We've Come A Long Way Baby

I suppose you know by now that I've been at this stuff for a long time.  As of December, I will have been a physical therapist for 38 years.  I've been an athletic trainer for 32 years.

I have a hard time even fathoming all that.  Heck, it doesn't even seem like I should be 38 years old.  

The reality is that I've been a father for almost that long.

Health care in general and physical therapy, athletic training, and sports medicine in particular bear no resemblance today to what it was then.

A couple of weeks ago, I talked about physical therapy treatment of back pain.  Things like body mechanics, core strength, fitness, and weight control today serve as the basics for evidence-based physical therapy care of back pain.

In 1977, it was hot packs, ultrasound, massage, and Williams Flexion Exercises.   Physical Therapists today don't even know what Williams Flexion Exercises are, since we now know, because of solid research, that they don't work.

In 1977, Athletic Trainers were still limiting fluid intake.  As an athlete in the early 70's, I can remember one small cup of this new thing called Gatorade that we were allowed in the middle of an August football practice.  We now know that to be a big mistake.

As I wrote last week, in 1977, we were telling everyone that there was no evidence that steroids made you bigger and stronger.  I even went on Bob Gilbert's The Sports Page radio show to declare that they really wouldn't do much for you.

Oh how wrong we all were.  What we didn't know much about then was also all those horrible side effects.  All I knew was that a buddy of mine that was into bodybuilding after a UT football career had gotten into steroids quite heavily.

I was an undergrad at UT and headed for physical therapy school so I was everyone's health care person.  So he confided in me that his testicles were the size of pinto beans and wondered if it could be those steroids. 

My family doc at that time had even recommended steroids to me a couple of years before.  He knew I was trying to make it as a college football player and needed to be bigger and stronger.  He shared the product information sheet that came with the steroids and one word jumped out at me:  Impotence.

I knew then that I wanted children one day so that's all it took.  Football, for me, was not worth that.

So my undergrad diagnosis of my buddy's testicular atrophy was "well...YES."  Little did I know how right I would prove to be.  That buddy never fathered children.

So jump forward to 1985.  What do we know now that we didn't know then?

That early intervention is the key.  That proper treatment started early makes all the difference in the world.

That concussions are serious business.

That rushing someone back to competition after an ACL reconstruction is simply wrong.

That ankles don't become "dependent" on ankle braces.  We used to avoid bracing ankles because of that.  We now know that the braces just protect the ankle.

We used to say "ice for 48 hours, then heat after that."  No way.  Ice is almost always better than heat.  And if it's an injury and there is still pain, inflammation, or swelling, you NEVER use heat.

We've come a long way baby.