S2W4: Physio Culture

This week I discovered Pinterest! So I've put up some images that seemed relevant to physio! Looking through the images I noted that there were different cultural ideas associated with the images and so I thought it would be interesting to discuss the culture of physiotherapy, at least superficially for the first two paragraphs anyway!

You may remember different social groups at high school - it probably reflects similarly to the movie "The Breakfast Club" directed by John Hughes. At university we hope to be more culturally aware but we still gravitate to certain people who share similar cultural norms or to fill our own social needs. Just for crudeness sake I'm going to match physio disciplines to a stereotype like in the movie 'The Breakfast Club' (in reality it is not like this at all): private practice musculoskeletal practitioners are the 'Jocks', neurological physiotherapists are the 'Nerds' and cardiopulmonary physios are the 'Princess/Prince'. But in reality we are all jocks, nerds and princess/princes... and probably outcasts too (just like the movie portrays). Note that none of us are criminals! (Parking tickets don't count - we have 'police vetting' next week which shall deem us 'safe' to practice in a clinical setting). As therapists we create our own identity which shows through in our treatments. Some therapists are known to be 'hands off' (that was the case for our MSK lecturer, who appeared to love the idea of not having to palpate the patient) whilst many therapist's touch feels empathetic and you know you will be taken care of. Other therapists have a firm touch and you know there will be no mucking about! Hopefully they don't rip your limb off when clearing joints!

There is a culture within Physio students at the University of Otago to be widely accepting of one another. We're all a bit different, and that is perfectly fine. There is a sense of unity between students. Furthermore, we don't feel pressured to compete against each other for the best marks (like medical students may) which allows us to compete against ourselves and to achieve the best patient outcomes. We are known to share and discuss ideas openly but when it comes to answering questions in class the cultural norm is to hide behind your notes. However there is always a voice or two that has a go - followed by a friendly response by the lecturer. Our understanding is what matters at the end of the day! It's very hard to explain cultural identity when you consider the diverse upbringing of each student and generalise across the student cohort. I could talk to you about cultures surrounding ethnicity, gender, sexuality, socioeconomic status, religion, disability, education... but it'd be too long for this blog. With all these differences, at least we have physiotherapy in common!

Placement! I'm placed at Unipol (the Otago University student's fitness centre) for the chronic disease exercise class (we just call it the diabetes exercise class haha). This placement required some pre-placement reading/refreshing on diabetes and other common chronic conditions with questions being asked before we began to ensure that we understood the conditions.. This is a community class but most participants are referred by their local general practitioner or from Diabetes education through their district health board. I had one patient with poorly controlled diabetes decide to increase their resistance on the cycle ergometer while I was off assisting another patient (my supervisor spotted them working with their HR nearly at their predicted maximal! Oh dear!!)

On Friday morning after our pharm lecture we decided to make the most of the stunning weather by going sand skiing!

Phty254: McKenzie management of low back pain featured this week. We learned about mechanical diagnosis therapy (MDT) for the lumbar region. This was pioneered by the NZ physio legend (Robin McKenzie) that invented the 'lumbar roll'! The lecturer was very keen on us identifying 'derangement', often overemphasising "derangement" in different tones for humorous effect. I was very amused by this. I was also used as a demonstration model for the therapeutic movement which meant continually moving my hips between two postural positions (e.g. hips poking out to the left then right) while the lecturer discussed points. The second MSK lab focused on clinical biomechanics of the foot and prescription of footwear.

Phty250: Muscles of the hip and thigh were covered this week. We were also given an anatomy assignment last week which I think is due next week. I chose to research the adductor longus muscle of the thigh, in particular any anatomical conflicts in the literature. For example, the adductor longus muscle is not reported to have fibres attaching to the rectus sheath at the proximal attachement in anatomy text books, however in dissection studies the fibres are said to be fused (this could have clinical relevance for patients with groin pain).

Tip for surviving physio: backup your electronic assignments to a cloud service like Dropbox (or email them to yourself). My flatmate lost her assignment due to a computer malfunction - lets all learn from this and prevent such a disaster happening to ourselves!

Phty252: The pharm lab this week had us physio kids consuming drugs (well... one drug)! We were measuring heart rate and peak expiratory flow rate after low and high intensity exercise, then again after taking metoprolol! Metoprolol is a b-Blocker which decreases heart rate and heart contractility. There is nothing much to add here (you can probably guess what happened to our measured variables). I think it is interesting that the pill is heart-shaped! The stamp is for the unlikely incident of an adverse reaction - it is so the medical staff know what we had consumed. The lecturer supervising the lab had a keen sense of humour; we were talking about the assignment which required looking up drugs on MIMS or Medsafe, "In my day I use to walk to uni in the snow... wait that's a different story! In my job I look up drugs every day that I don't know about - you should get into the habit too".

I found some physio related memes on Pinterest / internet too! ...