#4. De-emphasize imaging

Imaging (MR, XR) has its use.  It can be great to rule out sinister disorders, fractures, space occupying lesions, etc.  However, for the most part it is opposite of milk’s slogan, “does a body good”.

De-emphasizing impractical and useless terms to how I, as a physical therapist, will treat the patient comes at day one.  I don’t get nasty with it as patients take the liberty to bring in their imaging results, but I make it a point that it will not change the way I treat you.  Again, I do not need to preach to the choir here but I recommend addressing this sooner than later in the treatments.  It should allow you and the patient to have a clean slate and move on from what is seen deep inside.

There are many ways to address this issue, including telling the patient that a one time picture of their spine does not show me how they move day to day.  The dysfunctional movement patterns, disharmony in motor control and symmetry during daily activities is what I want to know.  Uncovering the truth with a thorough subjective and objective examination will allow me to treat you more effectively, and get you quicker faster!

I’m a number’s guy, so I always throw out the 40-70% of asymptomatics have IDH on MRIs too.

If these fail, I also go to the “Wrinkles on the Inside” presentation by Evidence in Motion.  You can find it here.




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