This blog was inspired by a recent conversation I noticed on the Twitterverse, wherein two PTs were discussing passive treatments (i.e., treatment not requiring the patient to actively participate, including modalities, thrust manipulation, dry needling, other manual therapies) and their effects on self-efficacy. As has become the norm in PT circles, one therapist claimed that over-utilizing passive treatments harm self-efficacy. This idea has become so widely stated and recognized that I was surprised when the other therapist genuinely asked if we had any hard evidence to corroborate this intuition. The original therapist then posted a link of another physical therapist, someone believed to be an expert in the area, who had written an opinion validating this point.
As I read this exchange, I realized that our profession may be jumping the gun on the supposed harm of passive treatments. I did a quick search of Google Scholar and couldn’t find a randomized trial that supported the idea of passive treatments harming self-efficacy.
Certainly, we should continue to promote active interventions and strategies for self-treatment. However, if we don’t have any hard evidence that passive treatments are harmful in excess, perhaps we are doing our patients a disservice. For example, could it not harm a patient’s self-efficacy if they followed, to the letter, our active intervention strategies and did not have any improvement?
Check out our YouTube channel for tips on thrust manipulation techniques!