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  • Mark Austin

Active Rehab is Key


I'm self-righteous to a fault, but I take great issue with physiotherapists who make manual therapy and passive work the main focus of their treatment plan. This approach is not supported by science and does a disservice to both our profession and our patients.


These approaches DO help, and I use them myself, but movement should be the foundation of everyone's plan in physiotherapy. Passive treatments provide short-term relief, and can sometimes speed up recovery, but in isolation their benefits are minimal. If your physiotherapist isn't making this the main component of your treatment, they should be collaborating with other professionals (personal trainers, kinesiologists, athletic therapists, etc.) to make sure it is still a big part of your treatment plan.


I tell my patients that if you get better with only passive treatment, it is quite likely you were going to get better on your own without it anyway, or there was a big enough placebo effect that you got moving again and recovered that way.


I think these approaches have become so popular in our profession because it is easy to see more patients in a day (and at once) when we rely on passive treatments. They are also easier to use to market our businesses with-- society loves the idea of a quick and easy fix. Patients themselves view these treatments as a more tangible solution than movement-based rehab and education. Needling, cracking, scraping, and shocking seems really 'cool,' and novel, so it must work, right?


I get it. However, if you have more than a minor injury or condition going on, focusing mainly on passive treatments can leave you feeling stuck, demoralized, and going in circles. Many patients pay a lot of money for physiotherapy, only to get minimal one-on-one time with their physiotherapist, minimal results, and walk out of the clinic thinking that physiotherapy does not work. Now other professions, often with less training and regulation, are popping up to fill in for what we aren't doing. We can do better.


Find a rehab professional that focuses on getting you moving. If movement isn't the main focus of your treatment plan, move on to someone else! Yes, it's more work on your part, a little more uncomfortable, and less trendy, but if the goal is a full recovery back to doing the things you love, we all have to accept reality, lean into some discomfort, and put in some hard work from time to time. The real shortcut to getting better isn't in a needle, shockwave machine, crack, or soft tissue release-- it is simply doing the hard work now, rather than later. In Calgary (or anywhere in Alberta), and looking to solve your back pain, knee pain, shoulder pain for good? Get in touch with me for in-person or online physiotherapy. We will get down to the root cause of your symptoms, rather than just focus on masking them.

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