IS Forum
Forum Index Register Members List Events Mark Forums Read Help

Go Back   International Skeptics Forum » General Topics » Science, Mathematics, Medicine, and Technology
 


Welcome to the International Skeptics Forum, where we discuss skepticism, critical thinking, the paranormal and science in a friendly but lively way. You are currently viewing the forum as a guest, which means you are missing out on discussing matters that are of interest to you. Please consider registering so you can gain full use of the forum features and interact with other Members. Registration is simple, fast and free! Click here to register today.
Tags physiotherapy

Reply
Old 25th December 2020, 02:48 PM   #41
Darat
Lackey
Administrator
 
Darat's Avatar
 
Join Date: Aug 2001
Location: South East, UK
Posts: 97,092
Originally Posted by bruto View Post
I think in some cases physical therapists would rather go on past the end of insurance coverage, but since they know you won't, they sort of have to go with the reality. Others, no doubt, are trying to maximize their income and could stop sooner. It's up to the patient to decide where to draw the line, I think.

Some of this is likely also a matter of what sort of patient you are. A surprisingly large percentage of people don't do the home exercises they're supposed to, and I presume the practitioners know this. If you're the kind of person who actually does all the exercises, then you're probably well off quitting the sessions sooner. Or you can decide to keep going for the cost of the copay and let the insurance company pay the bulk.
Physiotherapy is part of universal healthcare in many countries, and we seem to have the same pattern of “we will assess you, teach you some exercises in clinic and then you go away and carry on at home and we will see you in 6 months”.
__________________
I wish I knew how to quit you
Darat is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 03:23 PM   #42
novaphile
Quester of Doglets
Moderator
 
novaphile's Avatar
 
Join Date: Dec 2009
Location: Sunny South Australia
Posts: 2,942
I've had excellent results from physiotherapists.

Treatment is in this form:

1. Diagnosis
2. Explanation of the problem, usually with diagrams.
3. A set of stretching exercises and muscle rehab exercises, laid out as a program for me to complete at home (or elsewhere).

My personal favourite?

I detached a small tendon in my foot, the physio recommended twice daily walks, barefoot, on the beach in the soft sand. (Note they also recommended a set of exercises to be achieved with a bicycle inner-tube, but I could do those sitting in a chair at home)

I complained about this to my employer, who said: "Do what they say, we'll pay for taxis to the beach and back twice per day."

Best physical therapy I've ever had.

__________________
We would be better, and braver, to engage in enquiry, rather than indulge in the idle fancy, that we already know -- Plato.
novaphile is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 04:57 PM   #43
P.J. Denyer
Philosopher
 
Join Date: Aug 2008
Posts: 7,855
Originally Posted by Darat View Post
Physiotherapists are sadists, everyone knows that!
Ah, Juliet from Wrexham Park Hospital hand clinic. Petite, blonde, lovely, hands of a strangler. Without her I wouldn't have been able to play guitar again after my left hand was smashed in a motorbike accident and I will be forever grateful to her.
__________________
"I know my brain cannot tell me what to think." - Scorpion

"Nebulous means Nebulous" - Adam Hills
P.J. Denyer is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 04:58 PM   #44
SusanB-M1
Incurable Optimist
 
SusanB-M1's Avatar
 
Join Date: Jul 2006
Posts: 3,748
Post

Originally Posted by Darat View Post
I've been seeing sadists since I was 13, apart from when special equipment was required the physios taught me exercises for me to do at home. I would say that's the case for most physio.
Important too is to maintain a routine of exercise to help prevent a problem recurring.
SusanB-M1 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 05:52 PM   #45
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Originally Posted by Darat View Post
If you think about it that’s because it encompasses so much. If you look up an individual treatment provided by physios you can often find papers.

I can't find anything about the theory supporting any kind of treatment. Some here have spoken positively about their experiences, but they have almost exclusively told about stretching exercise results. I am prepared to accept there may be benefits in this type of treatment. What I am questioning is the treatment I was subjected to: Pressure applied to sore spots in my back. Pressure that caused me considerable pain, and increased discomfort for a day after the treatment. I would like to know the theory behind this treatment.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 07:05 PM   #46
angrysoba
Philosophile
 
angrysoba's Avatar
 
Join Date: Dec 2009
Location: Osaka, Japan
Posts: 29,397
Originally Posted by Modified View Post
Much of what's done in medicine is done just because it is obviously what is needed and it obviously works, and is too obvious to be studied. Sometimes though, those obvious things do get studied and turn out to be more harmful than helpful on average.
Really???!?? What is done in medicine that is too obvious to be (or have been) studied?

Leeches? Bloodletting? Miasma theory? Trepanning? Lobotomies? Balancing the humours? Psychoanalysis?

What we might think of obvious now was not always obvious and often had to be done through trial and error. I would be surprised if anything that replaced Ye Olde Medicinal Ideas had not gone through a lot of testing. Even procedures as "obvious" as the doctor washing their hands was not always obvious and has most certainly been studied.

