03/09/2026
If only we had 🤔😉😸🐾
Science evolves ….and as we learn more about many of the common conditions that we see and treat, then the things that we do to help sometimes change.
Sometimes they are dismissed with good reason, sometimes they may remain valid treatment approaches, but under a new understanding and with a new narrative or framework.
However, often the baby gets thrown out with the bath water, and the pendulum swings too far from one side to the polar opposite.
Rather than simply changing the narrative or our understanding around certain things that we do, we completely dismiss them, we label them evil and we chastise any therapist who still uses or advocates for them (whatever the supporting narrative!).
A great example of this revolves around pain relief and symptom modification for plantar fasciopathy.
Many moons ago, as a young therapist (no comments please 🤭😁) in the industry one of our front-line approaches as a “fix” or “cure” for this common condition was to roll a frozen bottle as ice massage under the foot, or get patients to use some hard object like a ball to massage the painful area.
At the time we used phrases like “this will release the tissue”, “break down the scar tissue” because that’s what the science and our best intentions suggested was the mechanism of effect.
Fast forward a decade (or two!🤭) and our understanding of the condition has evolved.💡🤔
We understand a specific graded loading and strength programme coupled with some activity modification is the best approach to gain long term relief and a return to activity.
Allied to this I now hear therapists telling people NOT to rub a ball under the foot or use a frozen ice bottle for some massage.
Yet alongside the fundamental rehab that is needed and understood these days, why shouldn’t they use these old techniques if it helps relieve pain, settle symptoms and allows them to complete the required rehab with less aggravation?👌🤔
There is no reason people can't still do these things: its self-managed, cheap and has little to no negative effects if framed within the correct narrative and understanding of what it is, and more importantly isn’t doing.
Of course they shouldn’t be the primary care treatment choice, of course they shouldn’t be the sole👣 treatment choice, of course the outdated narrative of mechanism of effect shouldn’t be used.
But it’s absolutely still okay to do some of these adjuncts, and as therapists we shouldn’t be so lazy to just dismiss them categorically, because of the contempt we hold these concepts in based on old concepts and context or their misuse by some today.
I just tell them “ you now know what it does and you know what it doesn’t do, you also know the stuff we really need you to do...as long as that’s getting down than I’m absolutely good with you trying it if you think it will help”.👍
This doesn’t mean I give carte blanche approval for ANYTHING to be used, but there are so many self-help things for everyday injuries and conditions that are thrown out as the proverbial baby with the bath water without a second thought.
Even a "kiss it better", or put some "spit on it" can help 🐾👌💖
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