PT/DC

ptdc · 04-10-2011, 04:46 AM

Hey everyone. My name is Mark and I'm a PT (5 months) and chiropractor (9 years). A few years ago I dove into the pain sciences (devouring Butler, Moseley, Nijs, Bialosky, George, etc.) and it's been a game-changer in my practice. I work for a hospital-based outpatient rehab clinic (32 hrs) as a PT and private practice (8 hrs) as a chiro and PT.

Jon Newman · 04-10-2011, 05:24 AM

Welcome. You must have some interesting perspectives to share.

ptdc · 04-10-2011, 05:45 AM

Quote:

Originally Posted by Jon Newman

Welcome. You must have some interesting perspectives to share.

In some ways yes. At the end of the day I see myself as a PT that's really good at manipulation. I will never defend chiropractic, but I will defend manipulation.

**Diane** · 04-10-2011, 05:50 AM

...Of the high neck? (Just checking to see how de-chirofied you are.)

Welcome to SomaSimple.

mrupe82 · 04-10-2011, 05:26 AM

Mark,

Good to see you made your appearance here at SS. A few words of advice, read what they suggest and don't take anything as an ad hominem. You'll die sooner that way. That's a good thing around here...

**John W** · 04-10-2011, 05:30 AM

Welcome, Mark. Why did you decide to go back to PT school?

ptdc · 04-10-2011, 06:01 AM

Quote:

Originally Posted by John W

Welcome, Mark. Why did you decide to go back to PT school?

I went through a "diplomate" program in chiropractic on rehab. It was a 300 hour seminar series focusing on spinal rehab (something never taught in chiro school). This program really lit a fire under me to actually teach patients how to take care of themselves and how to become independent rather than dependent.

I was at a Stu McGill seminar where someone in the crowd asked the speakers "with chiros wanting to do rehab and PT's wanting to do manipulation, where do you see the future of MSK medicine headed?" Craig Liebenson, a chiro I really respect, said "if chiros don't step out of the box and learn rehab, in the end they will be one-trick ponies, and ultimately dinosaurs."

I didn't see a long-term future as a chiro. In IL PT's can do manipulation and have "pseudo-direct access"...they can eval but not treat. If eventually PT's got direct access, can do what I do, AND get better insurance reimbursement for it, where does that leave me? Spinal screenings at a mall in 15 years?

I wrote out a pro's/con's list prior to applying to PT school and there were 12 pro's and 3 con's (the 3 con's were temporal and related to going deeper in debt). I focused not on the next 3 years but the following 25 and have not looked back.

**zimney3pt** · 04-10-2011, 05:30 AM

Welcome Mark, was it the pain sciences that had you take on PT in addition to your DC or something else?

**John W** · 04-10-2011, 05:58 AM

Quote:

I will never defend chiropractic, but I will defend manipulation.

It sounds like you have a perception that manipulation-by which I assume you mean high velocity thrust- requires a defense.

Do you think it's a strong position for the profession to be in to have to defend one of its treatment interventions? Maybe you mean that the way PTs approach and are re-defining manipulation away from the chiropractic concept of subluxation is what needs defending?

ptdc · 04-10-2011, 06:19 AM

Quote:

Originally Posted by John W

It sounds like you have a perception that manipulation-by which I assume you mean high velocity thrust- requires a defense.

Do you think it's a strong position for the profession to be in to have to defend one of its treatment interventions? Maybe you mean that the way PTs approach and are re-defining manipulation away from the chiropractic concept of subluxation is what needs defending?

I love the fact that the majority of the research on manipulation is being done by PT's.

I do not subscribe to subluxation theory and never have. As far as the chiro profession defending it, well, there are fewer and fewer willing to stand in defense of it. Subluxation-based chiros are by and large the loud minority that give the profession a bad name. How would PT's react to the whole profession being painted as myofascial release or craniosacral practitioners?

TexasOrtho · 04-10-2011, 01:27 PM

Hey Mark. Great to have you. Sounds like you'll find a lot of helpful information here. Once you hit 10 posts, you'll have access to the Sounds of Silence forum where we post quite a bit of peer-reviewed evidence.

**Bas Asselbergs** · 04-10-2011, 01:37 PM

Welcome Mark. Enjoy the wealth of resources here (as Rod said - 10 posts and it is a BIG library that opens up).

As a bit of counterpoint to your thought about subluxation: (from SBM blog) Mirtz et al
suggest in 2 studies that 98% of chiropractors believed that “most” or “many” diseases were caused by spinal misalignments and over 75% of chiropractors believed that subluxation was a significant contributing factor to 50% or more of visceral disorders (such as asthma and colic), an implausible idea that is not supported by any evidence whatsoever.

You probably operated in a much more enlightened environment/peergroup, but it seems that the profession is not yet out of those woods. I really think you made a good move! Now, it will be tough to withstand the PT-dogmas that still persist in the academic realm - without evidence......

