What are we accomplishing with assessment?
What we find in assessment can only be relevant to that particular person if and ONLY IF pain is provoked. When pain provocation maneuver is determined, the only thing we can deduce from that is: there is something we have to change about that particular movement pattern. It could be getting up from a seated position, lifting an arm up, bending over to pick up a pen, tying shoe laces, breathing in and out, or simply just turning the neck. Science has provided us the ability to break down human movement and physiology into multiple different components, biomechanical (which is essentially orthopedics), neurological, psychological, and endocrinological (and maybe others that I don’t know yet).
The point is, we try our best to break down a complex system that we don’t understand, and go through different research and studies in hopes to generalize and finalize a concrete understanding of the body. The truth is, even with the impressive studies that have been done, it can never allow us to fully understand how to properly treat/help a client. That is not to take away anything from these amazing pioneers such as Stuart McGill, Moseley Lorimier, Paul Hodges, Bergmark, Janda etc. They have provided us to a vast knowledge of the human body, but more importantly, they have started debates and questions that have never been sought before.
In the end, we do not, and can never know what is really going on with a client’s body, the studies that have been done and deemed significant are done on a very insignificant population of the human race. A sample size of even 1 million subjects in a research study is insignificant compared to the 7.3 billion human beings on this planet. Is the person in pain because of an irritation of a particular joint? A ligament that is not doing its job? A muscle that delays in firing for miliseconds? A psychological trauma? An injured nerve? Or all of the above? Even if we can identify some of these during a treatment, what is the best course of action? The answer shall be “I have no idea, but I can make the best educated guess with the knowledge that I have”. To say that one can predict pain outcome, I find is close to impossible.
Unlike researchers, we don’t just deal with population of human beings that are considered as the average human being, we deal with people who may be outliers as well. So we do not have the luxury to have one particular way of working on people. It is catastrophic to stick with a particular theory or school of thought. Practitioners who have had a lot of success with a particular approach are successful because the ones they have failed have moved on and sought other forms of therapy. In my classes I call a treatment a period of time for a practitioner to exercise his/her best judgment and go through a series of trial and error. All schools of thoughts are valuable, they are all useful tools for a practitioner, it is up to the practitioner to choose when and who to use a particular tool. According to Albert Einstein: “insanity is doing the same thing over and over again, and expecting a different results”. So really, the difference between a practitioner being called doing witchcraft vs therapy, is the ability for one to be result driven with what they do.