SomaSimple Discussion Lists

Hello again!

Wolfe — Wed, 22 May 2013 00:01:05 GMT

First came to SS years(?) ago...twas a little over my head, so I've been away.

I read the article by Jason Erickson recently and thought, oh yeah, I remember that.
I enjoyed playing around with the techniques shown and came to see what I've been missing. I'm curious to learn more -- I don't have the in-depth training around nerves at this point. I am very interested in working with the brain and seeing how this paradigm can mesh with my practice as an MT.

As I surfed around, I noted a few authors to read (Butler, Moselely, Schacklock)...if anyone has a suggestion for a good place to start, I would appreciate it.

:)
Sheila

[Paper Request] Liang: Compliance and quality of life

Ban84 — Tue, 21 May 2013 21:10:43 GMT

Read this one the other day. Definitely worth sharing. Talks a lot about reframing non-compliance as an often appropriate, almost darwinian response. Ie: if the trade offs on your therapy are too high (in terms of the whole person) then people just won't take to it - irrespective of 'best practices', gold standards or RCT's. If you were ever curious why some things aren't 'sticky', this might be it.

Tl;dr - In the end, sometimes the good > perfect...to the point that good = perfect

Anyway, patient compliance is seen as a real issue....when maybe it should be 'practitioner dense-ness' or 'practitioner paternalism'

OTOH, people will trade off a mountain of pain for a moment of meaning - and it's ok to let them do that. See Yoshida

Interesting papers, anyway - especially in light of 'well they're in pain, but they refuse to do their exercises to get any better. They *must* be malingering'

[Tip] A quick glimpse at our culture

keithp — Tue, 21 May 2013 21:04:48 GMT

I was lurking on my fav fantasy football site and saw that someone was on there asking for advice re: "sciatica".

Sometimes we forget how information is passed/shared, praised, believed and acted upon.

This is what we are battling...

Respectfully,
Keith

On Feldenkrais Training

Ban84 — Tue, 21 May 2013 14:15:34 GMT

This discussion between rkathryn and myself appeared on Barrett's Global Resources thread. I think it's probably more appropriate as a stand-alone discussion, so am deleting it and moving it here.

I would be happy to engage any Feldy's or other interested parties in this discussion or generally shoot the breeze on Feldenkrais training (merits and demerits).

Quote:

Originally Posted by Barrett Dorko (Post 156241)

Not "combine" it?

I really don't get that, but I'm growing even more uneasy about what's being done with Feldenkrais' name.

I spent a weekend with Betty Fuller, a Trager and Feldenkrais practitioner. Her story was that she brought these two together (the men themselves) and they treated each other to great effect and the delight of both.

I watched Feldenkrais rage at people who wanted to know what they should do for a specific joint and now I see that there are "Feldenkrais exercises" for low back pain. I imagine he's spinning.

Quote:

Yeah, they don't teach us marketing, either.

The thing is, the public wants "exercises", so in an attempt to appease, some have started talking that language. But without expertise in that domain, a shallow approach is produced.

Are "feldenkrais exercises" bad? Maybe. I use to think so anyway, but then it occurred to me to look at it from "feldenkrais in exercise" (aka approaching exercise from an educative/motor control/neuro perspective - a deeper model then just pumping iron).

The issue with FM is that no-one wants to say what it is for fear of pigeon-holing it, so you end up with paralysis by committee.

Rkathryn: have you looked at Rywerants books? "Acquiring the Feldenkrais profession" is the one I suggest - it gives you some of the where and whys of ATM and FI.

www.achievingexcellence.com/p-a_ryw2_review.html

Teaching thru handling is his seminal work, but to my shame, I've not read much of it. That discusses the idea of FI as a means of communicative touch.

There is another book, written by an Australian PT called something like Feldenkrais for physiotherapists. I'll try to find the exact title.

Found it (I think): www.iffresearchjournal.org/volume/3/elgelid

Finally, may also check out Jeff Hallers & Larry Goldfarbs work. Haller was the first person I ever saw to reference the core stability myth article, and as a martial artist and firmer basketball coach, tends to have a pragmatic approach.

www.insidemoves.org/

Goldfarb wrote his Phd (kines) on Feldenkrais and has several wonderful models (such as SPIFFER)

I'd love to continue this discussion, btw, here in public. It's something that bothered me for years. We need to do something, because as a friend of mine said "it was life-changing, but did I basically pay $30K to roll around on the floor for 4 years? How the hell does it work and what do I tell people?".

http://Www.utahfeldenkrais.org/blog/...rt-a-practice/

Made By Hand I

Barrett Dorko — Tue, 21 May 2013 10:20:42 GMT

I designed it from memory, built it with my own hands, and watched as others enjoyed it for a few years. I have no idea what happened to it, but I think about it now and then. It was a simple game for a neighborhood festival, and perhaps the only thing I ever built by hand.

