Updated: Apr 27
Once or twice a month a patient will ask me "Out of the exercises you've given me, which is the one I really need to do?"
I get it - I mean I talk so much about diagnosis, which essentially means putting someone's problem in the smallest box possible. If you can do that - really pinpoint the problem - can't there be one treatment - be it manual or movement based - that will be the domino that pushes all of the other dominoes over? Do I really have to do all of the exercises? Every day?
Sometimes you can narrow the treatment (aka plan of care) down to one thing, and still be as effective as a complete plan of care. But usually not.
Usually a plan of care is like a recipe. There may be a key ingredient - let's say it's rice - but without the vinegar and basil and whatever else goes into it (can you tell that I'm not a cook?) the meal just won't taste right.
As Mia (an amazing PT - and person too - that was part of our team for 9 years) used to say - it's like wine pairing - you put the correct foods with a certain wine. PT diagnosis and treatment is the same. We have evidence based diagnosis, and then we have evidence based plans of care that match that diagnosis. If we can get the job done with one intervention, one time, we will. Unfortunately it usually takes more than that to get rid of pain, return to full function or optimal performance, and get sustainable results.