Is Physical Therapy Fraud? (Audio Only)
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- Опубликовано: 3 июл 2017
- An audio reading by Mark Rippetoe by his article entitled, "Is Physical Therapy Fraud".
The text of the article can be found on the Starting Strength website: startingstrength.com/article/i...
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I had bone spurs in my neck vertebrae that caused numbness in my hands but never HAD to be dealt with until I started doing SS because the pain got so bad in my neck and shoulders. I actually stopped working out before I sought out help. I got an MRI and then was referred to PT. I happened to get a guy who had 3 sons all into strength training. He basically put me through some neck stretches that took the pressure off the nerves being effected by the spurs, and all my symptoms were gone. After he made sure I was good and practiced, he gave me "homework" to do for my neck and told me get back to those weights, which I am getting ready to do and fairly confident I'll be fine.
I'm very thankful for his guidance and I won't write off all doctors and PT's.
I think the exercises you were prescribed were based on the McKenzie method, which is also highly recommended in treating low back pain. Two great books -Treat Your Back Pain/Neck Pain are available on Amazon.
I seen a Physical therapist for a bicep injury. He told me to never deadlift over 225 pounds.
Lol
All PTs are not the same.
Too many of them are.
*_*flexor digitorum profundus flexing intensifies*_*
*supinated bosu-ball proprioceptive circle-banded ankle plantar flexion antagonistic release inhibition for slow and controlled sets of 20* your knee will be back to full range of motion in no time!
@CAIntegrity nah man. More like sts 2x A with 2x UL support with commode to follow 😝
I did the program and got strong.
I also found a lot of aches (from old injuries) diminishing over time.
Left shoulder doesn't pop and hurt anymore, left kneecap doesn't slip out of place anymore and cause immense pain, right side of my rib cage doesn't pain me anymore.
Lifting heavy helped me.
Eric Black exactly the same for me for my shoulder and back. 20 years of back pain with physical therapy, no pain anymore with 3 months of heavy lifting, amazing...
Eric Black I agree. While training 5x5, I was NEVER hurt/injured. When I stopped, little aches and pains re-appeared. Good comment.
It's not just aways black and white. PT has it's place. I had shoulder pain that would not go away even after stopping training. Turns out I needed rotator cuff surgery to reattach it to the bone. PT would never have fixed this. However, PT was essential for my recovery. I was back to Bench Pressing 6 months after the surgery and back to my max after a year.
I use the Starting Strength program and it has helped me big time, but physical therapy also helped me heal my ankle injuries, which was sinus tarsi syndrome in my left foot and achilles tendonitis in both. It wasn't until I started seeing a physical therapist that those actually started healing after dealing with 4 -5 years of day to day pain and inflammation.
Was that making your heel tender and painful to walk on ?
There should be a trigger warning. I got sweats when he said the word titration.
Icing injuries is useless too..
Corrina Barber YES. the swelling is SUPPOSED to happen
Does starting strength recommend any exercise with frontal plane focus, such as suitcase carry? I think this is important supplementary work to sagittal plane focus. This is especially important in sports where you have to do sudden changes of direction.
Turned into Jim Rhone at the end.
I love this mans straight talking. Makes total sense to me.
Man I love the way you analyze your thinking!
Like him or hate him, Rip can make a strong argument.
This is one of the most inspired and passionate rants that I have heard in recent memory.
I had a problem with knee pain in one knee (VMO was "not firing").
I kept squating and getting stronger.
However, the knee pain went nowhere and my VMO on that leg was not responding to efforts to flex and was visibly smaller.
I started doing 1 leg squats on that one leg. My vmo got bigger and the pain went away.
👍
Yeah he's usually pretty 1 sided
Speaking as someone facing down about 2 years of recovery from a nerve injury, that analogy regarding "not firing" was on point. To the point of rendering the term nonsensical.
One's own developing kinaesthetic awareness or lack of cues from coach is a very VERY different thing from a muscle group actually not firing.
Nothing like being pinned by 135 and wondering why your right side just won't press the weight.
Did you get it sorted?
@@tommyharris5817 It sorted itself really, the going recovery prognosis with these things I think is still "1mm a day", so beyond some occasional twinges in the first finger on my right hand everything has been back on track for a few years.
I can still see some atrophy in some areas but it's not as bad as all that, hard to see if one doesn't know what to look for.
Cheers though, thanks for asking.
Lateral imbalance also has a lot to do with core strength, hip strength,and potentially injuries to the spine or hips. Also pinched nerves can affect it
That ending is fantastic!
