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chiroortho -> Re: Diagnosis and Palpation in Manual Tx (February 17, 2005 7:23:00 AM)
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[QUOTE]I have found a gentle PA exploration with hands in manipulation type postion does very well to relax the tissue, and often get cavitation and some relief of symptoms in neck or Tspine without a thrust.[/QUOTE] [QUOTE]I thought John Duffy had an interesting point about this when he said the presence of trigger point type things was a signal to him that something was not right, and used their presence or absence to gauge recovery or treatment effectiveness. I thought that was pretty cool and a great idea.[/QUOTE]Jason, I fully appreciate and agree with these two points. And with Mr. Dorko, I find some common ground with the implication that we often feel the need as clinicians to 'address' palpatory abnormalities of irrelevance.
A few thoughts. First, we have to remember to do no harm. Trite, but true. Second, the 'treatment of irrelevancies' may be difficult to ascertain, so if the area of hypomobility is proximate to the area of discomfort, I see no harm in applying a gentle manipulative force. At best, we have fixed it. At worst, we have done no harm. Further, I have avoided comment about the 'Clinical Rule' video offered by my august PT colleagues, but I will admit to one reservation: the therapist seems to be applying a general manipulative thrust to the thoracolumbar area, without any pretense of directing the thrust to the area(s) of dysfunction purported to be present at the time of his clinical examination. The fact that the patients reported lasting symptomatic improvement of 90+% is at the same time puzzling, interesting and provocative for those of us that are of the impression that precision, as far as it is possible, is a virtue.
Thank you for the opportunity to opine. Forgive me in advance if I have offended.
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