The obviousness of germs, vaccinations, keeping bloodflow to the muscles as part of the healing (as opposed to complete rest of the muscles) etc... have never been "obvious".
__________________
"The thief and the murderer follow nature just as much as the philanthropist. Cosmic evolution may teach us how the good and the evil tendencies of man may have come about; but, in itself, it is incompetent to furnish any better reason why what we call good is preferable to what we call evil than we had before."

"Evolution and Ethics" T.H. Huxley (1893)
angrysoba is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 07:07 PM   #47
angrysoba
Philosophile
 
angrysoba's Avatar
 
Join Date: Dec 2009
Location: Osaka, Japan
Posts: 29,397
Originally Posted by P.J. Denyer View Post
Ah, Juliet from Wrexham Park Hospital hand clinic. Petite, blonde, lovely, hands of a strangler. Without her I wouldn't have been able to play guitar again after my left hand was smashed in a motorbike accident and I will be forever grateful to her.
Hmmm.... would she be able to help me play the guitar as well?
__________________
"The thief and the murderer follow nature just as much as the philanthropist. Cosmic evolution may teach us how the good and the evil tendencies of man may have come about; but, in itself, it is incompetent to furnish any better reason why what we call good is preferable to what we call evil than we had before."

"Evolution and Ethics" T.H. Huxley (1893)
angrysoba is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 07:52 PM   #48
EHocking
Philosopher
 
EHocking's Avatar
 
Join Date: Apr 2004
Posts: 8,548
Originally Posted by Thor 2 View Post
I can't find anything about the theory supporting any kind of treatment. Some here have spoken positively about their experiences, but they have almost exclusively told about stretching exercise results. I am prepared to accept there may be benefits in this type of treatment. What I am questioning is the treatment I was subjected to: Pressure applied to sore spots in my back. Pressure that caused me considerable pain, and increased discomfort for a day after the treatment. I would like to know the theory behind this treatment.
Ah yes - "knots"!

These being "massaged", just jabbing a thumb into the spot and grinding, was always something that I thought was an unjustifiable torture during a massage.

It was my clavicle that the metal plate was screwed into, not my scapula!
__________________
"A closed mouth gathers no feet"
"Ignorance is a renewable resource" P.J.O'Rourke
"It's all god's handiwork, there's little quality control applied", Fox26 reporter on Texas granite
You can't make up anything anymore. The world itself is a satire. All you're doing is recording it. Art Buchwald
EHocking is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 08:16 PM   #49
Modified
Philosopher
 
Modified's Avatar
 
Join Date: Sep 2006
Posts: 6,892
Originally Posted by angrysoba View Post
Really???!?? What is done in medicine that is too obvious to be (or have been) studied?
Most things have not been studied because they are considered too obvious. Look at longtime medical/health recommendations that have been changed in the last few decades, such as an aspirin a day, HRT for women, giving babies peanut-containing foods, or the starting age and/or frequency for mammograms and other routine screenings. It is human nature to put a high value on things that will help a medical problem, and not to consider that the treatment or testing may do more harm than good.
Modified is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 25th December 2020, 08:25 PM   #50
angrysoba
Philosophile
 
angrysoba's Avatar
 
Join Date: Dec 2009
Location: Osaka, Japan
Posts: 29,397
Originally Posted by Modified View Post
Most things have not been studied because they are considered too obvious. Look at longtime medical/health recommendations that have been changed in the last few decades, such as an aspirin a day, HRT for women, giving babies peanut-containing foods, or the starting age and/or frequency for mammograms and other routine screenings. It is human nature to put a high value on things that will help a medical problem, and not to consider that the treatment or testing may do more harm than good.
I don't know why examples of things that have been studied and that have changed are evidence of things that are not studied so are done...

These seem like examples of medical science in action.

Many medical interventions take place because they seem to be the best idea among a range of options, but not necessarily because they are "obvious". In fact, the very reason why there is a reverse course on many of these things is because they are studied and found to be incorrect.

However, this is only relevant if you are making the case that physiotherapy is only done because people think it is obvious and it has not been studied. Is this the case?
__________________
"The thief and the murderer follow nature just as much as the philanthropist. Cosmic evolution may teach us how the good and the evil tendencies of man may have come about; but, in itself, it is incompetent to furnish any better reason why what we call good is preferable to what we call evil than we had before."

"Evolution and Ethics" T.H. Huxley (1893)
angrysoba is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 26th December 2020, 06:31 AM   #51
Chanakya

 
Join Date: Apr 2015
Posts: 2,602
Here's what they teach you in Physiotherapy school. (Course curricula from two programs, googled out at random: here, and here.)

Looks good to me. (What is covered in each course is further detailed, in those links, and those interested can take the time to click through and check this out in more detail than just looking at the course titles, which is all I did.) Can't swear to it, for all you know those scientific-sounding course titles may perhaps be euphemisms for woo-ridden instruction, that's possible I suppose, but that seems unlikely, given the course titles. Besides, despite being taught all this, the practice of physiotherapy may differ from what has been taught, that also is possible I suppose.

