SomaSimple Discussion Lists  

Go Back   SomaSimple Discussion Lists > Physiotherapy / Physical Therapy / Manual Therapy / Bodywork > Barrett's Forums
Albums Quiz PubMed Gray's Anatomy Tags Online Journals Statistics

Notices

Barrett's Forums This discussion is devoted to the latest advances in neuroscience and the clinical phenomena it explains.

Reply
 
Thread Tools Display Modes
Old 12-07-2006, 06:33 PM   #151
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Ron Hruska is currently trying to balance his clinical practice as well has his schedule for teaching courses. He also travelled with University of Nebraska Womens Volleyball team to China for a tournament. His main priority currently is final steps in publishing a book outlining these concepts. We at the Institute often receive criticism that we don't have published text for these concepts. It is Ron's goal to remedy that as soon as possible. Once that is accomplished then it will be easier to have these types of dicussions, and challenges to our concepts on a morebroad spectrum. So for now youwill have to be satisfied with a lesser and slightly more endomorphic faculty member.
Raulan2 is offline   Reply With Quote
Old 12-07-2006, 09:35 PM   #152
Jason Silvernail
Clinician and Researcher
 
Jason Silvernail's Avatar
 
Join Date: Dec 2005
Location: El Paso, TX
Age: 40
Posts: 4,277
Thanks: 346
Thanked 966 Times in 286 Posts
Default

Raulan-

Thanks for continuing to post.

A few questions -
1. Regarding these soft tissue restrictions you mention that prevent ideomotion from fully expressing itself.
A. do you have a valid and reliable method for discovering and identifying them? I assume you are aware of the extensive research existing in the literature demonstrating the poor reliability and questionable validity of spinal motion palpation/manual spinal diagnosis.
B. if indeed a soft tissue contracture can be identified, can the forces provided by manual therapy or exercise be of sufficient force, duration, and direction to change the tissue, given what we know of human physiology? I would refer you to Threlkeld's excellent article in 1992 in the journal "Physical Therapy" for the background on the basic science of this issue.

2. When you say Mr Hruska is looking to "publish text" - you mean a textbook or manual of some kind, as opposed to a peer-refereed document such as a review article or case series? If so, how does the publication of non-scholarly material (read: opinions) help PRIs concepts become more scientifically accepted?

Thanks again.
Jason.
__________________
Jason Silvernail DPT, DSc, FAAOMPT
Board-Certified in Orthopedic Physical Therapy
Fellowship-Trained in Orthopedic Manual Therapy

Certified Strength and Conditioning Specialist


The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.
Jason Silvernail is offline   Reply With Quote
Old 12-07-2006, 10:42 PM   #153
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Jason-
great questions. I am not using manual spinal motion, or palpation. We at PRI use myokinematic funtional performance grading, and assessments to determine position of the body in tri-planar motion(which identifies neuromuscular patterns). Of course I use goniometric ROM measurements, but I interpret that with empahsis on myokinematic function, not osteokinematic, or arthrokinematic.

When I refer to restriction this could include some adaptively shortened connective tissue, but it also includes understanding contractile tissue that has been utilized repeatedly in mal-adapted positions and becomes hypertonic. I will give you an example. If the left hemipelvis were oriented forward in the transverse plane with respect to the right. Then the left hip will adapt into an externally rotated position to allow for gait. the left posterior hip capsule, and more imprtantly, the deep hip external rotators (obturator internus, piriformis, gemelli, etc.)will be functioning in a shortened, hypertonic state. It is my experience that this limitation is usally related to the contractile tissue, more than the connective tissue. I am aware of those articles and that is why I agree with this groups criticism of MFR.
Yes currently Mr. Hruska is preparing a text. but if you go to www. postural resotration.com, education tab, references section you will find an extensive list of references by topic. One of the criticisms of PRI (somewhat deserved )is limited outcome based studies. Currently in my clinic we are in the process of conducting a case series. Ron is just completing a case series. We are diligently trying to get as many research projects underway as possible(Elon University in North Carolina, and Loma Linda in CA). We are not unlike this group, these concepts are understood and acccepted by those in clinical practice, but not as readily in the world of acedemia. There have been several studies done 8-10 years ago with PRI concepts regarding pelvic-fermoral relationship and the use of the Protonics Neuromuscular Repositioning System. The concepts are PRI concepts, www.protonics.com, references tab. I will clarify that Protonics and it manufacturer Inverse Technology are not affiliated with PRI.

Mr. Dorko cites excellent scientific based articles and texts as reference. Are there any studies with the use of Simple Contact as a treatment?

