Top 10 (honest) reasons why physios are heroes… A joint blog with Sandesh Rangnekar

So this blog is a joint effort by myself and a physio based in Mumbai, India called Sandesh Rangnekar, please go follow him. I have been watching Sandesh’s work for a while now and he has that rare skill of being able to see through the endless waves of bull shit and pseudoscience that most healthcare professionals put out on social media in an attempt to gain followers, look clever, and sound important. He also has a wicked sense of humour and can take a guru down a peg or two with his brutal yet honest views and opinions. 

So a few days ago some happy clapper types posted a list of ‘why physios are heroes’. It had things like physios are rays of sunshine in the darkness, giving hope when all is lost, riding unicorns, and smelling of lavender, and some other overly optimistic self-promoting vomit inducing niceties. Although we understand the sentiment it was a little too vanilla for us, so we decided to do a list of our own, giving some more ‘honest’ reasons why we think physios are heroes. So here are our ‘Top 10 (honest) reasons physios are heroes‘… buckle up this could get bumpy!!!

No1: They take a lot of shit

With Instacrap, Twatter, Facepalm, You-Turd, and not forgetting Dr Google lots of patients come to see us with their heads full of pseudo science and bullshit due to some square jawed, white toothed, buttock toned, celebrity health care guru. Real physio heroes have to sit calmly and quietly listening to patients telling them some ridiculous far-fetched explanations about why and what their problems are, and how they need to to be fixed thanks to these online fucktards.

Biting their tongues hard the real physio hero listens patiently whilst screaming on the inside, then slowly, carefully, tactfully tries to explain a more simple, rational, honest explanation to the patient. Sometimes this works but often they are told that they don’t know what they are on about and that Dr ‘I’ve 100,000 followers’ DPT does.

No2: They take an awful lot of shit

Even harder than trying to deal with the online celebrity guru shitty advice, is trying to deal with the shitty advice patients often get from other local healthcare professionals. Patients often come to see us with unrealistic expectations thanks to some well meaning advice from their family doctor or local surgeon. Often patients are told that physio will be a simple, easy, quick fix. Often the real physio hero has to tell the patient the exact opposite and often they get a lot of flack because of this.

Other times patients are sent to physio by our colleagues with negative expectations, such as when surgeons tell patients to go and try physio before their operation ‘just in case it works’. Having to try and turn this negative expectation around is a monumental, exhausting, and often fruitless task.


Finally getting referrals from doctors and surgeons for ultrasound, acupuncture, massage is just not helpful. Often these things are not needed, but because some sharp suited, smooth talking, well paid medical professional has said so, it’s very hard for the track suit wearing, slightly awkward talking, not so well paid physio to challenge.

No3: They don’t get paid well

There is a huge difference in earnings between all healthcare professionals, with some who clearly deserve to be paid handsomely for what they do and the skills and experience they have acquired. But when you look at the average earnings of a decent physio compared to other degree qualified, autonomous professionals we are paid poorly.

In my opinion, many of the real physio heroes are not paid enough for the level of work, clinical reasoning, and responsibility they are given. I see some amazingly talented physios working along side GPs and surgeons in first contact, primary care roles being paid a fraction of what their colleagues get for doing exactly the same job. This needs to be challenged and changed. If we expect the standard of physio care to improve we need to reward the heroes who are giving it.

No4: They work hard

Real physio heroes are hard workers, there are many lazy physio shits out there doing the bare minimum, but real physio heroes often start early and finish late, working 10-12 hours, 6 days a week, seeing patients back to back giving them 100% all the time with little to no time to catch up on paperwork, emails, or even catch their breath.

Most of these heroes will also use their rare and precious spare time to seek and learn and advance their skills, reading and attended post graduate courses. Nowadays most employers will not give physios the time or finances to do this during working hours. Most physio employers, due to the increasing demand for their services and growing waiting lists want their physio seeing patients and doing nothing else.

