The Known Constraint

“Science advances one funeral at a time.” A quote by physicist Max Planck which holds up all too well in so many fields. New ideas are difficult to come by, and when they challenge the status quo, they often receive heavy criticism if they are not completely banished from the established understanding. Physical therapy lives in a similar environment. Established evidence and paradigms dominate the narrative for treatment rationale and they dictate options for clinicians when it comes to patient care. The outcomes these dogmas result in are sub-optimal, yet they prevail in their power over interventions applied.

A long time ago we discovered muscles during human dissections, we traced their attachment points, and we equated them to pulley systems. This was our best understanding of how systems moved. Today we still use this model as our best approximation of how human beings create motion, despite clear progress in our interpretation of the rules of nature. We have yet to move past this explanation because the established truth runs so deep, questioning it can lead to being discredited in your capabilities as a professional. The knowing has become the constraint on further understanding.

We can do better. Challenging what we have presumed is true is a bold move, but a necessary one. Developing better explanations for what we observe is a way in which we can continue to learn and improve our current circumstances. There is so much we have yet to discover in terms of how people move. Asking questions that promote curiosity and even just temporarily suspend our current beliefs can lead to advancements that we had never before considered. 

Austin Ulrich, Physical Therapist