The goal of a practice that adopts an EBP approach is to provide the most effective care we believe is available, (at the present time) based on scientific findings.
What IS an "Evidenced-Based" Practice? EBP?
"An evidence-based practice is any practice that relies on scientific evidence for guidance and decision-making. Practices that are not evidence-based may rely on tradition, intuition, or other unproven methods."
There Are Many Versions of the EBP Concept:
- "Evidence-Based"
- "Evidence-Informed" (Our preference)
- "Science-Informed"
these terms are used in many disciplines of health care; from physical medicine to social work to psychotherapy.
Evidence Based Medicine originated from those practicing medicine in France in the early to mid-19th century.
Currently:
It appears that most of today's clinics provide therapy or medical intervention based on what they learned years ago in school.
They've found some approaches that work to get the clinical outcome they're shooting for, like pain relief or improved movement, but...
newer clinical approaches may actually work even more effectively.
If the practitioners are still 'stuck' in their old ways, they and their patients don't have the opportunity to reap the benefits of newer protocols and current scientific understanding.
They may still be touting mis-informed concepts or information, that are either false, out-dated, or mis-construed.
Quick List of Information that Is Out-dated or Wrong, and NOT Science-informed:
(If your therapist is still touting these thoughts, you might want to reconsdier their level of current clinical information)
- CLAIM: "Lactic Acid needs to 'be released'"
TRUTH: Lactic acid is a by-product of high-intensity muscle contraction. Lactic acid levels are down to baseline within about an hour and starts to dissipate from our body naturally within seconds to minutes through breath, movement and appropriate hydration. (The soreness that many people equate to lactic acid is actually DOMS (Delayed Onset Muscle Soreness) which is due to tiny, micro-tears in the soft-tissue. Gentle, low-intensity movement of the same activities that caused the miscro-tears is suggested to speed the recovery and reduction of soreness from a hard workout. ) - CLAIM: "Toxins Build Up, so Drink Lots of Water After a Session"
TRUTH: It's smart to stay hydrated, always. There's no such thing as "toxins being released that need to be flushed"...
Our bodies are pretty darn capable and smart at how to handle any by-products on their own. - CLAIM: "No Pain-No Gain"
TRUTH: Why? Just why? For anyone who's already in pain... what good can more pain produce? Our belief is the amount of manual pressure applied or the intensity of the stretch, or the ... should ALWAYS be considerd HELPFUL, rather than HURTFUL.
Pain is subjective, each person guages 'enough' differently. However, if it 'hurts' to the degree of wanting 'it' to be over -- it's too much. A chemical cascade of hormonesoccurs when we experience pain. Chroniuc pain actually changes our brain.
If the sensation is subjectively interpreted as , "wow, this is intense, and I'm glad we're doing it because it feels beneficial..." then the intensity is probably appropriate. - CLAIM: "The Deeper, The Better"
TRUTH: See above! - CLAIM: "It's Normal to Be Sore After A Manual Therapy session, or Massage session"
TRUTH: See above! And, NO.
As our director, Irene Diamond, often says, "It may be COMMON, but it's not optimal!"
If a client is 'sore' after a session it's most-often because the therapist either applied (1) too much pressure, (2) moved the tissue/ their hands too fast, or (3) pressure used was too deep for that area, or that person or both.
Certianly, some people's skin or tissue is more sensitive than others... And, maybe, once in a blue moon a person might have mild discomfort in an area that was 'worked'... but it's rare to have the discomfort last longer than a few hours, and certianly there should be no extreme bruising or discoloration. - CLAIM: "My Therapist Can Fix Me"
TRUTH: We faciliate, and support you to experience changes, rather than 'fix' you. We believe we partner WITH you, to co-create the therapy and treatment plan so you achieve your goals and desired clinical outcome. We encourage you to recognize that physical change comes from within ourselves, with external support. (the goal is to build your self-efficacy).
Many providers used to think our physical changes only came from the external intervention that the therapist provided. Now we know our psychological and cognitive awareness, observation, and thoughts all play a role.
Science (and we) support the 'top-down' reality, rather than a 'bottom-up' old-school approach.
A 3-Step Approach:
A therapy or medical practice can consider themselves "Evidenced-Based" IF & WHEN they follow a 3-step approach to how they treat their clients and patients, the protocols or plans of care they follow, or the methods and modalities they incorporate.
The concept of 3 pillars of EBP began around the 1990's:
David Sackett is recognized as the pioneer of Evidence Based Medicine. He said,
"It's about integrating individual clinical expertise AND the best external evidence."