Jon Newman · 04-10-2011, 02:14 PM

Hi Mark,

Given your interests, you may have something to share in the manipulation solution thread and your input would certainly be appreciated.

**Barrett Dorko** · 04-10-2011, 02:17 PM

Welcome Mark.

I'm pretty sure we got into it with Liebenson a while ago. He left.

Does anybody else remember that thread?

Steve Hill · 04-10-2011, 02:23 PM

So it only takes 10 posts to get to the library? Whew, I just hit 11. I was thinking I was on 7 and was going to keep posting silly questions until I hit 10. Never mind.

**keithp** · 04-10-2011, 03:18 PM

Quote:

Originally Posted by Steve Hill

So it only takes 10 posts to get to the library? Whew, I just hit 11. I was thinking I was on 7 and was going to keep posting silly questions until I hit 10. Never mind.

I believe there is a 30 day wait (from registration) that accompanies the 10 posting requirement. Do not be dismayed if you do not get access to the library immediately.

Welcome aboard.

Respectfully,
Keith

**John W** · 04-10-2011, 06:16 PM

Mark,

Perhaps you misunderstood my question. I wasn't talking about defending the indefensible subluxation theory. That has been definitively debunked despite its persistent popularity and invocation among most chiros, as Bas has indicated above.

I was asking about defending manipulation in general. When I hear someone state that they will defend a technique, the logical inference is that it is under attack. I'd be interested to hear what your impression is of the "attack" on joint manipulation and how well the current science and research evidence supports its use.

This may be a topic for another thread if you'd like to start one. That'd be a good way for you to get engaged in a discussion here that will eventually result in your access to all the site has to offer.

joebrence9 · 04-10-2011, 10:34 PM

Quote:

I was asking about defending manipulation in general. When I hear someone state that they will defend a technique, the logical inference is that it is under attack. I'd be interested to hear what your impression is of the "attack" on joint manipulation and how well the current science and research evidence supports its use.

Was Manipalooza not enough evidence for you John???

**John W** · 04-10-2011, 11:09 PM

I missed it.

I prefer my "-paloozas" as entertainment events, not vehicles for supposed professional growth.

04-10-2011, 04:46 AM	#1
ptdc Junior Member Join Date: Aug 2011 Location: Peoria, IL Posts: 5 Thanks: 0 Thanked 0 Times in 0 Posts	PT/DC Hey everyone. My name is Mark and I'm a PT (5 months) and chiropractor (9 years). A few years ago I dove into the pain sciences (devouring Butler, Moseley, Nijs, Bialosky, George, etc.) and it's been a game-changer in my practice. I work for a hospital-based outpatient rehab clinic (32 hrs) as a PT and private practice (8 hrs) as a chiro and PT.

04-10-2011, 05:50 AM	#4
Diane Human Primate Social Groomer and Neuroelastician Join Date: Mar 2004 Location: Weyburn Sask. Posts: 19,664 Thanks: 1,484 Thanked 3,180 Times in 1,562 Posts	...Of the high neck? (Just checking to see how de-chirofied you are.) Welcome to SomaSimple. __________________ Diane www.dermoneuromodulation.com SensibleSolutionsPhysiotherapy HumanAntiGravitySuit blog Neurotonics PT Teamblog Diane Jacobs.com (personal website) Canadian Physiotherapy Pain Science Division (Archived newsletters) Canadian Physiotherapy Association Pain Science Division Facebook page @PainPhysiosCan WCPT PhysiotherapyPainNetwork on Facebook @WCPTPTPN Neuroscience and Pain Science for Manual PTs Facebook page @dfjpt SomaSimple on Facebook @somasimple "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

04-10-2011, 05:26 AM	#5
mrupe82 Senior Member Join Date: Feb 2009 Posts: 419 Thanks: 5 Thanked 168 Times in 54 Posts	Mark, Good to see you made your appearance here at SS. A few words of advice, read what they suggest and don't take anything as an ad hominem. You'll die sooner that way. That's a good thing around here... __________________ Matthew Rupiper Physical Therapist Last edited by mrupe82; 04-10-2011 at 06:08 AM.

