Evidence-based practice (EBP) is a term that gets used a lot in healthcare and rehab, but what does it actually mean? It’s often described as the integration of best available research, clinical expertise, and patient values. While all three are important, they aren’t truly equal or separate in practice. A more useful way to understand evidence-based practice is as a funnel — where research provides the starting point, clinical reasoning refines it, and the patient ultimately determines what is appropriate.

In rehab, we often label movement as “too much” or “not enough”, but how do we actually know when that’s true and relevant? If you’ve ever had an injury assessment, you might have heard terms like “over-pronation” or “under-pronation.” Maybe you have too much knee valgus when you squat, your low back is hypo-mobile, your pelvis is out of alignment, or maybe it’s poor posture. The problem with many of these descriptors is that they’re largely subjective - no therapist can actually measure joint movement simply by watching you. These terms are often used to explain pain or injury, but the relationship between movement and pain is far less clear than many people assume.

Baseball and softball are growing in numbers and visibility in Ireland, especially at the recreational level. Injuries can and still do occur, but sports medicine is understandably built around hurling, Gaelic football and rugby. Throwing in baseball and softball is different. The forces are different. The long-term adaptations are different. Therefore the rehab has to be different too. If you throw, you need someone who understands throwers. Treating a thrower like a general shoulder is misguided.