Hi
I am a physiotherapist. In response to benguela in a post a good while back it is a constant source of professional embarrassment that so many physiotherapists deny good science in their practice. The uncritical adoption woo and pseudoscience within the profession is rife although I don’t think you would find that physios are worse at this then Nurses, GPS or many other mainstream health practitioners.
However the basis for all branches physiotherapy is applied science where we rely on evidence. Our background science is the biomedical sciences, particularly anatomy, physiology, pathology and biomechanics. We draw heavily on the applied exercise sciences and movement science. Physiotherapists in most western countries are instilled in evidence-based practice. We now can rely heavily on clinical guidelines and systematic reviews that are in turn based an excess of 3,000 randomised controlled trials to base our practice on. We have one of the most comprehensive databases for evidence-based practice that is devoted solely to physiotherapy (PEDro)
One reason why a number of physiotherapists adopt kooky ideas in their practice is that physical medicine is by its nature dramatic and very prone to placebo effects. When you are working within the realm of touching people which is a big part of physiotherapy practice the non-specific and placebo effects are often ramped up - much more so than prescribing a pill for instance. It isn’t just the patient that gets fooled - therapists that fail to keep a skeptical viewpoint of their practice, get sucked into thinking they are being more effective then they really are and draw wrong conclusions about cause-effect relationships. We and are often influenced by charismatic practitioners who run short continuing education courses who provide “certainty of effectiveness” if you just follow their methods (this is where a lot of dubious practices such as acupuncture are adopted).
Some countries do better at producing and maintaining science-based physiotherapy through high quality faculties and high professional standards. Countries such as Australia, Canada and the better courses in the US are good examples. So there is a marked difference between nations.
Physiotherapy is a valuable part of health science but we have our problems. We could do better.
I’d be interested to know what members have found in their dealings with physios