But what's likely, going by those curricula they're taught, is that this is grounded in science. At least that's how it looks to me.
Chanakya is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 26th December 2020, 06:45 AM   #52
Roboramma
Penultimate Amazing
 
Roboramma's Avatar
 
Join Date: Feb 2005
Location: Shanghai
Posts: 14,283
Originally Posted by smartcooky View Post
I used to have a long term problem with a severe, chronic pain in the back of my right knee. I used to take pain killers for the worst of it. Went through the same rigmarole as you (GP visit who gave a physio recommendation). Several visits to the physio for manipulation and massage of the back of the knee joint as well as heat treatment. No results, and the pain, if anything, got worse. Eventually the pain would go away on its own, but within a few weeks or months, it would always come back. This went on for a few years.

Finally, a friend recommended a local chiropractor, so I went. The chiropractor said the physio was treating the wrong thing. My knee was not the problem, it was my lower back. I had a pinched nerve in an area known as "the horse tail" - it had a fancy Latin name I don't recall - a bunch of nerves in the lower back. She said what I was feeling was "reflected" pain, the nerve being pinched was being felt as pain at that nerve's ending point behind the knee. First session on the drop table and the pain reduced dramatically. Two further sessions on the drop table over the next two weeks and the pain disappeared entirely.

I have been pain-free ever since. and that was over 20 years ago.

PS: Its worth noting that the chiropractor said the physiotherapist should've been able to work this out himself when it became apparent that treating the knee was not working, and had the physio done their job properly, he would have been able to alleviate the pain and I would probably have not ended up needing to visit her. I was rather annoyed by this because it meant in all probability that I had been putting up with that pain unnecessarily for years
About 15 years ago I injured my wrist. At first it was a mild pain, but it got progressively worse to the point that I couldn't make a fist with that hand. I remember pretty vividly not being able to grip the handbags of my bike (which I rode for about an hour a day at the time).
I was teaching yoga for a living, but as it got worse it made that job a lot more difficult. After about six months one day I went in to teach a class. I started out and within about five minutes found that I couldn't do anything that put weight on my hand. There were a lot of people in a small room and it got quite warm, the vibe was good, and as the class went on I forgot about the pain in my wrist and just enjoyed the atmosphere. There was one girl in the room who was pretty strong and at the end of the class I suggested she do a more advanced variation of a difficult arm balance. I started demonstrating the position and it was only after swinging around on my arms for a while that it struck me "wait, isn't my wrist supposed to hurt?". But it didn't.

And it never bothered me again after that.

I have no idea what happened that day, but I was pretty happy to be able to back to training the way I had been prior to the injury.
__________________
"... when people thought the Earth was flat, they were wrong. When people thought the Earth was spherical they were wrong. But if you think that thinking the Earth is spherical is just as wrong as thinking the Earth is flat, then your view is wronger than both of them put together."
Isaac Asimov
Roboramma is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 26th December 2020, 07:21 AM   #53
angrysoba
Philosophile
 
angrysoba's Avatar
 
Join Date: Dec 2009
Location: Osaka, Japan
Posts: 29,397
Originally Posted by Roboramma View Post
About 15 years ago I injured my wrist. At first it was a mild pain, but it got progressively worse to the point that I couldn't make a fist with that hand. I remember pretty vividly not being able to grip the handbags of my bike (which I rode for about an hour a day at the time).
I was teaching yoga for a living, but as it got worse it made that job a lot more difficult. After about six months one day I went in to teach a class. I started out and within about five minutes found that I couldn't do anything that put weight on my hand. There were a lot of people in a small room and it got quite warm, the vibe was good, and as the class went on I forgot about the pain in my wrist and just enjoyed the atmosphere. There was one girl in the room who was pretty strong and at the end of the class I suggested she do a more advanced variation of a difficult arm balance. I started demonstrating the position and it was only after swinging around on my arms for a while that it struck me "wait, isn't my wrist supposed to hurt?". But it didn't.

And it never bothered me again after that.

I have no idea what happened that day, but I was pretty happy to be able to back to training the way I had been prior to the injury.
There is an idea that there is a biopsychosocial model of pain, injury and training as opposed to a mere biomechanical model.

Under this idea, feelings of pain that are sometimes interpreted as dangerous may simply be the muscles having been exerted just as we would feel if we had been to the gym. If we could interpret the same sensations the way we would have if we had had a heavy gym session we wouldn't feel that "Oh no! I have to get acupunture/chiropractics/massages!"

I haven't read the whole of this article, but the ideas here and especially in the diagram seem to fit.
__________________
"The thief and the murderer follow nature just as much as the philanthropist. Cosmic evolution may teach us how the good and the evil tendencies of man may have come about; but, in itself, it is incompetent to furnish any better reason why what we call good is preferable to what we call evil than we had before."

