No Guru Is An Island | Modern Manual Therapy Blog

No Guru Is An Island

One of the criticisms of our profession is that many PTs adhere to the teachings of the "big names." I even started out proudly referring to myself as a Parisite, after graduating from the University of St. Augustine. However you roll, whether it's McKenzie, Mulligan, Paris, Grimsby, Butler, Jones, Rocabado, Maitland, etc.. you are only as good as you the limits you impose on yourself.

It seemed like every spine patient would be easy after starting out with a MDT based curriculum at D'Youville College. After graduating, I immediately started at St. Augustine, and the first thing we heard was some IMO about MDT and how it promotes the evils of hypermobility. After finishing my DPT and getting manual therapy certification, I enrolled in McKenzie's courses. Of course, they present their side of the story about palpation, manual techniques, and 80% of patients not needing therapist manual intervention. Can't we all just get along?

Needless to say, it took some years to really expand my bag of tricks and getting them to work together. Professionally, you should always be a work in progress. Many patients who come back to me after a few years state that I am using very different techniques. I hope the same would be true for you readers. No doubt you are better for following the assessment and treatment techniques of some of the bigger names in the profession. For every 20 patients you help by learning new techniques, you will still find 1-2 you are unable to. Take more continuing education. Think outside the box. Don't limit yourself to dogmatic teaching and especially only the evidence.

If we limited ourselves to EBM, we would all be doing MDT for the lumbar spine, spinal manipulation for cervical and lumbar, thoracic manipulation, but only for cervical spine and headaches, and spinal stabilization. Your shoulder hurts? I'm sorry, there are no quality RCTs that show anything we may do for it will help. But you're in luck, according to the Guide to PT Practice, your frozen shoulder should be better in about 1 year, and it may spontaneously thaw.

My best advice to students and professionals is to finish a series of courses, take time to add the techniques to your repertoire. Experiment, but don't abandon what you found to be useful in the past. Take another series of courses, but not until you're finished with the previous series. You'll find the faculty normally bashes what you just learned from another institute. If you can learn just one great technique that you can use every day, the course will be worth it.

1 comment:

  1. There is an astonishing lack of reliability for a vast majority of the commonly used special testing In orthopedics. This leads to faulty selection of intervention. As a result , PT is as effective as TENS, a stay active program, a back booklet and the Alexander technique. " Garbage in, garbage out" as the saying goes. We need to move into classification based intervention for better efficacy. Terry Rose PT, MS, DPT, FAAOMPT.

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