This blog is something that is perhaps self-indulgent, but I think there are some useful nuggets to take away from it. In my humble opinion.
The last 10 years has been a huge learning curve for us. We have come into physio business ownership with no business ownership knowledge (how dumb!) in the middle of the global financial crisis (oh, really dumb!) but thankfully we are still going strong.
A lot has changed over this time in the world, and more specifically in the medical and physio world. New knowledge has come as other pieces of ‘knowledge’ have been disproven.
Foundational knowledge
There is one lesson that I have learnt that I think is worth sharing. There is ‘knowledge’ and there is ‘foundational knowledge’.
I don’t know where I first heard the term ‘foundational knowledge’ but it has stuck with me.
To me, it means ‘knowledge that is true and will always be true’.
Rock solid stuff. Like gravity. And morals and ethics.
Some things that we learn through life seem foundational at the time but are later disproven or modified as new knowledge comes to the fore, perhaps through research.
Examples of foundational knowledge that really wasn’t foundational
Take for example LARS surgery for ACL reconstruction. It was the bee’s knees for a while back there (10-15 years ago) and everyone was returning to sport so much sooner. Now, orthopaedic surgeons won’t touch it with a barge pole (see an article from the ABC website here).
Or a topic even more dear to my heart – coffee preparation. When I started my coffee journey, there was a golden rule of 25-30 mls in 25-30 seconds. It was unquestionable. Now they talk in ratios of input weight vs output weight which varies for each coffee, batch, roast depth etc.
Or even the tamping pressure! This was always always always 15 kg – it was an absolute constant. Now the thinking has completely changed on this. Heavy stuff!
But it does make you think about things that are just accepted to be true. Are they really true or is that just a kind of consensus that hasn’t been questioned?
Foundational knowledge in physio
In the manual therapy world, there have always been fads and phases to treatment.
But surely there are things that are foundational, like using ice with acute injuries, and the harms of ‘bad’ sitting posture? And the concept that has spawned many a physio practice names – THE CORE?
Well guess what?
Ice is no longer thought about the same way (upcoming blog topic), sitting posture is not the cause of all evil either (upcoming blog topic) and I know it might seem blasphemous, but the core isn’t all that it is cracked up to be either (probably should be an upcoming blog topic too!)
So what knowledge will remain true long after we are no longer on this earth?
I picked out three things:
1. The value of education and understanding your condition
There is no doubt that education is foundational and something that has gradually become embraced by health professionals, though not by all.
Education means not just understanding what not to do, but more importantly understanding what to do. What is happening in your body, what you believe and how it might influence things, what you can do to help yourself, what is realistic, what the relevance of examination findings are, what the research says about certain things and much more.
The other part of education is how to teach, when to teach and when not to teach, what kind of language to use to convey the knowledge and much more.
2. The importance of understanding and helping people to understand pain biology
There is enough evidence to say that the man/woman/person on the street can understand pain biology and that health professionals tend to underestimate how much their patients will understand.
Though this isn’t universally practiced like it should be, the tide is turning.
The importance of understanding pain biology is definitely increased in conditions where pain lasts beyond tissue healing times (chronic or persistent pain).
I think it is just as important in acute pain, to reduce the onset of chronic painful conditions.
But in my humble opinion, the more that the everyday person without a problem can understand how pain works, and reduce the ‘threat value’ of pain in advance, the less likely they may end up with a persistent pain problem if they do suffer an injury.
3. The value of exercise across many areas of health
What else is there to say? Exercise is a vital part of helping and preventing so many chronic diseases it is amazing. For example:
- controlling weight
- reducing risk of heart disease
- help manage blood sugar and insulin levels
- help quit smoking
- improve mental health and mood
- help thinking, learning and judgement skills stay sharp as you age
- strengthen bones and muscles
- reduce the risk of some cancers
- reduce risk of falls
- improve sleep
- increase your chances of living longer and last but not least…
- improve sexual health
If you were looking for a panacea for pain, illness and prevention, this is as close as you can get.
If only the pharmaceutical companies could trademark it and put it into slow-release capsule form…..
There are undoubtedly many more pieces of foundational knowledge, but these are the three that I felt were worth picking out.
And I hope that in 10 years time, I don’t live to regret these words!
