Are We Palpating the Wrong Things?
- Sherry Routledge
- Jul 30
- 2 min read
A post from Adam Meakins popped up in my feed this week asking…
“Is palpation a dying skill?”
And honestly…
I hated it.
And I loved it.
Let me explain.
I completely agree that therapists shouldn’t pretend their fingertips have MRI vision.
If someone tells you they can feel your pelvis is “out,” your SI joint is “upslipped,” or your fascia is “stuck”…the evidence for those claims is, at best, pretty shaky.
That’s not what good palpation should be.
But I think we sometimes swing too far the other way.
I’ve heard people say…
“Palpation is useless.”
I couldn’t disagree more.
The question isn’t…
Can you feel a sacral torsion?
The question is…
Can you find the most irritable, most sensitive, most clinically relevant area to treat?
Because those are two completely different skills.
When we palpate someone, we’re not trying to identify an invisible structural fault.
We’re looking for the spots that make the patient immediately say…
“Yep… that’s exactly it.”
Those highly sensitive areas often feel different.
Sometimes they’re thicker.
Sometimes they’re ropey.
Sometimes they’re gristly.
Sometimes they’re nodular.
Sometimes they feel completely normal…
…until you press on them.
Could we prove under a microscope exactly what we’re feeling?
No.
But we don’t need to.
The patient tells us.
Their reaction tells us.
Their movement changes tells us.
Their pain changes tell us.
That’s why RAPID has always been built around one simple principle…
Find the loudest signal.
Treat it.
Retest.
If nothing changes…
You probably found the wrong target.
If everything changes…
Then clinically, you found something that mattered.
Notice that nowhere in that process do we need to invent stories about adhesions, scar tissue, twisted pelvises or vertebrae that are “out.”
The treatment isn’t validated because we created a convincing explanation.
It’s validated because the patient’s pain, movement or function measurably changed.
We think this is where the profession sometimes gets itself into trouble.
We’ve spent years arguing about what our fingers are feeling.
Maybe we should spend more time asking…
Does finding this spot consistently lead to better outcomes?
Because patients don’t care whether we call it a trigger point, an adhesion, a nociceptive hotspot, or Bob.
They care whether they walk out feeling and moving better.
Maybe palpation isn’t about identifying anatomy.
Maybe it’s about identifying relevance.
And that’s a skill we hope never dies.
Until next week! Happy palpating! Lol
-Sherry and Rob
Link to Adam’s post
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