Last edited by Raulan2; 12-07-2006 at 10:47 PM.
Raulan2 is offline   Reply With Quote
Old 12-07-2006, 10:59 PM   #154
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,212
Thanks: 3,316
Thanked 6,520 Times in 2,962 Posts
Default

Raulan, it sounds like the focus of treatment or concern in PR is the "bungee cord" system, i.e, contractile tissue that won't eccentrically lengthen (for whatever mysterious reason). Would that be accurate?
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 13-07-2006, 02:21 AM   #155
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

The mysterious reason is that the body is putting a demand on those muscles for functioning in an improper manner. That could be due to developed neuromuscular patterns due to compensation from trauma, pathology, weakness of agonistic muscle groups. When I am treating a patient my main concern is to normalize tone. I am attempting to retrain muscle recruitment patterns to reciprocally inhibit dominant muscle chains. (See website for explanation of polyarticular chains). My main concern is not strengthening, but rather retraining proper recruitment of agonistic or antagonistic muscles chains in order to normalize tone and allow for proper length/leverage, and the ability of the nervous system to recognize proprioceptively that these muscles can now be recruited in a proper manner.

In a patient (i.e. a beautician) without pathology I totally agree with the concept that ideomotor movement can release neural tension. My concern is how does that help her the next day in the beauty salon when she is always standing with weight shifted to the right, a compensatory rotation of the trunk to allow to hold her left arm up for 8 hours while styling hair. Where is the carryover?

Last edited by Raulan2; 13-07-2006 at 03:09 AM.
Raulan2 is offline   Reply With Quote
Old 13-07-2006, 03:07 AM   #156
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Barrett-
Sorry I did forget to answer questions regarding the bones of the skull, Yes we consider the position of the temporal bones, and sphenoid. The following link explains how we assess this. http://www.posturalrestoration.com/r...ursenotes_id=7
Raulan2 is offline   Reply With Quote
Old 13-07-2006, 04:01 AM   #157
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,212
Thanks: 3,316
Thanked 6,520 Times in 2,962 Posts
Default

Quote:
The mysterious reason is that the body is putting a demand on those muscles for functioning in an improper manner.
Are you sure it's the body that's making the demands?
Quote:
That could be due to developed neuromuscular patterns due to compensation from trauma, pathology, weakness of agonistic muscle groups.
So... are the muscles talking to each other?
Quote:
When I am treating a patient my main concern is to normalize tone. I am attempting to retrain muscle recruitment patterns to reciprocally inhibit dominant muscle chains.
Are you trying to get muscles to talk to other muscles?
Quote:
(See website for explanation of polyarticular chains). My main concern is not strengthening, but rather retraining proper recruitment of agonistic or antagonistic muscles chains in order to normalize tone and allow for proper length/leverage, and the ability of the nervous system to recognize proprioceptively that these muscles can now be recruited in a proper manner.
Hmmnn.. I see the nervous system is being referred to. Is that all it can do? Recognize proprioception? Then recruit?
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 13-07-2006, 04:09 AM   #158
Jon Newman
Enjoy a moment of whimsy
 
Jon Newman's Avatar
 
Join Date: Dec 2005
Posts: 9,024
Thanks: 5
Thanked 59 Times in 45 Posts
Default

Raulan,

What is the incidence of sphenoid temporal unevenness in the population of asymptomatic people?
__________________
"I did a small amount of web-based research, and what I found is disturbing"--Bob Morris
Jon Newman is offline   Reply With Quote
Old 13-07-2006, 06:42 AM   #159
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Diane- It may have been better stated that the physical demands being placed on the body and the body's attempt to perform that function.

I have been referring to the nervous system in more macro terms in order to convey my approach in general terms. I will be glad to break it down in to a more micro level. I will post more info ASAP. But in general, I am not just talking about proprioception and recruitment. My goal is to guide a patient to restore position, and respiratory function to allow the nervous system to function how it wants. I am not trying to force or coerce it. I think you were interpreting my comment as the body can only function in biofeedback type activity. That is not my understanding, Feedforward mechanism and encoding for motor planning involves many systems. I am not only considering proprioception, but since we are asymetric beings living on earth, functioning as bi-pedal upright beings, who need to breath, proprioception is a key component. But you cant talk about breathing without understanding you have just included effects on the autonomic nervous system, and other systems as well. Sorry I dont have the other info at the present time.

Jon- This is something I have thought about a lot. I dont have research data that states the incident, I understand your argument. However, clinically we obviously see varying degrees. Why does it effect one person instead of another? can't answer that. Despite my physical resemblance I make a lousy Buddah at the top of the mountain. Why would an MRI of one person show a space occupying lesion clearly putting pressure (mechanical deformation) on neural tissue, but they are asymptomatic. Why do some people with clearly assymetric posture demonstrate patterns of symptoms, while others do not? Clinically when I manually restore position of temporal bones, or restore rib cage kinematics, there are clear, measurable objective, and subjective changes.

Last edited by Raulan2; 13-07-2006 at 06:45 AM.
Raulan2 is offline   Reply With Quote
Old 13-07-2006, 12:27 PM   #160
Bas Asselbergs
Physiotherapist
 
Bas Asselbergs's Avatar
 
Join Date: Jul 2004
Location: Canada
Age: 62
Posts: 4,658
Thanks: 2,022
Thanked 1,533 Times in 671 Posts
Default

Thanks for being here Raulan. Could you let us know how to objectively measure temporal bone position and ribcage kinematics? I assume that "objectively" refers to a reproducable, valid and reliable test.
Thanks
Bas Asselbergs is offline   Reply With Quote
Old 13-07-2006, 01:41 PM   #161
Jon Newman
Enjoy a moment of whimsy
 
Jon Newman's Avatar
 
Join Date: Dec 2005
Posts: 9,024
Thanks: 5
Thanked 59 Times in 45 Posts
Default

Bas interesting question.

