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Honesty in the age of Fake News

My first blog, lets keep it simple.

This is my first blog, lets keep it simple. I want to provide clear & accurate advice to people who are sore or injured. It can be really, really tough! We are living in strange times. The world has become a place where myths and lies get pushed as the truth, it’s hard to keep up. Everyone seems to have an agenda or something to sell, spouting whatever it takes to make us believe.

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What should we believe and why should we believe it? In my opinion it’s good to be a little sceptical, not closed to new things but wary of bullshit. I am a Clinical Specialist Physiotherapist, I am guided by scientific research and medical evidence. I have a duty to tell my patients the truth, but I also feel like that’s the bare minimum any healthcare professional should do! So why are there so many myths and lies out there about physical healthcare? Well, one reason is because we are all a little too easy to fool. Sometimes it’s easier to understand a simple explanation instead of a more complicated one, even though the simple one may be a lie. Ever heard of a slipped disc? Of course you have, people say it all the time. Let me clear something up… DISCS DON’T SLIP! They just don’t. Spines are strong & bits do not go jumping in and out of place. Yes you can injure a disc and that will hurt like hell, but it hasn’t slipped anywhere. So why the myth? Well for a long time people have been charging money and providing bullshit explanations and bullshit treatments because it SEEMS like it makes sense. If we mentally buy the idea, we will buy the offered service. I say it’s time for change.

“Ever heard of a slipped disc? Of course you have, people say it all the time. Let me clear something up… DISCS DON’T SLIP!”

People aren’t stupid and we aren’t all sheep. We can handle the truth. Personally, I am fed up with people being given the wrong explanations, wrong diagnosis, and the wrong advice. There’s a dangerous mix out there of those who don’t know enough to be tinkering with human bodies, and those who know but mislead people so they can part them with more of their cash. I run a clinic and I charge for the services provided, but I refuse to compromise my professionalism. I will not tell you to come in for 30 appointments when you can be better in 3. I trust that people are smart & are ready to hear truthful explanations, given by a qualified expert, in a professional manor.

I love helping people. I can change the treatment approach or rehab plan to fit your needs, but im going to keep being honest.

 

Why Quack Therapists Target Autism Parents

Foreword -Pendulum Physio here, and I’m over the moon to introduce our very first guest blog. The following paragraphs are written by Jean. She is a mother and a critical thinker. One of her kids is Autistic and I found her blogs (Autism; Practical Magic) to be so refreshingly honest, well-informed, and funny! Honesty is something I have become known for, I have a low tolerance of bullshit and my industry is full of it. Reading Jean’s blogs I reflected on some of the people I treat who are Autistic, and I realised that no matter how straight-to-the-point I try to be I will NEVER have the skills of brutal honesty that some of my autistic patients have.

 “How did you get on with those exercises? 
I did not get on them or with them. 
Did you try them? 
No. Those exercises are boring so I don’t want to do them. 
Okay no problem! That’s great information, let’s try something different. 
Fine but I probably won’t enjoy it”

I love how direct that communication is! I’d take that every day of the week. I’m certainly no expert in Autism, but I’m keen to learn more and I enjoy meeting & treating people with Autism. I try to treat the person, I have no desire to try and treat their Autism – in fact I’m not sure it’s something to be ‘treated’ at all. I do see many false claims from people who claim to treat or cure or prevent Autism. Jean is sharing her thoughts on why parents of Autistic kids make such easy targets for ruthless Quacks.

 

Why Quack Therapists Target Autism Parents

We live in curious times. We are safe in the knowledge that plague is spread by bacteria, and not witchcraft. We know that soundwaves crackling across the airwaves, and not the cunning work of the devil, transports music to our radios. We rely on doctors, and not witches, to heal illness and injury.

“You can buy a few healing crystals along with your weetabix”

It’s the 21st century. We’ve all been to school. We’re pretty enlightened, and books of healing spells are shelved in a dusty, unused library along with tomes on alchemy, sorcery and mythology. Right? But it seems that despite steady progress in science and critical thinking, that our fascination with all things alternative has done nothing but grow. You can buy a few healing crystals along with your weetabix on a trip to the supermarket. Homeopathic tinctures are displayed with grave credibility next to paracetamol. Aromatherapy oils bewitch us with promises greater than just making your home smell better than a month-old ham sandwich (true story, involving my older son, poor food hygiene, and the use of under his bed as a teenage black hole… I think the third secret of Fatima and the remains of Amelia Earhart could be in there somewhere too).

When our heads know better, and there are acres of evidence discrediting quack remedies, it’s puzzling that we continue to spend our time, energy and not inconsiderable money on them. In a time when ‘miracles’ can be explained with MRI scans and satellite images, we are still drawn to alternative remedies like moths to an expensive, but dishonest, flame. So why do we fall for it?

