Evidence based treatment

The Core Principles of Evidence Based Medicine


The core principles of evidence-based medicine dictate that relevant research, the practitioner’s clinical experience, and the patient’s values all need to be considered when determining the best course of action in any given clinical scenario. Because clinical experience and a patient’s values are considered subjective variables, clear communication and understanding between the practitioner and patient is crucial. Appraising and interpreting relevant research, however, offers a key objective component to consider in the clinical decision-making process.

When it comes to joint pain, we often think of injections or surgery as our only options, however, it is important to understand that the bio mechanics of a joint, or the way a joint functions, is heavily dependent on structures that are adjacent to it. Think of the nerves in the muscles, tendons, and ligaments that relay messages to and from the brain about that joint. Knowing this, it is not surprising that the relevant research around managing many musculoskeletal conditions is to employ what is known as a ‘multi-modal’ approach to treatment. This means that the best outcomes are achieved by utilizing a variety of treatment options, including addressing changes to fascia, muscles, and tendons surrounding a joint, in addition to working through an individualized strengthening program to re calibrate or rehabilitate the function of that joint, and perhaps even protecting it from further damage with a brace.

In applying these concepts, the key to successful outcomes at Elite Sport Performance and the Knee Clinic is our three-pronged approach to treatment: treat the problem, strengthen the area, and avoid or modify offending activities.

Dr. Arif Karmali

BSc(Kin), DC