No5: They are busy yet patient

With the waiting lists increasing and services under pressure, appointment times are getting shorter and shorter, meaning physios are seeing more and more patients in the working day, with 15-20 a day not being unusual for many. This makes it increasingly difficult to take a good history, listen effectively, build a therapeutic alliance, and give good advice and treatment.


However, the physio hero doesn’t let this phase them, they continue to give each patient their full attention and best efforts, listening attentively and patiently as the current patient explains how the ineffective, uncaring health care profession doesn’t understand their problem, and how long they have had to wait to be seen, despite it meaning they run over for their following patients and end up working late for nothing.

No6: They practice what they preach

Although busy and hard working the physio hero understands the importance of maintaining a physically active life style and the role that exercise plays in keeping a healthy body and mind. Many lead by example doing regular exercise and eating well despite the pressures on their time and resources. This is hard work requires a life long effort and commitment.

However, the real physio hero often finds themselves nodding and smiling politely when they hear patients telling them that it must be so easy for them to stay in shape, and how they couldn’t possibly understand how hard it is for them. They also tend to smile even wider when they hear patients explain that they couldn’t find the time to fit in the 10-30 minutes of physical activity you asked them to do a few times a week, yet somehow managed to find the time to watch tv or browse social media for hours.

No7: They are life long learners

As well as committing to a life long healthy life style the real physio hero is committed to a life long process of continuous learning. They realise that knowledge is forever changing and shifting and what they know today will be different or even obsolete tomorrow.

Real physio heroes will look to challenge their understanding and knowledge from many areas and sources, recognising that there are many explanations of what they do and why it works. The real physio heroes are comfortable with their uncertainty and are able to pass this onto their patients and others around them.

No8: They try to make a difference

Despite all the pressures and limitations on their time and resources the physio hero try’s their hardest to make even the smallest difference to all they see. Even if it as simple as getting someone to move a little more each day, or reduce a fear of a certain task or activity. Sometimes it’s just getting a patient to think differently about a problem or an issue.

Real physio heroes don’t exaggerate or promote their results to everyone and anyone on social media. They understand that successful results are not guarenteed and change is a slow and gradual process for many things they see. They recognise that those who continually shout about and promote their successes often forget about or ignore their failures. Real physio heroes don’t.

No9: They challenge the bull shit

Physiotherapy is often stereotyped by patients and other professions as just some massage and ineffective corrective exercises. Real physio heroes know differently and refute these accusations. They also question and challenge the many other dubious claims and dodgy interventions they see online or in practice.


Although direct and upfront with this challenging and often perceived by many as being unprofessional and rude the physio hero doesn’t let this deter them. They recognise that this is a common fault by those who can not differentiate their personal emotions and feelings from their ideas and interventions.

No10: They do it with a smile on their faces

Despite all the challenges and difficulties that exist to provide good quality evidence based physiotherapy day in day out, the real physio hero always does their best to do their jobs with a big smile on their faces. They recognise that although they may be frustrated, annoyed, exasperated, stressed, tired, even in pain themselves they don’t let it show to their patients.

Physio heroes know the power of humour and fun in the presence of pain and fear, and they know that if they can keep patients smiling then they are on the right path to successful outcomes.

So there you go, the top 10 (honest) reasons why physios are heroes. We understand and recognise that we all work in different environments and situations and that we all have our own unique pressures and stresses on our time and resources. We understand that sometimes it’s hard to stay on the path of a true physio hero, and that it would be easier and more financially rewarding to roll over and do whatever patients wanted, or go along with the fucktard gurus and give their shitty ineffective treatments whilst natural history occurs in the background making us appear to be miracle workers.

But real physio heroes strive for more. Real physio heroes remain true to themselves and their principles. Real physio heroes know they can help people without the bullshit and bluster that surrounds this profession of ours. Please stay a real physio hero. 

As always, thanks for reading…

Adam and Sandesh.




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