Over the course of the past few month I’ve done some of the most time-intensive work I’ve done since my college days. I was approached early in 2014 by Medbridge Education, a leading online resource for Continuing Education Trainings for physical therapists. They were in the process of expanding their offerings to include massage therapists and wished me to be a part of that process. Since that time they have expanded my offerings to be available for CE credits for PTs and MTs. Both the PT and MT CEU classes will be available in early 2015. A result of this process was the need to rethink my approach to not only teaching, but how to best represent my thoughts and beliefs to an expanding online/indirect market.
For years I have been refining/redefining the mental and physical process for I use for evaluation and treatment. I long ago discarded my reliance on a bio-mechanical/postural-based model of evaluation and treatment, in no small part due to published papers such as this one. As a part of my Medbridge preparations, I came up with a Feedback Loop that expresses my evaluative journey quite well. (The image of the Feedback Loop is a bit blurred, but left click on the image below to see it more clearly.)
What signals do we seek which tells us we have encountered an area in our patient that would benefit from treatment? Please notice I have avoided labeling the “problem tissue”, as I do believe there is too much guesswork when we do so and that any claims we make are more a result of our education/training/belief than it is from actual fact. (I speak frequently about avoiding “palpatory pareidolia”, as so well explained by Paul Ingraham.) This Feedback Loop is what I use every time I touch a patient and which helps me to not only locate areas of concern, but also gives a chance for validation from my patient and easily tells me not only where to treat, but even which direction to treat.
Thoughts?
For Now,
Walt Fritz, PT
Walt: Your proposed feedback loop makes a lot of sense, but perhaps an inexperienced therapist may have some problems implementing it. -I have simplified my approach by breaking down the pain by : shoulder problem, low back problem, plantar fasciitis, etc., then I narrow down the cause of the problem and proceed accordingly.I normally use MFR, STR, CST and Manual Articular approach for the treatment. My rate of success have been in the 85 to 90% and the treatment time have been reduced by approximately 50%. I also suggest some stretches and exercises and recommend some books to help staying out of pain.
Hi David,
Thanks for your feedback. I believe the Feedback Loop makes more sense ion the context of the classroom, so this is something I need to work on to make the concepts more universally understandable.
I can relate to and appreciate your Feedback Loop, great what it can accommodate!
Read the paper linked, found its headline/conclusion too broad for the scope of discussion – acquitING PSB altogether for back pain over non-correlation to lower back pain only. [Lbp is correlated to L5-S-1 hypermobiliy (sahrmann )] … what about upper back/neck/shoulder pain and PBS? Or injury and PBS. I’ll bet they will find a different set of answers (esp injury and athletes)…