The Educational Crisis
In this episode of World’s Best Physio, host Sam interviews Andrew Lock, a prominent physiotherapist and movement scientist. The conversation is a deep dive into the state of the physiotherapy profession, specialized clinical expertise, and the integration of diverse philosophies into patient care.
Key Highlights
Critique of Education: Andrew Lock expresses strong criticism of modern Western physiotherapy education, arguing that it has become "corrupted" by academics [00:44]. He believes the current system focuses too much on quoting research papers students don't understand rather than clinical intuition.
Apprenticeship Model: He advocates for an apprenticeship-style education, similar to trades like plumbing or electrical work, where students learn practical skills on the street and in clinics before or alongside theory [01:37].
Clinical Philosophy: Lock describes himself more as a "movement scientist" than just a physiotherapist [08:18]. He emphasizes that while he is an expert in biomechanics (specifically shoulders and powerlifting), he treats the "human being" first, asking patients what their functional problems are rather than just what symptoms they have [01:02:42].
Elite Performance: He highlights his success working with world-record-holding powerlifters, noting that objective measurements like a 300kg squat are clear indicators of effective outcomes [22:06].
Tradition and Storytelling: A unique part of the discussion involves Lock's interest in religious traditions and history. He cites the story of Jacob in 1500 BC as one of the first recorded sciatic nerve injuries [42:03] and argues that "stories of our traditions" provide a valuable form of evidence alongside science [45:07].
Professional Challenges: They discuss the high burnout rate in the field, noting that roughly 50% of Australian physiotherapists leave the profession within five years [38:21].
The Great Education Crisis
The conversation begins with a provocative critique of the Western education system. Andrew Lock argues that since the year 2000, physiotherapy schools in the US, Australia, and the UK have been "corrupted" by an academic focus that prioritizes research papers over clinical intuition [00:44]. He contends that students graduate with the ability to quote studies they don't fully understand but lack the hands-on skills required to solve real-world patient problems [01:14].
Lock advocates for a return to an apprenticeship model, similar to trades like plumbing or electrical work. In this vision, students would work "on the streets" as assistants, gaining practical experience before or alongside theoretical learning [01:37]. He suggests that a year of dedicated clinical mentorship could produce a more brilliant practitioner than six years of traditional university study [02:26].
Beyond the Label: The "Movement Scientist"
While many identify as physiotherapists, Lock prefers the term "Movement Scientist" [08:18]. He argues that the label "physio" often pigeonholes practitioners into narrow roles, such as Pilates instructors, while "Movement Science" encompasses a broader understanding of biomechanics, chiropractic, and exercise science.
This philosophy is built on the belief that physics doesn't care about feelings. Lock asserts that while the patient relationship is vital, a clinician must first master the biological and biomechanical issues before moving into the "spooky" realm of pain science [10:06].
The Sherlock Holmes of Shoulders
Lock’s reputation is built on solving complex cases where others have failed. He describes his approach as similar to Sherlock Holmes [14:50], focusing on diagnosing the "pain trigger" rather than just managing symptoms. His expertise is particularly sought after in the world of high-performance strength sports. He highlights spectacular outcomes with athletes, including helping the first Australian female to squat 300kg and assisting powerlifters in breaking national bench press records [22:06].
Crucially, he notes that these athletes didn't just "get lucky"; they earned the right to lift heavy weights through meticulous biomechanical correction [11:15].
Integration of Tradition and Storytelling
A unique facet of the discussion is Lock's integration of religious and cultural traditions into his practice. He believes that "stories of our traditions" provide a form of evidence that is often overlooked in modern clinical trials [45:07].
He points to historical texts as early medical records:
Jacob’s Sciatic Injury: Lock identifies the story of Jacob in 1500 BC—who became lame after being "touched behind the hip"—as the first recorded instance of a sciatic nerve injury [42:03].
The Wisdom of Movement: He references the story of Moses, where the people were not allowed to sit for 40 years but had to walk in the wilderness, illustrating the ancient understanding that "walking is man's best medicine" [35:08].
The Burnout Epidemic
A sobering statistic anchors the conversation: 50% of Australian physiotherapists leave the profession within five years [38:21]. Lock blames this on a mismatch between student expectations and the reality of modern practice. He argues that by teaching "non-specific" labels (like non-specific lower back pain), universities rob students of the confidence and competence needed to be effective healers [48:44].
Conclusion: The Impossible Dream
Host Sam Souk concludes by sharing his "Impossible Dream": providing world-class physical therapy to every human on Earth (and even the next planet) at near-zero cost [28:28]. While Lock admits he is expensive—charging up to $1,000 for a consultation [17:21]—he supports the dissemination of high-quality information as a way to "raise the tide" for the entire profession [19:15].
The episode serves as a rallying cry for clinicians to move beyond academic dogma and return to the roots of diagnosis, biomechanics, and human storytelling.