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Tweakology: The Superior Difference

November 27, 2014

Can you envision a physical therapy experience where the therapist truly cares about your story, truly cares for you, motivates you, and encourages you?  Can you envision a physical therapy experience where your care is unique, where the treatment is based on the most recent research, and the care is 1 on 1? Can you envision a physical therapy experience that looks and feels exactly like the activities you want to return to? The goal of physical therapy at Superior is to create an environment to allow the mind, body, and spirit to heal by empowering the patient to return to life as they remember it, allowing them to return to recreational activities and enable them to perform specific tasks throughout the day without being limited.

So what should physical therapy look like when having this idea in mind?  The answer is; it depends.  It depends because we know motion is driven, and we know motion is context specific.  Simply put, if we want to get better at walking, or be able to walk effectively without pain then it would be wise for the strategies to look and feel like walking!  So, the plan of care for an individual who has knee pain and wants to be able to cross country ski should be completely different than an individual who works at a factory and wishes to be able to perform their duties pain free.  Knowing this principle as a truth of human movement, how could we ethically treat each person with the same protocol?  How could we treat each person with significant use of artificial equipment (modalities) spending significant time in an artificial environment? (A table).    This is where the tweakology comes in to play, and this is one of the most important concepts at Superior.

Tweaking is complex, because human movement is complex!  Gary Gray and the Applied Functional Science approach teach that tweakology is the study of choosing effective strategies to create an environment for assessment, rehabilitation, prevention, and performance training.  In order for treatment to be effective, our strategies, our tweaks must directly reflect the truths of human movement, and functional biomechanics.  Tweakology is what enables us to apply movements to the plan of care that are authentic to an individuals life!

As humans, we were created to move!  Movement can be described as conscious actions and subconscious reactions.  Whether we are reaching for a cup, raking the yard, walking, or shoveling the driveway, we are not conscious of every movement taking place throughout our body (thank goodness)!  We are consciously aware of the task at hand but we are not aware of the chain reaction in our body that occurs with carrying out each and every task.  To illustrate this I encourage you to stand and reach for something across your body, or reach overhead for a cup in the cupboard, or even turn your head to look at something.  I want you to perform this motion a couple times, be mindful; what is going on at your feet/ankles? What is going on at your hips?  What is going on at your low back?  It quickly becomes evident that with whatever task we are attempting to accomplish, our entire body is involved.  This is the truth of what happens throughout our day, our body functions as a whole unit.  Aristotle says the whole is greater than the sum of its parts, this definitely rings true in function.  In order to be effective It is imperative to approach rehabilitation and training with this in mind.  Knowing the whole body is involved when performing a task at hand, why would we blame a single localized joint when it is in pain?  If your shoulder is in pain, why would we exclusively focus on this and ignore the rest of the body?  Knowing our body functions as a unit, wouldn’t it make sense for us to look up and down the chain to search for the dysfunction?

The good Lord created us in order to function as a wonderful complexity, this needs to be respected and appreciated in both the rehabilitation, and the training settings.

Author: Nick Hawkins DPT, CSCS, CAFS


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