From the Pond: Of Tedium and Ennui

Hippocrates has even left directions how we should cut our nails; that is, even with the ends of the fingers, neither shorter nor longer…

When I was in physical therapy school, the first thing that I was taught was how to assess the patient’s posture with a plum line. Which shoulder is higher? Does she carry her arms the same way on each side? Are his hips level? Are the knees in line?

When I began post-graduate courses I learned how to influence some of these postures with exercises/activities to restore symmetry. For instance, there are purported ways to correct for lateral shifts and an assortment of breathing exercises to reduce pelvic and thorax incongruencies. Contract relax and muscle energy techniques can seem to improve a patient’s static posture as well. Of course, a few days later, the patient often returns for their next visit presenting with the same ‘deficits’ as the visit before.

Most frustratingly for the clinician, sometimes the patient feels better, sometimes they feel no different, while other times the patient feels worse. The therapist would like for the patient’s report of symptoms to strongly correlate with the carry-over of symmetrical static postures from the visit before, but this happens less often than most would care to admit.

Now 15 years into this career that I have chosen, I remain fascinated by how the body can move in a seemingly innumerable number ways and combinations, yet every guru that I have every met or learned from claims that they alone know the way to make things right. Despite the unidentifiable variables and confounding experiences/beliefs that a patient brings with them into each therapeutic encounter, therapy clinics nationwide often take every patient and place them into the same one-size-fits-all bio-mechanical algorithm in an effort to improve posture and efficiency through the endless pusuit of symmetry. Each asymmetry (of course) has it’s own label/diagnosis/classification, each of which come with their own prescribed activity to correct that which is flawed; if one guru’s evaluative/treatment technique don’t work, surely the clinician can learn more from another.

Even still, I will work with the patient’s nervous system to allow it to find its own way.

…Undoubtedly the very tedium and ennui which presume to have exhausted the variety and the joys of life are as old as Adam. But man’s capacities have never been measured; nor are we to judge of what he can do by any precedents, so little has been tried.

*quoted passages from Walden


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