David Sackett's 3 Pillars of an Evidenced-Based Practice, which we follow:
- Clinical Expertise
- Evidence
- Patient Preference
David suggested all three Pillars were equally important, and they often used a 3-legged stool analogy to explain how 1 or 2 Pillars could not be used without all 3, or it would not stand up.
The 3 Pillars are important, but each pillar probably does not have equal importance.
MOST CLINIC'S GOAL IS TO BE TRENDY!
Choosing to incorporate scientific evidence or only providing services informed by scientific support is the opposite of how many clinics chose their Services and Offerings.
Most clinics create 'fancy' services based on what's popular or trendy at the time, or offer services that will bring in the most money for the clinic or practitioner.
Often, these non-science-based practices will provide treatments based on what the clients and patients are asking for, which may however, be bogus treatments.
For example, Reiki, Reflexology or Essential Oils are sometimes requested of us, but those are not offered in our center because science does not support their efficacy.
At Diamond Pain Relief & Wellness, we provide manual and movement-based therapies, that integrate what is currently being supported by science, along with our understanding of how each client has unique needs and comes from a unique background of experiences, therefore each therapy session and therapy plan is hand-tailored to the individual.
We incorporate thoughtful discussion with a client to partner with them on achieving their clinical goals. We strive to build 'self-efficacy' which empowers the client to take care of their own health and wellness.
Most People Have It Wrong:
Science Doesn't PROVE Anything!
In science, the term 'proves' is not an accurate word to use. It's better to say 'science supports...'
EBP's incorporate the most current, scientifically supported approaches to client care.
WE WERE OUT-DATED, Now We're INFORMED:
PERFECT POSTURE IS NOT THE GOAL!
Here is a perfect example:
Here at Diamond Pain Relief & Wellness, we USED to think that PROPER, PERFECT POSTURE while sitting , standing, working, reading was needed to reduce or eliminate neck, back and hip pain.
'Forward Head Posture"
"Wall Stand" to Create Awareness of Alignment, & Stretch and Strengthen.
It's accurate to think the very common 'forward head posture' in-deed can cause mechanical stress and strain because our heads do weigh 10-ish pounds, so our muscles are doing 'extra' work which can lead to fatigue, strain, and stress.
And, when we maintain our heads and upper torso in an up-right alignment, it reduces the mechanical forces that apply pressure on our fascia, muscles and joints, which often does reduce our pain, headaches and migraines.
What we now know (based on science) is that more important than "Perfect Posture" for pain relief, is moving and changing positions often, whether you're sitting, standing, working or even your sleeping position.
Now science re-inforces movement is key -- we incorporate movement into almost every therapy session (when appropriate) to achieve the best, most effective, efficient, results.
Listen as Paul shares his Ankle Rehab experience:
Your care through Diamond Pain Relief & Wellness:
- You will always be educated on the "what and why" we think things might be going on so you can be informed and understand your personal situation and experiences.
- You will always be asked for informed consent before we ever do anything to or with you.
- Your care will be corroborated by us along with your other health care providers (if and when necessary) so we support you as a team.
- You will always know what to expect from each session and from any program you participate in.
- Your therapy plan and practitioner will follow data-based, clinically supported modalities, plans of care, procedures and approaches.
- You will receive therapy to address the underlying cause of your pain, restrictions, and limitations - not just relieve your symptoms.
- Your therapist will use their critical-thinking skills, experience and training to accompany their knowledge of science-supported studies to design your treatment plan.
- Your therapist will not fall into the 'trap' of thinking 'Correlation Indicates Causation" and will help you to see things from a different perspective taking all variables into consideration.
- Your therapist will stay up on the current understanding of Pain Science + Neuro Science.
- You will partner with your therapist (and Irene Diamond, our director) as you progress. We encourage what we call, The Roadmap To Wellness, 4 Phases of continuum of care.
As a Precise Private Practice,
we support your care through
Peer Reviewed, Evidenced-backed intervention and support.
We will:
- Ask you in-depth questions to know PRECISELY what you hope to achieve regarding your health and wellness.
- Discuss your past therapy / surgery / treatment / intervention and experiences of what has worked/not worked for you.
- Explore with you any imaging you've had such as Xrays or MRIs, and doctor reports.
- Offer you PRECISE therapy options we think would be best to resolve your symptoms
- Determine (with you) the PRECISE Phase on The Roadmap To Wellness Continuum to know how to proceed.
- Continually monitor your progress on a regular basis so you get the absolute BEST outcome from being one of our PRECISE, hand-selected chosen clients!