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James McMahon writes: “How can you say that intersegmental relationships/positions have no influence on symptomatology? I think that traditionally, therapists utilized the "postural assessment/screen" as a way to collect additional objective information, however I found that therapists would make great leaps in correlating their findings with a specific PT diagnosis. Barrett Dorko: Well, I can say this without much trouble because there is no evidence I’m wrong. In fact, the absence of evidence for symptoms arising from intersegmental relationships is precisely what worries Dr. Sahrmann. Having conceded that general postural assessment reveals nothing reliable, she wants the research community to find something predictably painful about intersgmental relationships so that traditional (and not so traditional) assessment methods are justified. As I said, the chiropractors never managed this and neither have the osteopaths. I’m not talking about clinical results, I’m talking about the theories that support our methods of assessment and care. Nor did I say that postural assessment was anyone’s sole means of diagnosis. James Mc Mahon writes: “ … from an osteopathic standpoint, certain lesions (Type I) are often initially recognized through a postural screen. It isn't that a diagnosis is made based solely upon the visual inspection, but rather it helps to guide the clinician in identifying underlying pathology (ex. sacral base dysfunction, LE length discrepancy, myofascial dysfunction, etc)” Barrett Dorko: This is a matter of opinion and you’re certainly entitled. I did the same type of screening for years, taught other therapists how to do it and treated patients accordingly. The research community never supported the theory and I abandoned the tradition, simple as that. If my patients have suffered for its absence, that’s news to me. Barrett L. Dorko, P.T. http://barrettdorko.com