Physical Therapists Must Not Treat Back Pain?

At least that's what some people think.  Maybe too many people.  See what happened at the end of this interview when the anchors undercut their own content with chiropractic babble.

Link to Video [NBC Augusta]

[Update 3/8/08:  NBC Augusta has temporarily removed the story in response to viewer comments.]

Read about my thoughts on this at my blog, NPA Think Tank.

Felicity, I hope you're taking notes on this!

ERIC

Comments

[Rob Wainner]

This is an example of why we need to aggressively market PT as the providers of choice for musculoskeletal problems.

I think this is a testament to how effectively Chiro has marketed itself as being synonymous with manipulation; the reporters saw you manip and immediately thought "chiropractic" despite the fact you repeatedly talked about PT and ARE a PT.

In 3-5 years I want the general public to immediately think "musculoskeletal problem (insert disorder here)...I need to see my physical therapist".

Felicity, let's get the Marketing Machine rolling.

Rob

PS Great interview Eric

[Richard DonTigny, PT]

I have recently put up a website with the mechanics of idiopathic low back pain!!
This is an integrated scientific analysis of pelvic dynamics to include the anatomy, structure, the sacral axis, movement, function, kinesiology and biomechanics. Visit at www.thelowback.com.

[Jason Silvernail]

Richard-
How's that "SI Joint" thing working out for you?
http://blog.myphysicaltherapyspace.com/2007/04/everything_that.html
Yeah, I thought so.

[Richard DonTigny, PT]

If it didn't work so good I would not have spent forty years trying to bring it to the attention of PTs. What has screwed everybody up is treating for a posterior rotation or an upslip. This takes place at S1 and is not clinically significant.
If you treat everything as a simple anterior rotation you can have 90% of all patients free of pain within about ten minutes. This is what Shaw used in his study of 1000 consecutive patients. A study confirming my stuff has just been done and awaiting publication.
If you treat for posterior dysfunction or upslips - if as I suggest the pelvis is already anteriorly rotated and you treat to manipulate in the side-lying position, pulling the shoulder back and shoving down on the hip you run a considerable risk of avulsing the long posterior sacroiliac ligament from its attachment to the PSIS. Also with anterior rotation since the iliolumbar ligaments are put on slack and destabilize the lower lumbar vertebra increasing shear and torsion shear to the disk you also run the considerable risk of disk herniation and extrusion. Pool-Goudzwaard et al have verified this.
Better go back and read what I said, not just react to what you think I said. Better yet, re-evaluate your present position in the light of new evidence. I will wager that you cannot find fault in my biomechanics.

[Jason Silvernail]

Hello Richard.
I did indeed review your site before I commented so I stand by what I said.
I don't find fault with your biomechanics, the fault is connecting biomechanics to complaints of pain. If your soon to be published research can reliably demonstrate this, it will be groundbreaking in more than one way.
I guess until then we are forced to agree with the overwhelming state of current evidence - which says operators are unreliable in examining biomechanics and that such biomechanics have never been shown to be related to pain.

Other than that, projects like yours seem like a really good idea.

I look forward to it being published. Please do let us know and I feel certain somebody will blog about it here.
Thanks-
Jason

[PaulS]

Richard: thanks for bringing this to my attention. Clinically, it seems that every SIJ patient's supine to sit test has the same results, either positive as you stated it would be... or it is too painful to be performed. As a new grad I wondered in private about why doesn't it ever seem to be a posterior dysfunction, where are all the posterios dyfunctions... I am only seeing anterior ones... wondering if I were doing something wrong. Thanks and I look forward to the publication. Would it be wrong to seek some excerpts or the abstract to appear here? Thanks just the same

[Richard DonTigny, PT]

Jason, you may wish to review my site again as I did relate the biomechanics to pain. I found a reversible biomechanical vulnerability in anterior rotation and relationships to the herniated disk, to arthritis of the hip, sciatica and many other symptoms, most fully documented.
Paul. I am with you. All I see is anterior dysfunction and it is almost all bilateral. I do the same thing for everybody. I have done three outcome studies and on the last averaged 2.9 treatments/patient. Work recently completed by Fife in Savannah replicated Flynn's study, but used my method. I think it will surprise a few people, but probably won't turn any more heads than did Shaw.
Most PTs are so into treating posterior dysfunction and upslips that they do not realize that they are hurting people.