"Evolution and Ethics" T.H. Huxley (1893)
angrysoba is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 26th December 2020, 11:03 AM   #54
Carrot Flower King
Muse
 
Join Date: Mar 2020
Location: Northumberland, UK
Posts: 765
Originally Posted by Thor 2 View Post
I've been trying to research the question, regarding the scientific basis of physiotherapy treatment, with little success. One gets told, almost like a mantra, that it is scientifically based but finding detail about the proof is illusive.
https://www.nice.org.uk/

I've already mentioned NICE: pick a condition, look up the guidance, follow the evidence trails...
Carrot Flower King is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 28th December 2020, 10:00 AM   #55
Squeegee Beckenheim
Penultimate Amazing
 
Squeegee Beckenheim's Avatar
 
Join Date: Dec 2010
Posts: 31,254
Originally Posted by Thor 2 View Post
I can't find anything about the theory supporting any kind of treatment. Some here have spoken positively about their experiences, but they have almost exclusively told about stretching exercise results. I am prepared to accept there may be benefits in this type of treatment. What I am questioning is the treatment I was subjected to: Pressure applied to sore spots in my back. Pressure that caused me considerable pain, and increased discomfort for a day after the treatment. I would like to know the theory behind this treatment.
Find out what that particular treatment is actually called, and put that name into google scholar.
__________________
I don't trust atoms. They make up everything.
Squeegee Beckenheim is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 28th December 2020, 05:07 PM   #56
EHocking
Philosopher
 
EHocking's Avatar
 
Join Date: Apr 2004
Posts: 8,548
Originally Posted by Squeegee Beckenheim View Post
Originally Posted by Thor 2 View Post
I can't find anything about the theory supporting any kind of treatment. Some here have spoken positively about their experiences, but they have almost exclusively told about stretching exercise results. I am prepared to accept there may be benefits in this type of treatment. What I am questioning is the treatment I was subjected to: Pressure applied to sore spots in my back. Pressure that caused me considerable pain, and increased discomfort for a day after the treatment. I would like to know the theory behind this treatment.
Find out what that particular treatment is actually called, and put that name into google scholar.
Originally Posted by EHocking View Post
Ah yes - "knots"!

These being "massaged", just jabbing a thumb into the spot and grinding, was always something that I thought was an unjustifiable torture during a massage.

It was my clavicle that the metal plate was screwed into, not my scapula!
A physio page on muscle knot woo..
This article at NCBI, Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective, may be of more use.

Personally, I was not aware of issues I had with “knots” until a physio gave me a massages. They are undoubtedly trained to seek these out, seemingly only to justify their need to apply massage therapy.
__________________
"A closed mouth gathers no feet"
"Ignorance is a renewable resource" P.J.O'Rourke
"It's all god's handiwork, there's little quality control applied", Fox26 reporter on Texas granite
You can't make up anything anymore. The world itself is a satire. All you're doing is recording it. Art Buchwald
EHocking is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th December 2020, 06:17 PM   #57
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Originally Posted by EHocking View Post
A physio page on muscle knot woo..
This article at NCBI, Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective, may be of more use.

Personally, I was not aware of issues I had with “knots” until a physio gave me a massages. They are undoubtedly trained to seek these out, seemingly only to justify their need to apply massage therapy.

Thanks for the links.

The first yielded this:

Quote:
Muscle knots can be caused by:

A sedentary lifestyle
Overusing or injuring your muscles
Poor posture
Dehydration
Unhealthy eating habits
Stress and anxiety

It seems like there isn't much that doesn't cause knots. There wasn't any explanation or referrals to any scientific research identifying these nasty ailments however.

The second link was a bit better but seemed to just rely on comments like "this dude thought this" and "this other dude thought that" sort of stuff.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th December 2020, 06:48 PM   #58
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Location: Hong Kong
Posts: 49,666
OLOL.

Choosing beggar much? Do you have a sedentary lifestyle? Cut it out and see if your knots improve. You know it's the right thing to do anyways, in terms of your health.

No, let me guess: You're overusing your muscles, right? Cut it out and see if your knots improve. You know it's the right thing to do anyways, in terms of your health.

Ah! I've got it! You're one of those people with perfect posture, who exercises just enough and not too much, drinks exactly enough water, eats moderate amounts of healthy food only, and are neither stressed nor anxious about anything.

Your knots are a medical mystery, and it's criminal negligence that your GP hasn't recommended you for scientific research.
theprestige is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 30th December 2020, 07:12 PM   #59
EHocking
Philosopher
 
EHocking's Avatar
 
Join Date: Apr 2004
Posts: 8,548
Originally Posted by Thor 2 View Post
Thanks for the links.

The first yielded this:

It seems like there isn't much that doesn't cause knots. There wasn't any explanation or referrals to any scientific research identifying these nasty ailments however.
… I did declare it to be woo for a reason …
Quote:
The second link was a bit better but seemed to just rely on comments like "this dude thought this" and "this other dude thought that" sort of stuff.
Well, when you’re discussing the history of the diagnosis of an ailment, you are going to discuss background medical opinion on the subject. Those references are down the end of the paper for further reading.

again, my post re: both links was not in support of the idea of knots, merely a couple of cites show the difference b/w a scientific approach and out an out woo approach to explain the idea.

