Do you have a great GP who advocates for Pilates-not-painkillers and sensible “social prescriptions” etc. Do you have a great PT or Yoga/Pilates instructor who really knows their onions? But what if you don’t? Where do you turn? Following on from listening to a number of speakers at yesterday’s online version of Therapy Live (a huge UK therapy expo featuring numerous top physiotherapists and other industry professionals), I felt the usual surge of enthusiasm for the rehabilitation and fitness industry but it also made me think – what do you do if don’t know who to listen to? It’s a minefield out there.
One of the things I picked up on was that most of the therapists I heard made reference to their personal treatment bias. I’ve often experienced this not only when I learn a new skill and suddenly feel like it can help everyone, but, as a chronic pain sufferer, you often become slightly less sympathetic to others pain or forget that systems and plans that work for you may not be right for others or that other may not be as mentally capable of dealing with these things. Whatever it is, our personal lived experiences shape our offerings as therapists/trainers and we all have a bias!
Lockdown has proved to be an interesting time in the health and fitness industry with people largely paying more attention to their personal health and fitness. Obviously social poverty is the largest risk factor for serious Covid-19 illness but beyond that, obesity and heart disease, lung disease such as COPD and other respiratory conditions are really problematic. We need to be fit and healthy to have the best chance of survival. From another less serious aspect, what if the therapist you usually see is prevented from treating and your back pain flares up like nobodies business and you don’t have the tools to deal with it?! What if you are looking to either keep up your normal routine online or maybe people have just been looking for something to fill the boredom? Should people just be “giving it a go”?
In expanding my social media contacts over the last few weeks I’m pretty shocked at the sheer volume of us out there and the amazing plethora of free classes & advice available, but, on the flip side I have seen some dire misinformation and some exercises demonstrated truly terribly on some pretty big channels! I’ve seen advise from people who, on paper, are more qualified than me, that is totally wrong and out of touch with current information. It’s one of the reasons I rarely take new courses these days. It’s very difficult to find something that’s not just the same old stuff and not necessarily well thought out or anatomically sensible (see my rants on “boosting immunity” and “melting belly fat”). Anything I do look towards, I question thoroughly. One of the funny comments from yesterday was the number of physios who had been subjected to “health and safety” briefings to work in large organisations. There is absolutely zero evidence to support that picking up a box a certain was is any better or worse that any other way. People bodies function differently and unless you are going for gold in Olympic lifting then your form really isn’t a factor in whether your back might hurt in the work place. Usually these “trainings’ are given by someone not qualified in anatomy who is just spouting what they have been told, so we all end up believing it. Have you ever questioned if this is an evidence-base practice? Thought not.
The reason I do hands-on therapy along with Pilates is that you just HAVE to deal with and aches and pains as well as injuries through functional movement. You can lay on a massage table every week but unless you exercise to manage any issues you might have then it won’t help, however good you may feel after. Manual therapy is something I obviously believe in but in my opinion it is just part of a lifestyle plan to manage our physical and mental stress. It’s an amazing tool but it cannot solve ALL your problems on its own without your input.
So I would urge everyone out there to try to find someone to see in person or via FaceTime before we can get back to the studios. If you are starting from scratch you need to find someone you connect with, who understands you and your body and can help you make realistic management plans without too much personal bias. Equally, if your previous therapist or trainer has been content to treat ad hoc and you haven’t seen improvements or been given a homework plan if necessary, then perhaps you are not getting the whole package I believe we all should be offering.
I’ve also seen the fear from many massage therapists that as physios and osteopaths have been able to see clients during lockdown that soft tissue workers will not have a client base to come back to. We are in the midst of lobbying parliament to change our unregulated categorisation to get the recognition as the health workers that we are. But in the mean time I find this worry crazy! A half hour with a physio, however good their hands-on skills may be, will never replace a really good deep tissue treatment. If people are not coming back to you, probably pretty desperate after such a stressful time to wait, then you need to skill up! We can all learn the cross profession skills like medical acupuncture which many people expect these days, so we need not refer for these practices if that’s what your clients want. Equally we shouldn’t be afraid of referring, I have a couple of physios I refer to ALL THE TIME when I have something that I feel is beyond my remit, but people will come back for their massage 9 times out of 10 (the 1 usually being a financial issue as massage is rarely cover by insurers).
We need to stop putting so much emphasis on follows, likes and Youtube subscriber numbers. Yes, of course there are some great people out there but it’s peppered with quacks. Your real local experts may not have a huge Insta following because why bother? Personally, I’m too busy to advertise and use the platform more for this blogging and my existing clients find the extra advice helpful. It’s become part of the “homework” package and the general nagging you get from me. Like the client I used to see in a long-forgotten clinic who complained of aching knees every week – I was the only therapist he ever saw who just explained that there was nothing much I could do unless he lost some significant weight. We need to tell people the truth, I think on the whole people find it refreshing and much more helpful than pandering to excuses.
So find someone local and give it a try, I’ve had people say to me that they didn’t like Pilates because last time they tried it they hurt their back. To me that’s just terrible teaching and obviously the opposite intended outcome! You will not get everything right if you just try to watch a video. Followers does not mean expertise and expertise does not mean you get on and connect, after all this is a personal business, so find someone who gets you personally and more importantly, actually knows their anatomy and gives sensible advise from which you see results.