This post is based on a reader comment from our latest Therapy Insiders Podcast, An Eclectic Approach to Cervical Dysfunction. I thought it was right on the money and the podcast along with the comment can be found here.
All my regular readers know how I feel about special tests, or for you DC good guys (mixers) out there, ortho testing. For those of you who are not MDT, Sahrmann, PRI or other classification based training, my question to you is: Where will this take me?
- shoulder patient
- you may think, RC cuff tendinitis, impingement syndrome, labral tear, cervical radiculopathy, rule out referral patterns from certain TrPs...
- Neer's, Hawkin's/Kennedy, The battery of some of the worst special tests ever for TOS, cervical quadrant or compression testing.... does any of this lead you to intervention?
- or would you have still just treated any mobility and stability based impairment and asymmetry you found?
I am not just for cutting out most special tests (unless there is an actual traumatic injury), but any movement testing you do. You should always be asking yourself, why am I testing this movement, and where will it lead me to a particular treatment?
Dr. Gene Shirokobrod and I just finished another podcast for Therapy Insiders last night on Differential Diagnosis, special tests, and pathology. It's interesting hearing from the other side. I certainly do not expect a few blogs posts here and there to change anyone's mind in regard to moving away from pathoanatomy and special testing, and am only trying to get you to think and stimulate some discussion.
If you are strongly into special testing, biomechanics, pathoanatomy, and differential diagnosis as part of your evaluation, please chime in below or on my facebook page and let me know a few things. 1) How long you've been practicing 2) The background/training you have 3) How special tests or differential Dx, and pathanatomical practice helps your treatment and outcomes.
Keeping it Eclectic...