And I have heard similar mind boggling stories, such as feeling for pipes and cables through walls. This I was lead to believe would improve my sensitivity to touch and improve my skill as a physio. This belief delusion starts off very early for most therapists, with tutors filling their heads with nonsense and instructing students to practice the art of palpation in some weird and wonderful ways.įor example, in my first year as a physio student I was told by one of my more eccentric crazy tutors to practice feeling for strands of hair underneath sheets of newspaper! I kid you not, I was told to pull hair out of my head, place them under newspaper and feel for them. Many therapists believe they can develop these powers of palpation through vigorous training, relentless practice and years of experience. That they develop some kind of mystical extra sensory perception when it comes to feeling things. It’s a common fallacy and widely held misconception by many in the healthcare profession and the general public that therapists can detect things with their hands and fingers that mere mortals cannot. Well, To put it simply, I can’t do any of these things, and neither can you, despite what you may think or believe, or even have been told or taught to believe. Finally you would assume that my surface anatomy land marking is second to none and that I can find a structure with ease and tell you if it is in its correct position or not. That I can readily feel scar tissue, adhesions and ‘muscle knots’ with ease. That I can easily distinguish a tight and tense muscle from soft and relaxed one. So as an experienced and expert palpater you would assume that I can reliably feel the difference between a stiff and a loose joint. So I think I can confidently say that I’ve have had plenty of experience in palpation, and can be classed as an expert in palpation. In fact, I estimate I’ve prodded about 25,000 people so far, and that’s a conservative estimate. What I am trying to get across to you, is that I have palpated a lot of people in my career. Now before this starts to sound like some dodgy confession at a self-help group for ‘ Palpators Anonymous’ let me try and explain where I am going with this pre-ramble. I poke them, I prod them, I press them, I pull them in all sorts of ways, in all sorts of positions and in some weird and wonderful places. I palpate a wide and diverse variety of people from the old to the young, the fit to the not so fit. Well, believe it or not I do touch people. Now as a physiotherapist you won’t be surprised to hear me say, I touch people, I prod things, I poke stuff… Maybe you are surprised to hear that, as I know many think I don’t touch my patients at all due to my strong and scathing criticisms I often make about manual therapy. Instead I am only discussing palpation in its DIAGNOSTIC and ASSESSMENT capacity and seeing if it stands up to scrutiny to the claims made by many. However, before I get started, let me make it clear that I am not discussing the THERAPEUTIC effects of palpation or touch, thats another blog completely. This blog is a talk I did recently at a Sports and Exercise Medicine Conference on the role of palpation within our profession, highlighting some of the issues and doubts I have with many of the claims therapists make and beliefs they have with many palpation tests.
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