Recently a client called me a detective. I liked that description. Connecting the dots.
Good therapy should be about detecting what is not easy to see. Evaluation skills play a big part in this work: Investigating what is visible and what lies beneath the layers. I learned the beginning of detecting in my MFR training, but was abandoned when the rest was left too open ended. Some therapists like to allow things to unravel, to reveal itself as therapy progresses. I do some of this, but when something reveals itself, I like to dig deeper.
My physical therapy training certainly blessed me with basic orthopedic evaluative skills and my myofascial release training delved more into the soft tissue. I think that both play a role in how I view a client when they come for therapy. But so much more is the story. Symptoms are a clue, as they tell you where to begin looking. Find the symptoms, look elsewhere for the pain…some of the time. Often the symptoms are the cause, just buried where no one sees them.
A deep model of evaluation should be an integral part of every manual therapy training. Some get it close to right, others fail miserably (opinion inserted). Connecting the dots often takes great patience and listening; with your ears, as well as your eyes and hands. Its all about being a detective.
How are you at connecting the dots? What goes into your decision making process?
Walt Fritz, PT
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