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Manual Therapy 'Sucks'

Discussion in 'General Issues and Discussion Forum' started by Craig Payne, Oct 5, 2017.

  1. Craig Payne

    Craig Payne Moderator


    Members do not see these Ads. Sign Up.
    To put things into perspective, this from Adam Meakins is well worth a read for several reasons.

    Manual Therapy 'Sucks'

    It is worth reading for both his views on manual therapy and also what happens when you challenge a firmly held view in some sectors of a profession (the vindictive echo chamber)
  2. Admin2

    Admin2 Administrator Staff Member

  3. BEN-HUR

    BEN-HUR Well-Known Member

    Wow... that guy (Adam Meakins) doesn't mince words. It was an interesting read... many interesting points made... some of which reflective within Podiatry... & this forum.
  4. Craig Payne

    Craig Payne Moderator

    yep; Adam calls it likes he sees it. I respect that. The 'establishment' do not like it that their pet agendas and biases are being challenged, so go after him rather than the ideas, comments and questions.
    Critical thinking please.
  5. WalkWithoutPain

    WalkWithoutPain Active Member

    Obviously, as a podiatrist, we see a skewed sample of patients - If they come to us and have seen a physio first, then the physio wasn't effective in these cases. There are probably people for whom it was effective that don't need to visit me after. This probably gives me an unrealistic experience of the efficacy of physical therapy techniques. However, I would say with some conviction that I think physios over-stress tissues that are in trouble. Particularly stretching Achilles' and plantar fascia tissues that are already suffering from a traction injury. I think this makes things worse in the short term though of some use in the long term. I *almost* never send a patient to see a physio, maybe twice in the last decade. Having said all that, I do use manual therapies myself though :) I like shockwave for plantar fasciitis, Achilles' tendonitis and lateral thigh / buttock pain. I use a lot of prolotherapy for a wide range of things but especially Achilles' injuries, recalcitrant last vestiges of plantar fasciitis, tib post injuries, medial knee pain and neuropathy. I make good use of taping and more often then not will use orthotics for short/medium and long term reduction of tissue stresses. I also use pharmaceutical measures at times, specifically injecting corticosteroids into bursae, neuromas, the tarsal tunnel, around injured nerves and (external to the sheath) in Achilles' Tendon injuries. My treatment efficacy in the last couple of years has really been enhanced by these three things and I would encourage pods to look at whether their practices might benefit from these techniques.

    Furthermore, I think that some patients that I see who have seen other podiatrists before me could well make the same argument about pods as Adam makes here about physios. Some practitioners seem to rush to more expensive therapies without first spending the time (10 minutes?) to understand what is going on. You can always do the orthotics next week....

    Personally, I spent many years (nearly 20) with a painful medial scapula border hunting for a physio who could possibly work out and treat the problem. Perhaps there was one out there but I never found them. Often quick to use interferential or similar, rarely much in the way of considered assessment, and for me, never any real insight into the underlying issue. I think now that the pain was a chronic constriction injury of an intercostal nerve. A shot of corticosteroid every 5 years into the intercostal space sees me right. This understanding (assuming I am correct of course :) ) came about from my study of perineural injection therapy with John Lyfthogt which I highly recommend for podiatrists.
  6. Bruce McLaggan

    Bruce McLaggan Active Member


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