Why Biomechanics Matter | The Pitfalls of Science and Physiotherapy, With Louis Ellery
ฝัง
- เผยแพร่เมื่อ 16 ต.ค. 2024
- FP HBS Louis Ellery breaks down the dogma that "Biomechanics Don't Influence Pain..."
As a certified Physiotherapist, he sheds some light on the knowledge gaps that exist between standardized physical treatments and the practice of fixing biomechanics.
00:01 - Biomechanics matter
00:15 - Intro
00:34 - Functional Podcast
01:00 - Physios have no reference to what we do
01:40 - Zadrow 2019
02:30 - Results Matter Most
02:59 - Peer review is flawed and the research on mechanics is flawed
03:52 - Publication and Replication bias
04:15 - Research Article Summary
04:30 - "Substantial Decline"
05:10 - "Science is never settled.."
05:35 - FP Agrees With Science
05:55 - Research on Biomechanics
06:32 - Patient Demographics
06:54 - Population of research was elite/pro athletes
07:21 - Testing positions
07:40 - "Twelve of the included studies"
08:47 - "Risk of bias assessment "
09:05 - No longitudinal studies presented
09:33 - Summary of research given to us
10:32 - Final Study
10:49 - "Corrective Exercises"
11:17 - Biopsychosocial Model, and FP Metrics
12:22 - Final Points
12:40 - Burden of Proof
13:05 - Challenge to Physios
13:20 - Results
13:28 - Outro
Functional Podcast With Naudi Aguilar:
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Reference Articles:
bmjopen.bmj.co...
pubmed.ncbi.nl...
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Perfectly summarised 👏 hopefully it helps some people to understand how to think critically and get out of pain
Great breakdown here Lou! As a physio and FP prac I can totally agree with the points raised in this video. I jumped off the sinking ship that is modern physio about 5 years ago when I came across Functional Patterns. Really happy to see such a detailed breakdown here that can explain why the 'science' led physio I was using with clients was failing.
You're a physio? Where? Do you bill for FP in your practice?
Great video thanks very much! Loving the direction FP's moving with various videos with indepth explanations. I feel it helps people outside of FP understand the methodology better aswell as future Practioners like myself, to really get down to the details of what's to come! Thanks again:-)
Great video Lou, thanks for sifting through and breaking it all down . We get plenty of people who've been to countless physios, osteos and chiros who could not produce the same results as our pracs here in Melbourne. Hopefully this clip will help those on the fence rationalise more effectively, using first principles rather than outsourcing they're thinking to outdated and biased data.
Great delivery of the current research and their limitations. Hopefully the industry will adopt Functional Patterns’ higher standards when treating and correcting their clients dysfunctions. #fpisthestandard
Great video. Thanks for doing it and can't wait for the next one.
Fantastic explanation and great inisght ! In the first year of study of physical therapy I found FP . This definitely lead to some disilusionment with my studies when i felt what i was learning couldnt truly help my clients , but seeing physios and PT's who have made the shift to FP definitely is uplifting . Begining this shift myself with the HF course in september . Can't wait :)
Fantastic video Lou. Thanks for sifting through the research 🤘🏽
Great stuff Lou, brilliantly delivered
What ultimately sold me on FP being the standard is, simply, the results they get. It's amazing how people will point to "science" and "research" , however, completely overlook the real-world examples that are available.
I ran a little experiment with myself. I LOVE bodybuilding and building lean mass, however, I was in pain frequently. I told myself "I'll bodybuild for a few more months, and if my symptoms are the same or worse, I'll adopt FP as my full-time training approach". Needless to say, I've transitioned over to FP entirely and, even in the little time i've been doing it, I feel significantly better and healthier; FP is the biggest industry disruptor (Massage Therapy; Chiropractic; P.T.; Big Pharma; etc.) out there!
Hey Louis great depth in the video!! Do you see FP doing a series of courses on how to improve movement via gait? I have studied FP 10 wk course and got exercises via online FP demos to help better understand my gait issues! However an in-depth step by step improvement for running would be awesome, I hope to do the bio course when time allows👍 I would love to see a video on how to best train an elite athlete in their sport using FP? Good luck
Great video, nice to see the breakdown of these studies and their limitations.
