Palpation (Touch)


I believe skills of palpation are more about your understanding of anatomy than your amazing skill of touch.  When I was studying we did an exercise  to test their skills of palpation which involved putting a hair below a few pages of a telephone dictionary then running our fingers over the top page to see if we could detect it.  Then we would put the hair progressively deeper into the phone book.  Amazingly it was possible to reveal where the hair was sometimes as much as ¾ way through the pages.

Convinced that I had supernatural powers of touch I demonstrated this to my family at home, daring them to try and match my skills.  Perhaps not so astonishingly they were all are able to match my sense of touch.  It became clear to me than, that every human has a highly developed sense of touch.  What separates a skilled practitioner of physical therapy from the average person,  is not his sense of touch but his ability to make sense of what his sense of touch is telling him.

Years later when I was teaching at college I used the same techniques to demonstrate that we all had an equal ability to detect subtle changes with their sense of touch.  However if I gave each student something entirely unfamiliar to identify a purely with their sense of touch it became a different story.  I used a chess set that was made up of a variety of fantasy characters to represent each chess piece.  Visually each piece was distinct and different from all the others and quite recognisable, but when the piece had not been seen by the holder and was hidden in a bag it was virtually impossible to know what they were feeling.  Each student attempted to describe what they were touching  to the rest of the class, attempting to come to some conclusion as to what was hidden in their bag and ultimately being  only able to describe very roughly what they felt.

Then each student was asked to take their piece out of the bag and show it to the rest of the class.  After visually assessing the distinctive statues, everyone was finally able to use their sense of touch to identify each chess piece easily.

This is how I demonstrated that knowledge of anatomy was an essential part of being able palpate effectively.  If you do not already know in your mind what should be beneath your fingers how can you know what you’re feeling, or if it is different from how it should be?

Early on in my classes I tell students this…

From this point, your skills will develop to discern changes in the tone of muscles, you will become more and more aware of what ‘normal’ is as you work with more and more people and subsequently become more able to detect variations from the norm.  Gradually, as your sense of touch confirms your anatomical knowledge, you will become more able to specifically pick out and influence aspects of the structure in its function.

I am constantly updating my knowledge of anatomy and after 20 years of practise, I have a well developed sense of knowledge that enables me to effectively use my sense of touch to great effect.