Not willing to give in to ''silly bullshit'', or arrogance?

[Mark Rippetoe]

Thanks to everyone who has shared some light on this subject.

Still, the physiological reasoning behind exercise prescription that some physiotherapists give to their patients remains unclear. From what you gentlemen are telling me, it seems like they're more worried about ''not hurting'' the patient rather than forcing his recovery.

That, and they don't know any better. They have been trained in the conventional wisdom, and without a lifting background of their own, this preparation is inadequate.

[Aaron Wilkes]

Does fibrosis or a similar process also occur in ligaments/tendons if they are not rehabbed properly?

Several months back, my wife tore her meniscus, and had relatively minor tears of her MCL and ACL on the right knee. She was sent to a PT for several weeks, who had her do a random assortment of body weight and machine exercises using the legs. During and after her therapy, her knee would sometimes feel a little better, but sometimes feel worse. If she were to start squatting now, is it likely that she would re-injure herself if it wasn't healed properly through PT?

I assume she should start squatting either way, since this would be the best way to strengthen this injured area for long term health.

[Mark Rippetoe]

Scars will occur in connective tissue, but that's the only healing mechanism available to tendon, ligament, and fibrocartilage. Since it is not contractile, it's usually fine.

[Aaron Wilkes]

Oh, I see. Now it seems obvious - since connective tissue is not contractile, it can't be rehabbed in the same way. So the primary concern is contractile tissue forming scars, because it is likely to tear again in the future. Got it - thanks for the wisdom, Rip!

[Kyle Schuant]

Compounded with the utter horror that patients demonstrate when you explain to them they will benefit most from a linear barbell based strength progression. It's really amazing the look some patient's give you, and they invariably follow your recommendation with, "I thought I was coming here for massage."

Hmmm, and Austin Baraki tells us that,

I guarantee that every outpatient provider can attest to hearing the following phrase from a patient, as I have on more occasions than I can count: “I stopped going to physical therapy after a couple weeks because we did the same exact exercises every time, and I could do them myself at home just as easily for free.”

So the patients quit if you don't challenge and progress them, and quit if you do. I don't envy these people for their jobs, honestly.

[silachoo]

Hmmm, and Austin Baraki tells us that,

I guarantee that every outpatient provider can attest to hearing the following phrase from a patient, as I have on more occasions than I can count: “I stopped going to physical therapy after a couple weeks because we did the same exact exercises every time, and I could do them myself at home just as easily for free.”

So the patients quit if you don't challenge and progress them, and quit if you do. I don't envy these people for their jobs, honestly.

I don't either, especially when you spent 125 - 150 grand to learn something not useful to a large percentage of your patients.