Fit-For-Purpose

“This perspective proposes a corresponding treatment framework for persistent pain that aims to shift internal models of a fragile, damaged, unhealthy and unchangeable self toward the formulation of healthy, strong adaptable and fit for purpose, and to provide the system with precise and trustworthy evidence that supports this supposition while minimizing information that works against it.”

Wand et al, 2023.

Powerful words! Referring to what we call “The Fit-For-Purpose Model”.

Pain reduction is not the single, primary goal  of therapeutic intervention. As practitioners we want to help make space. Build a bigger life for our patients as pain can be incredibly constraining - taking away the quality of what we enjoy.

By creating space, expanding the quality of life circle, the pain circle gets smaller.

A Platform, Not a Point

We need to strive for more than a single point but rather broad and stable platform.

many traditional models over emphasize proper alignment, gait and/or running mechanics, or some perfectly prescribed and followed exercise/training or rehab routine. Not accounting for any additional contributing factors to adaptation - either positive or negative. we forget that variable;e, dynamic and complex nature of our body systems which can be leveraged to optimize quality of movement and being.

This idea allows for freedom of movement across many different activities with a broad range of perception regarding biochemical feedback. Instead of intense focus on achievement as a success or failure (i.e. did your hit you reps/sets, running mileage, split time or 0/10 pain).

Let’s get away from the rigid notions of single-point oriented biomechanics and training periodization.

So, instead of teetering precariously on a pyramid point, let’s stand confidently on a platform.

See:

Glasgow et al, 2018. Being able to adapt to variable stimuli: the key driver in injury and illness prevention?

Kiely, 2018. Periodization Theory: Confronting an Inconvenient Truth.

The Body as a Garden (Not a Machine)

The traditional Biomedical Model views the body structures and subsequent pain as a “tissue issue only” wherein, when something is broken, it must be fixed via intervention (ie pharmaceutical, injection, therapeutic, and/or surgical, etc.).

The Biomedical Model essentially views the body as a machine.

Counter this with new and emerging research supporting a more all-encompassing approach of the body as a garden.

This perspective appreciates the body’s innate healing ability which can be cultivated and influenced by both intrinsic and extrinsic factors (i.e. exercise, nutrition, sleep, stress management, etc.).

In the body as a garden analogy, pain is more appropriately identified as a complex, dynamic and emergent process without direct 1:1 correlation to tissue damage/abnormality.

“Framework“ refers to the small ways we define our practice as professional.

Framework can sound dull and dry. Who wants to talk about the joy of starting sessions on time and the delights of clean sheets?

“Framework “refers to the small ways we define our practice as professional – time boundaries, fees, the appearance of the clinic, confidentialities, etc. 

Framework is more important and deserves more thought than most of us realize. 

Framework is about the details that make clients comfortable.