Clinical Coherence - From Palpation to Purpose

Blog 6A: Clinical Coherence — From Palpation to Purpose 

We’ve discussed thrusts, vectors, planes, intent, and even the unseen inner dialogue of segmental listening. But what binds all of this together? 

Clinical coherence. 

It’s not a buzzword. It’s the quiet thread that runs through the work of every great chiropractor. It’s the feeling — in both practitioner and patient — when everything clicks: 

      •     The examination aligns with the story 

      •     The motion testing matches the restriction 

      •     The technique honours the dysfunction 

      •     The outcome validates the intention 

What Is Clinical Coherence? 

Clinical coherence occurs when your assessment, technique, and philosophy no longer operate as separate elements but as a unified system of care. 

It is: 

      •     The integration of tactile sensitivity and neurological reasoning 

      •     The fusion of your anatomical literacy with your clinical decision-making 

      •     The ability to move from palpation to action with fluid certainty 

It is the moment when you no longer “try things” — you do what needs to be done. 

From Chaos to Clarity 

Without coherence, we fall into: 

      •     Over-adjusting 

      •     Under-adjusting 

      •     Guesswork masked as treatment 

      •     Technique-driven rather than patient-driven care 

But when coherence is present, you no longer need to compensate with force, volume, or theatrics. The work becomes quieter, but sharper. 

You touch with purpose. You move with precision. You adjust with clarity. 

Palpation Is Only the Beginning 

Yes, you must be palpatorily literate. 

Yes, you must know your lines of drive. 

Yes, you must master thrust mechanics. 

However, that is only useful when it supports a coherent clinical objective. Otherwise, it’s just movement. 

Coherence is what turns movement into meaning. 

The Path to Coherence 

      1.    Know the body, not just conceptually, but through touch. 

      2.    Trust your assessment — stop and reassess if it doesn’t make sense. 

      3.    Adjust with intent, not because it’s “on the list”, but because it’s what the body asks for. 

      4.    Recheck and reflect — coherence doesn’t fear retesting; it invites it. 

In short, don’t just adjust the spine; adjust the reasoning behind the adjustment. 

Now, let’s look at another layer: not just how or why to adjust but also when not to. 

Aidan - Enchiridion Chiropractic Training

Essential skills- Proficient clinicians

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