I thought this quote from the 2nd paper would have explained that,
“Unfortunately, much of the terminology, theories, concepts, and diagnostic criteria are inconsistent, incomplete, or controversial.”
__________________
"A closed mouth gathers no feet"
"Ignorance is a renewable resource" P.J.O'Rourke
"It's all god's handiwork, there's little quality control applied", Fox26 reporter on Texas granite
You can't make up anything anymore. The world itself is a satire. All you're doing is recording it. Art Buchwald
EHocking is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 31st December 2020, 07:02 AM   #60
angrysoba
Philosophile
 
angrysoba's Avatar
 
Join Date: Dec 2009
Location: Osaka, Japan
Posts: 29,397
Looking into this a little more, I found a guy called Paul Ingraham who writes skeptically about something he used to be a practitioner of - massage therapy.

He has a post on Science-Based Medicine about why he quit being a Massage Therapist here.

I like his term for chiropractic patients ("crack addicts").

He writes a website called Painscience.com and has a lot of interesting stuff about things we have been discussing here, such as muscle knots and posture.
__________________
"The thief and the murderer follow nature just as much as the philanthropist. Cosmic evolution may teach us how the good and the evil tendencies of man may have come about; but, in itself, it is incompetent to furnish any better reason why what we call good is preferable to what we call evil than we had before."

"Evolution and Ethics" T.H. Huxley (1893)
angrysoba is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 3rd January 2021, 12:32 PM   #61
Oystein
Penultimate Amazing
 
Oystein's Avatar
 
Join Date: Dec 2009
Posts: 17,001
Originally Posted by Hellbound View Post
To be fair, the number of sessions set by insurance is usually the amount needed by most patients. The have actuarial departments to determine just this sort of thing.


Sent from my iPhone using Tapatalk
My experience (nurse in nursing home) is that the number is 10. No matter what the treatment, no matter what the condition. Patients in our house get 10 rounds of physio, cause that's what doctors prescribe and insurers pay.
__________________
Thermodynamics hates conspiracy theorists. (Foster Zygote)
Oystein is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 3rd January 2021, 01:21 PM   #62
deadrose
Illuminator
 
deadrose's Avatar
 
Join Date: Nov 2005
Location: the wet side of the mountains
Posts: 3,559
I used to have a problem with "knots" in my shoulder, back & neck muscles. Turned out to be the early stages of dystonia, and now I take anti-spasticity medication and have Botox injected into the area every 3 months. Before that, the only relief I could get was from those painful deep tissue massages. So it really is a problem for some people.

I saw a physiotherapist for a few months, starting with a referral for knee pain. I'd seen several doctors, had the joints x-rayed, MRI'ed, repeatedly injected with steroids, but they were still so painful that I went up and down stairs like a 90 year old. Not that much arthritis visible on the imaging to account for the pain levels. The physio observed my knees moving for a few minutes, applied some tape to them and asked if that helped. It was almost magical how much it did. Turned out is was because of my lax joints, my patellas were sliding off to the sides every time I bent a leg. So she taught me which muscles I needed to strengthen to help hold them in place, and how to tape them myself when needed, and years of knee pain ended just like that.

The sad thing was that none of the doctors had ever taken a look at how my knees moved. They just concentrated on the imaging results.
deadrose is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th January 2021, 09:16 PM   #63
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Just reporting back to say my back is now 100% again: I didn't go back for more physiotherapy and had no other treatment.

I have raised the topic about the efficacy of physio with many over the last few weeks, and although some have spoken positively about stretching exercises and such, non, who had the sort of treatment I had, had good reports about it. Many spoke of the agonising pain they had experienced.

I just wonder how the future will judge this therapy. Perhaps it will be dismissed in a similar way to that of blood letting and such.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th January 2021, 09:54 PM   #64
Orphia Nay
Penguilicious Spodmaster.
Tagger
 
Orphia Nay's Avatar
 
Join Date: May 2005
Location: Ponylandistan Presidential Palace (above the Spods' stables).
Posts: 38,751
Originally Posted by Thor 2 View Post
Just reporting back to say my back is now 100% again: I didn't go back for more physiotherapy and had no other treatment.

I have raised the topic about the efficacy of physio with many over the last few weeks, and although some have spoken positively about stretching exercises and such, non, who had the sort of treatment I had, had good reports about it. Many spoke of the agonising pain they had experienced.

I just wonder how the future will judge this therapy. Perhaps it will be dismissed in a similar way to that of blood letting and such.
It's been a month since you started the OP.

Did the physio recommend you do exercises?

Did you do them? I'm doubting it.

The back would have got better of its own accord if it hadn't stayed the same or got worse.

