The Clinical approach
What actuall happens
and why.
Most treatment starts with a decision about technique. This starts with a question about relationships. What follows is how a session is reasoned through, from the moment you walk in to the point where we check whether anything changed.The aim is to make the treatment more specific to you, rather than applying the same technique simply because a particular area hurts.
Observation is used to develop possibilities,
not conclusions.
Nothing seen in standing or movement can by itself explain why something hurts. What it can do is point to where it may be worth looking, which is a different and more useful thing.
Two starting assumptions
Where the work
begins.
Two ideas sit underneath everything that follows. Neither is complicated, and both change what a session looks like.
The First
The place that hurts is often part of a wider pattern
Your body adapts constantly to injury, habit, load, movement and the demands placed on it. Those adaptations are not faults. They are what your body worked out in order to keep going, and they usually have a good reason behind them.
The useful question is whether any of them are relevant to what you are experiencing now. That is what the session sets out to find, rather than assuming the painful area is either the cause or the whole problem.
The Second
A session is a loop, not a straight line
We look, we test whether what we saw appears to matter, we work with it, then we check whether anything changed. What the check shows feeds directly into the next thing we look at.
If nothing changes, that is information rather than a failure, and it redirects the next step. It also means you are shown what changed rather than simply being told that it did.
Inside the hour
The five steps
in more detail.
This is the same sequence described on the home page, taken one step further. It runs in this order in a first session, and in a shortened form in every session after that.
01
Understand
We begin with the reason you have come in. Your history, current symptoms, activities, previous injuries and what you would like to be able to do all help establish the context for the session.
This part matters more than it may seem. The same restriction in two people can mean two different things depending on what each person is asking their body to do.
What this looks like
Mostly conversation. What brought you in, how long it has been going on, what makes it better or worse, what you have already tried, and what you want to get back to.
02
Observe
Standing and movement may be used to look at relationships across the body. The goal is not to label your posture as good or bad. It is to identify patterns that may be worth investigating further.
Nothing seen here is a diagnosis. An observation is a question, and the next step is where it gets asked properly.
What this looks like
Standing while Nicholas looks at how you are organised, followed by a few ordinary movements. Bending, reaching, turning, walking, or whatever is relevant to your situation.
03
Test
Movement, palpation and simple positional or functional tests help explore whether an observed relationship appears relevant.
This is the step that separates a useful observation from an interesting one. If temporarily changing something in one region alters movement or experience somewhere else, that relationship becomes worth investigating. If nothing shifts, the observation may be incidental and we look elsewhere.
What this looks like
Often surprisingly small. Supporting a region by hand or with a wedge, changing the position of a foot or a rib, and asking you to repeat a movement to see whether anything feels or moves differently.
04
Work
Treatment may combine hands-on structural and myofascial work with movement, positioning and body awareness. What is used depends on what was found in the previous three steps.
This is why the technique is not decided in advance. The work is chosen in response to the relationships that appear relevant through assessment and testing, which may or may not include the region you originally came in about.
What this looks like
Table work, standing or seated work, or movement, in whatever combination fits. You may be asked to move while work is being done rather than lying passively throughout the session.
05
Re-check
We return to the things examined earlier and look again.
Did movement change? Did the area feel different? Did the relationship we were investigating appear meaningful?
The response informs what happens next, both in the rest of the session and in whether another one is worth booking. A clear change points one way. No change points another, and that is worth knowing before you commit further time or money.
What this looks like
Repeating some of the movements from earlier in the session, followed by a conversation about what was found, how you responded, and what would be reasonable from here.
Being clear
What this approach
is not.
Being straight about the limits is part of the method, not a disclaimer attached to it.
If what you are dealing with would be better served by medical assessment, imaging or another kind of practitioner, you will be told so. Working alongside your existing care is normal. Replacing it is not the intention.
- It is not a posture correction program, and there is no single correct way to stand
- It is not a fixed number of sessions you sign up to in advance
- It is not a diagnosis. No observation of posture or movement can identify a condition or a definitive cause on its own
- It is not a promise of a particular outcome
- It is not a substitute for medical care where medical care is what is needed
Beyond the first hour
How this works
over time.
There is no set program. What follows a first session depends on what the first session showed.
One session
Sometimes a single session answers the question, particularly when the aim was to understand what is going on rather than to change it.
A short series
Where something appears to respond and there is value in working with it further, a handful of sessions over several weeks may be appropriate. Each one starts by re-checking what was found previously.
Occasional
Some people return when something changes in their work, training or life that alters what their body is being asked to do.
Not at all
If the approach does not appear to be helping, that will be said plainly rather than extended into another appointment.
Ready to try it
Sessions available Monday, Tuesday and Friday at 167 Queens Parade, Clifton Hill.
If you are a practitioner
The frameworks behind this approach are taught two ways. One to one mentoring on your own caseload, or structured courses including the Case Review Clinic.