Your comments: 15 July 2015

This week's lead letter pays tribute to Stephanie Turner and Esther Hartsilver. Get involved now by sending your contributions by email to

Safety first

On 20 January our wonderful friend and fellow physio Stephanie Turner was tragically knocked off her bike by a lorry on her way to her first patient of the day. She did not survive. Steph used her bike to commute to work and to carry out home visits. As a group we are still coming to terms with the loss of our amazing friend and it shook us to hear that another young physio [Esther Hartsilver] tragically lost her life under similar circumstances
Six people have lost their lives while cycling in London so far this year, and involving lorries. Something needs to be done. Cycling is one of the main ways of commuting in London (quicker, more efficient and demonstrating a healthier lifestyle to patients).  If physios are going to cycle as part of their work (such as home visits, as Steph did) then our professional bodies need to campaign for safer cycling.
At a governmental level, there is a need to address the state of the roads, such as pot holes, and provide more cycle paths that don’t stop and start in irregular places. 
Could the CSP help support the current drive to fit lorries with appropriate safety equipment? Examples include sensors that detect cyclists in close proximity and lorries being prevented from driving during peak times?
The last thing Steph would have wanted would be to discourage cycling – she loved using her bike for work and often raved about how lucky she was to get to cycle through Hyde Park every day. The key is awareness and improving safety. 
  • Sarah Wood, highly specialist paediatric neurological physiotherapist, Hannah Cowan, adult neuro rehab physio, Rachel Black, respiratory physio

CSP professional adviser Stuart Palma responds: 

‘The CSP acknowledges that while cycling is a great way to keep active, there are inherent risks in cycling on busy roads and fully supports creating a safer cycling environment.’

Wise words

I agree with their analysis. With so many special interest groups, manipulation, mobilisation and exercise regimes, the treatment of musculoskeletal problems, especially back pain, has become too fragmented. 
I am a very senior citizen, still a practising physiotherapist, who has treated back pain for 50 years! I have seen all manner of regimes and miracle cures come and go over the years. 
Why can we not extrapolate all the methods which produce the best results from physiotherapy, osteopathy and chiropractic to try and create professional assessment, treatment, advice or referral for the scourge of back pain, which is now the main cause of time off work and brings misery to so many people? I have devised my own regime over the years and 90 per cent of the time it works.
  • Dianora Bond 

Flexibility the answer

I am sure Hannah Walton’s research revealed an accurate picture of the different approaches to practice taken by students and newly-qualified staff and more experienced staff (page 4, 17 June). Evidence-based practice is fine where the evidence is robust and widely applicable. But this is rarely the case and I am so frustrated by the tag line in most research conclusions that the results only apply to a specific group and further research is needed.
If we only use evidence-based practice we will not innovate and experiment to see what works best for our specific patient. The plethora of treatment approaches we use today would not have been developed and tested and, yes, researched. We would be stuck in a rut of prescribed practice and protocols – all helpful as a starting point, but not the flexible, imaginative practice which has become our hallmark.
  • Helen Lawrence  

Balance needed

Andrew Mooney wrote a brilliant piece, headed Stifling innovation (letters, 4 March), stating, in his opinion, (and mine) that anecdotal evidence needs to be given equal importance to EBM. 
  • Gill Randall
Frontline and various

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