Here's an idea: Appeal to the quality of craftsmanship that therapy might afford us.

Pushback is a relatively new way of describing behavior that results from an assertion or action in a direction we'd prefer not to go. We don't just pushback out of contrariness or because it will get other's attention. We do it because we are unique individuals with brains only satisfied in certain ways.

I didn't name my book as I did for nothing I guess.

What are we pushing back against?

Global Resources for Therapists - feat. Barrett Dorko

keithp — Mon, 20 May 2013 12:51:51 GMT

Global Resources for Therapists recently interviewed Barrett and have posted the interview on Youtube.

If you recall, this (like the Eyal Lederman interview) will likely go behind a pay-wall in the future, so be sure to check it out while you can!

Respectfully,
Keith

That time of year

Barrett Dorko — Mon, 20 May 2013 11:57:30 GMT

I wanted to reprint something I wrote a few years ago. It came to me while driving my car and I think it's still true.

I made the whole thing up by the way.

Quote:

Thank you for that wonderful introduction. I feel compelled to tell you however that my first name is pronounced just as it�s spelled, as in Elizabeth Barrett Browning�s maiden name, and not as in that thing women stick in their hair. But I understand. We�ve never met before and I know I�m only here because your first three choices bailed on you. In that the nursing home hadn�t called as of 10AM this morning I was free and already dressed. Somebody on your faculty must have heard of me though I don�t know who it might have been. To my knowledge, they�ve never actually spoken to me either. I must say, they all look a little nervous. In any case, I am happy to accept this very kind invitation.

Now, what I have to say to you graduates will take exactly 10 minutes and 13 seconds � though I haven�t factored in time spent on raucous laughter and spontaneous applause.

I have chosen for my title today What�s Goin� On. This was also the title of a remarkably popular song written when I was about your age and attending The Ohio State University. You should Google it. Wikipedia says the artist, Marvin Gaye, sang it while depressed over the death of a dear friend. There are sounds of a party in the background from which Gaye�s voice is purposely detached. Like I said, this was a huge hit.

I look around my profession today and ask myself, What�s goin� on? And now that you�re part of this profession as well you could do the same. I must say, I didn�t stay in school long enough to get a doctorate like all of you. This of course gives you a tremendous head start. By that I mean a head start on the crushing debt that usually takes about twenty years of steady work to accumulate. (PAUSE FOR LAUGHTER)

Uhhhhh, ahem, Anyway, here�s what I see is goin� on and how I feel about it:

I was once paid to express my opinion and treat patients in a fashion that I could defend. My methods changed as did my knowledge and I became more skillful and sensitive as time passed. Now I get paid to fill forms full of information that I feel is pretty much irrelevant. My personal skills as a clinician have nothing whatsoever to do with my pay. I get paid to show up and write. When you actually treat a patient it�s costing your boss money if an assistant is available and don�t expect them to tolerate that for long

I am surrounded by therapists, most a good deal younger than I, who never heard of the practitioners who formed the profession, fought the manual therapy wars in the latter part of the last century or tried to make us autonomous, individually powerful and respected. It used to be that my personal connection to these people implied that I had some of their influence as well. Now their names are unknown, as is my own. As an added bonus, mine is often mispronounced. (ANOTHER PAUSE FOR LAUGHTER)

Someone please help the director put her head between her knees! She looks just awful!

Now, where was I? Oh yes�I notice that most of my colleagues are perfectly willing to accept any sort of explanation for clinical phenomena just so long as it doesn�t include a visitation from multiply-limbed beings from the seventeenth dimension. While that might be a bit much, completely debunked notions of physiology continue to gain acceptance so long as someone throws the phrase �evidence based� in at the right time. Ask the person next to you about crop circles or Occam�s Razor and they might reveal more about their basic ignorance of science and modern culture than you really want to know. I recall feeling the same way about a lady in my neighborhood when she told me she thought that �O.J. is completely innocent.�

Our profession is also populated by therapists who have learned how to market courses to those of us who never want to study ever again. They also know how to draw the timid and needy among us. They know that if they behave in a certain way that they won�t be questioned in public. I don�t think the medical profession would put up with this, but we surely do. It used to be bad, now I see it�s worse than ever.

You seem a little deflated and I see that the faculty is slumped in their seats. In fact, I think I can guess whose idea it was to invite me today just by the spacing that has emerged.

