Dave & I probably shouldn’t admit this…

Dave & I probably shouldn’t admit this…

Last weeks “things patients apologise for” list seemed to hit a nerve, so I thought I’d keep the confessions going .. except this week, Dave is getting dragged into it too (with me, haha).

Dave and I went to uni together, graduated together in 2012 and both started working as physios in 2013. Which means, somehow, we have now been physios for 13 years each.

26 years of physio experience between us.

That is actually quite disturbing to write because I definitely don’t feel like I have been doing this for 13 years. I also don’t think either of us look old enough to have 26 years of experience between us, but maybe that is a discussion for another day?

We’ve basically done the whole journey together. We went from being idiot uni students, to young physios trying to work out what we were doing, to getting married, having kids (two each) and doing the whole babies, no sleep and parenting thing at pretty much the same time as well. So yeah, we’re very close.

He is also, genuinely, one of the smartest physios I know. I have an enormous amount of respect for him as a physio and I’m very lucky that after all these years I can still walk into the room next door and say “Mate, what do you reckon about this?” and get an opinion from someone I trust enormously, both as a physio and as one of my best mates.

Although … as you’re about to find out, neither of us have everything figured out.

Over the last 13 years we’ve treated thousands of people, seen some very weird injuries, learnt a lot, forgotten a lot and changed our minds about plenty of things we probably thought we knew when we first graduated.

There are also quite a few things that happen as physios that patients probably don’t know about.

So, following on from last week’s blog, I thought another list was in order!

Here are some things that two physios with 26 years of experience probably shouldn’t admit…

1. We talk about you after you leave
Quite a lot actually.
But probably not in the way you’re thinking.
It’s not uncommon for me to finish with a patient, walk into Dave’s room and say something along the lines of:
“Mate, what do you reckon is going on with this shoulder?”
Or vice versa.
Sometimes you get an injury that just doesn’t quite add up. Or you find something interesting in the assessment. Or you have a theory but want another set of eyes on it.
One of the best parts about working with other physios is being able to grab someone whose opinion you trust and say, “This is what I found, this is what I’m thinking… what do you reckon?”

2. We Google (*AI/ChatGPT) things while you’re in the room
Yep.
13 years each and we still do this. Its kinda evolved from Googling to looking things up on ChatGPT.
To be clear, we aren’t sitting there searching “what is a knee?”
It’s more likely something like:
“There is a weird little condition that does exactly this and I haven’t seen it for about six years… what was it called again?”
There is an unbelievable amount of information in physio and healthcare generally. It would be ridiculous to pretend we remember every condition, every test, every medication or every little piece of anatomy we learnt at uni.
Sometimes I’ll even tell a patient, “Hang on, I’m just going to look that up.”
No shame whatsoever.

3. We absolutely judge other physios’ exercises
Okay, maybe “judge” is a little harsh (is it?)
But sometimes a patient will pull out a sheet containing the 14 different exercises they were given somewhere else.
We look at it.
There is a brief moment of silence.
Then we move on.

4. Sometimes we’re just buying time
You know when your physio says:
“Okay, let me just check one more thing…”
Sometimes there is a very clear clinical reason we are checking that one more thing.
Other times our brain is currently trying to put the entire puzzle together.
Not every injury walks through the door looking exactly like the textbook said it would.
Sometimes the first few things you test don’t give you the answer you expected, so you keep looking.
And occasionally “let me check one more thing” really means:
“Give me another 30 seconds here, I’m getting there.”

5. We get excited when you have something weird
Eeeeep.
You’ve had this bizarre pain for six months.
You’ve seen three different people.
Nobody has really been able to work out what’s going on.
You are understandably VERY over it.
Meanwhile, there is a little part of our physio brain going:
“Ooooh… this is interesting.”
Obviously we don’t want anyone to have something seriously wrong with them.
But when you spend your days looking at shoulders, knees, backs and ankles, something unusual gets the brain ticking.
Particularly when we can actually figure it out.

6. Sometimes your treatment is a very educated experiment
This one might actually surprise people.
Physio isn’t always:
You have Problem A → therefore we do Treatment B → problem solved.
Human bodies just don’t work like that.
Sometimes we have a really good theory about what is going on and a really good reason for trying a particular treatment or exercise.
But part of the process is then seeing how you respond.
You come back significantly better? Great.
Nothing changes? Okay, that tells us something too.
You come back and tell us something completely unexpected happened? Also useful.
Sometimes what happens between appointments gives us just as much information as what happens during the assessment.
So yes, occasionally your treatment is an experiment.
Just hopefully a reasonably well-educated one!

7. We’ve both injured ourselves doing things we tell patients not to do
You would think 13 years of treating injuries would make us exceptionally good at avoiding injuries ourselves.
It does not.
We know when we are probably doing too much.
We know when something needs a rest.
We know when we should gradually build something back up.
Do we always follow our own advice?
Absolutely not.
Apparently having a physio degree doesn’t automatically lead to intelligent decision-making at all times.

8. We don’t always do our exercises either
This feels particularly relevant after last week’s blog about all the things patients apologise to me for.
Especially:
“Sorry Tom, I didn’t do my exercises.”
Well…
Neither do we sometimes.
There are few things more humbling than being a physio, getting injured, having another physio give you exercises and then being asked:
“Have you actually been doing these?”
And suddenly you find yourself giving the exact same excuses you have heard from patients for the last 13 years.
“I did them a couple of times…”
“I’ve just been really busy…”
“It actually started feeling better so I sort of stopped…”
We’ve heard them all.
We’ve also USED them all.
So no judgement here.

Okay, we’ve probably admitted enough (LOL)
13 years each.
26 years combined.
Thousands of patients.
And I think one of the biggest things you realise the longer you do this job is that you definitely don’t know everything.
Sometimes you need to ask another physio.
Sometimes you need to look something up.
Sometimes your first idea is wrong.
Sometimes the weird thing you tried works incredibly well.
And sometimes you need to admit that despite spending your entire working life telling other people how to manage their injuries…
you haven’t done your exercises either.

For me personally, one of the best parts of those 13 years is that I’ve basically done the whole thing alongside one of my best mates.
From uni, to our first physio jobs, through 13 years of treating patients, to marriages, babies and now raising our kids at the same time.
And after all of that, I still get to walk into the room next door and ask:
“Mate… what do you reckon?”
Pretty lucky really.