Consensus best practices

in May 8, 2024

This weeks blog topic is about the quest to establish consensus best practices for lower extremity health professionals.

If you are a doctor, physical therapist, massage therapist, chiropractor, yoga instructor, pilates instructor, strength and conditioning coach, personal trainer, or any other health professional who works with the lower extremity, this blog is written for you.

It's time to raise the bar as a community of health professionals. Treating symptoms without addressing root causes is no longer acceptable and best practices are required to establish a standard of care among health professionals.

In aviation, a pre-flight checklist is a list of tasks must be performed by pilots prior to takeoff and the purpose of the checklist is to ensure that no critical tasks are forgotten.

When helping individuals improve lower extremity health, there are six critical practices that must be performed in order to ensure effectiveness. Any professional who fails to apply these foundational practices is not meeting a reasonable standard of care. Consensus is achieved through professional endorsement which signals agreement and validates effectiveness.

Health professional is defined as an individual whose primary profession is helping others restore natural function and the lower extremity is a subsystem of the body which includes hip, thigh, knee, leg, ankle and foot. Natural function is defined as strong, stable, mobile, resilient and free of longstanding pain. In order to restore natural function, the lower extremity must be protected from unnatural behaviours and exposed to natural behaviours.

It is expected that health professionals apply best practices in their own lives and orient their offerings around helping individuals restore natural function. Pain is a significant consideration but improved function is the objective. Best practices include footwear education, functional assessments, pain education and guidance on making sustainable lifestyle changes.

If you are a health professional and agree with these best practices, please consider helping us build consensus by endorsing them. If you disagree with them, please consider participating in a quarterly roundtable discussion with fellow professionals to share your disagreement. These practices are updated quarterly by a council of professionals from varying specialties.


Best practices checklist:

- Footwear education (reduce time in unnatural footwear, advise natural footwear

- Chair audit (reduce chair sitting time, increase time on the ground)

- Screen balance   

- Screen resting squat position

- Daily session (walking, balance training, reconditioning foot strength & mobility)

- Pain education (pain as an important signal to be listened to, not muted)


Any professional who treats lower extremity dysfunction and does not incorporate these six critical practices is limiting their effectiveness.

If you wish to endorse these best practices, email with your name, profession, credentials and your current workplace.

Thank you for reading. Thank you for holding yourself to a higher professional standard and thank you for helping us build consensus.




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