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How do you actually choose a therapist to visit for the first time?

I’ve written previously about reasons to return to your therapist (or not) and the feedback I have received has been good. Its proven to be useful guide – some people have changed therapists, some have stayed where they are despite initial misgivings. Scroll down my blog to find out more.

This time I thought I would give guidance on how do you choose one in the first place. There are lots of channels and each have pros & cons. I’ll start from the more common/relevant/successful ones and work down.

  1. It doesn’t matter. What I mean by this is that ALL therapists (chiros/physios/osteos/massage) are all trying to do a good job, put bread on the table, pay the mortgage etc. All have been trained to internationally recognised standards and all are subject to oversight and penalties to ensure their practice is current, effective and that they themselves are decent members of society. However, this doesn’t, necessarily make them a good therapist for your condition.
  2. Word-of-mouth (WoM). This is the most common. First and foremost you need to know the therapist is not a wierdo so your friend’s/colleague’s judgment is vital. Again, this doesn’t, automatically make them a good therapist for you or your condition. Also, people are “unreliable” witnesses. What I mean by this is we forget important things or misinterpret information. In my practice a couple of years ago I asked every patient, following my assessment to immediately to to their personal trainer (in the same building) and tell them what I had diagnosed and prescribed; virtually 100% incorrect by the time the PT had retold me. Where did the breakdown in communication occur? I could only improve mine – so all patients are sent an email detailing the specifics of their condition and what I want them to do.
  3. Your GP or surgeon. If a therapist is savvy enough and good enough to have built a reputation and relationship with senior clinicians then they are pretty good. This takes time, experience, results and excellent communication skills. If a surgeon advises someone specific you would be well advised to use them.
  4. What kind of practice do they work from? The quality of physio you receive depends purely on the practitioner’s skill set but where they are based will give you clue as to how experienced they are. Large practices can afford to deliver training and so can employ less experienced people so don’t choose a practice (BUPA, Nuffield, The Medical, etc), choose an individual. Also larger practices tend to have shareholders so normally charge more for less. They do often have better facilities and better access to other services so would suit those with more complex issues. Individuals in small rooms tend to offer good value especially if they’re part of a gym but make sure they have suitable experience to work independently – minimum of 5 years. Also check accreditation and licencing, especially if they deliver acupuncture. ALL clinic rooms should be clean and well equipped and with access to toilets and cleaning facilities.
  5. Google: in terms of location and important factors such as opening times, parking, access etc this is crucial and I would advise that a quick check prior to visiting in all cases is useful.
  6. Google Reviews: there needs to be at least a handful of good ones and hopefully no bad ones. But given that this is a medical profession few people are likely to complain via Google – there is the HCPC for this. Where there are less than 5* reviews check the clinic’s response, this might be a better indication of how good they are than a slew of 5* reviews.
  7. Check their websites, most physios (especially) will have a strong web presence due to different clinic’s and interests. Do you like the cut of their jib? Are they into the same things you are into (shouldn’t matter but does help)? Does their profile match your expectation? Remember, in the UK there are a couple of important things which provide reassurance online; 1) Physios (and to a lesser degree chiros and osteos) are not allowed to make spurious claims to advertise their services. Contrast this to America and Canada where Chiros claim to be able to do all sorts of stuff from curing cancer to fixing autism. 2) There is an unspoken rule that an individual practitioner won’t say they are better than others. How would any of us know? Besides, that’s not the point – the best diagnostician in the world is no good if they cannot communicate.
  8. Speak to them. Not their receptionists. Either by phone or message. A good practitioner is going to give you good advice FOR FREE and not try too hard to get you to book, normally because they’re too busy. They should be honest i.e. if you have literally just sprained your ankle they should advise to see how it goes for a couple of weeks before even thinking of popping in. They should also not be afraid at suggesting A&E or GP first.
  9. Professional magazines, online or otherwise. I’ve written for a few, do not be fooled. Most editors want free contributions so most articles are written by people trying to make a name for themselves. That’s not to say this is a bad thing – read the article and make up your own mind.
  10. Researchers: good researchers don’t often make good Physios. But they sometimes make the BEST.
  11. Online forums. In my opinion, worse than Google. They are a combination of the worst elements of WoM and random selection. So asking other runners/climbers/bikers/etc is a total lottery. Avoid.
  12. Ask your mum – definite no-no.

So, that’s my advice. Or come see me. I’m good. But I would say that.

Are you getting “acupuncture” or something else?

Here at dbphysiobristol, Danny, our acupuncturist is exactly that – an acupuncturist. He can treat a wide range of muscular pains as well as stress, anxiety, insomnia and other issues.

