Shoulder Sling

TheKettleBellPhysioBlog, Evidence, Kettlebells, Pain, Shoulder, The Kettlebell Physio, Uncategorized0 Comments

Adam Meakins, The Sports Physio

His style of communication is noticeably not to everyone’s taste (see #physiotalk) and he’s certainly upset a few ‘Dinosaurs’ – “the iconic, influential and idolised clinicians and researchers who, despite a new ara in understanding pain and growing evidence of the biopsychosocial model, still stubbornly refuse to change their methods or mind-set, and continue to promote and teach outdated methods of assessment and treatment” http://bjsm.bmj.com/content/early/2015/08/03/bjsports-2015-095282.short?rss=1

He may be a loud and brash and sound a bit ‘funny’ with his London accent, but he’s by no means the only one promoting the same message of progress and pushing evidence-informed practice in physical therapies. The same message of progress was evident at the recent IFOMPT conference with the various discussion surrounding the stark contrast between Brian Mulligan and Lorimer Moseley. There was a lot about this from Jack Chew and @TPMPodcast (http://www.physio-pedia.com/conferences/ifompt/author/jack-chew/) and Sigurd Mikkelsen in particular.

From what I see on social media Adam’s one of the most prolific sharers of clinical research, yet people appear to be critical of Adam the person rather than critiquing the ideas, discussion, questions and evidence.

Regardless of personal opinion of Adam’s delivery, there’s no doubt that he’s more often than not right on the money. Rarely if ever does he share opinion pieces or stories based on personal anecdote – quite the opposite. I’m often confused by the (occasional) passionately negative response to his narrative based upon evidence from clinical trials – that’s not opinion and anecdote, that’s someone sharing evidence for discussion to help improve our practice and clinical outcomes. It’s also good to see him holding other people (the ‘gurus’) accountable and challenging them – Dr Derek Griffin and Diane Jacobs have both been in his sights this week.

His recent article about the use of shoulder slings following surgery is a good example: https://thesportsphysio.wordpress.com/2016/09/30/slings-of-outrageous-mis-fortune/

“So in summary the use of arm slings after shoulder dislocation and rotator cuff surgery has some common misconceptions and can cause some misfortune in producing some negative physical and psychological effects that may be detrimental to long term outcomes. However, although I do often see arm slings being used way too much, for way too long, I also see them helping some patients if used for the right reason and used judiciously and sensibly.”

It is no more than a commentary discussing current evidence, some of which contradicts current practices, supported by no less than 10 references. It’s hard to keep up with the rate of change in the field of physical therapies and the same is true of post-surgical guidelines – Continues Passive Motion machines used to be the norm following knee operations.

Based on the evidence Adam has highlighted, Clinical Edge has turned the post into an infographic, it will be included within the @clinicaledge online sports injury conference, and it’s been publicly praised by several well-respected clinicians and researchers, Assit. Prof Rich Willy, Paul Westwood and David Pope to name a few.

There’s a cost to progress in clinical practice; dissonance. Embrace it I say.

Rey Allen made this comment elsewhere yesterday:

“”I’m fascinated with the dissonance we all face when being introduce to these concepts. For myself, it was really really hard, moving away from the tissue-centered/tissue-explaining model. My entire professional identity went into chaos. It took me years to regroup, reconceptualize and redefine my work and my professional purpose. Pain science isn’t for sissies and it certainly isn’t a place for those of us with a heroes-complex. And if you didn’t know you had a heroes-complex pain science will certainly point it out. It’s a tough thing, admitting to how limited we are and how out of control things really are. It’s ego-depleting. In my own practice, I’ve had to move all of my focus away from me-centered (my goals, my knowing what’s best, my all powerful skill set) and into becoming a patient advocate. Even though I’m more clear how limited my skills are I think I’m producing about the same results. Sadly, I’m not as special as I thought I was but all-in-all it’s really had a profound change in my life in how I related to the people closest to me. In a way, all this pain science stuff has made room for more maturity in my life in ways I would have never expected.”

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