Patient Examination

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Hello all, I have previously posted regarding some of my classes this semester, and I find myself seeking some input again today. The unit we are currently in for an exam and eval course is the lower quadrant/lower extremity. To keep it brief… so many assessments for posture, prone flexibility, supine flexibility, muscle testing, what muscles might be “tight, stiff, or long”, and the constant mantra of how we as the “movement experts” are learning how to seek out dysfunctions at joints, find substitutions that may or may not be detrimental according to the pathokinesiological or kinesiopathological models. I had enough frustration that I went up and asked why it was that muscle “stiffness”, being such a poorly defined term as it is, plays such an integral part in what were doing as far as examining someone. The responses were along the lines of: “stiffness, if uncorrected, leads to shortness”, “hamstrings tight… wear and tear on the back”, or that with stiffness there is now a direction of susceptibility to movement that doesn’t coincide with the joints “path of instantaneous center of rotation”. While what they were saying did make sense from this model of thinking, the whole time in my head Dr. Ray’s BS button was being smashed over and over…

I apologize for being long winded, but I find this semester of school becoming quite difficult as both a student and personally. I do value the opinions and experiences of others, I understand the importance of keeping an open mind, but at the same time I find myself always in an internal conflict with what I have just been told and what I have seen, read, and discussed platforms such as this. If this model of dysfunction and pain being taught in PT school, the model of the “Human Movement System” is being toted around as the identify of the Physical Therapist, I just cant help but feel somewhat lost as to what MY identity as a future clinician will be.

Again, long post, but I appreciate the input and advice from you guys.

Thanks

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So I like what Quinn Hennoch says all the time “just get the paper and do whatever you want after that” meaning that after you get your degree you can do pretty much whatever you want with it.
I too kind of get nervous as to what i’ll be taught when I get to PT school but I do like to have an open mind about it and what has helped me is listening and reading a lot of critical thinking skills from audible and various other things. Not to mention the biggest thing would be to surround yourself which I think you have, with open minded people.

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Option 1: Take what you are being taught as truth and pass it to your future patients…please don’t…

Option 2: Listen, learn, pass tests, pass clinical, pass boards…treat in a fashion consistent with science and evidence.

Option 3: Option 2 + ask lots of questions (better than openly objecting and challenging). If you take this path, be brave and be tactful. To quote Jocko Willink; play the game. Use the socratic method. Way more effective than challenging a professor or clinical instructor directly. KNOW THE EVIDENCE. Not superficially. Know it inside and out. The more knowledge you have the better.

Option 4: Go into mathematics, physics or engineering where the answers are more concrete.

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