Thursday Thoughts: Everyone Has Their Tastes | Modern Manual Therapy Blog

Thursday Thoughts: Everyone Has Their Tastes

This edition of Thursday Thoughts comes from a conversation with a well educated young clinician, Dr. Kyle Balzer. Kyle has probably taken more con-ed when he was a student a few years ago than most clinicians will in their entire career. All he needs is experience (like I did as a young buck way back when).

In imparting clinical advice based on my experience in many different systems, I told him no one system will get 80% of your patients better. Some are definitely closer than others, and it all boils down to taste.

Let's say 80% of people love pizza, chicken and ice cream. Most nervous systems find these tastes enjoyable and have developed a preference for them. Repeated exposure only increases the preference. These tastes are analogous to manual therapy, repeated motions, and/or general ther ex. Along with appropriate patient education and HEP, you'll get a lot of people better.

Most clinicians are using variations on these common tastes. There are still rapid responders out there who may prefer sushi, are vegans or love anchovies. Let's say these are analogous to stabilization, and retraining breathing pattern disorders. I have found both of these useful at times, but are fallbacks after the initial flavors that most nervous systems prefer are tried and rejected.

Random manual clinician treating calf pain in a runner

  • TDN to calf
  • stretching to calf
  • IASTM to calf
  • US/ES to calf
  • ankle mobs
  • calf strengthening
  • HEP that consists of calf strengthening, stretching, and 5 other exercises
A less is more clinician treating calf pain in a runner
  • cuts back on training
  • looks at running form
  • looks up and down the chain
  • rules out repeated motions of the spine
  • maybe performs 1-2 treatments
  • HEP is key but only consists of 1-2 repeated motions and/or correctives

This is why I advocate a more varied menu but only within the context of need. Your eval should lead you to directional preference, appropriate patient education, and minimal hands on treatments; this is to stimulate the nervous system through healthy and non-threatening inputs that reset the CNS alarm and raise pain/movement thresholds thus improving motor control. Don't just throw everything you have at someone because most people in your practice order pizza, chicken, and ice cream. Have a reason for them, and in moderation, you will get results without over serving.

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Keeping it Eclectic....


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