Dear Alophysio

This approach of managing a patient is not new. I believe its something that Wikipedia reference-linkBobath therapists have used for many years, I believe Kinesiologists have described in many texts and I also believe even podiatrists use this approach.

Having read your comments, I believe its purely common sense for anyone who is addressing any mechanical issue to consider the body as a whole because every part is linked. It takes years of training and practice to acquire the skill that you clearly have...

However, this is nothing new to be honest, on a very basic level...its the same concept that is put into practice when a shoe raise is prescribed for a limb length discrepancy... its all about understanding the body biomechanics and seeing the whole body as one not individual parts...

Bobath therapists start by understanding what "normal movement " is, deviations from the norm is what we try to correct. I think we are all saying the same thing but speaking different languages...

Why I was impressed with SigMik's comment was because I thought only bobath therapists assess that way, but clearly it is a holistic problem solving approach.
It is the same reason why we treat someone with an impingement syndrome, we no longer treat symptomatically, we aim to address the faulty biomechanics that are resulting in the impingement...

Some author will wake up tomorrow and give this old concept another name...he could decide to call it...reverse pathomechanics and start a whole doctrine on something that isnt new but make it appear new...

why do scoliotic clients sometimes have backpain, or why would having a forward neck give you back pain, or why would having pronated feet cause back pain, or varus knee give you neck pain, or an LLD cause back and hip pain?
In My own experience, I have found that this approach cannot work for every single patient because the question still remains who are we to define normal movement or appropriate biomechanics? what is normal for you may be abnormal for me?...where there has been structural changes, this aapproach will not work...this is where you begin to start thinking of adaptations.

It is theoretical to explain but the reality is that people come in all shapes and sizes. Perhaps in an acute case in a young client you might be able to apply his approach, however the body has a way of adjusting to the forces it experiences (sometimes for good sometimes for bad)...attempting to align one part to address one issue can easily also cause a malalignment some where else making things complicated... this is why sometimes symptomatic management is fine for as long as a patient gets relief and is left with good advise and being well infomed of what the problem is and how to self manage...

I think I say this because right now I am basically seeing elderly clients wherein they do not follow the norm of what our trainings or courses have to offer...

A typical example...
saw a man with chronic back pain (greater than 15 years) with a clear small kyphose lumbar spine, extreme caps limitation in the spine, pelvic obliquity, with a forward neck...this man was roughly 6ft three had a protruding stomach, he was 83 years old...osteoporotic generally...history of a heart problem etc... can hardly stand up straight,
howver way I understand the pathomechanics going on...it is unlikely that any of my myofascial release, realignment and postural correction would make a difference to this mans symptoms...Things have become structural...im likely to cause more damage by applying any phsical intervention...

Another example, 19 year old cerebral palsy with tight adductors, plantarflexors, lordotic spine and retracted neck...where do you want to begin to address any pathomechanics, some surgeon was suggesting surgery to elongate the tight muscles...only problem was this was likely going to cause major balance issues as this boy had adapted to the postural control he had learnt since a baby...

I agree with you that a better description would be to call it an awareness of the neuromusculoskeletal system as a whole...there is an author sharmann I think his/her name is and they popularized some aspects of understanding movement disorders like the one you describe but the reality is it is not a new concept...

Based on what you've said, I agree with you that it should be an eye opener for all physiotherapists in general to understand the science of movement better...I have always felt it is easier for a neuro physio to have this skill than most other physios because they tend to see patients with a global movement disorder as opposed to MSk physios who are more likely to see patients with apparent localized problems...

cheers