I kinda somehow disagree with what rippetoe says. If you have imbalances other than weak arthritic joints used over by the years muscle then something like compound exercises like squats can be good. But if you have something like muscle joint imbalances. Like strong external rotators and weak internal rotators. Or the muscles pulls the joints bones in a wrong direction angle then isolation exercises can be good.
A.C.A:1995 assinine..
@Myr Luke
"
He can't --- but neither could any PT... with the conditions you impose on your question.
It's like saying "I'd like to see Rip make the deal walk" He can't but neither can anyone else.
But IF THERE is a way I bet on Rip way more than almost all PT
If you call his knowledge "limited" --- then the PTs knowledge is nonexistent. Or worse, WRONG.
And they apply THAT shitty "knowledge" on you to make you better, and fucking you up even more in the process.
@Piece of Plastic Rip has a ninety-one-year-old female friend. With the help of one of his assistants, using the Starting Strength method, the assistant was able to help this older woman walk, without the assistance of a cane, by having her do body-weight squats in his gym. This assistant also helped the ninety-one year old perform bench presses with 65 pounds. That may not seem like much, but for her and for many women, it is.
So basically any type of faulty posture would be fixed by doing squats?
"strong helps almost everything"
NimW And deadlifts, presses, bench and chinups.
To some extend. But face pulls and rows will cure that in a few months.
In general, big compound lifts like squat will expose a lot of imbalances (e.g lack of thoracic mobility) that need to be corrected first if the invidual wishes to improve their strength on that lift. So yeah, they do help in that respect.
I don't know much about physical therapy, not enough atleast to make arguments for or against them, but I do know this; not a single health professional, doctor, PT or any other in between makes a living from healthy people. I believe the indistry as a whole has become a fraud. Imagine if every single person on earth did basic barbell strenght training, how many physically incapable people would there be? Starting strength helps 80 year olds who haven't been able to function properly for years suddenly walk without a walking chair again. As far as I know, they're back on their walking chair after years of physical therapy. Not saying barbell training is the end-all-be-all answer for everything.... but it's as close to it as you can get.
Barbell medine is the best medicine!
And stopped eating sugar and garbage "healthy" foods with lots of carbs.
Dorian claims his nautilus pullover machine was what did it......
I see Ripp's point. If it is post-surgery, then yes PT is worthwhile. However, in my experience, PT's give over-complicated exercises. I wasted a lot of money on PT for years, trying to get my shoulder better. I'm glad I did not opt for surgery. I have a small labral tear. However, my strength is barely affected by it. What fixed it? Shoulder presses & rows! Incrementally increasing the weight.
So why did you need to get rotator cuff surgery?
atomism vs holism
One problem I have with therapy ,is that it involves passive exercise.Most are light,lying down ,and assisted. But as soon as you get home and take out the garbage,you get reinjured.
after you've been mangled in a car accident you may want to do some low bar squats with a pvc pipe nevermind that you can't stand up. I think PTs do have their niche.
Interestingly though what may have actually happened which lead to this pain and also was part of how the physio treatment worked is acute : chronic worload as a risk factor for overuse injuries. Maybe you started the program at too high intensity for what your tissues were used to, then when you backed off a bit with physio they actually had adapted and where you picked back up was now within your adaptive acute : chronic work capacity.
No doubt we as physios help though but just not as much as we could or even always for the reasons we presume
You missed the main point here. And, saving a person from a mangled car is not a PT's job.
As an LPTA, I hate that I even reference myself like that (sounds pretentious) I can say that I generally agree with RIP. However, there are times when the isolation of a muscle to strengthen it is necessary before compound movements are incorporated. After a TKA quad sets and pulses are very effective in the acute phase of rehab as you are trying to elicit a contraction from a muscle that either doesn't contract or contracts weakly. It would be malpractice to get a fresh knee post op and have them do squats and deadlifts. The squat will be limited by the weakest link in the chain, aka the knee. Strengthen the link then focus on strengthening the whole chain. Granted, I'm just an assistant to a PT, but I'm considered competent enough to carry out plans of care and make appropriate progressions. So I dont feel I should be completely discredited. In the end the goal is basically to improve strength and range of motion so they can squat deeply and with good strength, as well as the many other daily activities that require unilateral loading. I think it is absurd to think that therapy should just be squatting and deadlifting, which is what it sound like Rip is professing. I may somewhat generally agree, however, that it would be stupid to do some of these exercises with a supposed advanced athlete. Especially with light weights. An argument could be made that loading heavily some of these functional core, yes I used core as I don't think it should be entirely disregarded, could be beneficial, like his example of an overhead alternating dumbbell press. The problem that Rip faces is that not all activities require movement in the sagittal plane. The plane that all the exercises Rip purports to be all you'll ever need are in. So I think it is probably paramount to focus on strength training as Rip prescribed, but the cracks it leaves can and perhaps should be filled with corrective exercises and functional training that he rejects. I for one, like to focus on the big lifts. But on my off days I'll do the corrective exercises that require a direct contraction of the muscles that contract isometrically during the squat. Think hip hinging or side stepping with a band around the legs to strengthen the glute med/min. Meaning you may very well be working them harder with corrective exercises than you are when squatting. Potentially. This means that when you go to do the big lifts you have filled in the weak links and they wont be your problem when you cant do the next rep, persé. Getting strong bilaterally, with solely isometric contractions of the abdominal and erector musculature, does not necessarily translate into great function and strength when dynamic movement is incorporated via daily life or sports activities. Another example of when a more dynamic contraction of the "core" muscles may be very beneficial and only add to strength training not detract. Anyways, I've said enough. Just my opinion I guess.