But I want to say that what�s goin� on needn�t continue as I have described. You are now a part of what I have always considered the greatest of all the therapies for many, many problems inherent to the human condition. If you read and change you will find that medical, biological and neuro science has already figured out what would be best for you to do or not do in conjunction with the efforts and sensibilities of your fellow human beings. They are someone�s parent or child, they are someone�s brother or sister or dear neighbor or relative. Every age, every race, every manner of education and intelligence may one day fall into your hands and there they may be glad you�re attached and present - but only if you work continuously to know more.

And it will be enough, if, as Charles Hayes says, �When you go to self-university the tuition is your desire.� No amount of money or time can match your desire to become a servant � not to your patient and certainly not to your boss � but to whatever it was that drew you this far today. You can become the sort of person of whom some would say, �That one is different. They are called to service.� You can make everyone in your presence want to be better � not to please you � but because in you they can see it�s possible. Physical Therapy as a profession offers each of us every bit of this.

If we can honestly examine what�s goin� on we can change it. I promise you that this will be painful, and that making this sort of difference will require the courage to express what you now understand and how you�ve come to that point. Most others will not like you for it, and that is a choice you will have to make again and again.

Don�t worry, there are some colleagues waiting for you once you get there, and we are as disembodied from the party as was Marvin Gaye in 1971. Together we stand aside from the crowd, clinging to each other, and we�ll be glad to welcome you.

Now you may commence.

In Praise of the Spa

Laura D — Mon, 20 May 2013 08:37:51 GMT

There's been a lot of bashing of the spa industry on the BC MT facebook pages of late. Some BC RMTs are upset that their colleagues chose to work in a spa, as they consider spa treatments to be an indulgence and not therapeutic. They believe that the spa industry is hurting the MT profession. Personally, I feel like the spa is the only safe place for me to work at this moment. What I mean by that is I can 'sell' relaxation massage without any hype. I can even promote it openly on the website or other marketing materials, without being dishonest. I feel very confident that I can deliver on my promise to provide a relaxing, pleasant experience. This is not the case with 'clinical' massage therapy. Their claims are indefensible, yet they say I'm the one doing damage to the profession.

If I were a PT I�d be forced to face the therapy challenge head-on, instead of hiding out in a spa. Thank goodness my grades weren�t good enough to get me into PT! (it was my first choice). ;)

I think that deep down they know they can�t compete with relaxation massage. Even if they don�t understand the pain science that supports it, they feel threatened despite their lower fees, aggressive marketing, and tireless efforts to �educate� the public. No amount of hours, degrees, or CECs can differentiate them from the �zombie� MTs.

Yes, I know I�ve spent an inordinate amount of time lurking here with very few posts. Maybe one day I�ll get over my shyness, but everything seems to turn into a rant.

Sunday's Story II

Barrett Dorko — Sun, 19 May 2013 10:05:19 GMT

Quote:

I don't sell shower rings. I sell stories.

Implied by John Candy in Planes, Trains and Automobiles

Quote:

You're a heck of a salesman Dell.

Steve Martin, same movie

Quote:

I don't sell advertising, I sell products.

Don Draper

Stories are everywhere. They drive our individual versions of reality and we hold them within at our peril. Most are copies of the original, and the “mind machine” we possess tends to mutate things – sometimes for the good, sometimes not so much.

If we only hand out what we consider essential information regarding pain and then choose some method to alleviate it, our patients will miss the human element of care that sets us apart as individuals. By ignoring or only enduring what they have to say we also denigrate what they bring to care.

Our friend Michael Reoch in Vancouver recommended this podcast and inspired today's post.

A Massage Therapist's Guide to SomaSimple

Alice Sanvito — Sun, 19 May 2013 09:21:38 GMT

My dears,

I decided to write a "guide" for massage therapists who find their way to SomaSimple and don't know where to begin, are overwhelmed, or find themselves feeling intimidated. Perhaps it will encourage a few to check it out and stick around.

Your comments and suggestions are welcome and appreciated. Especially let me know if you see any glaring errors or omissions. I haven't put it up on FaceBook yet, thought I'd wait for feedback here first. If it looks okay to you, I'll put it up there.

I wasn't sure what prefix to use for this thread. "Tip" seemed like the best choice but if it should be something different, let me know.

http://www.massage-stlouis.com/massa...ide-somasimple

[Tip] A Massage Therapist's Guide to SomaSimple

Alice Sanvito — Sun, 19 May 2013 09:21:38 GMT

[Critical Thinking] Biomechanics, tissue adaptability and pain

PatrickL — Sat, 18 May 2013 21:21:23 GMT

Just sharing some thoughts re biomechanics and pain following a recent conversation. Feel free to critique.

