Demonization of Manual Therapy with Chad Cook | Ep. 047

In this episode we will talk about the demonization of and the future of manual therapy with Chad Cook. Chad is physiotherapist, a professor at Duke University and a clinical researcher who has published over 330 peer-reviewed papers. One of the latest papers he has published is called “The Demonization of manual therapy” where he evaluated common critique on manual therapy based on the current literature.

News:
We do have an announcement to make: You might be wondering why you’re listening to a podcast host with a German accent. Our former podcast host Sunny Sandhu has left us to work in the clinic again full-time after hosting our podcast for 46 episodes.
We wish him all the best and his British accent will be dearly missed.

To view and download the bonus content such as transcripts of this episode become a Physiotutors Member.

Content:

00:00:00 - 00:01:46 : Introduction

00:01:46 - 00:02:48 : Chad's definition of MT

00:02:53 - 00:04:54 : The Pendulum has swung too far

00:04:55 - 00:07:20 : How is MT different from other modalities?

00:07:25 - 00:09:04 : Does hypomobility assessment still have a place?

00:09:05 - 00:10:26 : Do we need to be specific with MT?

00:10:28 - 00:13:44 : How to know when to use MT in a patient

00:13:48 - 00:16:37 : Is the cost of current MT education justified?

00:16:40 - 00:21:31 : Time to embrace the placebo effect?

00:21:34 - 00:24:42 : The biggest critique on MT

00:24:44 - 00:26:11 : Are we sending the wrong message to patients?

00:26:14 - 00:32:10 : The value of Costs vs. Patient Satisfaction

00:32:16 - 00:36:05 : How MT education needs to change

00:36:06 - 00:39:24 : The future of MT

00:39:25 - 00:40:34 : Outro

[lislcroft]

As a soft tissue therapist with many years experience working with elite athletes and clients in private clinics who is also a trainer advocating for the active long term physiological and cognitive benefits, I appreciated this podcast very much. All the points re rapport, handling skills, being able to deliver a pinch of what the client needs as well as what they want etc; all so true in real life clinical application and progress. Would love to hear another podcast with Chad Cook. Found your platform today and am a fan.

[FrancescoBellotto]

I find this podcast of exceptional clarity and usefulness. I am an Italian physiotherapist, with four years of experience, and I moved to the German-speaking part of Switzerland two years ago. I have often been confronted with these issues, and I have found it interesting how the culture of the country and above all the type of national healthcare system influences the views of my colleagues in different ways. But Chad's arguments are transversal, supported by scientific evidence, and can be applied in any kind of clinical working environment. I really thank you for this contribution, because it has helped me to reach a new level of awareness and clarity regarding the conception of my daily evidence-based clinical practice.

[pshoyer]

As a therapist who combines manual therapy with active exercise based strategies I absolutely loved this podcast and it cemented all my beliefs in the practices I pursue. I have followed your channel for a long time and you continue to deliver a very high level of content. Thank you.

[jayrodd]

I think this goes back to EBP being best available evidence combined with personal experience. Use it as a tool in your toolbelt rather than an all or nothing approach. Why demonize things like placebo if they work in the context of patient expectations and satisfaction? Are we more concerned with making some move and feel better or doing it a certain way? I also think a big piece of this is education on the front end. When I use manuals I educate my patient ahead of time about that what I’m providing may bring a short term benefit that may help them move better and with potentially less pain during their exercises which will follow the manuals. I also tell them the first time I do manuals that we will eventually be getting rid of manuals because I want them to be able to take control of their own health via their HEP. Bottom line, there are a lot of ways to do this job. Is your method working? If so then great, if not may need to try a different approach on the patient or tweaking your treatment style.

[JeromeFryer]

Wonderful podcast. Thank you both for doing this.

[Prometeus_]

My thanks to you. So exciting to hear such podcast as this. Hope you will continue to do this stuff👍👍👍

[PoiosAftos]

"Locus of control" plays a big role in any therapy. That doesn't necessarily mean that active is better than passive. I think people might be conflating the two concepts when they make these kind of statements.

[honuman]

Very interesting interview. The past 10+ years has felt like pulling the rug out from under manual therapists and my experience of it has been challenging. I'm now more flexible with my approach. I'm just curious, who were the"gurus" you mentioned that manual therapy is still basing some approaches on?

[adriengirones]

Great podcast guys. Thanks for that.

Whether it is passive or active, the important is to find the good Mouvement at the good moment ;-)

- Just too many adds YouTube -

[MrBroda]

Awesome podcast which should be taught in universities!!
Would it be possible, that you also share the links of the papers which were mentioned in the podcast? Personally I would be most interested in the one he mentioned at the end from Adam L. (Lud? Or something like this) from 2021 about the clinical profile.
Thanks for everything that you guys are doing - as a student I really appreciate it!!

[rjeffadpt]

Great video! I would submit that the “active is superior to passive” attitude may be driven by the focus on ‘functional movement’ by insurance companies.

How many times have we heard “but is that functional?”

[ladieesc]

I clicked this video because I have a book by Chad Cook and I wanted to know what he looked like lol; great video though!

[antongiuliomastro]

with the white background you can't see the subtitles