11/11/2025
Here’s a hill I will readily and absolutely die on:
Clinicians- Your. Words. Matter.
We’ve all heard of the placebo effect. The nocebo effect is its opposite: it’s the occurrence of worse outcomes due to patient expectations.
And where do those expectations come from? Often, it’s from the language we as practitioners use.
Nocebo comes from that latin root of “I shall harm.” Our words, if not chosen carefully, can do exponentially more harm than good.
Telling someone they “have the spine of a 90 year old” or their knees are “bone on bone” creates a narrative that these things are permanent and the person is broken. Tell someone this sort of garbage enough times, and it’s no wonder they believe it.
We as physical therapists are uniquely positioned to be able to change these narratives. Because we get the chance to take those unhelpful comments and show people what their bodies can *do*.
🏋️♀️Sure you have disc degeneration, but look at how you can squat without pain.
🚶♀️Your ortho may have told you you needed a hip replacement yesterday, but you’re still walking 2 miles a day.
💪Sure your MRI showed a rotator cuff tear, but you are still in the gym doing upper body work without symptoms.
But, as they say, with great power comes great responsibility. Telling someone their form is “bad” or that deadlifts will hurt their back, or not to twist in order to protect their spine reinforces feelings of vulnerability and hesitancy.
Beliefs create outcomes.
So be intentional when discussing findings. Be impeccable with your words. Be the reason that the person in front of you believes in themselves today.
