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Embrace the Science, Stop the BS!

As 2017 rushes towards its end, we look back at another crazy year that almost only left a blurry line behind as it sped past.  To reflect on 2017 and everything that happened in it from a professional point of view, I have decided to get this site going with its very first blog post.  Socrates rightfully said that an unexamined life is not worth living and I have to agree and suggest that we constantly reflect and examine ourselves professionally.  That is exactly what planted the seed for a platform such as this…

Currently enrolled in a masters degree in exercise and sports physiotherapy I have had the privilege of being surrounded by like minded individuals that are passionate about their career as physiotherapists and that have a desire to promote physiotherapy as profession and get people moving.  This blog is a direct result of that, we aim to promote the profession by creating content aimed at the general public and physiotherapist and also create a network and platform where we can engage with one another.

I find physiotherapy loaded with irony and contrast.  Let me explain…We are extremely lucky that we have the privilege to work with people and really spend enough time with patients that we are able to build a trust relationship with patients.  There is irony in this for me as this can be the very same reason that leads us down the path that leads to burnout and exhaustion (which is a article on its own for later). So without any further delay I want to share the five things that I have taken from 2017 and that has kept me sane while trying to navigate this profession thus far.

Start with the correct structure

In simple terms this means stop the “wors-masjien” mentality.  I believe that this is  where you lay the foundation for either a strong, satisfying career path or a frustrating, mindless and passionless path.  I believe that as a sports and exercise physiotherapist, you need time with patients.  Enough time to evaluate or re-evaluate, treat, educate and rehab and I truly believe this cannot be done in 30 minute appointments.  I have seen this time and time again.  If the correct structures and framework are not in place and you are chasing patient numbers, you will end up reverting to an approach and techniques that are comfortable and easy and you will end up neglecting patient education and rehab.  Leading not only to your own stagnation and dissatisfaction with the profession, but also leading to a poor quality service and probably a frustrated, dependent patient.

Evaluate and hypothesize, avoid the shotgun approach

I cannot stress this enough.  Physiotherapists should have the ability to evaluate musculoskeletal structures better than any other healthcare provider and according to scope of practice we are allowed to diagnose according to clinical evaluation.  Embrace this privilege fully as physiotherapist, not only for your patients, but also for yourself and your won stimulation.  We fall into the shotgun approach way too easy, meaning we get a broad picture or idea of what we think is wrong and we use the shotgun approach and hit the patient with everything we have.  Yes, I know, this often works, but I’ve found that being very thorough in your evaluation, coming up with the most likely diagnosis and then treating very specifically is much more rewarding than shooting the pigeon with the shotgun.

Become a practitioner of first-hand experience

This simply means that you are blessed enough yourself to be healthy and have mobility.  I truly believe that if you want to be the best exercise and sports physiotherapist that you can be, you need to engage in sport and exercise yourself.  You basically have the “memorandum” of your patients problems.  You need to experience the effects and adaptations of exercise, volume and load to truly understand what your patients experience.  I am not saying that in order to treat a Comrades runner you need to run the Comrades yourself, not at all!  I am just saying that as a sports and exercise physio you need to understand the demands of your patients sport and sometimes just imagining it is not enough.  So get out there and get moving yourself!

Set boundaries and be somewhat selfish with your personal time

Being in a profession where you are listening to patient complaints and trying to solve problems the whole day can be somewhat draining most of the time.  The last thing you want to hear after hours is friends and family throwing in their own share of complaints and trying to score some “mahala” physio.  I am totally for helping out your friends and family,  but my advice is to keep it all within your working hours.  Let them come and see you at the office if you want to help them (yes you can do it for free), but the important consideration for me here is to keep it separate from your personal life.  You need to recharge and refresh after hours to be able to do it all over again the next day.  Switch off after work and don’t let work slip into your friendships and relationships.

Embrace the science and stop the BS 

Let us be honest and upfront here.  We know that there is very little evidence for a lot of the techniques and interventions that we use on a daily basis, but it almost seems that we are also reluctant to embrace the things for which there are beautiful evidence.  We need to really start owning the areas in our field where there is good solid evidence and stop selling bullshit in areas where we know evidence is lacking.  I love to use tendons as an example.  Why are we not embracing and implementing the beautiful evidence on tendon management more?  Why do we keep on “shockwaving” tendons before we have attempted to implement a good tendon loading exercise programme?  I cannot stress this enough, it is every physiotherapists responsibility to stay up to date with the latest evidence based practice guidelines and actually to implement them.  And then of course, let’s all stop with selling BS to our patients about areas that are grey, you are only creating incorrect patient beliefs and attitudes, I mean seriously you cannot cure an Achilles tendonopathy with McKenzie extension push-ups.

Please feel free to share this content if you found it useful and engage with me at any time.

Let’s keep on enhancing the profession and moving the people!

*Handre Hay is a physiotherapist in Pretoria. He is a an incredible athlete himself, running Ultra Marathons, Mountain Biking and promoting exercise by living a balanced lifestyle. Handre is completing his MSc. Sports and Exercise Physiotherapy through UCT and is a promoter of the #Makephysiogreatagain Movement! He’s a great friend of ours, all round world class human being and we highly recommend giving him a follow on social media IG: HandreFrancoisHay_Physio and check out his website for some great content on sports physio and exercise science –