Whenever I find myself having an argument/discussion about biomechanics and it's influence on tissue damage and potential pain, I ask the following questions:

Mechanical requirements

Are humans proportionately similar enough (in terms of bone length and shape) to make generalizations about the mechanical requirements for a given task?
Assuming there exists a degree of variation across the human population, doesn't that mean that at best, we can only ever theorize a range of mechanical requirements for the performance a given task?
If such a theory was quantifiable (accounted for the variability across the whole human population), would we be left with a narrow or broad range of mechanical requirements for the performance of a given task?

Tissue damage

Do human tissues adapt/fail similarly enough across the whole population to make generalizations about dosage parameters (frequency, intensity, duration) for preventing tissue breakdown?
Assuming there exists a degree of variation across the human population, doesn't that mean that at best, we can only ever theorize a range of dosage parameters within which tissue breakdown is preventable?
If such a theory was quantifiable (accounted for the variability across the whole human population), would we be left with a narrow or broad range of dosage parameters for the prevention of tissue breakdown?

Pain

Do humans experience pain as a result of tissue breakdown similarly across the whole population?
Assuming there exists a degree of variation across the human population, doesn't that mean that at best, we can only ever theorize a range of "tissue breakdown values" within which pain should be absent?
If such a theory was quantifiable (accounted for the variability across the whole human population), would we be left with a narrow or broad range of tissue damage values that we could label as painful tissue damage?

Putting it all together

Given the variability of each category above, if you were to do a mashup and calculate the variability across the population for mechanical variation, tissue adaptability and emergence of pain, would we be left with a very broad or very narrow model for relating biomechanics, tissue damage, injury and pain?
What would clinical assessment and treatment routines look like if they reflected the actual variability between biomechanics, tissue adaptability and emergence of pain across the human population?
Do you think your current clinical assessment and treatment routines reflect an understanding of a broad (non linear) or narrow (linear) relationship between mechanical requirements, tissue adaptability and pain?

[Question] Mouse Shoulder

Ken Jakalski — Sat, 18 May 2013 14:34:08 GMT

This is a new thread at Supertraining.

Has anyone heard of this or treated patients with a similar problem?

Poster:

"I've developed what I'll call Mouse Shoulder. At my job, the application I have to use is heavily mouse driven, with nokeyboard shortcuts. I've been doing this for about 7 years, butthe last 8 weeks I've noticed my shoulder sometimes aches towards the end of the day.

In working out, I notice it on Bench Presses and Dips - so muchso, that I've had to cut those from my workout. If I get myhand positioning just right, I can still do pushups - but eventhose sometimes cause my should to be sore. Interestingly,overhead presses do not cause any pain. I also do lots of rows- both barbell and dumbbell - and these do not cause any pain.

I took a 4 week layoff from weight exercises, but Benches and Dips hurt just as much when I started back.

I've tried switching hands at work, but I was so slow and error prone with my left hand that I had to switch back.

Has anyone else experienced anything like this? Any suggestions as to what I can do to alleviate this?"

Now what?

Barrett Dorko — Sat, 18 May 2013 11:33:25 GMT

The Facebook conversation I got involved in recently ended much the same way I've seen them end before. My posts get deleted, I'm told to reign in my disdain and argumentative �tone� and the people who remain after I leave are happy and feel vindicated, I guess.

When one brought up �trigger points� I added a link to this thread because it was full of details regarding the issue. It was also long and very popular.

It was deleted because citing previous discussions about an issue currently being discussed was �not part of their etiquette.�

I was told:

Quote:

I have always found that bones follow muscles, and contracture of muscles due to trigger points can cause that misalignment of bones. The interaction of bones and muscles has been well-documented in medical journal articles, and recent research is finally contemplating that trigger points may be the force behind osteoarthritis.

And:

Quote:

Those who have the ability to see the tissues through their fingertips deserve great respect, in my opinion. When experts are kind enough to offer their wisdom here and elsewhere, I am thankful.

I suppose you can see the problems with this and I won't detail them.

My question: Where do we go from here?

[Livre] Une mine d'or

Laurent La Fl�che — Sat, 18 May 2013 07:38:30 GMT

Bonjour � tous

En pr�parant mon cours sur la douleur, je me suis souvent retrouv� sur ce site : http://lecerveau.mcgill.ca/avance.php

En fran�ais et tr�s bien organis� et document�, cet un outil tr�s int�ressant, o� l'on peut se balader facilement. Avec les journ�es froides de ces temps ci, �a peut �tre sympa...

Bon week-end � tous