Is Physical Therapy Fraud? | Mark Rippetoe
Excellent question. Where did it come from? How do nominally intelligent people come up with this shit, and then remain convinced of its value?
I work as a Strength & Conditioning Coach at a High School and the worst part of my job is having to witness the absolute bullshit that the Physical Therapists prescribe when they enter my gym floor. Yesterday I watched 3 Physical Therapists stand around to "teach" a box jump to a highschool kid coming off ACL reconstruction. Today I was surprised to see them take the same kid to the Squat Rack... but I wasn't surprised to see all 3 of the same PT's stand around "spotting" the kid through a quarter squat, and then proceed to teach him some ambiguous deadlift like movement where the bar never touched the floor, but the knees bent, and emphasize a vertical back angle. I want to feel bad for these people, but I can't when I think about the salaries they collect for teaching people terribly incorrect technique on the most basic of barbell movements.So very frustrating. "Ohh you have Patellar Tendonitis? Let's do Pistol Squats for that!" Where did all this bullshit come from and why won't it go away?
Is Physical Therapy Fraud? | Mark Rippetoe
Excellent question. Where did it come from? How do nominally intelligent people come up with this shit, and then remain convinced of its value?
One of my wife's friends had her left hip replaced in August. She has been in "therapy" to this day. She still has pain. I suggested the Barbell Prescription. She would have none of it.
It appears that a lab coat and/or a framed certificate on the wall counts more than reality.
IanMcArdle, as a practicing physical therapist I am sorry you have to witness this bullshit. I practice in an outpatient facility in a hospital using starting strength barbell/compound movements as well the principles of the strength, recovery and adaptation cycle. I almost feel obligated to repossess the ten of thousands of dollars I paid to the university I obtained my degrees from, and give it to the Aasgaard Company as I have learned more about rehabbing injuries from Starting Strength and it's content. I receive a great deal of weird looks from my co-workers having patients squat, press, and deadlift, or perform some variant of these movements for their rehab. Bottom line is there is no education in the physical therapy curriculum regarding the benefits of barbell/compound movements or the stress, recovery, adaptation cycle. Also as Rip has stated on many occasions its easier to teach a theraband shoulder external rotation exercise instead of a properly executed overhead press, so therapists opt for the former. They haven't learned this stuff and from what I have seen so far in my department most are not interested in learning it or scoff at it. The thing that irritates me the most is for years the therapists in this department have created a culture of hot packs, ice, massage, easy exercises, and passive treatment modalities that the word has gotten out and patient's expect it. They are so confused and almost mad when I have them actually perform some taxing exercises. It may take a while before this bullshit changes.
In not a PT (ATC) but in my own personal experience in my initial practice I felt the need to complicate to validate the time spent in my education. I am now coming around to doing the simple things right but a lot of my peers will continue to insist that their special methodology that is "evidence based" (and we all know if you read it in a study it must be true).
If something is your entire career you can't afford to realise it's bullshit.
I talked to a physical therapy student recently. I told her how physical therapists had been unable to resolve my back pain with their prescribed exercises. I told her I didn't think the exercises ever would have worked, no matter how long I'd done them, since no amount of rubber band use would have resulted in getting strong and it was getting stronger that ultimately resolved the back pain.
She sympathized and explained that the PTs were incentivized, for lots of reasons, to go with lighter, easier, simpler exercises rather than heavier exercises that could require coaching. "A ha! Progress! A sensible PT!" I thought.
Then we talked about deadlifting specifically and she said deadlifting over 500lbs was dangerous because someone could hurt themself. At which point my newborn optimism died.
Well, she is right. You can if you do it wrong or have not spent the last 12 months working up to that weight as most people would.
I injured myself last week at 330 , but not the earlier set at 400, so in my simple case, lifting lighter weights is dangerous.
I'm sure no coach or PT would start someone at 500 anyway , especially of they are rehabbing, so the point is moot.