04-10-2011, 05:30 AM	#6
John W Harmless creampuff Join Date: Sep 2006 Location: New Orleans, LA Age: 48 Posts: 4,643 Thanks: 614 Thanked 966 Times in 436 Posts	Welcome, Mark. Why did you decide to go back to PT school? __________________ John Ware, PT Fellow of the American Academy of Orthopedic Manual Physical Therapists "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

04-10-2011, 05:30 AM	#8
zimney3pt life long learner, clinician, and instructor Join Date: Dec 2009 Location: Sioux City, IA Age: 43 Posts: 1,902 Thanks: 149 Thanked 675 Times in 265 Posts	Welcome Mark, was it the pain sciences that had you take on PT in addition to your DC or something else? __________________ Kory Zimney, PT, DPT http://koryzimney.blogspot.com "Study principles not methods, a mind that can grasp principles will create its own methods." - Gill "All truths are easy to understand once they are discovered; the point is to discover them." - Galileo Galilei

04-10-2011, 05:24 AM	#2
Jon Newman Enjoy a moment of whimsy Join Date: Dec 2005 Posts: 9,024 Thanks: 5 Thanked 54 Times in 40 Posts	Welcome. You must have some interesting perspectives to share.

04-10-2011, 01:27 PM	#11
TexasOrtho Senior Member Join Date: Feb 2008 Location: Huffman, TX Age: 41 Posts: 1,319 Thanks: 278 Thanked 212 Times in 82 Posts	Hey Mark. Great to have you. Sounds like you'll find a lot of helpful information here. Once you hit 10 posts, you'll have access to the Sounds of Silence forum where we post quite a bit of peer-reviewed evidence. __________________ Rod Henderson, PT, OCS "To teach is to create a space in which the community of truth is practiced" - Parker Palmer

04-10-2011, 01:37 PM	#12
Bas Asselbergs Physiotherapist Join Date: Jul 2004 Location: Canada Age: 61 Posts: 3,693 Thanks: 835 Thanked 484 Times in 233 Posts	Welcome Mark. Enjoy the wealth of resources here (as Rod said - 10 posts and it is a BIG library that opens up). As a bit of counterpoint to your thought about subluxation: (from SBM blog) Mirtz et al suggest in 2 studies that 98% of chiropractors believed that “most” or “many” diseases were caused by spinal misalignments and over 75% of chiropractors believed that subluxation was a significant contributing factor to 50% or more of visceral disorders (such as asthma and colic), an implausible idea that is not supported by any evidence whatsoever. You probably operated in a much more enlightened environment/peergroup, but it seems that the profession is not yet out of those woods. I really think you made a good move! Now, it will be tough to withstand the PT-dogmas that still persist in the academic realm - without evidence...... __________________ We don't see things as they are, we see things as WE are - Anais Nin Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

04-10-2011, 02:14 PM	#13
Jon Newman Enjoy a moment of whimsy Join Date: Dec 2005 Posts: 9,024 Thanks: 5 Thanked 54 Times in 40 Posts	Hi Mark, Given your interests, you may have something to share in the manipulation solution thread and your input would certainly be appreciated.

04-10-2011, 02:17 PM	#14
Barrett Dorko Writer and Clinician Join Date: Nov 2005 Location: Cuyahoga Falls, Ohio Age: 61 Posts: 12,644 Thanks: 605 Thanked 1,452 Times in 856 Posts	Welcome Mark. I'm pretty sure we got into it with Liebenson a while ago. He left. Does anybody else remember that thread? __________________ Barrett L. Dorko P.T. www.barrettdorko.com

04-10-2011, 02:23 PM	#15
Steve Hill Member Join Date: Jan 2006 Location: Madison WI USA Posts: 73 Thanks: 16 Thanked 9 Times in 6 Posts	So it only takes 10 posts to get to the library? Whew, I just hit 11. I was thinking I was on 7 and was going to keep posting silly questions until I hit 10. Never mind.

04-10-2011, 06:16 PM	#17
John W Harmless creampuff Join Date: Sep 2006 Location: New Orleans, LA Age: 48 Posts: 4,643 Thanks: 614 Thanked 966 Times in 436 Posts	Mark, Perhaps you misunderstood my question. I wasn't talking about defending the indefensible subluxation theory. That has been definitively debunked despite its persistent popularity and invocation among most chiros, as Bas has indicated above. I was asking about defending manipulation in general. When I hear someone state that they will defend a technique, the logical inference is that it is under attack. I'd be interested to hear what your impression is of the "attack" on joint manipulation and how well the current science and research evidence supports its use. This may be a topic for another thread if you'd like to start one. That'd be a good way for you to get engaged in a discussion here that will eventually result in your access to all the site has to offer. __________________ John Ware, PT Fellow of the American Academy of Orthopedic Manual Physical Therapists "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

04-10-2011, 11:09 PM	#19
John W Harmless creampuff Join Date: Sep 2006 Location: New Orleans, LA Age: 48 Posts: 4,643 Thanks: 614 Thanked 966 Times in 436 Posts	I missed it. I prefer my "-paloozas" as entertainment events, not vehicles for supposed professional growth. __________________ John Ware, PT Fellow of the American Academy of Orthopedic Manual Physical Therapists "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

Thread Tools
Show Printable Version Email this Page
Display Modes
Switch to Linear Mode Hybrid Mode Switch to Threaded Mode