I drew this on whiteboard for my intern and to share with others on Twitter. It came from several sources, including initial thoughts that i read awhile back via Allen Besselink on his site here (make sure you follow his blog!) And thanks to one of our pediatric patients for her signature at bottom!

I would like to get your thoughts too so decided to put on my blog. What else would you add?



  1. I like this post. I think all too often, I try the shotgun approach instead of testing further or digging deeper with my clinical reasoning to get a more focused plan. Thats where i know i need to grow to get better outcomes. I also find myself getting into a rut with the same exercises routines with patients with similar conditions rather than being evidenced based on tissue physiology as Allen Besselink described. That being said, I think we should strive for attaining the right side of the curve whereby we let the patient (the subjective report, where Maitland would say we get 80% of the info we need for a Dx) and our clinical reasoning skills guide our treatment with an eclectic approach rather than being biased to any certain manual therapy or exercise based school of thought. I do think we need to get better at being evidenced based and finding a way to make sense of the immense amount of research data is coming out all over the place. I will say I am excited about how much research is out that is backing what we do as a profession and I’m excited for how make the transition as a profession

    1. Thanks for the kind comments Steve and more insight. Sometimes we need to hit reset button on ourselves to improve.

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