Evidence or Research?
*Written May 2020*
If I'm being honest, this one is a bit hard to hit post on [taken nearly a year to share!]. But the theme of it has come to mind in multiple ways recently and I can't let go of it.
What role does research or "evidence" play into your decision making, whether you are a client or practitioner? How do you say yes to one thing and no to another? We make countless decisions in a day's time, for ourselves and others - how do YOU seek best practice and find peace in your decision making?
My education has largely been based in science and "evidence-based" is something I have been, at times, force fed to interpret as law. I've come a long way, though, and now respect evidence for the conversations it brings to light, but always keep it in check within the context of the decision I'm trying to make. It's one piece of the puzzle.
In uncertainty, I tend to hang on research a bit more than usual. And since life is full of uncertainty right now, my head seems to be first searching for data rather than clinging to my typical intuitive, holistic viewpoint.
I spent the last two weeks feeling like a hypocrite as I exercised. I'm 10 weeks postpartum and there's a beautiful clinical decision making flow chart making the rounds that dismisses postpartum running until 12 weeks. Guess what I've been up to? Yep, running.
I absolutely respect research as a welcome starting point for any conversation on intervention, so it's not that I take the recommendations lightly (I actually waited to run a full 2 weeks longer than usual). Rather, it's that my body KNOWS running and my mental health is dependent on it. Once I felt healed and ready, every day that I DIDN'T run was detrimental to who I am. But yet, I held out because of research. Thinking out loud: is physical health more important than mental health? If not, why isn't it a larger part of our decision making?
Switching gears: my newborn was unexpectedly born with right clubfoot. We have just finished phase one of weekly casting and are now in phase two of wearing a brace for 23 hours/day. She's doing great. There are a few brace options, but one gold standard. Why is it the gold standard? Well, possibly because it is the best. But also, possibly because newer bracing options have yet to be substantiated with research. Therefore, newer options could actually be better, but no one is studying them in the same proportions as the decades old recommendation. Our pediatric orthopedist and orthotist have been awesome to provide input but ultimately let me make the decision. And, guess what? I'm going with the brace that I feel makes sense for my daughter, but has only been involved in a study of 10 people. (Update! We still use the same brace!)
My goal in this post is not to tell you to push back against research. Use it! It's awesome that we have studied resources. But understand how it fits into your decision making ability and keep it in check. As clinicians, we can do our job the best when we present evidence and pair it with empowerment: to say "does this resonate with you and your lifestyle?" We are each living out our own individual case studies and the variables present in our lives may mean that we have to incorporate research in different ways.
For me, this has been a time of good reflection - to remember that each body system is not meant to be considered as an isolate and can only be truly considered in the functional context that is life.
And guess when this post came to mind? ....yep, you got it - on a run!
(Also, this clearly isn’t medical advice to any group of people, postpartum or pediatrics. It’s a reflection of my choices given my/my child’s circumstances).
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