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  • #16
    Physiotherapeutic modalities, like, say, therapeutic ultrasound or exercise? (spinal manipulation was better than ultrasound and exercise for chronic low back pain - Auatralian Journal of Physiotherapy; 2006;52(4):306.

    Or stabilization exercises - do they belong to PT's only? (no additional benefit of adding specific spinal stabilizing exercises to a conventional physiotherapy package for patients with recurrent LBP - Spine 2006 Sep 1;31(19):E670-81.

    ... and I do believe, for the record, that these studies were done by PT's, who, as Jason points out, are on the forefront of NMS research.

    Jay

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    • #17
      Hello Jay,

      If PTs are demonstrating that, according to the two sources you quoted, these techniques/modalities are not significantly helpful, then why would you want to use them?

      Research includes clinicians demonstrating what doesn't help with pain and dysfunction, and that is very important to encourage PTs /chiros to look at other approaches, hopefully, rather than waste people's time and money.

      As has been stated previously, it is the bad apples which create a lot of publicity and attention. All professions have them. No-one is going to say ALL chiros are bad apples, and if they do, they are open to challenge.

      Nari

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      • #18
        Thank you for your well thought out reply.

        I think we can all agree here that there is no panacea - especially in the area of spinal disorders. I am just always mystified by the divide between PT's and DC's, when it seems that we have more in common than it would appear.

        Comment


        • #19
          Jay,
          Thanks for asking. No, I don't believe that it is. Physical Therapy is not explained by the modalities we provide. In other words, PT is not exercise, ultrasound, etc. anymore than chiropractic is manipulation.

          Physical Therapy describes services provided by a movement specialist who is a physical therapist. We may treat using exercise or manual therapy or many other methods. That doesn't mean that PT is synonomous with exercise. As you said, we don't own exercise just as you don't, or shouldn't I should say, own manipulation (I live in the state of washington where it is illegal for a PT to perform a manip. thanks to the work of the chiropractors in the state).

          Would it be OK if we called manipulation something like chiropractical modalities?

          If you are providing therapuetic exercise that is what you should call it. If you are providing ultrasound, that is what you should call it. If you provide neuromuscular re-education, that is what you should call it. Otherwise it is a marketing ploy to make it seem as though you can receive PT through a chiropractor, which is not true.
          Cory Blickenstaff, PT, OCS

          Pain Science and Sensibility Podcast
          Leaps and Bounds Blog
          My youtube channel

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          • #20
            Hi Jay,

            I'm encouraging new participants to introduce themselves in the Welcome Thread

            Thanks.
            "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

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            • #21
              Jay
              Seems you would like to distance yourself from the more common type of chiro . The ones who extoll their own virtues by leading their clients to believe they are the only or best source of continuing spinal health by providing the short term outcomes that are likely with manipulation.
              Those chiros who mislead their clients into accepting the tired old subluxation nonsense. Who regularly attach themselves to their clients with contracts that allow access for a period of months ( with discounts for up front payers!!!! ) to five minute crackety crack sessions of dubious value. Who provide "treatments' such as cranio sacral , and an assortment of 'energetic' ballyhoo.
              Good for you Jay. You have your work cut out for you. Quite a challenge . I hope you continue the trend towards science based quality treatments, avoidance of the improper use of the word PT or physiotherapy. Why not go a step further and drop the 'doctor' tag. One more and act assertively against the chiro lobbyists who seek to undermine physiotherapy with innapropriate legislation to "protect' what is in the public domain.
              I , personally , would welcome you. How do you stand on these matters?
              :lightbulb vox clamantis in deserto

              Geoff Fisher
              Physiotherapist

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              • #22
                Right. I'll drop the "doctor" tag, and the "Doctors of Physical Therapy" can take that over as their own. Have you ever seen a chiropractic curriculum?

                I cannot stress enough to everyone involved in this discussion that I DO NOT KNOW ABOUT POLITICAL MOVES IN MY, OR YOUR, PROFESSION! I am not interested in discussing politics - I am trying to get to the heart of where the animosity arises, and maybe now i see it, right where I thought it was. I don't employ any of the ballyhoo you speak of (discounts, prolonged care plans, etc.), and I regularly speak out and condemn those who do. But to suggest that I, or anyone who has undergone training, "drop" their degree (in favor of what?) is ludicrous.

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                • #23
                  Not having a clue what your own profession is up to politically or having a sense of their common and questionable marketing practices is your choice, not ours.
                  Barrett L. Dorko

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                  • #24
                    Perhaps you are right. My time in the clinic has left me away from the political fray, possibly to my peril. I have prioritzed patient care over marketing and politics.

                    My profession is not as cohesive as your in the political arena, which has been evidenced by the direct access you have been afforded despite the objection of the American Academy of Orthopedic Surgeons. Very nice work.

