Can We Do Better as Therapists?
There has been no shortage of discussion and coverage over Asafa's trainer, naturally. If you're unfamiliar with why he and Tyson Gay have caused quite a stir on both twitter and blogs alike, simply click on the link above to get a bit of an overview.
Aside from the obvious, what really has been running around in my mind is the topic of unlicensed professionals performing therapy.
In the track world this is not uncommon. Stu MacMillan has talked about this topic at length and I have my own personal opinions. But let me tell you this, I have both seen and know of coaches who do a great job in not only enhancing biomechanical performance through various means but also in preventing injuries. And I have seen coaches who have absolutely no business putting their hands on their athletes.
So why the need for coaches doing manual therapy anyway? Are we as clinicians lacking the necessary skill set to work with this demographic? Sure we may be trained in the gold standard of soft tissue therapy and know the latest in fascial research. And sure our websites may list the dozens of courses we've taken. But why then, do coaches feel the need to take it into their own hands (pun intended) and do the work themselves?
In my opinion, we (clinicians) need to stop pointing fingers, worrying about who's licensed and who's not, and start looking in the mirror. Because sure they may not be certified, but frankly, many of us aren't qualified.
Rehabilitation isn't just strengthen this and release that. Perhaps in the really early stages of injury it may be reasonable and effective to treat within the confines of a clinic. But in the later stages of rehab, let alone a healthy athlete, if the therapist isn't "trackside" then I don't know how precise they can be.
And this is why I still have some difficulty in comprehending core medical teams during major competitions. How do you know your athlete's personality and what they look like in action - not to mention competition - when you're confined to a polyclinic or the therapy tent?
Injury prevention additionally isn't just strengthen this muscle and activate that. And table tests and "functional testing" in the clinic aren't always what they seem once the spikes are on. We need to understand what variables, specific to that individual IN their sport, may predispose them to specific injuries. Biomechanically, we need to know how far they deviate from the ideal model and systemically, we need to know when they're deviating from homeostasis.
And I don't think we can be 100% precise without being present.
Finally, performance enhancement is well, a different beast all together. There are far too many variables involved in this realm and unless a dynamic, almost daily, communicative relationship is present amongst the athlete, coach(es), scientist/support staff, and therapist is present, then I don't think it can truly be performance enhancement.
So what's the answer? Time? Education? Financial compensation?
If the latter, then I strongly think we (again, the clinicians) need to revisit the certification vs qualification question.
Because in general, overconfidence and entitlement are the first two words that come to mind.
We first need to start paying our dues and earn the trust of the coaches. And maybe then the issue of whether a person is certified becomes a non-issue altogether.
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