He is a post-graduate qualified (Masters level) Western Medical Acupuncturist – a protected title.

He is also accredited by the Association of Acupuncturists in Chartered Physiotherapy (AACP).

He is also licenced by the local council to practice as well as working from licenced premises.

Are you sure the person sticking needles into you is all of these? They should be. It’s illegal otherwise. Be sure to check out your safety is at risk.

Any questions, get in touch.

Exercise is exercise is exercise

There are many reasons to exercise and actually, our motivations differ quite widely. Like and dislike are too binary.

Some are social exercisers; they play team sports, join running/cycling clubs, go to the climbing wall.

Some are experiential; climbers are good examples of this. Just being there is good enough.

Some want to go faster, further, lift heavier. Personal improvement is all.

Others gauge themselves against others. Others just want to get some space to themselves.

There are others.

I think my motivations are changing. I guess it’s because I’m getting older. Climbing used to be my life but I’m as happy walking the dog. Cycling and running we’re about self improvement. But yesterday, I struggled to get out the door. So I told myself just a short ride to go and see a friend across town – social rider.

I got half way there and changed my mind – did this instead. I was just so happy to be out.

Not sure what that makes me: retroexperiential achiever?

Maybe

Staying focussed

I know how difficult this can be. I am easily distracted by any number of things;

Excellent TV – my favourite programmes of 2019 are The Expanse, Chernoble, Catch 22, Das Boot remake. Brilliant.

Playing the drums – being in a band is not as time consuming as practicing a new skill.

Family time and a happy labrador.

And worst of all, injury.

To get back in the zone I work with interesting people and mix it up so my tendancy to get bored is kept at bay until I finally get back my mojo focus. So far its working; gym, climbing and runnning.

Unlikely heroes

I’m frequently inspired by my friends and clients; when people do things that push them despite everything.

I’m not one to idolise the privileged.

However, I’ve just finished Everest, The First Ascent by Harriet Tuckey. It’s about her father, Griffith Pugh. It’s a critical biography of a deeply flawed genius and a fascinating account of some of the early British Himalayan expeditions.

But what has inspired me the most is the number of things he could rightly lay claim to having invented. As I see it the following were his ideas:

  • High altitude oxygen protocols
  • Same for hydration
  • Down jackets
  • Thermarests
  • Hypothermia treatment
  • Running shorts
  • Trainers
  • Peaked visors that are not hats
  • Post fracture rehab
  • Modern physiotherapy

And more.

It’s a great read. Highly recommended.

Link below.

Toe/barefoot running – the inside story

I’m back running after a 4 month hiatus due to injury and to keep me focused and motivated I thought I would investigate barefoot running (see previous posts).

I was convinced. My plan to run everyday for 1 month started with 10km – felt good, no problems. Day 2 – 5km, shortened to 4 due to calls pain.

Next day…….

Ooooh. Ow. Very tight calves.

However, back up and running thanks to Louisa Clarke and her magic cups. Feeling good.

Chronic disease vectors

The wider role of a Physio could simply be to maintain health and fitness. Whether working in A&E helping clear lungs of blood (yup, that’s a thing we do), repositioning intubated and unconscious patients in intensive care so they can breathe (another thing) to helping people walk again (obvious that one).

Part of our remit must therefore be “lifestyle” factors. We can’t be an expert in everything but we should always be looking for answers; questioning things, asking ourselves if there is anything else we can do and importantly, looking at the evidence.

I used to work alongside a personal trainer who adamantly believed meat was an essential part of diet to the extent where they had meat at every meal; bacon for breakfast, pork chop for lunch, steak for dinner. They passed this onto their children so convinced were they of their belief. Indeed, they even wrote a recipe book for their clients. When I pointed out that the WHO (World Health Organisation) had determined (by looking at the evidence) that red meat was “possibly” carcinogenic my PT colleague said they had interpreted the evidence wrong!

Now, I didn’t argue; beliefs don’t work like that but I did review the evidence and it seemed sufficiently robust for me to become a vegan (I was already a vegetarian).

However, I recently listened to Michael Gregor’s podcast at nutritionfacts.org and discovered not only was the science sufficiently robust but that the word “possibly” was only inserted as a result of pressure from the American FDA (Food & Drugs Administration) due to pressure from the food lobby.

In fact, meat does give you cancer.

Full stop.

In the same way as a mosquito is an infectious disease vector the report describes the food industry as a “chronic disease vector”.

Fascinating stuff.

I wonder if my PT colleague is still mainlining meat…..

Here’s my favorite bag of meat swimming with too many sticks.