“I am sleep deprived, anxious and depressed, yet I’ve never been happier”

I have a 14 year old autistic son, who has made my life harder and better than I ever imagined possible. I am sleep deprived, anxious and depressed, yet I’ve never been happier. I have fewer, but better friends. My career is a distant memory, but I get to hang out with the best kids in the world. The cracks in my marriage (which are in every marriage if you stay the course long enough) have been stretched and pounded with relentless force, but have not broken. I am often lonely, exhausted and hopeless but am deeply grateful for the depth of love in my life. I have less money to spend on making myself and my home look like a magazine photoshoot, but I am honest about who I am, and have a home with an endless supply of tea and coffee, if not designer decor. Life is desperately hard and awesomely brilliant.

And some days are more hard than brilliant.

So, if my son is having what I call an “autistic day”, and somebody knocks on my door and says “hey, gimme all your savings, spray bleach around a lava lamp, feed your child nothing but corrugated iron and Goji berries, and I can magic away all the hard stuff”, it’d be hard to restrain myself from dragging them inside, chaining them to the radiator and screaming “do your magic NOW!!!” while tearing off to the nearest ATM. (btw, that ‘crazy’ stuff I just listed isn’t a million miles away from many of the so-called autism therapies I’ve come across, just so you know).

So why, when we know better, do we continue to get sucked in by snake-oil salesman?

snakeOil

I can’t pretend to have all the answers, but I think I’ve come across a few of them over my years of trying to ensure that my son receives the best education and therapies available to him.

First up, alternative therapies are easy. Living with an illness, injury or disability is hard. Taking medication and coping with it’s side effects sucks. Doing the physio, speech therapy, or Applied Behavioural analysis (ABA) is tiresome and slow. Results are rarely rapid or complete. And professional therapists will never massage your tired soul with lies. On the other hand, an alternative therapist will promise quick, easy, expensive cures and will shamelessly lie through their teeth while selling you ionising foot spas to suck the autism out of your child (that’s an actual ‘therapy’). We will always prefer the easy option. We’re human. But, if a therapy sounds too good to be true, it is.

As parents, we have to accept a large amount of responsibility for our child’s progress. We can’t hand our Little Dear to an Occupational Therapist and say “fix him” while we spend an hour having a nice pinot noir in a book shop (my idea of heaven…. although Prince DJ-ing in a corner would make it completely divine). Parents have to get involved, attend the sessions, and do the work. There is no get out of jail free card on this one. As with anything worth achieving in life, whether it’s regaining health, weight loss, fitness, using speech, or learning a skill, we reap what we sow. It takes work, patience and tenacity to achieve the good stuff and as parents we have to accept that responsibility on behalf of our child. The temptation to hand this over to an alternative therapist for a quick fix can be overwhelming, especially when we’re at a low ebb. But they are our kids to nurture and to coax towards achieving their full potential, with the help of teachers and professionals, and nobody else’s. We lean towards quack therapists because we’re tired, and the road is long, but it’s important to recognise this and avoid it.

“your child is still here, after all. But you grieve for hopes, dreams, a normal existence”

Where we’re at in the grieving process makes us especially vulnerable to quackery. When your child is diagnosed with a life-long disability, you grieve hard. It can be difficult for other people to understand the pain and loss you feel, because your child is still here, after all. But you grieve for hopes, dreams, a normal existence, your career, your marriage, friends, holidays, conversations, sleep, money, going to Lidl without a written schedule, trusting your child not to eat glass, no shit smeared on the walls, having a shower, remembering the names of your other children….. that type of stuff. When you’re chest-deep in all that, and somebody waves a shiny something under your nose and promises to make it all better, it’s a test of character not to grab it and hold on for dear life. It’s pretty depressing that there are people in the world who will happily strip the shirt off your back while you’re devastated with grief, but that’s how it is. One of the big reasons that we are drawn to quackery is that we’re heart-broken and we want the pain to go away. Of course, there’s no avoiding grief; we have to go through it, and avoiding it by focusing on bleach enemas or restrictive diets will only delay our acceptance of our child’s condition. This helps no-one except the salesman, but it’s an easy cycle to keep slipping into.

The last reason I want to touch on is marketing. Alternative therapies are huge business, which are not above scaring parents into buying their product in case their kid is missing out. When you’re new to autism, and you’re trying to wrap your head around an entirely new language, meeting therapists you’ve never heard of and trying to separate the grain from the chaff, you’re ripe as a juicy plum for being devoured by hucksters. Everything scares you in the early days. What if I prevent my child being cured because I didn’t invest in a hyperbaric oxygen chamber? How can I live with myself if I don’t suck out the autism-causing toxins with chelation? I don’t deserve children because I’m not feeding them gluten-free, casein-free, hypoallergenic, extra-virgin, cold-pressed fish ears (or something equally ridiculous)? Marketing works by figuring out our fears and poking at them with heartless, pointy sticks, and Autism parents have plenty of fears.

