What is the HEMME Approach?


The HEMME Approach is a technique for the treatment of patients with soft tissue injuries and impairments. It is a treatment that places more emphasis on manipulation and modalities than on medical surgery and other invasive practices. The acronym HEMME stands for history, evaluation, modalities, manipulation, and exercise and is described as a language model which outlines the approach a medical practitioner might employ in treating a patient with a soft tissue injury.

Hands-on manipulation and massage plays a central role in the HEMME approach.
Hands-on manipulation and massage plays a central role in the HEMME approach.

The first two steps, history and evaluation, are commonly performed together and help to establish the status and extent of the patient’s injury, his medical history and the most suitable method of evaluation of said injury. Only once these preliminaries have been performed can the next stages –- modalities, manipulation, and exercise –- come into effect. A thorough and pervasive history and evaluation process will enable the modalities, manipulation and exercises available to the medical practitioner to suggest themselves.

Should modalities, manipulation and exercise be necessary, the medical practitioner must know the most suitable and efficacious ones that are available. The HEMME approach validates and checks itself by a series of feedback mechanisms which help to keep the process in check. This feedback can be both positive and negative. Positive feedback ensures that the direction the HEMME Approach is taking is headed in the right direction, while negative feedback suggests the changes which are necessary and the improvements that might be made to the HEMME approach currently in progress.

If the feedback occasioned by the approach is positive, the HEMME Approach is deemed to be appropriate to the injury and should continue its course. However, if the feedback is negative then the changes available to correct the treatment are five-fold. These include changing the activities which comprise the individual steps, repeating one or more steps, changing the sequence in which the steps are performed, seeking outside information and assistance, and finally, abandoning the process altogether.

The HEMME Approach has three scientific foundations which go to confer it with authority in the eyes of the medical authorities. These foundations are scientific method, systems theory, and medical science. The medical authorities concur that medical history, physical evaluation, therapeutic exercise and the modalities, the HEMME Approach, are all medically acceptable and a viable means of treatment. Although, it must be added that some medical practitioners have demurred at the HEMME Approach’s non-invasive methodology and would incorporate into the HEMME mix the tools of medicine and surgery.

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