Your conclusion is not based on evidence that physiotherapy is woo.
__________________
"We stigmatize and send to the margins
people who trigger in us the feelings we want to avoid"
- Melinda Gates, "The Moment of Lift".
Orphia Nay is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th January 2021, 10:31 PM   #65
bruto
Penultimate Amazing
 
bruto's Avatar
 
Join Date: Jun 2005
Location: Way way north of Diddy Wah Diddy
Posts: 27,773
Meanwhile, on the other side of the coin, I just finished a course of PT, and although of course one can never quite tell, I think it helped. I had a really bad (worst in life) back attack from a slipped disk. Hardly able to move for a while, and even some months after, compromised in sitting. Went to PT, got some massaging (dubious efficacy but nice) electro stimulation for a little while (seemed to help a little but not for long) and a growing list of exercises, which I've been doing. Since part of my problem has been inflexibility and a bit of lopsidedness from a previous accident, I think the exercises, directed specifically at gradual improvement of flexibility, etc., have helped, and I think the physical therapist, knowing how things are put together and whatnot, was useful in deciding how much to do of what. I could clontinue, and insurance would continue to pay for a while, but she suggested that it's time to cut loose and just do the exercises at home.

Having had me before after I broke my neck, she probably does realize that I actually do the exercises (I still do some of the neck and shoulder exercises 8 years later). I think PT is one of those things that requires input from all parties, and if you just go and forget it until the next time you go, it's probably not going to do much.

I suspect that PT is not as definitively helpful as some medical procedures, and I also think it depends a lot on who is doing it, but I do think it has its place.
__________________
I love this world, but not for its answers. (Mary Oliver)

Quand il dit "cuic" le moineau croit tout dire. (When he's tweeted the sparrow thinks he's said it all. (Jules Renard)
bruto is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th January 2021, 11:29 PM   #66
Orphia Nay
Penguilicious Spodmaster.
Tagger
 
Orphia Nay's Avatar
 
Join Date: May 2005
Location: Ponylandistan Presidential Palace (above the Spods' stables).
Posts: 38,751
Originally Posted by bruto View Post
Meanwhile, on the other side of the coin, I just finished a course of PT, and although of course one can never quite tell, I think it helped. I had a really bad (worst in life) back attack from a slipped disk. Hardly able to move for a while, and even some months after, compromised in sitting. Went to PT, got some massaging (dubious efficacy but nice) electro stimulation for a little while (seemed to help a little but not for long) and a growing list of exercises, which I've been doing. Since part of my problem has been inflexibility and a bit of lopsidedness from a previous accident, I think the exercises, directed specifically at gradual improvement of flexibility, etc., have helped, and I think the physical therapist, knowing how things are put together and whatnot, was useful in deciding how much to do of what. I could clontinue, and insurance would continue to pay for a while, but she suggested that it's time to cut loose and just do the exercises at home.

Having had me before after I broke my neck, she probably does realize that I actually do the exercises (I still do some of the neck and shoulder exercises 8 years later). I think PT is one of those things that requires input from all parties, and if you just go and forget it until the next time you go, it's probably not going to do much.

I suspect that PT is not as definitively helpful as some medical procedures, and I also think it depends a lot on who is doing it, but I do think it has its place.
Indeed, the saying, "Motion is lotion" applies.
__________________
"We stigmatize and send to the margins
people who trigger in us the feelings we want to avoid"
- Melinda Gates, "The Moment of Lift".
Orphia Nay is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th January 2021, 11:48 PM   #67
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Originally Posted by Orphia Nay View Post
It's been a month since you started the OP.
Very good! Something you got right .... almost. Almost a week less than one month actually.

Quote:
Did the physio recommend you do exercises?

Did you do them? I'm doubting it.
Huh?

I am not talking about exercises if you would read what I have written. And why would you doubt that I have been doing said exercises?

Quote:
The back would have got better of its own accord if it hadn't stayed the same or got worse.
Something profound in these words but I just can't quite nail it.

Quote:
Your conclusion is not based on evidence that physiotherapy is woo.
Conclusion? Well that's something of an overstatement. Suggestion might be more appropriate.

My thrust in this thread is just to suggest that some physiotherapy treatments are not based on scientific evidence.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th January 2021, 08:17 PM   #68
arthwollipot
Observer of Phenomena
Pronouns: he/him
 
arthwollipot's Avatar
 
Join Date: Feb 2005
Location: Ngunnawal Country
Posts: 70,273
I have been diligently doing the wrist extension exercises and stretches as recommended by my physiotherapist, and I have recovered almost 80% of my range of motion.
__________________
Please scream inside your heart.
arthwollipot is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 18th January 2021, 08:50 PM   #69
Orphia Nay
Penguilicious Spodmaster.
Tagger
 
Orphia Nay's Avatar
 
Join Date: May 2005
Location: Ponylandistan Presidential Palace (above the Spods' stables).
Posts: 38,751
Originally Posted by Thor 2 View Post
Very good! Something you got right .... almost. Almost a week less than one month actually.



Huh?

I am not talking about exercises if you would read what I have written. And why would you doubt that I have been doing said exercises?



Something profound in these words but I just can't quite nail it.



Conclusion? Well that's something of an overstatement. Suggestion might be more appropriate.

