What to do: My DPT anatomy professor is clueless.

If at any point I exhibit the dunning kruger effect, please don’t hesitate to call me out on it.

I am currently in a DPT program.
While going through the vertebral column in lecture, my anatomy professor made multiple points to say that lumbar flexion during lifting WILL (emphasis on will) result in herniation and pain.
Later on in lab, he further insinuated the idea that, and I quote, “if you have poor biomechanics, you WILL hurt yourself” and “pain is always the result of some sort of damage or degeneration.”
For further context, he has repeatedly cited McGill in Lecture.

In an attempt to challenge this in a nice way, I emailed him this systematic review: PMID 31775556. I noted that the findings report this relationship only being seen in cadavers, and no evidence of this relationship has been shown in living humans. I also tried to emphasize a more BPS approach by noting that factors such as sleep, stress, and other external factors playing a role in pain. I made these points and then asked his opinion, trying to take a polite approach.

In regard to this email, he approached me in class. He said that it’s not really up for debate anymore, and almost all PTs and physicians accept that flexion activities will result in herniation and pain. He also stated, and I quote, “some things just make so much sense you don’t need research to support them.” I found that statement disgusting.

When he talks about how he has treated patients in the past, he repeatedly notes that he chose interventions based on what made biomechanical sense, even if the evidence wasn’t there to support it. Which further illustrates, to me, a fundamental flaw in his scientific reasoning and understanding of research methodology.

When he approached me in class, I didn’t challenge further; as I felt it would be futile. I just nodded my head and waited for him to finish.

However, I don’t feel morally right letting this go. There are 50+ students in my cohort who seem very impressionable to these ideas; and that seems dangerous to me. The rest of the faculty have noted repeatedly physical therapy’s transition to the BPS model and all the external factors that go with it. So, it seems just he is the problem.

Should I approach the program director with these concerns? Or just shut up, pass the NPTE, and move on? I posted this question to r/physicaltherapy in reddit, and was told to leave it alone. Would this be your position as well?

Thank you greatly in advance.

i know you arent asking me, but as frustrating as it sounds, if i were you i would let it go. its not your job to enlighten the other 50 students in your class…they are adults and some will choose to think for themselves and question current trends while others will blindly follow. this will happen regardless of whether or not you intercede in this specific sitaution. i would be willing to guess a decent portion of the students in your class probably already have questioned the certaintey of his statements. i have had professors and bosses like this in the past and couldnt bite my tongue and it never worked out in my favor. all you can do is continue to be open minded, willing to grow, and try to be the best PT you can be

I agree with Cole. Unfortunately, this is likely to happen a lot throughout your training. As a sort of optimist, I agree that the students are likely impressionable by this material. I suppose that is the point of having a teacher. In any case, I think a more realistic outcome is the program director AND the teacher responding unfavorably to further escalation. I would advise against that, even though it irks me big-time.

You’ll continue to note a lot of people paying homage to the BPS model, but then contradicting it seemingly every chance they get. Heck, Dr. Baraki and I both learned about the BPS model in medical school, but I’d wager < 10% of my cohort actually uses it in clinical practice.

I’ve already started to notice that trend. One of my professors notes it and then notes the only psychosocial aspect relative to PTs is the optimism or pessimism of the patient, nothing else. I would have thought doing so would be limited to the likes of huberman, but goes to show how much I have to learn.

I greatly appreciate you taking the time to reply to this.