Therapy Insiders interview with Stu McGill entitled “the mechanics of a treatment approach with Dr. Stuart McGill"This was an interesting interview with some nice clinical pearls. Anyone who has had the opportunity to see Dr. McGill speak will certainly appreciate his humor and candor.
After a lengthy discussion on mustaches, they began to talk about competency of therapists. Dr. McGill then explains some salient points in his three hour evaluation of patients. His goals are to "precisely define The pain triggers to that patient” and then to “remove them”. Pretty simple but effective. We think the keyword here is “precisely”.He then talks about utilizing your clinical knowledge based in the powers of observation.
His assessment begins with a patient interview to determine The character of the patients pain. He’s very careful to listen to “exactly” what the triggers and really are for a patient’s pain. He then goes on to offer some nice clinical diagnostics pearls that we will leave for you to listen to the podcast to glean.
He then again emphasizes observing the patients movement and movement habits to establish their stability/mobility continuum. His examination consists of three parts: provocative motions, neural tests, and tissue specific tests. He looks for provocative motions postures and loads. Once the pain should use identified, he then seeks to find positions postures or movements which will alleviate it. He then does neural tests, looking for things like neural or root tension. Finally he discusses some tissue specific diagnoses.
There’s an interesting discussion on pain and pain science. Dr. McGill emphasizes that people need to avoid the movement which causes pain not moving in general. He then goes on to talk about Central sensitization and how, if you can teach people to not invoke their “pain trigger” motion, that they will actually improve and central sensitization will decrease. in other words, don’t move “through” pain but find ways to work around the trigger.
There’s been a series of “Twitter” questions that are answered with an interesting discussion on Core stability and superimposed axial movement. All in all a informative interview with some clinical pearls.