Love the Moneybag reference, and I wanted to add that speedsters (like Ricky Henderson) definitely went against the model and it played a huge part in what defined their careers. I am curious what your views are on manipulations in physical therapy? I worked alongside a PT who was all about them, along with dry needling.
Thanks, Bryce, I really appreciate the comment, and that you brought up Rickey Henderson. He’s a perfect example of how mechanistic insight can challenge a population-level model. If the model says “don’t steal,” but you know something the model doesn’t (like a unique acceleration profile, the catcher’s arm strength, or the pitcher’s delivery lag) you’re not defying data; you’re applying deeper causal reasoning. That’s clinical thinking.
As for manipulations and dry needling: great question. First off, whether it worked in a particular situation is a different question than whether it "works" in some population for some targeted reason to achieve a particular outcome. To look at whether it works in a population we have to dig into the evidence, and that would be organized around what is called a "PICO" question - patient population, intervention, comparison and outcome. And the patient population indicates the situation in which that intervention has been evaluated, compared to what? (for example nothing, or some alternative), and outcome - to what end?
For example, I can't answer whether "dry needling works", but I could look into whether dry needling tends towards being effective in the population of people with Achilles tendinopathy (population), when done with eccentric loading compared with eccentric loading done alone (comparison) to improve function (measured with a functional outcome scale, or perhaps actual measurement of force generated, or ROM, etc) (outcome).
Based on that - a comment on Substack is not a great place for me to dig into that answer! :)
Love the Moneybag reference, and I wanted to add that speedsters (like Ricky Henderson) definitely went against the model and it played a huge part in what defined their careers. I am curious what your views are on manipulations in physical therapy? I worked alongside a PT who was all about them, along with dry needling.
Thanks, Bryce, I really appreciate the comment, and that you brought up Rickey Henderson. He’s a perfect example of how mechanistic insight can challenge a population-level model. If the model says “don’t steal,” but you know something the model doesn’t (like a unique acceleration profile, the catcher’s arm strength, or the pitcher’s delivery lag) you’re not defying data; you’re applying deeper causal reasoning. That’s clinical thinking.
As for manipulations and dry needling: great question. First off, whether it worked in a particular situation is a different question than whether it "works" in some population for some targeted reason to achieve a particular outcome. To look at whether it works in a population we have to dig into the evidence, and that would be organized around what is called a "PICO" question - patient population, intervention, comparison and outcome. And the patient population indicates the situation in which that intervention has been evaluated, compared to what? (for example nothing, or some alternative), and outcome - to what end?
For example, I can't answer whether "dry needling works", but I could look into whether dry needling tends towards being effective in the population of people with Achilles tendinopathy (population), when done with eccentric loading compared with eccentric loading done alone (comparison) to improve function (measured with a functional outcome scale, or perhaps actual measurement of force generated, or ROM, etc) (outcome).
Based on that - a comment on Substack is not a great place for me to dig into that answer! :)