I find it amusing to read case reports in our profession’s journals concerning the treatment of one condition or the next.  It is not because they are not written well, because they are; but mainly what ‘we’ do as a profession.  We literally seem to stretch in every direction and strengthen every muscle within a 3 foot proximity of the injured area.

Many of you are balking in your seats thinking, well we need to because the muscles are weak, or shortened, or it has been shown that movement of thoracic spine is related to shoulder pain, etc.  All of this is true and I know as well that a simple pain is very complex and requires a multimodal treatment approach.

For a mechanical change, do we really need to stretch both shoulder internal and external rotators, knee flexors and extensors?…you get my point.

My concern is, where does this stop?  With more research coming out showing relationships between various mechanical aspects of the body, the flow sheets could go on and on.

Do we do this because reimbursement comes from how much time we spend with the patient (not always but typical)?

Or, do we want to make sure we do not leave any rocks uncovered?

Or, do we need to prove our education and knowledge of everything on and around the injured part?

But in all, do patients need to spend 45 min stretching and strengthening everything their mother gave them for US THERAPISTS to get results?  Is this how we are going to separate ourselves from the rest of the rehabilitation/exercise world?

Harrison Vaughan, PT, DPT, Cert. SMT is a physical therapist at In Touch Therapy in South Hill, Virginia.  His clinical interests involve orthopedic and manual physical therapy, including clinical diagnostic tests.  He enjoys treating the spine but his dynamic work setting in a rural area provides an opportunity to treat a wide variety ranging from pediatrics to the neurological population.  Harrison received both his Bachelors of Science degree and Doctor of Physical Therapy from Old Dominion University in Norfolk, Virginia. Dr. Vaughan is certified in Spinal Manipulative Therapy through the Spinal Manipulative Institute and American Academy of Manipulative Therapy. He is a member of the American Physical Therapy Association with a special subsection in Sports and Orthopedics and currently assists as Co-Chair of Technology position of the Virginia Physical Therapy Association.  More of Harrison’s blogs can be found at

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