My thrust in this thread is just to suggest that some physiotherapy treatments are not based on scientific evidence.
Did the physiotherapist prescribe exercises?
__________________
"We stigmatize and send to the margins
people who trigger in us the feelings we want to avoid"
- Melinda Gates, "The Moment of Lift".
Orphia Nay is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 19th January 2021, 01:24 PM   #70
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Originally Posted by Orphia Nay View Post
Did the physiotherapist prescribe exercises?

No.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st January 2021, 10:05 AM   #71
Segnosaur
Penultimate Amazing
 
Join Date: Jan 2002
Location: Canada, eh?
Posts: 17,122
I have been to physiotherapy twice in my life.

The first time was after I had broken my hand back in university. After the cast was removed, the doctor had me visit a physiotherapist several times in order to get strength back in my hand. They gave me exercises to do, and measured my progress.

The second time was more recent.... I had an unexplained pain in my hand when I bent my wrist back. It didn't look like Tunnel Carpel syndrome (and the doc did check for that) so he sent me to a physiotherapist. Treatment involved massage of the hand, followed by ultrasound and electrical stimulation. The situation started to improve after the first treatment, and after the 4th the pain was gone.

Now, it is possible that my hand would have gotten better without treatment. However, I had been in pain for several weeks before physio, so if it was just a case of the "body getting better on its own", the timing was an amazing coincidence.
__________________
Trust me, I know what I'm doing. - Sledgehammer

I'm Mary Poppin's Y'all! - Yondu

We are Groot - Groot
Segnosaur is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st January 2021, 10:46 AM   #72
Carrot Flower King
Muse
 
Join Date: Mar 2020
Location: Northumberland, UK
Posts: 765
A few of us have provided links to evidence: did the OP read any of them? Or are we just going to have a circular, anecdotal discussion without looking beyond that?

Go to the NICE website, pick a condition, look at guidance, follow the evidence provided...
Carrot Flower King is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st January 2021, 02:45 PM   #73
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Originally Posted by Carrot Flower King View Post
A few of us have provided links to evidence: did the OP read any of them? Or are we just going to have a circular, anecdotal discussion without looking beyond that?

Go to the NICE website, pick a condition, look at guidance, follow the evidence provided...

Well yes I did if you would read some of the above. I did have an exchange with EHocking as one example.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st January 2021, 08:07 PM   #74
bruto
Penultimate Amazing
 
bruto's Avatar
 
Join Date: Jun 2005
Location: Way way north of Diddy Wah Diddy
Posts: 27,773
I think if the physiotherapist did not specify some ongoing exercise, you got a bad one, and I think it's probably unfair to judge the whole lot thereby.

Of course I don't know how things differ between here and Australia either. After a fairly serious knee surgery my wife discovered, the hard way, that after an injury or the like your body can recruit or abandon muscles, and what seems like recovery can end up as wrong postures and bad habits that cause difficulty later. It took a fair amount of physical therapy to get all the muscles working in unison again.

A good physical therapist should know her muscles, know what does what, and where they are, and be able to help you retrain them so they work as they should, without doing any new harm. The one I went to the last couple of times always gives homework, and always expects, after you leave, that you'll sustain at least some of that exercise.
__________________
I love this world, but not for its answers. (Mary Oliver)

Quand il dit "cuic" le moineau croit tout dire. (When he's tweeted the sparrow thinks he's said it all. (Jules Renard)
bruto is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 21st January 2021, 08:15 PM   #75
arthwollipot
Observer of Phenomena
Pronouns: he/him
 
arthwollipot's Avatar
 
Join Date: Feb 2005
Location: Ngunnawal Country
Posts: 70,273
Originally Posted by bruto View Post
I think if the physiotherapist did not specify some ongoing exercise, you got a bad one, and I think it's probably unfair to judge the whole lot thereby.

Of course I don't know how things differ between here and Australia either. After a fairly serious knee surgery my wife discovered, the hard way, that after an injury or the like your body can recruit or abandon muscles, and what seems like recovery can end up as wrong postures and bad habits that cause difficulty later. It took a fair amount of physical therapy to get all the muscles working in unison again.

A good physical therapist should know her muscles, know what does what, and where they are, and be able to help you retrain them so they work as they should, without doing any new harm. The one I went to the last couple of times always gives homework, and always expects, after you leave, that you'll sustain at least some of that exercise.
This was my experience at the Hand Clinic.
__________________
Please scream inside your heart.
arthwollipot is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 22nd January 2021, 01:41 PM   #76
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Originally Posted by bruto View Post
I think if the physiotherapist did not specify some ongoing exercise, you got a bad one, and I think it's probably unfair to judge the whole lot thereby.

Of course I don't know how things differ between here and Australia either. After a fairly serious knee surgery my wife discovered, the hard way, that after an injury or the like your body can recruit or abandon muscles, and what seems like recovery can end up as wrong postures and bad habits that cause difficulty later. It took a fair amount of physical therapy to get all the muscles working in unison again.

