Thursday Thoughts: Why is it Always Vs? | Modern Manual Therapy Blog

Thursday Thoughts: Why is it Always Vs?

I touched upon this topic in my recent interview on Therapy Insiders Podcast. I read the research, and try to implement both it and science based decisions daily.

Let's review what is currently supported by research
  • manual therapy + exercise + education
  • pain science education
  • suggestions to include self management
My question is, Why is it always VS? Or, why does it have to be one or the other? Part of The Eclectic Approach is to use the 
  • best parts of Pain Science Education
  • principles of self management from MDT
  • various manual therapies as "cheats" to get someone moving and self managing
I think science based clinical reasoning should always be used, along with clinical expertise, and a "feel" for the patient that only you can have, and research can never capture. A combination of these factors should be behind the interventions and interactions you chose.

Some patients will have different needs and preferences, but no one approach (commercial or otherwise) is going to net you results on 80% of patients. Even recently posted a case where Moseley's trainees were using most likely the best Pain Science Education possible, yet a patient was failing to respond. When asked why she was not improving, she replied that she was so fragile, no one could touch her. It is very possible some old school manual therapist, who is very gentle, interactive, and personable may have had much better results. Touch is very powerful, especially when administered in a gentle, non-threatening manner; it always has and always will have a place in rehabilitation. 

Keeping it Eclectic...


  1. Two words.....Red Cord! LOL

  2. Great! You are right! it's impossible and not very smart thinking of a rehab experience without the power of touch