practice, but it cannot provide all of the information needed in any individual patient encounter; it does not paint the whole picture of the patient. In order to effec- tively treat patients, clinicians need to have well-organized knowledge including propositional (knowledge ratified by research trials), non-propositional (professional craft or ‘knowing how’ knowledge) and personal (knowledge gained from personal experiences) (Jones and Rivett, 2004). It is indeed a process, one that requires you to be informed (read the evidence or systematic reviews, journals, attend conferences), skilled (expose yourself to multiple approaches, techniques, training and integrate what is effective for you and your patients in the clinic) and capable of critical thinking (don’t merely accept every- one’s conclusions, reflect on how they resonate with your own experience in the clinic) to know when the evidence, or interpretation of the evidence, should, or should not, transform your clinical practice. The evidence cited in this article, as well as the interpretation of its author, have not convinced me that his representation of the postural- structural-biomechanical model in manual and physical therapies is accurate, or that it should fall. References Canadian Institutes of Health Research, 2009. About knowledge translation 2009 Ottawa: The Institutes. http://www.cihr-irsc. gc.ca/e/29418.html. Dankaerts, W., O’Sullivan, P.B., Straker, L.M., Burnett, A.F., Skouen, J.S., 2006. The inter-examiner reliability of a classifica- tion method for non-specific chronic low back pain patients with motor control impairment. Man. Ther. 11 (1), 28. Dankaerts, W., O’Sullivan, P., Burnett, A., Straker, L., 2007. The use of a mechanism-based classification system to evaluate and direct management of a patient with non-specific chronic low back pain and motor control impairment - A case report. Man. Ther. 12 (2), 181. Ericsson, K.A., Smith, 1991. Towards a General Theory of Expertise: Prospects and Limits. Cambridge University Press, New York. Fersum, K., O’Sullivan, P., Kva ˚le, A., Skouen, J., 2009. Inter- examiner reliability of a classification system for patients with non-specific low back pain. Man. Ther. 14, 555e561. Fritz, J., Delitto, A., Erhard, R., 2003. Comparison of classi- fication-based physical therapy with therapy based on clinical practice guidelines for patients with acute low back pain: a randomized clinical trial. Spine 28 (13), 1363e1372. Jones, M.A., Rivett, D., 2004. Introduction to clinical reasoning. In: Jones, M.A., Rivett, D.A. (Eds.), Clinical Reasoning for Manual Therapists. Elsevier, Edinburgh, p 3. Lee, L.J., Lee, D., 2011. Clinical practice - the reality for clini- cians. Ch. 7. In: Lee, D. (Ed.), The Pelvic Girdle, fourth ed. Elsevier, Edinburgh. Lee, D., Lee, L.J., 2011. Clinical reasoning, treatment planning and case reports. Ch. 9. In: Lee, D. (Ed.), The Pelvic Girdle, fourth ed. Elsevier, Edinburgh. O’Sullivan, P., 2005. Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man. Ther. 10 (4), 242e255. Sackett, D.L., Straus, S., Richardson, W.S., Rosenberg, Haynes R B, 2000. Evidence-based Medicine. How to Practice and Teach EBM. Elsevier Science, New York. Sahrmann, S.A., 1988. Diagnosis by the physical therapist e a prerequisite for treatment. Phys. Ther. 68 (11), 1703. Salbach, N.M., 2010. Knowledge translation, evidence-based practice, and you. Physiother. Can. 62 (4), 293. Vleeming, A., Albert, H.B., Ostgaard, H.C., et al., 2008. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur. Spine 17 (6), 794. Vleeming, A., Fitzgerald, C. http://www.worldcongresslbp.com. Invited response Stuart McGill, BPE, MSc, PhD Spine Biomechanics Laboratory, University of Waterloo, Canada I have generalized philosophical concerns together with concerns over substantive issues regarding this paper. The topics are worthy of discussion, however, the sensational title sets the expectation for solid evidence and rigor in developing an issue and the counterpoint. The author repeatedly used a strategy in the framing of a question to make it easily dismissible, and then declared that “there is no evidence to support XXXX”. The arguments put forth in many instances were unidimensional, incomplete, based on undeveloped expressions of concepts, and neglectful of developed bodies of knowledge together with their inter- actions. Critique of cited works was, for the most part, absent. I will also declare at the outset that I am sympa- thetic to several positions that the author took. But this must not affect the job assigned to me here. My points are largely directed towards the process of creating compelling argument e the appropriate treatment and interpretation of specific papers and quotes I will leave largely to others. Back pain is not a homogeneous condition. Any thera- peutic approach that helps one individual will exacerbate another. Epidemiological studies of “back pain” will never reveal cause and effect, or efficacy, since each individual will respond to a different approach, and different dosage. Thus a controlled study on “back pain” will result in the conclusion of “no effect”. However, when patients are categorized into sub-groups based on pathomechanics, or pain patterns, or history, or even psychosocial variables, E-mail address: mcgill@uwaterloo.ca. 150 S. McGill