One of the things we encounter as physical therapists is a need for an eclectic approach. What this means is that we need to have many different methods to accomplish the same goal. Why is that? Often, patients will present with certain restrictions that may limit the effectiveness or safety of another approach. For example, when addressing cervicothoracic junction mobility using joint mobilization/manipulation, we recently posted a video on the Insider Access Page describing 3 manual techniques for this. They included a seated distraction manipulation, a prone chin pivot mobilization/manipulation, or a seated PA mobilization. Some patients will not be able to tolerate all these techniques. A patient with shoulder pain/instability would have difficulty with the seated distraction manipulation. A patient with TMJ dysfunction could not tolerate the prone chin pivot technique. Not every technique is appropriate for every patient.
Another reason for knowing a multitude of methods for treatment includes the case where not every patient will respond as well to the same technique. I recently had a patient who I had regularly performed distraction manipulations, repeated motions, dry needling, IASTM, and mobilizations in OKC and CKC to improve talocrural mobility. While there was some progress, the results were limited compared to what was expected. I consulted another PT with two additional techniques I was unfamiliar with in order to trial them on my patient (soon to be shown on Insider Access!). He immediately displayed significant improvements in mobility and pain. This is a perfect example of why we should continue to learn as many treatment techniques as possible. Not all patients will respond as significantly with the same technique.
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