HEMME is a non-invasive treatment for soft tissue injuries that emphasizes manipulation and modalities. The approach includes history, assessment, modality, manipulation, and exercise and is validated through feedback mechanisms. The approach has three scientific foundations and is considered medically acceptable, although some physicians prefer to incorporate surgery into the treatment.
The HEMME approach is a technique for treating 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, assessment, modality, manipulation and exercise and is described as a linguistic model that outlines the approach a physician might employ in treating a patient with a soft tissue injury.
The first two steps, history and evaluation, are commonly performed together and help establish the patient’s state and extent of injury, their history, and the most appropriate method of evaluating said injury. Only once these preliminaries have been performed can the next steps – modality, manipulation and exercise – come into effect. A complete and pervasive history and evaluation process will allow the methods, manipulations and exercises available to the doctor to be suggested.
If modalities, manipulation and exercise are necessary, the attending physician must know the most suitable and effective ones at his disposal. The HEMME approach is validated and verified through a series of feedback mechanisms that help keep the process under control. This feedback can be both positive and negative. Positive feedback ensures that the direction taken by the HEMME approach is in the right direction, while negative feedback suggests necessary changes and improvements that could be made to the currently ongoing HEMME approach.
If the feedback elicited by the approach is positive, the HEMME approach is deemed appropriate for the injury and should continue its course. However, if the feedback is negative, the changes available to correct the treatment are fivefold. These include changing the activities comprising the individual steps, repeating one or more steps, changing the sequence in which the steps are performed, seeking information and outside assistance, and eventually abandoning the process.
The HEMME approach has three scientific foundations that give it authority in the eyes of medical authorities. These foundations are the scientific method, systems theory, and medical science. Medical authorities agree that the medical history, physical assessment, therapeutic exercise and modalities, the HEMME approach, are all medically acceptable and a valid means of treatment. However, it should be added that some physicians have balked at the non-invasive methodology of the HEMME approach and would incorporate the tools of medicine and surgery into the HEMME mix.
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