“I love shiny crystals. I give my kids fish oils. I enjoy meditation. But I know none of them will cure autism.”

I think it’s important not to beat ourselves up over being attracted by alternative therapies. I love shiny crystals. I give my kids fish oils. I enjoy meditation. But I know none of them will cure autism.

The best way forward is to read lots, talk lots and listen to the professionals…. and keep the shiny stuff to hang on your Christmas tree.

Gareth’s story: A tale of warning

 

 

Gareth and I talked about whether to share his story online, he didn’t hesitate for a second, “let’s do it”. Like myself, Gareth is a medical health professional. He is part of a highly respected and prestigious group of clinicians that help people in pain every day. When was his turn to be in pain he wasn’t 100% sure what to do.

 

“I work hard to provide the very best care for my patients”

We all get sore, that’s part of being human. As a physio it’s my job to give the right advice and guidance. People often think that a ‘good physio’ is whoever does a good massage, but massages don’t do much (no matter how much you love them). I work hard to provide the very best care for my patients, but usually that isn’t any magical treatment or impressive device with flashing lights. When Gareth contacted me I promised him one thing… good advice.

 

I’ve worked in a lot of different settings through private practices, sports medicine settings, and several NHS departments. Building experience is important, knowledge and skill are important, but I feel that most important of all is putting the patient’s needs first. That doesn’t mean the patient is always right of course, often people want their back rubbed better when really it’s a complete lifestyle change they need, that’s never an easy sell! But Gareth isn’t one of those people, a GAA player in his early 30s who goes to the gym, he wouldn’t be the type of person who typically develops chronic back pain. He did, however, hurt his back. That’s pretty common though, people hurt their backs all the time. Most back pain isn’t serious and goes away on its own, it can be a good idea to have it assessed and get some advice for how to deal with it properly.  By the time Gareth came to see me he was so twisted, so bent and shifted and rotated, that I honestly thought he was winding me up! I’ve looked after a lot of people with back injuries… A LOT! But I can’t think of another time when a person resembled a mangled body from The Walking Dead quite like this. He was exhausted looking and in obvious agony, but this never should have gotten this far.

 

“Physiotherapy has to do better than wacky and immoral placebo approaches”

To bend down and feel a little twinge in your lower back is a familiar complaint. Gareth wouldn’t be alone in his approach to just keep going and try and get through it, in fact, that’s probably the best thing for it. He tried to go to football training but wasn’t able to fully participate. After chatting to some friends he was recommended the name of a ‘Physio’ to go see. Now you can tell from the ‘…’ business that I’m letting you know that this person wasn’t a physio. You might ask “so what?” or say “I’ve been to loads of physios and they didn’t help me!”. I would be the first to say that many physios aren’t doing a good enough job, anyone who knows me will agree that I have a low tolerance for these folks who rub your back 50 times and just take your money and those who stick magic needles in your skin to cure a hamstring tear. Physiotherapy has to do better than wacky and immoral placebo approaches. But there is a big problem brewing, a huge variety of self-professed ‘Therapists’ have emerged & every town now has multiple ‘clinics’ offering all sorts of ‘treatments’. These are mostly unregulated and using unprotected titles. I cast my mind back to the comedian Dara O’Brian quipping about going to see the ‘Toothiologist’ instead of the Dentist.

 

Gareth fell victim to a person who calls himself a physio but who isn’t one. This person runs a “spinal clinic”. He was told that his “pelvic joint is out of place” and a short time later he was given a manipulation to put it back in. Let me just state for the record that these explanations, despite being common, are ABSOLUTE BOLLOCKS!

 

“there seems to be far more people out there now with barely a clue what they’re talking about”

A couple of days later is when  Gareth came to see me, now I’m not bragging that it was me who made a difference or anything like that, I know tonnes of top quality physios and doctors who do a great job of looking after backs every day. But there seems to be far more people out there now with barely a clue what they’re talking about when it comes to physical medicine, and they’re not just down the pub talking shite, they’re cracking backs in YOUR neighbourhood. Gareth had started with a very minor lumbar disc injury, which would have settled with some time and movement, and ended up with a large disc proplapse – a serious injury. Even the tiniest disc injuries can be very sore, but applying high speed & high force manipulation to an injured structure is a recipe for catastrophe. He needed an MRI scan to show the extent of the injury, which was now compressing his spinal nerves, and he spoke to a spinal surgeon.