Yes
for me, Mark rippetoes answers are cocksure and not systems thinking at all.
you can't rehab and emend any compound or chain function as long as a structure in my body , which is needed for this compound function is still fresh after an injury for example!!
Mark should know as a profession (whatever).. hihi.. that training begins after rehab.
so he should speak about training and not about things he has no knowledge, I guess.
there are so many experiences examples for my opinion all over the world... ridiculous to mention it here.
Agree, it is clear that there are some PTs performing very unskilled interventions and who do strengthening for muscle groups that are already strong/etc. (Also under insurance constraints). As I'm listening to the rant, and I really like Ripp generally, he does not understand, for instance, focal Scar Tissue adhesions and how this can affect the synergy of a system. You can extend the hips with very little glute activity, which is why some elderly are actually over-using lumbar musculature, causing high degree of pain downstream. I work with elderly special populations as an OT. So it's very clear where OT/PT are valuable. Come work with my population for 1 day Ripp, then say all this again....
PT is great for people who have fresh injuries such as whip lash. It helps bring back their range of motion!
It’s likely they just healed up. Most physical therapy is bs.
I fail to see how physical therapy is a fraud because in some cases it uses isolation movements. It was never intended to develop barbell strength, but to help people recover from a specific injury so they could do barbell training if they so desired. One does not replace the other. If you wish to get strong, follow the Starting Strength program. If you have a specific injury to your nerve-muscle-bone system, get it repaired if possible; physical therapy may be one way to accomplish that, and then follow the Starting Strength program. Doing squats, dead lifts, bench presses, overhead presses, power cleans, and bent-over rows, the essentials of the Starting Strength program, along with pull-ups, sit-ups, and push-ups as possible assistance exercises, are not easy to perform correctly with excellent technique. Far too many people do these exercises incorrectly, whether they are in shape or not. Incorrect performance of these exercises may lead to injury. The medical profession chooses not to take that risk. So that may be why these exercises do not make up the standard care often rendered in most physical therapy treatment plans. Isolation movements, as Mark has pointed out, are easier to do and easier to manage, if done correctly, and therefore carry less risk to the patient.
PTA here, while much of what is said here can be true and probably is true at least 50% of the time, maybe more than that... The reasons for it are often complacency combined with the pressure of the "system" (hospital, nursing home, clinic) to force the therapist to perform at an unreasonable efficiency rate. However, PTs and PTAs (as well as OT, ST, OTA etc). Are generally not stupid people, many have a strong sense of ethics and the need to continually educate themselves on how to be a better practitioner of physical science and health. I for one wish I could have a squat rack for all my 80+ year old patients at he retirement community I work at. I have been reading starting strength and implementing it into my personal training program recently and have also implemented it as best as possible into my therapy practice. It is very hard however to convince 80+ year olds to squat and lift heavy weights outside of a gym or starting strength environment.
Very true and difficult to motivate an 80yr old that has never weight trained or participated in any sport other than making love
I think certain muscle groups need to be isolated to prevent muscle imbalances that lead to injury. Rear delts and low traps are two that need to be isolated. Another then to prevent muscle imbalances and promote joint health I agree with Mark
"Never attribute to malice, that which can adequately be explained by stupidity " Nice
i broke my elbow and pt put Ice and hot in the same routine. I never understand the reason of that. I had to strech my elbow by myself and almost all his rehab was shit.
lol Rippetoe triggering physical therapists for sport.
IF YOU FEEL THAT YOUR CONDITION REQUIRES SURGERY, GET AN MRI THEN MAKE A DECISION. DONT LET DOCTORS TAKE OVER.
