As a physiotherapist I tell every patient that my primary responsibility is to educate them about their body. My job isn’t to fix them, it’s to teach them how to fix themselves and help them to get on the right track with quality advice. Here’s the thing – Effective physical therapy works but it isn’t easy. It involves a strong motivation to improve yourself with daily consistent work. A competent physical therapist can be your guide but success or failure depends on one person: YOU. Its your body, you can become painfree but you need to work at it.
I read a quote the other day from max shank that said people make things complicated in order to sell you something and its very true in both the physical therapy and personal training industries. Physiotherapists sometimes overcomplicate things because they either don’t understand whats going on well enough to explain it simply or want it to seem complex to make themselves look smarter. An effective physical therapist de-complicates what people are told from doctors and surgeons and allow you to understand both what is going on inside your body and what you need to be doing to correct your movement and mobility on your way to becoming painfree and prevent future injury. In the personal training world, teaching basic movement fundamentals and a basic training routine have taken a back seat to fancy “trendy” exercises and a sales pitch to sell as many sessions as possible. Things need to change and Optimize is working to set a new standard in Ottawa within both worlds.
Physiotherapy only works with motivated people
Effective physiotherapy requires a very important element in each patient: A motivation to work towards improving their body and the commitment to being consistent in devoting time daily to achieve that. Therapy isn’t cheap, it costs time and money and the best way to get the most value from it is look at each session as a way to learn new techniques and exercises that you can work on at home. With the best advice given, success in improving your body rests on the shoulders of one single person: YOU. Lack of improvement comes from one of the following two reasons: 1) You aren’t being given the right things to work on by your therapist, or 2) You aren’t being consistent with your rehab work at home. I no longer stress or feel responsible when patients aren’t improving because if I’m giving the best possible advice the responsibility is then on the patient to execute the plan. I can help out with some tissue work and movement coaching but 80% of the work to improve is done outside the clinic. I mention this concept to all my patients in the first 5 minutes of the first visit and its very important for clarifying expectations and the work required on their behalf.
If the focus of your current physiotherapy is more on using machines or getting worked on by a therapist than being educated about your body and what you need to work on at home then your therapist (or more typically the clinic they work for) might be more interested in making their wallet thicker than in helping you independently maintain your body. Real physiotherapy works but it isn’t easy. If you aren’t improving fire your current therapist and look for a better alternative – it might require some work to find someone who has your best interests in mind but they do exist and the reward is well worth it. End of the day the only person responsible for your health is you. Its your job to find someone that can help and put in the work toward a better body.
Big Business Physiotherapy
The big business physio model has created an environment where as a therapist you get 15 minutes with each patient you see and because of that, are forced to use techniques that might give short term pain relief but do very little to address the root cause of your problem. Therapists are taken advantage of and patients don’t get value for both the money and time they devote to therapy. Its fairly simple: when your main goal is to maximize profits in a healthcare world it creates a conflict of interest and both patients and therapists get screwed at the expense of juicier profits for the corporation. Less time with your therapist, a push to increase the number of visits, hiring assistants to do more work – all things that have slowly degraded the quality level of physiotherapy in this city and that needs to change. Make sure that the clinic you attend has your best interests in mind – unfortunately that seems to be a rare focus in big business physio.
My goal when treating every patient is to create a human being that has the knowledge to independently maintain their body and feels in control of their pain and how to manage it. Unfortunately this mindset isn’t shared by the majority of the physiotherapy industry in this city with most therapists being told by clinic management to maximize their weekly visits with every patient. Its too easy to take advantage of people in pain and tell them to come for treatment 3-5x/wk. Its an abusive relationship and it has to stop starting with tighter monitoring of physiotherapy clinics and removal of profit hungry non-physiotherapist managers.
Better physiotherapist education
The unfortunate truth is that the physiotherapy curriculum taught in Canada is decades behind when it comes to educating therapists on treating patients in the orthopaedics world. They teach antequated techniques that are not effective in addressing the postural and movement faults causing most of the dysfunction we see today. They also teach a model largely based on building a dependence to see a therapist to get relief instead of one where the focus is teaching patients self maintenance to prevent injuries from happening by maintaining their body.
To address the formal schooling deficit, we have created Optimize Academy – a course program where we can provide improved training to therapists to address the root cause of problems instead of simply treating pain. The curriculum is based on teaching effective self maintenance to patients and assessing and treating dysfunction with a postural and movement based focus. We will be expanding our curriculum to create a full optimize therapist certification and will create a registry where certified therapists who have completed the course and who practice within a clinic that allows appropriate visit times will be listed with their contact information. We are currently refining our courses and will be offering a new and very affordable course framework for interested therapists.
Optimize Academy: Progressive education for personal trainers
Personal training is currently in a very similar situation as physiotherapy with the industry being a mess in terms of quality of advice, a rep counting mentality and a lack of priority on creating independent humans capable of learning and training independently. After an initial group of sessions with a qualified trainer where movement quality and basic fundamentals are reviewed (and not just how to read pictures on a cable machine and get yelled at to do an extra rep), clients should be set up with an independent program where they can follow up monthly to ensure they are continuing to train safely and effectively and talk about any questions they may have regarding pain, diet, sleep, recovery etc.
We’re working to extend our Optimize Academy curriculum to personal trainers in the Ottawa area. Movement fundamentals, body maintenance, movement screening – all things a competent personal trainer can and should be able to work on with clients. The physiotherapy and personal training worlds are only separated by one major element: the presence of pain and disease. We want to create a new standard in personal training where courses we have created for physical therapists can be delivered to fitness professionals. Along with delivering courses, we will be creating a trainer registry where Optimize Academy certified personal trainers can be found along with their current contact information. Our clinic physiotherapists and sport medicine doctors will use this registry to direct our patients to personal trainers who are on the same page with a focus on quality movement.
Optimize Physio and Sport Medicine: Creating a new standard
We have created an environment at optimize where one on one patient therapist time is double the Ottawa standard and where our treatment approach revolves around education and teaching independent self maintenance. We don’t use any machines like ultrasound or tens because they do nothing to help you better yourself. Its time for a change and that change starts with better information being given to the public about what to expect from physiotherapy to get value for the time and money they devote to it.
A word to physiotherapists: we need to take back control
There is an alternative to big business physiotherapy. Where you can both learn to treat people by teaching them independent care of their bodies, get rid of modality based therapy, get paid what you are worth based on your caseload, and reduce your stress by seeing less people each day to deliver better care. Joint investment from a group of therapists with shared responsibility and profit distribution is an extremely attractive alternative to the traditional corporate structure which will eventually die off. You have a relationship with your patients, they are under your care. The company doesn’t own those patients (as much as they might like to think they do), and you have the right and also obligation to inform those patients where you are moving and why. Strength in numbers is a powerful thing, we need to stop letting corporate greed get rich off of each of us and make a mockery of our profession by gradually decreasing the quality of care we can give and increasing our stress levels.
The optimize brand will be looking for groups of therapists to join forces and make joint investments into their future careers with a business structure which mandates that a level of quality be maintained – a cap on patients seen per hour and training standardization provided to ensure the highest quality care is delivered to every patient that walks in the door.
Whether its Physiotherapy or Personal Training – the goal should always be to create independent humans capable of working on their bodies to prevent injury and stay painfree. This gets accomplished with both body maintenance education and a physical practice to reinforce optimal movement and create a resilient body. It starts with better knowledge by the public on what quality effective physio and personal training truly consist of and putting in place proper training to create a new generation of professionals that together can create a newfound faith in both industries starting within the Canadian Capital.