Searching for Certainty

This past week I had a few instances that made me feel quite inadequate as a therapist. The first was a patient with knee pain and the other was a patient with neck pain. In both visits I managed to use up everything I knew, every decision path and subsequent treatment solution. And I got… no within session change.


As it happens I was stuck with the uncertainty of their treatments, their prognosis, and the uncertainty of my ability to be effective. I knew what bothered them, I thought I knew Continue reading

Think about it…

How do I help my patient get better? It may depend on many things, the disease, injury, co-morbidities, etc. And in many cases it can be hard to ignore big factors that “stand in the way” of recovery. Some patient’s are just tough. Complex. Hopeless.

Of course, we make sure to keep a mask on. We attempt to prevent our patients from seeing Continue reading

Was it the HVLAT? A Reflective Case Discussion

There is quite the debate these days about how manual therapy works and particularly what types are best or get different/better results or is it all just placebo. Here is a case,  n=1.

I’m evaluating a patient with upper back pain, medial to the scapular border and lateral to the spine, around T5-ish.  We all know where this spot is, right? The complaints are approximately 8 months in duration, 5/10 pain secondary to increased breast tissue (20 lbs) during pregnancy and post-partum time periods, per the patient. Continue reading

Clinical Practice Algorithm: Motor Control Series

greyscale photography of car engine

Photo by Mikes Photos on

More of this Motor Control business.  See the previous Background and Learning post to get caught up.

“Science is built up of facts, as a house is built of stone; but an accumulation of facts is no more a science than a heap of stones is a house.”-Jules Henri Poincare

Practice is built upon theories, as a house is built of stone… Let’s put these theories into practice. Time to build a house….. Continue reading