We’re all out of low hanging fruit

There’s been some tasty fruit on the low branches of the MSK tree in recent decades. Things hurt because they were damaged, so we healed them with massage, ultrasound and activation exercises. Things hurt because they were held badly at rest, so we trained posture. Things hurt because people moved badly, so we corrected their biomechanical faults. Things hurt because the nervous system had become sensitised, so we recalibrated it with education and CBT. Things hurt because demand had exceeded capacity, so we adjusted training loads. Delicious.

These fruits were different types and flavours, some more similar than others, some more familiar than others, some more palatable than others. But they were accessible, they were intuitive and they were low hanging; so we gobbled them up.

But the global health burden of MSK disorders and diseases is at an all time high, the contribution of these issues to long term health conditions is increasingly evident and the reputation of MSK therapists of all stripes isn’t sparking universal professional pride.

So what are the low branches yielding this time? What tools, techniques or paradigms can be devoured as our next fashion trend?

Spoiler alert: They’re empty.

The world is an ever more complex and challenging place with a state of flux persisting across many domains from the economic and cultural to the spiritual and political. You enlightened MSKMag readers know all too well how much these can influence both health and healthcare, so whether you’ve joined the dots yet or not you’ll have noticed that your patients require more and more tailored fruit salads. And not always solely containing the garden variety produce we are used to.

As ever though, I remain an optimist…not because I’m naive and on a sugar high from succumbing to a sudden fructose craving… but because I edit MSKMag, host Therapy Live and probe the finest minds in the game with waffly questions each week on The Physio Matters Podcast.

Some of them grace this bumper July edition and articulate with far less tortured metaphors than me that we MUST think laterally and combine approaches thoroughly to meet the needs and expectations of our patients and the public.

Adam Dobson knows more than most about how common and disabling sciatica is but isn’t complacent for a second, so is here explaining when it’s NOT in fact the correct diagnosis. These days, Chews Health’s former clinical lead loathes marketing cowboys as much as he did clinical cowboys in his glory years! Mark R. coins ‘Evidence Based Marketing’ in this month’s business piece. Claire Minshull PhD doesn’t require any objective measurement devices to evidence that she is one of the finest educators in the MSK game. In this issue she challenges us to be better with our dynamometry. Alistair Beverley opens his excellent piece ‘The Toll of Our Indifference’ with an admission that very much inspired this editorial; we must do differently or risk complicity in an even worse future for those with learning disabilities and beyond. I rarely forget how brilliant Michelle Angus is at cutting through the noise, but she gave me a cracking reminder this month. Her piece; ‘Saying ‘no red flags’ is a red flag’ will hold an awkward mirror up in front of you. It did me.

Finally, the mighty Jo Turner reflects on the recent news that the use of an AI tool in NHS MSK care is being called a ‘Physiotherapy Service’… let’s be honest, she’d have been writing about it as our agony aunt ‘Auntie Version’ next month if she didn’t tackle it head on. It’s fair to say theres some worry in the air.

Clinically reasoned, personalised, functional rehabilitation won’t pick itself.

Get foraging.

Jack Chew

Editor in Chief

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