Great video. Also a Physiotherapist here and couldn't agree more. the Pendulum has swung way too far into the psychosocial side of the biopsychsolcial model
Great video! Converted physio giving us an inside look 🔥
Great to see information being discerned like this for those who haven't looked into the science for themselves
Great explanation! Folks will eventually come to their senses..... hopefully before injury!
Great video Louis! I think that this is the kind of content that will stand the test of time and provides a great resource for people who question FP.
Years of physios never helped me nearly as much as fp Is doing right now.People need to know there Is a better alternative,thanks for making this video up💯💯
Surgical with the dissection of this information by Lou. Solid work
Great video, i’ll use it when people are too attached to peer-reviewed science.
Great video, thanks for breaking it down the research.
Solid, well balanced presentation
This was a very well crafted argument, great video
As a podiatrist that uses Taiji based exercises to assist with clinical outcomes I agree with the sentiments….basically it’s complicated this biomechanics thing we talk about however our patients just want to have better balance and move hopefully without pain.
All stems from Anatomy Trains. That book changed my life.
Keep people sick and chemically induced, never look at people's mechanics.
What happens when we start looking at metaphysical elements?
Grounding and earthing whilst sleeping needs a good look at.
Keep up the good work ❤
I enjoy these videos 👌🏽
Well thought out and coherent 👏🏽
100% I have been explaining this for almost a decade! Well said
This guy should always speak for Naudi. A much better spokesperson for FP by far. This guy makes me want to give FP another shot.
Great video thanks for the content.
@ 2:00 you cite a study that says 46% of physio's don't follow best practice guidlines (Evidence informed guidelines) and then mocking the profession, and here you are promoting FP which has no evidence at all. Does that even make sense?
The smoking 🔫. Great job Lou and the fp research team
Great video thanks lou 👊🏽
Great explanation Lou, thanks!
Well said Lou!
Nice Lou! Awesome work 👍🏼
This system is opening a new era…
Awesome video thank you guys for this
Does FP program and periodize their exercises?
some good points made but really ion the topic of why much of physiotherapy is not scientifically supported, and why the public (and medical funds) should really be referred to an exercise physiologist or biomechanist (an actual university qualified one), where their assessments definitely consider regional interdependence and gravitational impact on individual joint mobility and stability.
More free and transparent explanation of how the very first FP exercises were developed and tested would be good, otherwise just jumping around doing twist actions isn't necessarily "biomechanics".
I know it's kinda a flashy request, but can we please get a big cut of a ton of different populations or demographics getting the before and after treatment from FP. Like specifically I think injured or disabled populations, like a physio would work with would be awesome! Been following for years and most of the best stuff is spread across Instagram 😂
yeah this would be cool
have a look at the website under "results". There you can sort the results by issue
Interesting video, great information! Thank you.
What would you recommend for 65yr old who recently bruised the left I.T. Band & possibly peroneal nerve while doing body weight forward lunge. P.T. has me doing much stretching & single leg exercises afterwards cold therapy. I can only squat to about parallel without pain or difficulty, any further down immediate discomfort & fear of more damage.
Hx:
right hip Birmingham procedure...'08/yr
Both knees tears meniscus '11 & '20/yrs.
Injury in April.
Has gotten a little better but cannot sit for long period...sciatic gets affected. Much walking affects it. Laying down or just standing is ok.
Just want my normalcy back or much better.
Hey Reece,
Would be irresponsible of me to try give you direct advice online- if you check out functionalpatterns.com there’s a practitioner map on there, otherwise in general advice I would tell you that sciatica and chronic knee issues are pretty common in a lot of our clients when they first come in.
I’d back off the stretching, add some myofascial release if you’re able to and check out functionalpatterns.com for some ideas to get exercising again
Thank you.
I had earlier checked the web site but I'm in mississippi & no one for this area. I have been going to massage therapist (sorry forgot to mention that), had deep tissue, scraped, & cupping done but it's temporal.....BUT it does help. P.T. therapist among massage therapist plus chiropractors & doctors have all said I was extremely tight around hip area. I warm up before any stretching & exercise.
