Geoff Bostick

@CaulfieldTim Especially when there is almost no funding for allied health (PT, OT, SLP, Psych, etc). 😢

I still can't believe that the Alberta government is seriously considering funding homeopathy as a way to fix our healthcare system. Terrifying that our leaders don't know how patently absurd this is. Next, flying carpets to fix delays at the airport?

@NathanHutting @DBelardoMD @GregLehman @gantzeac I can buy that anomalies need to be present for a dissection to occur, but since there is no way to easily identify these in your average clinic and given the risks, it is hard to tell a patient that benefit > risk

You can’t say for certain they have zero risk factors unfortunately. A careful clinical reasoning process is very important! Clinicians often have a lack of knowledge and not all risk factors are easy to identify. One of the most difficult things in my opinion is that spontaneous artery dissections also occur. And that anomalies are risk factors for dissection, however, it’s impossible to identify anomalies in the patient history and physical examination. And yes, the current hypothesis is that in most cases people already have an underlying vascular pathology which is subsequently aggravated by treatment. This is plausible as it is very unlike that a healthy blood vessel will be dissected by spinal manipulation.

Heartbroken after seeing a young patient with no medical history, end up with a BIFFL GRADE II dissection of the vertebral artery and subsequent acute PICA infarct immediately after a neck adjustment from the chiropractor. This has to stop. Chiropractors - you HAVE to stop.

@GregLehman @k8purcellphysio @RobSetters @DBelardoMD @IFOMPT When I did it back in the day neck manipulation was part of the curriculum and was examined on it, but I soon learned that almost no one consented to it when I shared the risks, so it quickly disappeared from my practice.

@k8purcellphysio @RobSetters @DBelardoMD @IFOMPT I can’t find anything that @IFOMPT puts out that says one must do cervical manipulation to receive their accreditation. Hence, I don’t understand why you must in Canada. Could @IFOMPT clarify?

@AdamMeakins Adam: you are free to make this argument, but not at the expense of this particular athlete - what you have written does not appear to be supported by facts

@MaxiMiciak Just a tad!!

@BostickUAPT Slightly bigger crowd than when we saw them😜

@Retlouping I think it is strange to study authentic and meaningful therapeutic relationships with highly controlled randomized controlled trials.

Time for me to just give up being nice to patients then?

@FakePTStats Would private practice owners be Mr. Pitt or Jackie Chiles?

@FakePTStats Bubble boy: ICU physios? David Puddy: PT students staring blankly in class then painting their chests yelling at priests on Sat night at a hockey game?

If Seinfeld characters were physical therapy practice setting, a thread.

@JasonGregor @cspotweet "For comparison purposes, a probability sample of this size yields a margin of error no greater than ±2.51%, (19 times out of 20) for the Canadian sample" - so maybe not representative of ABs, but likely Canadians- I've never seen a survey of every single human

@cspotweet come on man. 44% of Albertans don't believe that. 44% of people who did this pole do, but they don't represent the entire province.

Did you know 44% of Albertans believe there's a secret global elite working to establish a world government? Oh, and that 19% claim feminism is a strategy to enable women to control society. #yeg #yyc leger360.com/wp-content/upl…

@GregLehman I was being cheeky, but I don’t think so. Certainly not injury, pain might be another story.

@BostickUAPT Do think something is injured at the time, but you don’t feel it, and then you make the injury worse? This isn’t about delayed onset pain or doing too much too soon.

Bias Check! Are there cases where someone has an injury/pain but they’ve found an activity/movement that feels great. Is it ever possible that that great feeling activity is in fact causing more damage or future pain and they just don’t know it?

@adamdobson123 If that’s the criteria for a master clinician, I’m hooped.

This is quite cringe, actually. Sorry. A 'master' clinician with those hands. Competition with colleagues, sales type metrics. Like a car salesman with superficial swagger. How about. Are you honest. Do you communicate well. Do you provide options & exhibit good reasoning 🧏‍♂️

@GregLehman That’s fair and I hear your frustration

@BostickUAPT Because I was an academic and that was my job. I don’t begrudge clinicians. I’m pissed about academics leading clinicians astray. Even teachers at universities have to listen to academics. The leaders did everyone wrong here and I resent them

Can anyone tell me how manual therapy decision making is better now than 20 years ago? If you were motion palpating and thinking you were specific 20 years ago then you were out of date then as well

@GregLehman You’ve always been ahead of the curve. The rest of us trying to keep up!

@BostickUAPT Fair. But I would say we knew this 10 years before that #physiohipster

Are you a licensed #healthcare professional working in Canada and seeing #chronicpain patients? You're invited to complete an online survey to understand the use of trauma-informed approaches in your clinical practice with your chronic pain patients: sondage.crir.ca/redcap/surveys…

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In Press: Rocío Fortún-Rabadán and co. (@_usj_) report that for women with dysmenorrhea, widespread hyperalgesia occurs throughout the cycle and pressure-induced pain is worst during menstruation. — This pain might be a progressive condition Full: jpain.org/article/S1526-…