I used to be amazed by health care professionals who would diagnose a person’s movement problems by just watching them walk across the room.
Equally I would be very impressed when practitioners claimed they could feel tension in a muscle.
In a recent NOI post the idea that practitioners can be so precise as to not only feel tension within a muscle but to identify taught bands within specific muscle fibres is called into question. They point to a 2006 review study that showed only muscle endurance tests and symptom response tests have any significant reliability.
That is not to say that there aren’t practitioners out there with incredibly precise palpation skills, it’s just that decisions made as a result of those palpations may owe more to pareidolia than to anything quantifiable and repeatable.
If you push into tissue and feel more resistance in one area than in another, what does this represent anyway?
Every therapists favourite spot to push is on the top of the shoulders, usually into Upper Trapezius. Patient and practitioner alike normally hum in unison ‘that feels tight’.
Let’s do an experiment, try this and tell me what you feel. Sit with your shoulders slumped forwards in so called ‘bad posture’. Now push a couple of fingers into the top of your shoulders. How does that feel? Tight? Now sit up tall and drop your shoulders back. How does the same spot feel now? Looser?
What did we change?
The position of a few joints. The funny thing about the example above is that upper trapezius will help keep those shoulders back but not of course if you keep massaging the life out of it.
My point is this, pushing into an area of the body and making both a diagnosis and treatment plan based on how much resistance there is to your touch is not a reliable way to treat. Just as you can’t really decide what is wrong with somebody by watching them walk across a room.