Thank you though. 😊
I appreciate your response !! Much success!!
Great video Louis very informative. #fpisthestandard
@ 3:00 If a PT uses a Mulligan's MWM to affect dorsiflexion, he has effectively affected mechanics. Are you sure you went to physio school?
Agree with Benestad's quote, and more or less, it is in many circumstances where, of course as you mention, the research capabilities are not completely dominated by, dare I say, pharameceutical research.
Here is where FP has an advantage, in sports performance, it is NOT. If you can prove FP protocols to be superior to best practice S&C at the moment, then the protocols would be readily assimilated. There is no way you can convince me, or anyone else who is serious about seeing real results tested that the industry would ignore FP if it could consistently prove that it is superior at injury prevention and performance enhancement. You have a whole world of sports teams that would switch over in a heart beat if you can prove that you can lower their injury % and bring back athletes from injuries faster.
The problem is, you don't have that data. Naudi and the crew continue to make those claims, but they are ANECDOTAL and you should understand that this doesn't count because you cannot account for what changes exactly happened. Maybe the participant never really pursued a sound strengthening program before. You don't know.
I find it also interesting that Naudi constantly says that you cannot attribute strength gains to a squat, for example, because you cannot account for EVERYTHING ELSE THAT ATHLETE DOES, or that athletes INNATE ATHLETIC ABILITY, but then makes the reverse claim for FP.
That's hypocritical.
@2:48 you ask "Can you show me that these studies can be replicated on the population you are treating!"
Is this a serious question?
Bobath on Parkinsons
Maitlans on Spinal conditions
Mulligan's etc
All evidence informed, based, etc, and all used on the population that physio's are treating if the physio decides to use that tool.
Where is FP's evidence?
You aren't seriously saying testimonials and before/after pictures are evidence, are you?
Where were you in school when evidence was explained.
A good fitness coach can demonstrate many of the changes in physique that the majority of FP before/after pictures show.
One can look up Jeff Cavaliere, a famous S&C Physical Therapist from the US and the plethora of "before/after" pictures of people who have done his courses. Their posture, physiques all notably improve.
Is this scientific evidence, or evidence that resistance training works?
Peer Review is inherently flawed?
Why again?
So if Naudi took speed, as he regularly claims his FP improves speed over traditional speed coaching/training, and sought to actually PROVE IT. How does he do it without studying it's effects on a group of athletes over traditional speed training methods?
A test variable, one only, like the 30m sprint with track athletes randomly put into FP or Control groups is as basic a scientific study that one could perform, but it would give real world data, would it not?
Explain how that is flawed.
Very informative! Good job sir! #fpallday
Thanks a lot
You're right, the bar has been set very low. Unfortunately humans are mainly sedentary species now and so any increase in bar height for the general population will be impractical and physios would not make any money. In 100 years' time, walking will be something only people from 3rd world countries will do.
great
Biomenchanics matter, their is optimal posture and length tension relationships. Their is fualty movement patterns, their is joint dysfucntions, modern science says muscles cant shorten , excess tension, they are agianst myofascail release ...this is leaving people with no results and chronic pain and eveb disability due to muscle becoming fibrotic
At 0:15 you make a false claim and argument. Physio's don't claim that biomechanics don't matter. IN the case of some chronic conditions the bio psycho social model becomes relevant because people's physiologies have made physical changes where non noxious stimuli is now being perceived as noxious to the brain and therefore pain is exacerbated. That is called upregulation and centralization of pain.
There are proven evidence based methods to deal with that.
Physio's are being trained to understand how to make those distinctions.
To say that physio's don't correct mechanics is to throw out the WHOLE BODY OF evidence for practices, validated in physiotherapy reserach, like McKenzie, Mulligan, Mailtand that are ALL mechanical and biomechanical in nature.
You're making a broad statement that is FALSE.
3 years of functional patterns, still out of shape (gut) and poor thoracic extensors, and inevitably injures himself doing FP needing PHYSICAL THERAPY and Imaging.
of course, cognitive bias kicks in and he claims FP didn't injure him, just that he hadn't done it in a while and then went back to an FP exercise and INJURED HIMSELF WITH THAT EXERCISE.
Can't make this stuff up
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