s good and bad but i note none of you have managed anything like a differential beyond ‘something neckish’ so really i don’t think anyone should be throwing stones in that respect.

Without examining the patient (which the majority of GPs don’t do) it would be impossible to say anything else…

patient first, ego second seems to me to be a pretty decent way to work as well as assessing the type of person looking after you.

There’s too many egos in the healthcare profession – that’s why there’s so many divisions. The patient should always come first but sometimes that seems to get lost in the arguments.

How much do you charge?

How much do you charge?

What’s that got to do with anything?

I think the westernised medical system is all geared towards targets and £££

How much do you charge?

Western life is geared towards £££££’s

Medical practitioners aren’t exempt from needing money. They have skills that are difficult to acquire so can charge accordingly.

There’s very few people who work for less than the market will bear.

If you must know: £45 for an initial consultation and treatment and £30 for follow up treatments.

Patients typically respond well after 4-6 treatments.

Patients typically respond well after 4-6 treatments

Amazing. And if they don’t?

Western life is geared towards £££££’s
Medical practitioners aren’t exempt from needing money. They have skills that are difficult to acquire so can charge accordingly.

Very true. The medical staff earn their money. I was talking more specifically about the megabucks being made by the large pharmaceuticals and US health insurance companies. But that’s capitalism for you.

Are you a straight chiropractor or a mixer?

Amazing. And if they don’t?

Do I detect a touch of cynicism?

I will re-assess and discuss further options with the patient. If I feel the condition would be best referred to another specialist for imaging/further testing, I will do so. If I feel the condition needs further treatment to respond (which can often be the case which chronic issues), I will propose a further, perhaps modified treatment plan with the patients informed consent. Fortunately this doesn’t happen too often. As I said most respond well after 4-6 treatments 😉

In my experience, most GPs wouldn’t have a clue how to treat a musculoskeletal problem (and I’ve had one as a patient who admitted as much).

In my experience GPs get about 7 minutes to do a complete consultation and write any notes. I take 45 minutes to an hour. I couldn’t get to the bottom of a complex musculoskeletal case in 7 minutes and my training in musculoskeletal issues is probably better than a GP would be expected to have.

That was very stifling as I wasn’t allowed to teach the students to think outside the box, which you need to do to solve complex musculoskeletal problems.

Can you explain why you think it’s necessary to think outside the box when solving complex msk problems? I am of the opinion that there are no complex msk problems, merely complex solutions looking for a problem. I go for a logical approach to diagnosis and treatment and keep things firmly in the box – works great for me and my patients.

In my experience GPs get about 7 minutes to do a complete consultation and write any notes. I take 45 minutes to an hour. I couldn’t get to the bottom of a complex musculoskeletal case in 7 minutes and my training in musculoskeletal issues is probably better than a GP would be expected to have.

I appreciate the time constraints of the GPs, but surely this is more a failure of the ‘system’ rather than of their assessment skills. I’ve no doubt that most would be able to diagnose these problems if they actually assessed, I still doubt they’d be able to treat them ‘hands on’ effectively – they simply don’t have the training.

I still doubt they’d be able to treat them ‘hands on’ effectively – they simply don’t have the training.

i think that if they had time they might be able to diagnose the most common conditions.

Say you were the patient – would you rather pay a GP, or a specialist in msk injury rehab, keeping in mind the relative cost of each? Physio is cheaper than a GP.

Anyway Hora – how are your neck and hands today?

Say you were the patient – would you rather pay a GP, or a specialist in msk injury rehab, keeping in mind the relative cost of each? Physio is cheaper than a GP.

A good point raised.
But…would the MSK rehab specialist be able to arrange prompt in house nursing care because your wife, whom you care for and lift, hence the back injury, is now left without a carer? And would the MSK specialist be able to discuss the side effects of your ‘water tablet’ with you at the same time, because you’ve only got the time and strength to see one specialist, and although not related in the slightest to the back issue, is also on your mind. Plus, you’ve ran out of blood pressure pills too and thought that stopping them was what was causing your back issues, alongside the water tablets that may have been ‘making your kidneys hurt’….

I’m not saying one profession can or can’t manage simple health problems in isolation better than another, but whoever the patient sees needs to see past “hello, I’m dan with a sore back” and see the bigger picture (which I’m sure we all try to do)…

DrP

DrP – we’re in agreement here. Physios are cheaper because they don’t have the power or training to deal with those things. I do not envy GPs. GPs work far too hard and have too much stress for he money they are paid – I’m happy with the amount of responsibility that I have in my job and I don’t want any more than that.

Still painful- especially in middle and index.

I’ve traced the median nerve up into the side of my bicep/armpit- manipulating that REALLY helps immediately.

Hmm – Interesting. I still think it’s neck related, but your best route to go down would probably be to see your GP and see if they can sort it out or refer your to physio.

Release bicep fascial bag.
Assess pec minor for facilitation [a given] and compensatory patterns [try opposite psoas test]
Pec Minor likely impinging brachial plexus nerve bundle.
TOS between anterior and medial scalenes also very common.

If Pec Minor is causing impingement, you prob have anterior humeral glide, and resultant restrictions. Assess those. may have glenohumeral adhesions. Release if so.

May have inhibited Rohomboids. But not always.

Subscapularis often needs release and subclavius.

Assess cervical facets [often locked closed]
Release as required.

Just a few quick off the cuff things I usually check and treat.

Forearm glide along pec minor to bicep with client humeral rotation often works well.

If pec minor is the main issue [might be, might not be] you need to figure out how many muscles it is compensating for and address those issues if you want a long term solution.

Don’t forget to ask your therapist to test the cervical intertransversarii if you have locked facets [and resultant neck restrictions]

Good luck

What Podium said

cervical intertransversarii

Is that not lady parts related?