The problem with Evidence in Physiotherapy

It would seem that the problem with evidence in physiotherapy is quite often that: a) there isn’t enough of it b) what there is is of bad quality c) you can’t really blind people to a lot of the treatments d) a number of the outcome measures are subjective as opposed to objective which gives an inherent risk of bias. e) the outcome is nearly always “we need to do more research”. And these are only the problems that I can pull off the top of my head on a Saturday evening. Traditionally we see clinical trials- randomised double blind … Continue reading

The problem with nocebic language

Nocebic language? What? Is Tim making words up now? No. Ok- let’s back up a little bit and start with an old saying. Sticks and Stones may break my bones but words shall never hurt me. This is perhaps not the most truthful of statements, as pretty much anyone can attest. Ok, so words can hurt you emotionally- but they can’t hurt you physically… can they? Nocebo is the opposite of placebo. A harm inducing practice. Nocebic language is pretty much an encouragement to harm. Why would any health professional say something that might harm you? It might seem strange … Continue reading

The BioPsychoSocial Model is Descartian…

I’ve had a problem with the Biopsychosocial (BPS) model for a while, and I didn’t quite know what it was. For those unfamiliar with this model, in a nutshell, the idea is that we look at each patient not simply as a biological problem- a hurty leg, for example- but rather in the context of their psychological and social situation as well. We know that there has been a fairly traditional issue in that a lot of therapists tend to focus on the bio much more than the other sides of the coin- as it were. For the visual people … Continue reading

Reconciling the 3Rs and physio treatment

A blog from Tim – not meant to be evidence backed, not meant to be science, this is personal experience. It is a blog not a scientific paper. Background I’ve had an on- going issue with pain in the area around my Sacroiliac Joint (SIJ) for about a year now. It originally came on in June 2017, stopped me running for pretty much 5 months – and at one point stopped me weight bearing for a short time. Even though I knew that a scan wasn’t going to help, there were a few moments back in August last year where … Continue reading