Reflections on The Eclectic Approach to UQ and LQ, Philippines | Modern Manual Therapy Blog

Reflections on The Eclectic Approach to UQ and LQ, Philippines

I am truly blessed to have as many blog readers and support as I do. Thank you so much! Thanks to social media, I was invited for an Eclectic Approach to UQ/LQ two day course in my homeland, the Philippines!

I have not been back for 27 years! This was an amazing chance not only to teach, but to spend some time with family on both my mother and father's side of the family.
#grateful to Sir Leomil P. Adriano, PTRP,MSPT, DO-MTP,CAc, Grad Dip Man Ther (Hons)
This was the first time I have taught a LQ and UQ together and it went very well! All of the participants were amazing, inquisitive, and per the norm, plenty of within class mini cases, as PTs make for great patients (poor histories, great patients).

Course points
  • movement assessment
    • SFMA prior to repeated motion testing
    • check for the asymmetries first, which actually may be reset if they are rapid responders if you do MDT first
    • this is not what I always do in the clinic, but I rely on intuition, so this is how I have been instructing it as the movement screen order
  • no surprises that asian females can bust out an easy overhead deep squat
  • remember to use PNF (especially agonist reversals) to get the sticking points of movement patterns
    • upcoming video of this for OMPT Channel subscribers!
  • palpation - not needed, nor is specificity
  • treatment along broad tissue patterns or areas is more comfortable, less threatening, and may stimulate the cortex in broader areas than joint mobilization
    • possibly why the effects seem to work well
  • for repeated motion testing
    • cervical retraction and SB
      • load up in posture stacked position, hold the retraction with passive SB, slight cervical protraction will cause unloading and any asymmetries may be lost to observation
    • SGIS
      • again make sure scapula are over the pelvis with a lordosis slight COG moving posteriorly or trunk flexion, you will lose even obvious asymmetries
    • when you're checking for ipsilateral loading asymmetry, make sure they're starting in neutral, not an unloaded position

Physical Therapy in the Philippines
  • when I saw the above t-shirt, I thought, hmmm, he must have gotten that in the US
  • nope! Turns out there is another country where it's not physiotherapy, it's physical therapy in the Philippines as well!
  • many of the PTs here share the same concerns that we do, plus that I also found in South America
    • too many PTs perform passive treatments
    • not enough manual therapy (or none)
    • very little patient education
    • generic exercise prescription with reliance on physical agents
  • like South America, they thought it was just the sad majority of their country's clinicians that were like that
  • based on my experience with better clinicians who come to courses, I had to tell them, it is also like that in the US...
    • sadly seems to be the pattern that the average rehab clinician (or medical practitioner in any discipline) follows the bell curve, and the top of that curve is more of the same regardless of the profession
  • PTs in the Philippines were told not do to MET as it's an osteopathic treatment - and those of us who cannot manipulate or TDN thought we had it bad!
    • my argument always against "MET" is that it's just fancy PNF, and more based upon outdated pathoanatomical models
    • osteopaths did not invent PNF
This guy was a great interpreter, even tho everyone here speaks English

my loyal blog followers! Thank you for making this happen!
A great group of clinicians! My wife asked my three year old to find me
"I can't find Dada!"
Overall, it was an honor and an amazing experience! Next up for the Eclectic Approach is Vancouver, then Italy, then back to Chile, with a few US dates getting scheduled as well!

Keeping it Eclectic....


  1. Great stuff! Now that you've mentioned, last time I went home was 1999! Sad part of PT practice in the Philippines ( at least when I was there circa 1994!) is the way it's delivered: MD making ALL the decision as to what specific modality and exercise to give to patients. Think MD and RN relationship. Still heavy on the "I'm the Doc so you follow my order." Agree on lack of or minimal training in modern manual therapy (but they're catching up with those aussie's helping!) and probably modern pain science. Not sure. But hey, great job on sharing your knowledge and skills over there!

  2. This group in particular is having NOI group come in the fall, and they read my blog so they're getting the right ideas on modern manual therapy combined with pain science. Those deficits however are everywhere and not just the Philippines, US included!