Adam Meakins: The Problem With The Most Popular Physiotherapy Treatments
Apr 5, 2021
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Adam Meakins, known for his evidence-based approach to physiotherapy, discusses the problem with popular treatments like acupuncture and ultrasound. He emphasizes the importance of educating patients and using uncertainty in supporting physio patients. Meakins also criticizes manual therapy and highlights the need for open, honest conversations and cost-effective treatments. Additionally, he explores the adaptation of pain tolerance and the future of physiotherapy in collaboration with other professionals for holistic care.
Passive treatments and manual therapy techniques may not be as effective as believed and can often be a waste of time.
Manual therapy does not actually change the structure or quality of the tissues being treated and relies on the power of expectations and beliefs to alleviate pain.
Understanding the concept of a circle of capacity can help individuals make informed decisions about their activity levels and manage their pain effectively.
Deep dives
Physiotherapy as a Profession
Physiotherapy is a profession that aims to help people regain normal movement and function after an episode of pain or injury. However, there are misconceptions within the profession about the need for certain treatments that may be wasteful and distract from more effective approaches. Passive treatments and manual therapy techniques may not be as effective as believed and can often be a waste of time. Natural history, or the body's natural healing process, plays a significant role in recovery and should not be overlooked. Overall, physiotherapy should focus on assessment, education, and exercise to help patients achieve their goals.
The Problem with Manual Therapy
Manual therapy, such as massage, mobilization, and instrument-assisted techniques, often relies on the power of expectations and beliefs to alleviate pain. However, these techniques do not actually change the structure or quality of the tissues being treated. The concept of breaking down adhesions or releasing trigger points is not supported by scientific evidence. Manual therapy can provide temporary pain relief through the distraction of the nervous system or the placebo effect, but it does not have long-lasting or specific effects on tissue healing.
The Circle of Capacity
The circle of capacity refers to our body's ability to tolerate and adapt to various activities and stresses. This capacity can vary depending on factors such as training, lifestyle, and age. When the circle of capacity is exceeded, pain and discomfort may occur. It is important to balance activity levels and gradually increase capacity to avoid overloading the body. Understanding the concept of a circle of capacity can help individuals make informed decisions about their activity levels and manage their pain effectively.
The Role of Personal Trainers
Personal trainers play a crucial role in helping individuals improve their overall health and fitness. Their focus on regular physical activity and lifestyle changes aligns with the goals of physiotherapy. A multidisciplinary approach involving personal trainers, physiotherapists, and other healthcare professionals can provide comprehensive care to individuals with pain and injuries. Effective communication and collaboration between these professionals can benefit patients by providing a holistic and well-rounded approach to their care.
The Future of Physiotherapy
The future of physiotherapy lies in a more proactive, networked approach, involving personal trainers and other healthcare professionals. Physiotherapists can provide reassurance, assessment, education, and exercise planning, while collaborating with personal trainers to facilitate physical activity and lifestyle changes. This integrated model can enhance patient care and overall outcomes, while reducing the reliance on passive treatments and unnecessary interventions.
In today's episode, Stuart welcomes Adam Meakins on. Adam, @adammeakins on Instagram, is well known for his evidence-based approach to physiotherapy, strong views and his willingness to call out some of what he describes as nonsense surrounding his profession. He's got a novel approach to helping his patients and in this episode, they get into how he describes physiotherapy, the line between personal training and physio, finding good physios, the problem with manual therapy and a lot of other popular rehab techniques as well as a number of analogies to help you think about the myths surrounding injury and pain. Timestamps are below.
Timestamps:
[01.47] - how he explains what physiotherapy is?
[03.39] - how would he help a trainer think about physiotherapy if they've only had positive experiences with treatments like acupuncture, massage and ultrasound?
[08.47] - The over and under-treatment paradox of healthcare
[10.37] - How he re-educates patients who believe in treatments that have no evidence behind them?
[12.37] - The importance of using uncertainty in supporting physio patients.
[22.07] - How to find good physiotherapists?
[23.47] - does physio need to be in-person?
[25.27] - How much of his job involves reassurance?
[30.58] - Helping people better manage pain that arises for no real reason.
[33.22] - Why he doesn't use manual therapy anymore?
[39.47] - Why giving yourself more pain (through something like a scraping technique) can give you less pain than you felt originally?
[41.47] - The circle analogy of pain tolerance or capacity?
[44.22] - Story of a practitioner who did surgery on his knee to better understand pain.
[46.57] - Is physiotherapy and personal training becoming more blurred due to approaches like his that include more education on movement and lifestyle?