❤❤❤❤amazing
In my opinion for the general population yes it is a fraude.. So many times they have sent me there with absolutely no benefit to my wellbeing what so ever!
without watching this..... long term joint structural change is only made through load in a complex movement. everything else is just short term or changing pain perception. just watch oly lifters.
After you fix an imbalance you need to start a lifting program. What about that isn't understood?
The perky PT Assistants are what kept me there working on my Levator Scapulae.
perky assistants the best part of PT
I don't understand his argument about correcting muscle imbalances. If you had a scale with 10lbs on one side and 20 on the other side, how do you make that balanced? You can't do the same thing to both sides (+ or -) and expect it to correct itself. That's what he's proposing about using the squat itself to correct an imbalance.
Does this concept work in other areas? Are there other types of skill acquisition that are better learned by doing the activity as a whole than by targeted practice on a portion of the skill and then bringing it back in context of the whole? And I'm talking about isolating patterns, not muscles. Ex: sports teams just playing more games instead of practicing skills that are done in games and bringing those skills back into game settings.
And does progressive overload not apply to single leg exercises? If not, then why not just do the 1 Starting Strength exercise that you can lift the most weight in? Every other lift would be a waste of time because it's not the heaviest weight you can lift.
Also, people bring in imbalances all the time to exercise based on injury history, movement habits, and lifestyle factors like jobs and hobbies. Perfect coaching is not necessarily going to fix those things if all your looking at is technique.
I could go on, but this is long enough.
Your strength will be dictated by your adaptation. If you are not overexercising one side it will resolve over time.
Very intelligent man, All pay close attention to what he says.. I can take myself for example i've had pretty bad pain in my left shoulder/neck to spine since i was 15 years old (had a car accident then), now im 30.. I've been to so many doctors and put on different medications yet noone can figure out the problem... They all tried to narrow it down to individual parts of my body so they all failed to see the whole picture, The numbers of so called specialists i have seen with no results is pathetic.. So i decided to do my own research and i figured it must be some sort of nerve issue so i saved up some money to see a chiroppractic to get me adjusted and my pain is down by 80%+... TLDR the body is systematic and need to be seen in a holistic way!
I tore a ligament in my knee when I was younger. My PTs had me do lots of stupid exercises with bands and a coffee can. It was a complete waste of time and I still couldn't go into a full sprint even years after the injury. Miraculously, I started doing Starting Strength and by the time I got my squat to 225 x 5, everything was as good as new. Physical therapy really is a joke.
I had a grade 2 sprain to my MCL. My physio got me doing both stability exercises and functional strength training and after 3 months it was if I had never had the injury.
John Doe Matrix exactly lol
Fiddler crabs are typing furiously.
10:54 lol
Physical therapy is horse shit.
Destroys athlean x gimmick
First minute is already completely false information.
Btw my ac joint hurts
Rip gives pseudo intellectuals a bad name...
...Physiotherapie is a little more than doing exercises, this comment is bullshit...
Respectfully Mr Ripteo, you are plain wrong.
I have had physio several times, for both sports and motorcylce injuries.
Every visit to a good physio was of benefit.
After knee reconstruction surgery my VMO was not firing, a 15 minute massage got it working.
Climbing 1 stair step with proper gait took hours on practice, suggested and policed by my physio.
I am an intermediate body building who always uses multi joint barbell exercises.
Mr Ripteo, I do respect you, however on this subject you are plain WRONG.
Maybe if you were stronger you wouldn't have to keep coming back to a physio. I don't know...If you keep getting injured shouldn't be wondering why? Isn't being injured once enough?
@@frankopanklaric I mean. You can't avoid a motorcycle accident can you. Any serious lifter or sports athlete will inevitable get injured multiple times throughout their career. It's unavoidable
I disagree with you. You obviously don't know how to squat because if you did, you wouldn't have the problem in the first place. Listen to the podcast again because it's for idiots like you who go to PTs which are 99% bullshit.
Mike Rippertoe is my favourite vegan hyyyyeeeepppp draaahve
so much butt hurt in the comment section!!! LOL @ PT's!!! PT's are glorified personal trainers -
It's great cause he's asking the question, "Is Physical Therapy a Fraud?"
arvand shabazi and what do we know about headlines that ask questions? The answer is always no.
Thanks Rahill
Is a Strength Coach giving medical advice fraud?
Yes.
Is physical therapy fraud?
Yes.
No. Just because you have had bad experiences doesnt mean that scientifically supported rehabilitation programs dont work.
Kyle Curness doesn't mean they work either