Joe, I’ve watched the entire thing very carefully. It was interesting that Eric quoted a Whitney Houston lyric and Joe immediately thought of The Terminator. Contained within that exchange was the essence of my problem with Eric’s assertion that CPRs prove useful and make us “safer” because so much research has been done regarding their validity; unless it hasn’t or they don’t predict outcomes as we’d hoped. Kyle’s speaking of nominal diagnosis is especially relevant and reminded me of the essay, Incantation, on my site. I would love to have Eric bring his thinking to Soma Simple but he’s an academic and realize that’s probably not going to happen. In any case, I think his students would benefit greatly from Kyle’s thinking.
Wonderful discussion. It revealed a split in our profession that few see or, as far as I can tell, understand.
Why would a PT need to “treat” rotator cuff tendinitis other than by providing advice and re-assurance so that the tissues heal appropriately?
Pain ***is*** a rabbit hole- we need to get used to that.
This appeal to some pathoanatomically driven condition seems to be the fall-back position of those who argue in favor of implementing CPRs in practice- they seem to hold out the possibility of some underlying peripheral driver of the pain experience that we are capable of influencing with a certain intervention- no matter what the condition. Except, of course, for those “crazy” patients with central sensitization.
This was a spectacular performance by Kyle Ridgeway. He made his points clearly and persuasively. I think I saw him bite his lip a couple of times- and I almost wish he hadn’t.
This should be must see PTTV for all DPT students.
Exactly right. Kyle’s forbearance is laudable, but I understand as well Eric’s tendency to make sense of the CPRs. They’re poorly understood.
I like the discussion that the CPRs are not (and are not intended to be) a be-all-end-all. I think it is very useful to consider the rules as an addition to your clinical expertise and the patient presenting in front of you. I think they are particularly useful for new therapists as a starting point and a guide to build from when they haven’t yet developed that clinical expertise piece.
I also think for example the LBP classification rule that this is useful for marketing/referral relations – we have evidence to present to the physicians we have relationsips with that if they refer the patients to us sooner, we have evidence-based tools that can get them better faster. Also, I think it is useful for public education not to wait to seek treatment, and fuel for patient direct access legislation.
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