Photo courtesy: udmercy.edu

As the Final Four approaches, it is fitting to relate some comments on a recent article I found on USA today.  The floors are made of the highest quality wood and inspected to the highest standards. The article can be found here for full reading, but I wanted to comment on the quote below with main point underlined:

‘Stromberg tells of being approached by a company that offered a $1.5 million machine that could detect cracks as small as 1/32 of an inch.“I said our people can detect a crack down to 1/64th of an inch, easy,” Stromberg says. “Very little here is automated.”‘

Carpenter Scrutinizing Wood. Photo courtesey: images.inmagine.com

Now putting on a research scrutiny hat, I know most are thinking ‘no way’, ‘I want to see evidence on that’, or ‘reliability to detect faults in wood has to be poor’.  But, have you ever seen a master carpenter pick out a straight piece of wood or even mechanic correctly identify the size of a nut to choose correct tool by just looking at it or rolling around in their fingertips?  

I think this is talent and really don’t argue with the person. It is done, and the reason, these people are professionals.  They are the best at what they do.

Let’s relay this back to our profession.  Palpation.  It is scrutinized, down-played, and some even don’t do it as research says the reliability is poor.  However, this is one of the staples of our examination.  Let’s not throw this to the wolves yet.  We are professionals and we can pick up differences.  

Photo courtesy: thumbs.dreamstime.com

My favorite part of the examination is palpating a patient’s cervical spine (try with your eyes closed so you can’t see the patient’s facial expressions) and be able to detect subtle differences.  You can (and should) be able to tell them where their pain is before they tell you.  You get the awe factor and you don’t need expensive tests/measures.

As the old men say, ‘this is not my first rodeo’.  Trust your instincts, experience and continue palpation.

Now the next question is clinical utility.  Is the difference in the soft tissue’s texture, tone and overall feel clinically meaningful?  Well, that is a discussion for another day.   

 

 

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2 comments

  1. This article couldn’t have come at a better time Harrison! I’m currently doing an advanced manual therapy course and this weekend is the cervical spine. As a budding manual therapist, I sometimes find it hard to believe all that is being taught to me on these courses….”If C5 is restricted in its superior anterior lateral (SAL) glide you can do an indirect technique at the contralateral segement above (C4) in an inferior medial posterior direction to achieve the desired SAL glide at C5″ OR we were taught how to detect U-joint motion differentiating it from Z joint motion—Can we actually do this or are we just building constructs in our mind to help up justify what it is we do as manual therapists?

    I guess the answers come based on our patients response to treatment. If what we say we are doing is working, who am I to argue?

    Thanks for the excellent commentary!

    Jesse, P.T

    1. Jesse,
      Thanks again for your comments. I really do appreciate the response. I would like to hear more about the course this weekend, especially anything new you could share.

      Harrison

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