A good physical therapist should know her muscles, know what does what, and where they are, and be able to help you retrain them so they work as they should, without doing any new harm. The one I went to the last couple of times always gives homework, and always expects, after you leave, that you'll sustain at least some of that exercise.

Well I thought I said it quite clearly before but here we go again.

I am not challenging the efficacy of physiotherapy as a whole. I am just questioning the efficacy of the treatment involving the applying of pressure to sore spots. I would like to see some science supporting this treatment. I can give you a first hand account of how painful it is.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 22nd January 2021, 03:21 PM   #77
bruto
Penultimate Amazing
 
bruto's Avatar
 
Join Date: Jun 2005
Location: Way way north of Diddy Wah Diddy
Posts: 27,773
On the pressure issue I would guess there's at least room for argument, and I haven't researched what science may or may not say on it. I do think a good physiotherapist can achieve something by massaging sore spots, relieving spasms and so forth, as well as helping to track down where problems are arising using probing and feedback, assuming they have some anatomical knowledge. I would also guess, though, that aside from wide variation of skills, there's a good bit less substantive going on then, and I've never met a PT who does that alone.

I do admit my posting has had more to do with the thread title and its implication than with your specific issue.
__________________
I love this world, but not for its answers. (Mary Oliver)

Quand il dit "cuic" le moineau croit tout dire. (When he's tweeted the sparrow thinks he's said it all. (Jules Renard)
bruto is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 23rd January 2021, 11:21 AM   #78
Carrot Flower King
Muse
 
Join Date: Mar 2020
Location: Northumberland, UK
Posts: 765
Originally Posted by Thor 2 View Post
Well yes I did if you would read some of the above. I did have an exchange with EHocking as one example.
All I can see is some discussion of muscle knots. Anything else, considering your original question was quite broadbrush? What did you think of any of the rest? Was it scientific or evidence-based enough or not?
Carrot Flower King is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 23rd January 2021, 03:03 PM   #79
Thor 2
Philosopher
 
Thor 2's Avatar
 
Join Date: May 2016
Location: Brisbane, Aust.
Posts: 6,609
Originally Posted by Carrot Flower King View Post
All I can see is some discussion of muscle knots. Anything else, considering your original question was quite broadbrush? What did you think of any of the rest? Was it scientific or evidence-based enough or not?

Well I have seen some evidence-based endorsements of some physio treatments, but the science seems skimpy. Mind you I think it would be difficult to do a meaningful scientific study to establish the efficacy of physio treatments. You would need a group of folk, who have precisely the same condition or injury (and how would you establish that?), subject some to precisely the same treatment and some not, then look at the results.

That massage and exercises my be of some benefit I tend to acknowledge, because it just seems to make some sense and we have some here testifying that it seems to work. Applying pressure to sore spots (knots?), doesn't seem to have the same endorsement, from those who have experienced it.
__________________
Thinking is a faith hazard.
Thor 2 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 28th January 2021, 10:45 PM   #80
novaphile
Quester of Doglets
Moderator
 
novaphile's Avatar
 
Join Date: Dec 2009
Location: Sunny South Australia
Posts: 2,942
Originally Posted by Thor 2 View Post
Well I have seen some evidence-based endorsements of some physio treatments, but the science seems skimpy. Mind you I think it would be difficult to do a meaningful scientific study to establish the efficacy of physio treatments. You would need a group of folk, who have precisely the same condition or injury (and how would you establish that?), subject some to precisely the same treatment and some not, then look at the results.

That massage and exercises my be of some benefit I tend to acknowledge, because it just seems to make some sense and we have some here testifying that it seems to work. Applying pressure to sore spots (knots?), doesn't seem to have the same endorsement, from those who have experienced it.
Sorry to be a gainsayer, but "accupressure" self administered, has been an absolute game changer for me.

I used to get very hard, very small lumps in my muscles, about the size of a hazelnut. They were excruciatingly painful, and would get larger over time.

My physio showed me technique where I apply pressure to the site with a ball (tennis ball, golf ball, $5 spiky physio ball - they all work just as well) and it forces the muscle to relax.

This technique works perfectly every time, and takes seconds.

The only technique I know that is as effective, is stretching to get rid of a cramp.

(Also works instantly for me).

There's a reason why I like physios you know.

And none of them have ever told me that I need to come back for 100 visits...

__________________
We would be better, and braver, to engage in enquiry, rather than indulge in the idle fancy, that we already know -- Plato.

Last edited by novaphile; 28th January 2021 at 10:46 PM. Reason: s/if/it
novaphile is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Reply

International Skeptics Forum » General Topics » Science, Mathematics, Medicine, and Technology

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT -7. The time now is 11:58 AM.
Powered by vBulletin. Copyright ©2000 - 2021, Jelsoft Enterprises Ltd.

This forum began as part of the James Randi Education Foundation (JREF). However, the forum now exists as
an independent entity with no affiliation with or endorsement by the JREF, including the section in reference to "JREF" topics.

Disclaimer: Messages posted in the Forum are solely the opinion of their authors.