Issue link: https://www.massageandbodyworkdigital.com/i/1402696
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 61 HOW DO WE KNOW WHAT WE KNOW? I believe there are four major models for accumulating knowledge and wisdom: the authority model, the experimental model, the evidence-based research model, and the critical thinking model. Let's explore each one. AUTHORITY MODEL The authority model posits that we follow whatever authority we believe can impart knowledge and wisdom to us. Sometimes the phrase "sage on the stage" is used to describe a seminar or workshop presenter who is the proponent of some technique. Or perhaps "sage on the page" for the author of a book that we read (or even this article). The problem I have with this model is: Authorities often disagree with each other. So, whom do we believe? EXPERIMENTAL MODEL The experimental model involves us trying manual or movement therapy techniques that we have learned. After all, if it is valid, we should see good results with our clients. The problem with this model is two-fold. First, our clients do not necessarily want to be our guinea pigs. Second, and more importantly, when first learning a new technique, we might not have the expertise to carry it out well enough to judge whether it is effective. EVIDENCE-BASED MODEL The third model is following evidence-based research. I believe this is an important model but can have the limitations I discussed, as well as others. Recently, I came across an Instagram post that read: "Don't let 'the research' get in the way of LOGIC and CRITICAL THINKING . . . Research is only one piece of the puzzle. Don't let it blind you." CRITICAL THINKING MODEL While there is some value in each approach to gaining knowledge and wisdom, I believe critical thinking is the most important. Although we might never know all aspects of how the human body works, our understanding of the fundamentals of the biomechanics of tissues (characteristics like tissue adaptation, elasticity versus plasticity, creep, etc.), as well as the biomechanics of forces and movement (compression, shear, torsion, tensegrity, etc.), and our understanding of how the nervous system organizes the myofascial- skeletal system (proprioceptive neural reflexes, neural facilitation, etc.) are well understood and time-tested. Ultimately, it is our role to treat and counsel clients about their postural patterns, including FHP. While we can consult what thought leaders in the field say, and we can consult the latest research findings, I believe the most important thing is to take a step back and look at the mechanics of the posture. What muscles are shortened, lengthened, or working harder? What are the loads on the fascial tissues and bones? What are the mechanics? What are the pathomechanics? What are the physical stresses to the tissues? What will be the likely effect of those stressors on the health of the client's body? I believe that by integrating fundamental biomechanical principles of anatomy and physiology with our assessment and treatment skills, we are empowered to critically think so we can assess the role of postural distortion patterns such as FHP. We can then creatively apply our manual and movement therapy skills. NOTES 1. Nesreen Fawzy Mahmoud et al., "The Relationship Between Forward Head Posture and Neck Pain: A Systematic Review and Meta-Analysis," Current Reviews in Musculoskeletal Medicine 12, no. 4 (2019): 562–77, https://doi.org/10.1007/s12178-019-09594-y. 2. Nesreen Fawzy Mahmoud et al., "The Relationship Between Forward Head Posture and Neck Pain: A Systematic Review and Meta-Analysis." Dr. Joe Muscolino has been a manual and movement therapy educator for more than 30 years. He is the author of multiple textbooks, including The Muscular System Manual: The Skeletal Muscles of the Human Body (Elsevier, 2017); The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns, and Stretching (Elsevier, 2016); and Kinesiology: The Skeletal System and Muscle Function (Elsevier, 2017). He teaches continuing education workshops around the world, including a certification in Clinical Orthopedic Manual Therapy (COMT). He has created LearnMuscles Continuing Education (LMCE), a video streaming subscription service for manual and movement professionals, with new video lessons added each and every week. He has also created Muscle Anatomy Master Class (MAMC), the most comprehensive and detailed muscle anatomy online class in the world, with each muscle taught in five distinct video lessons. And he has created Bone And Joint Anatomy Master Class (BAJAMC) and Kinesiology Master Class (KMC). Visit learnmuscles.com for more information or reach him directly at joseph.e.muscolino@gmail.com.