...and they all get along just fine!

There is still a weird belief that different health care qualifications are significantly different from one another. This belief exists amongst the general public as well as amongst health professionals. It makes sense that it exists amongst the general public because these different allied health qualifications have different names and there are some reasonably clear differences between the hands on techniques that may be used. For example; chiro's and osteo's are taught joint manipulation techniques whereas physios and myo's are not. Different therapists from each qualification will have a different bias to certain techniques and in the way they prescribe rehab. But there should be FAR MORE similarities than differences in how we all approach treating someone in pain.

For an allied health professional to believe there is a big difference between what one qualification does and what another does is a bit odd, and here's why: manual therapy techniques, regardless of what popular media may say, all work in the same way (more or less). When it comes to treating pain massage, joint mobilisation, dry needling, joint manipulation, 'myofascial release', friction techniques etc they ALL WORK primarily by regulating sensitivity and pain responses of the nervous system. They DO NOT directly change joint position or alignment, muscle texture, fascial tension, tendon stiffness or any other physical trait. Although the intention of the technique may be more directed to one of those body structures, the pain relief that you can get is because the nervous systems processes have been temporarily changed. This is called a 'functional' change and, as was just mentioned, it is typically a temporary effect. That's why many people only report a treatment benefit of 1-3 days. The short term pain relief effect wears off and the original issue still remains (or could be a little bit better or a little bit worse depending on the next steps).

Now, in my opinion, what is most important when helping someone in pain is to ask these three questions:
What technique/s help to change YOUR pain?
What technique/s have the lowest risk of causing YOU harm?
What is the plan to help YOU stay pain free, be in control of managing YOUR OWN pain and overcoming the issues that caused your pain in the first place?

It is in answering the first question that you may find a bias towards one type of therapy over another. Joint manipulation may work very well for you but could be terrible for the next person. Dry needling might give someone amazing short term pain relief but it could cause lots of pain or discomfort for someone else. Identifying what helps to get relief for each person is a question that's well worth asking and any health care practitioner who relies solely on one type of treatment is going to miss the mark with A LOT of people!

The second question is also very important to consider. It is always a key consideration for a health care professional that your treatment shouldn't cause you more harm. Joint manipulation and dry needling are inherently more risky than massage or joint mobilisation type techniques. Therefore the low risk options should be explored before attempting the more risky techniques. In other words, if you can get excellent improvements in your pain and movement without relying on higher risk treatment options then stick with the low risk options!

This last question is where each of those therapists who walked into the bar together should all agree: it should be the goal of EVERY health care professional to help you be in control of your own pain recovery journey. You should be taught how to minimise your pain without needing to rely on regular treatment and you should be guided along a rehab pathway that means that your pain is at a lower risk of returning. Again, these beliefs and attitudes should be more or less equal amongst the different types of allied health qualifications. The more someones approach and methods differs to what I've outlined here, the more likely it is that is they are aren't up to date with the latest research. It would also stand to reason that they would be more "belief based" rather than evidence based and would be more likely to be recommending treatments that, at best, only every provide short term pain relief. It is also possible that these people are more concerned with their business model than they are with your health outcomes.

Obviously, I and many others have a huge issue with this sort of approach!! Not just because of the financial implications though. If you are relying on your therapist to "fix" you or to put something "back in place" then you may be running the risk of getting weaker and weaker over time and actually increasing your risk of injuries and pain complaints developing. Despite how common it is to hear explanations like being "realigned" or "deactivated" or having things "put back in place", treatment just simply does not work like that! It doesn't! And anyone who suggests otherwise is lying to you.

So if a physio, a chiro, a myo and on osteo walk into a bar and all agree that there are more similarities than differences between them, then it is likely they are all doing a pretty good job at doing their best to help you! The one who believes their hands have the power to change fluid movement in your body, to realign joints, to stretch fascia or to deactivate muscles is not going to fit into too well at a gathering like that. Furthermore, they are probably putting a big hole in your wallet without too much of an outcome to show for it!

That's enough ranting from me for one day 😉

As always; have fun and train smart!

Carey