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  • Dr. Piotr Solowiej PT, DPT

A Major Milestone

Advanced physical therapy low back assessment (MDT manual)

This is pretty crazy to say, but as of April 3rd Team Sapiens has officially been providing physical therapy and wellness services to the Northbrook and greater Northshore/Chicago area for 1 year!!! Obviously I'm a little late in announcing, but for good reason. The clinic is going strong and I've been busy with the daily operations of patient care. Karen, Slavko, and I want to do something special for all our amazing friends, family, and of course patients that have made our first year such a success. Stay tuned for details about our 1 year celebration!


The last year has gone by incredibly fast and been packed with non-stop learning experiences and personal growth. The whole team continued that theme last weekend as we spent our company's anniversary in Austin, TX for a 4-day intensive course on advanced lumbar spine and lower extremity assessment and management (Part C of the McKenzie Method).


A quick aside - Austin is pretty great city. Very active, and growing fast. For the foodies reading, there are tons of food trucks and craft breweries and restaurants. Here are some of my favorites from the weekend: churros, mini donuts, and arepas (Venezuelan).


The reason all 3 of us are fans of the MDT system is because it gives us a consistent and systematic way to evaluate patients. No two cases are alike, and the possibilities for how a person can present are pretty much endless.

When dealing with such a high level of complexity, it behooves us to have a system for testing and identifying patterns so we don't get lost in our own, or the patient's biases because many examination tools result in false positive findings. It's very easy to be duped by a confirmation bias (among many others) and develop a logical, but erroneous and fallacious case for a particular course of care.

That's not to say that the MDT system is immune to faults. But it is the best system I have come across that effectively curbs the leaps in logic and thought of this fallible human brain of mine.

The MDT system classifies 3 main clinical presentations. Let's call them A, B, and C. The details of these syndromes are not important for this post. But it is important to know that there is some overlap among the 3, which requires a degree of analysis to differentiate definitively.

One of the most powerful thoughts about last weekends course is that in order to initiate treatment for a certain condition, you had better prove all other possibilities are no longer in play. As I said this requires a bit of investigation, and with all the variables we're dealing with as healthcare providers, this can often take several sessions to confirm.

This is no revolutionary thought. In fact, the basic premise - examine and differentially diagnose the problem based on the findings - is a foundational tenant of the physical therapy profession. However, it's easy to get intervention happy and burn through the examination to get to the sexy stuff (wanting to 'fix' people, demonstrate a certain level of skill or expertise). I often fall into this trap. I'm working on it.

It's called physical therapy practice for a reason.

It has to be worked at to perform at the top of your game. Even the basics.

This last weekend was just another step I'm taking to further my understanding of the human body. And it was a great reminder to utilize the basics of my professional training.

Thanks for reading,

Dr. Piotr

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