herniated-disk-ectomy

I have been in that scenario – chatting to a spinal surgeon about the risks vs rewards of opening up the spine to cut off a bit of disc. No matter how smart/educated/brave/whatever you are that chat is scary biscuits. The surgeon shared my clinical view, to only proceed if absolutely necessary. Mr Surgeon briefed him about a special set of Red-Flag symptoms to watch out for, Gareth responded that I had already talked him through these and he joked about being asked so often if he had lost control of his bowels. Now was a tense waiting game, gentle treatments and exercises while seeing if the symptoms got better or worse. They got better but it was very, very slow progress. It’s over a year later and big G is finally back playing football, going to the gym, and working away. But like I said before it never should have gone that far, what happened to Gareth is tantamount to assault. An unregulated quack performing an unsafe technique on a vulnerable member of the public, taking a year of his normal life away from him and charging him for the experience! How many work days lost? What about the number of opportunities lost to play with his kids? That same quack wanted him back for a repeat session, one can only imagine what kind of wheelchair Gareth’s poor wife could afford on a carer’s allowance. He was unlucky, but it was so close to being infinitely worse.

 

“how do we all tell the difference between what’s real and what’s not?”

So if this can happen to a smart guy who works in healthcare, how do we all tell the difference between what’s real and what’s not? It’s definitely getting harder. The Health & Care Professionals Council (HCPC) is a good place to start though.  http://www.hcpc-uk.co.uk/ . They regulate allied health professionals and you can check the register online. If they’re not on the register then they’re not a physio! Many people will have been to other varieties of therapist, and many people may have been helped, but I recommend you are very picky about who you trust your life with! Gareth may have narrowly avoided a spinal cord injury but if it had been his neck he might have suffered a stroke (the carotid artery to the brain runs through the spine).

At least physios (actual physiotherapists) are externally regulated. That means they are answerable to independent bodies if anyone has a genuine complaint. You’ll need to find a good one, and that might be tricky, but please avoid the unregulated and unsafe quacks.

 

Take care,

 

-Pendulum Physio.

 

 

 

The real-life X-Men

If you’ve never heard of the X-Men you don’t know what you’re missing. A bunch of men and women who have extraordinary abilities thanks to genetic mutations, a leap forward in human evolution. Abilities such as super-fast healing, psychic powers, or shooting frickin’ laser beams from their eyes! They are of course a work of fiction from Marvel Comics, and have spawned a whole franchise of cartoons, films etc. This little blog is about the X-Men who live among us.

“Lots of people move and stand and have anatomy that is not ‘text book’, but we are supposed to, we really are all different.”

I talk all the time about a “normal spectrum of human variation”. What I mean is that people come in all shapes and sizes. In the world of Physio we can be far too obsessed with saying that you need to be a certain posture or you need to run a certain way when, in reality, variation is fine. Lots of people move and stand and have anatomy that is not ‘text book’, but we are supposed to, we really are all different. So I try to reassure people and not feed into myths or insecurities, if something looks different from ‘the normal’ it’s usually still fine and just part of that normal spectrum of how different all humans can be. One thing that varies a lot is human flexibility. It can depend on your genetics, activity levels, environment, and other lifestyle factors. Genetic flexibility mostly involves how tight or loose your ligaments are, but also relates to muscular flexibility, bone/joint geometry, and how elastic your other tissues are. Some people are loosey-goosey and others are tight as a drum. For those that are very loose (or you may hear it referred to as hypermobility or double-jointed) it can be a benefit – particularly for those that want to do activities that require a lot of flexibility like dance or gymnastics, but flexibility is only your friend if you can control it.

“So how do we control hypermobility”

So how do we control hypermobility? Well the simple answer is with strength. Resistance training, and particularly weight training, can reap big rewards for someone who keeps dislocating their kneecaps or over stressing their spinal joints. More muscle control to make up for the lack of joint control. It’s a simple idea but very hard to get right every day, week, month…

“Their extreme flexibility causes regular dislocations of joints, pain, damage, inflammation, arthritis, and plenty more.”

Some people are so flexible that they fall outside the normal spectrum. Recently I’ve had more patients who have genetic tissue conditions than I saw in the last 10+ years.  Some of these people tell me “I’m a freak”. They’re being funny and laughing about it but they know they’re not like other people. Their extreme flexibility causes regular dislocations of joints, pain, damage, inflammation, arthritis, and plenty more. It is usually caused by a genetic mutation… just like the X-Men.

So everybody has their own baggage, right? We all have these problems and issues that we carry around with us, making life tough. Well I took a little inspiration from these people, that problem is not going away for them but they are wearing a smile and visiting the Physio to see what more they can do. Staying in bed and being upset are valid responses to dealing with a challenging genetic condition but these folk are looking for answers, finding ways around the problems.  Their mutations may not be a leap forwards in evolution but their state of mind is, and it shows true strength of character. Of course the same is true for so many people who deal with all kinds of physical, mental, or emotional challenges. Life is not easy but meeting people who have that fighting spirit and strong will inside them certainly helps me dig deep for my own challenges.

 

-Pendulum Physio