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Old 04-10-2011, 04:46 AM   #1
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Hey everyone. My name is Mark and I'm a PT (5 months) and chiropractor (9 years). A few years ago I dove into the pain sciences (devouring Butler, Moseley, Nijs, Bialosky, George, etc.) and it's been a game-changer in my practice. I work for a hospital-based outpatient rehab clinic (32 hrs) as a PT and private practice (8 hrs) as a chiro and PT.
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Old 04-10-2011, 05:24 AM   #2
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Welcome. You must have some interesting perspectives to share.
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Old 04-10-2011, 05:26 AM   #3
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Mark,

Good to see you made your appearance here at SS. A few words of advice, read what they suggest and don't take anything as an ad hominem. You'll die sooner that way. That's a good thing around here...
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Old 04-10-2011, 05:30 AM   #4
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Welcome, Mark. Why did you decide to go back to PT school?
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Old 04-10-2011, 05:30 AM   #5
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Welcome Mark, was it the pain sciences that had you take on PT in addition to your DC or something else?
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Old 04-10-2011, 05:45 AM   #6
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Quote:
Originally Posted by Jon Newman View Post
Welcome. You must have some interesting perspectives to share.
In some ways yes. At the end of the day I see myself as a PT that's really good at manipulation. I will never defend chiropractic, but I will defend manipulation.
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Old 04-10-2011, 05:50 AM   #7
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...Of the high neck? (Just checking to see how de-chirofied you are.)

Welcome to SomaSimple.
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Old 04-10-2011, 05:58 AM   #8
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Quote:
I will never defend chiropractic, but I will defend manipulation.
It sounds like you have a perception that manipulation-by which I assume you mean high velocity thrust- requires a defense.

Do you think it's a strong position for the profession to be in to have to defend one of its treatment interventions? Maybe you mean that the way PTs approach and are re-defining manipulation away from the chiropractic concept of subluxation is what needs defending?
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Old 04-10-2011, 06:01 AM   #9
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Quote:
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Welcome, Mark. Why did you decide to go back to PT school?
I went through a "diplomate" program in chiropractic on rehab. It was a 300 hour seminar series focusing on spinal rehab (something never taught in chiro school). This program really lit a fire under me to actually teach patients how to take care of themselves and how to become independent rather than dependent.

I was at a Stu McGill seminar where someone in the crowd asked the speakers "with chiros wanting to do rehab and PT's wanting to do manipulation, where do you see the future of MSK medicine headed?" Craig Liebenson, a chiro I really respect, said "if chiros don't step out of the box and learn rehab, in the end they will be one-trick ponies, and ultimately dinosaurs."

I didn't see a long-term future as a chiro. In IL PT's can do manipulation and have "pseudo-direct access"...they can eval but not treat. If eventually PT's got direct access, can do what I do, AND get better insurance reimbursement for it, where does that leave me? Spinal screenings at a mall in 15 years?

I wrote out a pro's/con's list prior to applying to PT school and there were 12 pro's and 3 con's (the 3 con's were temporal and related to going deeper in debt). I focused not on the next 3 years but the following 25 and have not looked back.
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Old 04-10-2011, 06:19 AM   #10
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Quote:
Originally Posted by John W View Post
It sounds like you have a perception that manipulation-by which I assume you mean high velocity thrust- requires a defense.

Do you think it's a strong position for the profession to be in to have to defend one of its treatment interventions? Maybe you mean that the way PTs approach and are re-defining manipulation away from the chiropractic concept of subluxation is what needs defending?
I love the fact that the majority of the research on manipulation is being done by PT's.

I do not subscribe to subluxation theory and never have. As far as the chiro profession defending it, well, there are fewer and fewer willing to stand in defense of it. Subluxation-based chiros are by and large the loud minority that give the profession a bad name. How would PT's react to the whole profession being painted as myofascial release or craniosacral practitioners?
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Old 04-10-2011, 01:27 PM   #11
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Hey Mark. Great to have you. Sounds like you'll find a lot of helpful information here. Once you hit 10 posts, you'll have access to the Sounds of Silence forum where we post quite a bit of peer-reviewed evidence.
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Old 04-10-2011, 01:37 PM   #12
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Welcome Mark. Enjoy the wealth of resources here (as Rod said - 10 posts and it is a BIG library that opens up).

As a bit of counterpoint to your thought about subluxation: (from SBM blog) Mirtz et al
suggest in 2 studies that 98% of chiropractors believed that “most” or “many” diseases were caused by spinal misalignments and over 75% of chiropractors believed that subluxation was a significant contributing factor to 50% or more of visceral disorders (such as asthma and colic), an implausible idea that is not supported by any evidence whatsoever.

You probably operated in a much more enlightened environment/peergroup, but it seems that the profession is not yet out of those woods. I really think you made a good move! Now, it will be tough to withstand the PT-dogmas that still persist in the academic realm - without evidence......
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Old 04-10-2011, 02:14 PM   #13
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Hi Mark,

Given your interests, you may have something to share in the manipulation solution thread and your input would certainly be appreciated.
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Old 04-10-2011, 02:17 PM   #14
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Welcome Mark.

I'm pretty sure we got into it with Liebenson a while ago. He left.

Does anybody else remember that thread?
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Old 04-10-2011, 02:23 PM   #15
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So it only takes 10 posts to get to the library? Whew, I just hit 11. I was thinking I was on 7 and was going to keep posting silly questions until I hit 10. Never mind.
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Old 04-10-2011, 03:18 PM   #16
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Quote:
Originally Posted by Steve Hill View Post
So it only takes 10 posts to get to the library? Whew, I just hit 11. I was thinking I was on 7 and was going to keep posting silly questions until I hit 10. Never mind.
I believe there is a 30 day wait (from registration) that accompanies the 10 posting requirement. Do not be dismayed if you do not get access to the library immediately.

Welcome aboard.

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Old 04-10-2011, 06:16 PM   #17
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Mark,

Perhaps you misunderstood my question. I wasn't talking about defending the indefensible subluxation theory. That has been definitively debunked despite its persistent popularity and invocation among most chiros, as Bas has indicated above.

I was asking about defending manipulation in general. When I hear someone state that they will defend a technique, the logical inference is that it is under attack. I'd be interested to hear what your impression is of the "attack" on joint manipulation and how well the current science and research evidence supports its use.

This may be a topic for another thread if you'd like to start one. That'd be a good way for you to get engaged in a discussion here that will eventually result in your access to all the site has to offer.
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Old 04-10-2011, 10:34 PM   #18
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Quote:
I was asking about defending manipulation in general. When I hear someone state that they will defend a technique, the logical inference is that it is under attack. I'd be interested to hear what your impression is of the "attack" on joint manipulation and how well the current science and research evidence supports its use.
Was Manipalooza not enough evidence for you John???
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Old 04-10-2011, 11:09 PM   #19
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I missed it.

I prefer my "-paloozas" as entertainment events, not vehicles for supposed professional growth.
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