                    Comment


                    • #25
                      There is as we can both agree , a lot of ground to cover in the chiro world , to bridge the gaps between what is and what could be. I'm not in favour of any doctor tag being applied to either physiotherapy or chiro or osteopathy ( the exception being US trained osteos who also have medical degrees). It is confusing and an unnecessary marketing ploy. I would much rather be adressed as MR. , though this is rare in australia where first name basis is the norm for all .
                      As a participant in a hospital environment it makes no sense to require others to consider me the equal of a doctor. That would be a considerable downgrading in the sense of a physiotherapists leading role in MSK diagnosis and treatment, to name but one aspect of our role.
                      I welcome your stated distancing from the list of objectionable chiro practices Jay. A strong clinical profile speaks best and loudest in the world of MSK Rx. Chiros calling themselves doctors just serves to continue a badly judged attempt to allocate credibility that very rarely exists. You may be one such rarity. I wish you well.
                      nil desperandum.
                      :lightbulb vox clamantis in deserto

                      Geoff Fisher
                      Physiotherapist

                      Comment


                      • #26
                        Jay-

                        Most of the more scientifically-oriented DCs I've met tell me that the first 10 minutes of any conversation with other healthcare providers involves reassuring everyone that they are not that kind of chiropractor.
                        Once this is out of the way, then the discussion can proceed to everyone's benefit. Or so I'm told. This is one of the liabilities, I'm told, of having that certain set of letters behind one's name.
                        It may be that you are about 8 minutes into that here, and that's good news if you are the scientifically based practitioner you claim to be. Welcome, and like Jon, I encourage you to introduce yourself over in the Welcome thread.

                        Jason.
                        Jason Silvernail DPT, DSc, FAAOMPT
                        Board-Certified in Orthopedic Physical Therapy
                        Fellowship-Trained in Orthopedic Manual Therapy

                        Certified Strength and Conditioning Specialist


                        The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                        Comment


                        • #27
                          Jay,

                          I think part of the problem, at least from my perspective, is that we surround ourselves with like-minded chiropractors. We go to cont. ed. courses with these evidenced based chiros, subscribe to SPINE, MANUAL THERAPY etc. I think, in part, we may be ignorant as to what the "dark side" does on a daily basis because we (the evidence based guys) think we're the majority. Or that we can affect change by minding our own business and doing good work. I don't know the stats, or if there are any, but if you look at the number of grads and the schools they come out of, it looks like we are in the minority, at least in the United States.

                          Over the last few weeks I think I've read every word on this forum including the archives. (Extremely informative and very addicting!). In trying to learn more about neurodynamics I've gone to various links to discover that chiros are not welcome at some (or all?) of these courses.

                          Is this true of Simple Contact as well? I didn't find any indications as such.

                          I would also like to say to the mediators, I hope that you do not feel that the chiros who do visit your site are here to antagonize or debate. I personally am here to better my knowledge and inturn improve my results with my patients. I was directed here by a collegue with similar intentions.

                          From what I can tell, everyone here agrees that there is much lacking with the the status quo, be it DC's, PT's or any other profession.

                          I think what Jay and I feel we need is a pat on the back and someone to say good for you for not being "one of those guys".

                          Hey, Jay, good for you for not being one of those guys (pat, pat, pat).

                          So now let's learn something new.

                          Comment


                          • #28
                            Hi Luca,

                            Consider introducing yourself in the Welcome Thread
                            "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                            Comment


                            • #29
                              Luca,

                              Chiropractors are welcome at my courses and I've had more than a few the past 3 years. It's been my experience that they are quiet as I speak and often thank me afterward for the information. No questioning of any sort that I can recall, much less any objection.

                              One of the first attendees from your profession came up to me at the end and said, "You're a better chiropractor than I am."

                              I still haven't figured that out.

                              Oh, none has ever subsequently contributed a word here.
                              Barrett L. Dorko

                              Comment


                              • #30
                                Here is an interview with a chiro, David Seaman that I hope attaches properly.
                                He sounds pretty reasonable, and I agree with much of what he says, for example that most chiros get lost when discussion of the actual nervous system or pain come up. So do PTs! And his info seems quite current with respect to placebo. But he still thinks manipulation is the be-all/end-all treatment for pain, even though he concurs that it's useful for only a small percentage. :thumbs_do

                                Manipulators are so attached to their coercive toolkit.
                                Diane
                                www.dermoneuromodulation.com
                                SensibleSolutionsPhysiotherapy
                                HumanAntiGravitySuit blog
                                Neurotonics PT Teamblog
                                Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                                Canadian Physiotherapy Association Pain Science Division Facebook page
                                @PainPhysiosCan
                                WCPT PhysiotherapyPainNetwork on Facebook
                                @WCPTPTPN
                                Neuroscience and Pain Science for Manual PTs Facebook page

                                @dfjpt
                                SomaSimple on Facebook
                                @somasimple

                                "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                                “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                                “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                                "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                                "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

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