But how do they know, and how do we know, what exercises are of benefit and how to do them 'correctly'? There are no meaningful trials for most of these things. How did they 'find out' that they were useful or correct? People get better after seeing physios just as they get better for no particular reason quite often. Having worked for years with physios I never heard of them having any real evidence for an exercise being useful other than some other physio said it was good.
The NHS should not be wasting time and money on unproven treatments, in whatever form.
I worry that the myth that physios can do you good with exercises has done the ME/CFS community an awful lot of harm and is still doing so.
There are likely cases where this applies, very specific cases, but it's obvious that the promises of rehabilitation have been wildly inflated based on wishful thinking. It even almost plays a magical role: if you can't treat illness, then you can rehabilitate it, which is not a treatment, but also is. Based on... vibes, it seems.
Earlier this year, my father slipped on ice, and probably tore a ligament or muscle in his groin. Fortunately, no bone damage. He had to use a wheelchair for months. Once he was able to, he went to see physical therapists, who he had seen many times over the years. They advised a few exercises, but my father being who he is, he had the mentality that if a few exercises were good, then more should be better. And he overdid it a bit, while still slowly improving, the natural course of biology doing its thing. Then he reduced the exercises, and things got even better from there.
But he also has a few quirky beliefs, such as acupuncture. So he took an emergency appointment, literally spent 4h in traffic for it because it was worth it to him, and although he was already feeling better generally, he thought the acupuncture must have worked. He went back once, and cancelled his physical therapy appointments.
The passage of time did its thing. Had he only seen physical therapists, he would likely have attributed some of it to them. But he believes in acupuncture more, and so decided that it was that. Even though had he just done things at his own pace, moved when the pain was improving, it would have likely ended up all the same. Most people can figure that out with minimal knowledge and common sense.
There's very likely as much of this going on about acupuncture, and other alternative medicine, as with physical therapy. Not that the role is not needed in some cases, but the evidence seems generally very lousy, so it's very difficult to know what works and what doesn't, and there's obviously a heavy bias towards it being good, simply because it's meant to be good. The process is judged based on its intentions, not its results. As is tradition.
www.theguardian.com
