Hey all,
In the gym the other day I overheard a physiotherapist saying stuff like “pullups are going to destroy your rotator cuff” and “never train your biceps on days when you bench or you will get elbow tendonitis” etc. It made me wonder how it came to be people with a serious education in strength and conditioning have such widely varying beliefs about how the body works. I mean, is it just because they don’t keep up with the literature, but I heard that first papers on the BPS model were already published in the seventies so surely this can’t be the only reason? How come professors and teachers at universities often say things that vary so much from what you guys are saying? I understand that this is difficult to answer completely but I would like to hear you guys’ thoughts.
Thanks
You just asked the million dollar question. The answer is a mix of reasons but a lot of it has to do with our desire for a narrative and lack of ability to reflect and critically think. We like assigning meaning to things; why are their stars in the sky? those are obviously gods of course! One poll has 45% of Americans believing in ghosts. If that is the case I have no problem believing a large portion of the population believe that “pull-ups are going to destroy your rotator cuff.” Everyone remembers Isaac Newton for gravity and calculus but forgets he was also an alchemist.
Some of this comes down to in-group and out-group behaviors. I highly doubt Mike, Austin, Jordan or I would last very long in a clinic that was spouting that kind of narrative. Try as we may, we would probably end up taking our knowledge and going home. In the same token, I interviewed at a place that advertised themselves as “McKenzie trained” and to no one’s surprise didn’t get the job. Many more therapists and chiros start their own practices where they and maybe one more clinician are the only people there. If 80% of people get better on their own you could believe that you’re channeling ghosts to cure patients and have a 4/5 success rate.
Some of it does come down to dissemination of knowledge as well. There is some humility in looking back on what clinicians were doing 50 years ago and laughing at how dumb most of it seems. Seriously, the last lobotomy was performed in 1967. We can take that as “look how far we’ve come” or we can say “I wonder what they’ll be making fun of us for 50 years from now.” My money is on saying dumb shit like “pull-ups cause rotator cuff damage.” I’m comfortable saying with 100% certainty that something I’m currently saying or doing in practice will be shown ineffective 50 years from now. It’s what makes me keep looking for evidence instead of just saying the same thing I said at graduation.
I think there are something like 220 PT schools in the U.S. there is no way even half of these schools can be staffed by professors with a true commitment with staying up to date on the literature. Unlike medical schools where schools are affiliated with research universities and hospitals (physicians still do dumb shit), many PT schools and chiro schools are on islands. If you’re not surrounded by other people who are going to challenge you, you’re not likely going to get any better.
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