Don't 'Technique' Your Patients

When teaching courses I am often asked by students and practitioners

"What techniques are good for this condition? " 

or

" What techniques should I use for that injury?"

This is not an easy question to answer as the line between technique and treatment is a blurred one. 

It is important that we do not technique our patients.

By this I mean we do not just perform a given list or series of techniques or moves on a patient. The osteopathic approach to treatment does not have recipes or protocols for conditions and practitioners should not restrict themselves to a limited number of techniques in a certain position as they will surely be lost when they come up against a situation that calls for them to adapt their methods.

What we should aim to do is select and apply our technique to the patient in front of us in a flowing therapeutic way constantly monitoring the response from the patient and their tissues. We should be ready at a moment’s notice to adapt our approach in terms of patient or practitioner position, force, speed and timing.

Technique can easily and unfortunately be given as series of one-off moves in the hope of providing some relief for the patient and can sometimes succeed. But this is not treatment, you can easily teach a lay person off the street a supine thoracic ‘DOG’ technique, leg tug and neck stretch but performing these on patients is not treatment, it is just technique. The lay person does not have the clinical experience or palpatory skills to adapt to the patient in front of them, they just know three techniques.

In order to give effective treatment, there must be a specific plan.  

Our patients present with all kinds of previous history’s, musculoskeletal dysfunctions, emotions, morphologies, pain levels and expectations. We should have formed an initial diagnosis from our examination, have a specific goal or objective in mind in conjunction with the patients’ expectations as well as an idea of a realistic prognosis. Then we can begin to draw on our knowledge of and training in techniques to begin to formulate a treatment, adapting and applying our techniques into treatment that is appropriate for them each time we see them.

Don’t technique your patients: train hard to improve your motor skills in manipulation so that you can intelligently apply and convert your technical skill in to effective treatment.

Jamie