Evidence vs. Experience: Navigating the Complexities of Patient Care

Sensory Approach to Manual Therapy

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What happens when the science we rely on and the patients we treat seem to be telling us different things? In this thought-provoking conversation with osteopathic practitioner Sam Jarman, we dive deep into the sometimes confusing relationship between evidence-based medicine and patient-centered care in manual therapy.
Sam challenges us to reconsider how we apply evidence in our hands-on practice, noting that "the map is not the territory" – research papers represent averages and populations, while our clients are unique individuals whose responses may not match what studies predict. This leads us to one of the most fascinating paradoxes in our field: techniques like myofascial release that work clinically despite research suggesting they shouldn't be effective based on their proposed mechanisms. Rather than abandoning these approaches, Sam suggests we might be "talking about the wrong mechanism but doing the right behavior."
Perhaps most valuable for practicing therapists is Sam's framework for balancing technical skill and bedside manner. When there's an identifiable problem that will respond to technical intervention, your expertise should lead. When there's no clear target or when conditions aren't responsive to manual techniques, your interpersonal skills become your most powerful tool. This elegant framework provides clear guidance for the moment-to-moment decisions we make in treatment.
We also explore why experienced therapists from different disciplines often converge toward similar techniques despite different theoretical backgrounds, suggesting there are fundamental principles underlying effective manual therapy that transcend our professional divisions. Sam proposes focusing on these bedrock principles rather than getting lost in terminology that may not fully apply to our work.
Whether you're a massage therapist, physical therapist, chiropractor, or osteopath, this conversation will give you practical insights to enhance your clinical reasoning and treatment outcomes. Subscribe to the podcast for more conversations that bridge the gap between science and practice in manual therapy.

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فصول

1. Introduction to Sam Jarman (00:00:00)

2. Defining Evidence-Based Medicine (00:08:30)

3. Map vs. Territory in Manual Therapy (00:17:43)

4. The Myofascial Release Paradox (00:30:53)

5. Fractioning Systems in Manual Therapy (00:43:17)

6. Patient-Centered Care and Autonomy (00:54:12)

7. Balancing Technical Skill and Bedside Manner (01:01:06)