Daily Maestroism

DM #268

Thursday, February 16th, 2017

DM #268: Was privy to a pretty dope convo last night between @drcourtconley, @paul_the_physio, and @joelavaPT that inspired me to write tonight's DM.
Treat enough people and you're gonna see some crazy ?. Stuff that makes you go ?, how in the hell is that person even walking?! Meanwhile, that very same person has zero pain in that area that appears to be a biomechanical nightmare, and is instead coming to see you for some isolated pain somewhere else very far removed from said disaster zone.
Now, I know. It's all connected. But realistically, if someone has no pain in an area, do you poke the bear and risk opening Pandora's box? The group consensus was pretty much treat the symptoms while trying to find and fix the cause regionally, all the while remembering the importance of making stuff work good globally.
Yes, your shoulder pain could ABSOLUTELY be attributable to your crappy foot mechanics. However, as clinicians, when you hear hoofbeats it's best to think horses, not zebras. What does that even mean?! Well, while in theory you could use that regional interdependence model to link someone's dysfunctional non-painful big toe extension to their painful shoulder, in practice you gotta start somewhere…and make sure that that patient is actually going to come back and see you.
Just because an area doesn't hurt doesn't mean that it's working properly. Just because an area looks like a disaster doesn't mean that patient will be in pain. We are far more resilient than that biomedical model would have you believe. Time to adopt that biopsychosocial model and listen to your patient. Address their concerns and use your clinical skills to assess just how much that other area might be affecting the “problem” area. Remember, movement NEVER lies. Ask the right questions, observe the right movements, and you'll know right away whether or not that biomechanical ? storm needs to be addressed now, later, or in some cases….not at all ??‍♂️. Daily Maestroisms dropping every night at 7pm-ish PST. Get yours.
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