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PT and the Greater Good

A Culture of 'Don't!'

Published April 9, 2014 2:05 PM by Dean Metz

I was doing some research on a particular activity this week... head rolls. Not the soft round things one puts under one's neck to maintain the curve while supine, but the act of rolling the head around as an exercise or activity. I did this because I read an article in the popular press that said, "even physiotherapists say you shouldn't do head rolls anymore. They're too dangerous!" I thought about it, and although I haven't prescribed this for someone in recent memory (or at all that I can think of), I wanted to see if there was evidence to support the statement.

In terms of hard evidence, I came up with nothing. I did come up with pages of discussion on the topic from the members' section of the Chartered Society of Physiotherapy (CSP) though. Comments ranged from "Under no circumstances should anyone, ever do this!" to "If the body wasn't meant to move that way, it probably wouldn't." Granted, I probably accelerated the OA in my own neck by way too many Friday nights in the East Village of New York in the 1980s dancing the pogo and whipping my head around. Ah youth! There were a few reasoned discussions about athletes, dancers, and even jet pilots who would need to perform this activity to be able to function. Still a few physios held onto the belief that if an activity has any risk, it should be discouraged.

Since when have we become the profession of "Don't"? Shouldn't we be the profession of "Do... but do it right!" Our job is not to wrap every patient in cotton wool and tell them to avoid injury by avoiding doing things. Personal trainers, fitness "experts" and yoga instructors are teaching people how to keep doing things. (Oh, I just started yoga two months ago. Apparently I'm flirting with certain death according to some of the physios). These professionals may or may not be giving good information, but they are reaching the people we are not. Remember my post about working proactively and toward prevention? One good example of how we're not embracing that mindset on the whole.

So lets embrace, "I can help you do that better and safer!" whether it be a break dancer in the Bronx or a pensioner who wants to go shopping in Brighton. We are the ones for the job.

Do take my advice on the pogo though... don't revive it, it really isn't good for one's neck.

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The problem with evidence is someone actually has to do the research and that research has to be publishable.  Now days research is geared to what will be published rather than what we need to know.  Very rarely is negative research, as in this won't be dangerous, be published.

We need to use common sense and remember to do things correctly.

Toni April 11, 2014 7:39 PM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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