Raulan, you asked:

Quote:
Why would an MRI of one person show a space occupying lesion clearly putting pressure (mechanical deformation) on neural tissue, but they are asymptomatic. Why do some people with clearly assymetric posture demonstrate patterns of symptoms, while others do not?
People begin to have pain, (of the type most relevant to PT), when their sensitive tissue has been mechanical deformed beyond a certain threshold. They seek help when it is beyond their tolerance. Perhaps that helps answer those questions.
__________________
"I did a small amount of web-based research, and what I found is disturbing"--Bob Morris
Jon Newman is offline   Reply With Quote
Old 13-07-2006, 02:07 PM   #162
Jason Silvernail
Clinician and Researcher
 
Jason Silvernail's Avatar
 
Join Date: Dec 2005
Location: El Paso, TX
Age: 40
Posts: 4,277
Thanks: 346
Thanked 966 Times in 286 Posts
Default

Raulan-

Thanks for your prompt and courteous replies.

1. Regarding "Myokinematic Functional Performance Grading" - have there been any reliability or validity data determined for these findings? While I know it isn't the same as spinal motion palpation, I wonder is there any reason to think these "findings" are any more reliable or valid than spinal assessments?
Has the interpretation of these findings (you mentioned it was "myokinematic" function and not joint movement you were interested in) been studied for validity or reliability?
The reason I ask this question is that many other evaluation systems (such as the classification approach for LBP) are interested in the validity, reliability, and predictive value of their assessments, especially when the use of the treatments can't always be well defended in terms of theory. I believe this is a fair comparison to the PRI concepts.

2. I'm glad to see that some studies are underway. No outcome-level studies are published for Simple Contact yet, but like PRI, projects are underway currently.

I think you'll find that most of us here are less interested in outcome studies (though they are important) and more interested in the theory behind the treatment and whether that makes sense in terms of what we know about human physiology. I don't think it's difficult to put together an outcome study and prove that some type of treatment or approach can be helpful. The issue for us as a profession is what is the theory that drives all that treatment. Otherwise we are simply collecting a large number of diverse and at times diametrically-opposed systems of measurement and treatment that while possibly efficacious clinically, don't make theoretical sense.

It might be helpful to think of this problem in terms of Craniosacral Therapy (or Cranial Osteopathy) and Spinal Manipulation therapy for spinal pain. While both certainly can produce helpful outcomes, it is the disparate theory of the two treatments that is problematic, meaning how can they both help if their mechanism is supposedly so different? Without a convincing theory, we just end up collecting more and more little systems of thought and treatment without a true analysis of what we really are dealing with - human physiology and the neurobiology of pain.

I think you'll find most of the posters here are looking for you to explain why what you do works, and to do it in a way that makes sense given what we know of modern neuroscience. Your example to Jon of why nerve tissue can be compressed without symptoms is easily explained and is therefore not a controversy among those here. Your question of why some with assymetry have pain and others do not is also easily explained with modern neuroscience. I would respectfully suggest that if the theory offered by PRI does not explain these findings, then those in your organization are uninformed about modern concepts of pain and neurobiology. Unfortunately, this is the rule rather than the exception in our current medical system.

Those of us here are trying to change that. I wonder if PRI and it's concepts will help that process, or confuse the issue further?

Jason.
__________________
Jason Silvernail DPT, DSc, FAAOMPT
Board-Certified in Orthopedic Physical Therapy
Fellowship-Trained in Orthopedic Manual Therapy

Certified Strength and Conditioning Specialist


The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.
Jason Silvernail is offline   Reply With Quote
The Following User Says Thank You to Jason Silvernail For This Useful Post:
Tero (08-01-2013)
Old 13-07-2006, 03:02 PM   #163
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

Jason,

Great post. Like a knife.

One thing: If I'm not mistaken, Luke is looking at the effect of ideomotion on pain rather than the effect of Simple Contact. The method itself (SC) is far less important than the movement it reveals and encourages. Since that movement is instinctive it can't possibly do anything other than help, which is nice of course.

I feel as if the theory, such as it is, behind PRI is being exposed as incredibly weak in the realm of neuroscience. This should not surprise any ectodermalist. Mesodermalist's theories get shredded regularly when we begin to question them.

In Joel Achenbach's wonderful Captured By Aliens there's a line I love: In science, if you don't work hard enough to prove youself wrong your friends will gleefully take up the slack.

The key word there is "friends." By questioning the theory and working to explain its weaknesses (if not its actual absurdities as well) we are being Ron Hruska's friends, not his detractors.

Just thought I'd mention that.
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com
Barrett Dorko is online now   Reply With Quote
Old 13-07-2006, 03:51 PM   #164
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,212
Thanks: 3,316
Thanked 6,520 Times in 2,962 Posts
Default

Raulan,
Quote:
Diane- It may have been better stated that the physical demands being placed on the body and the body's attempt to perform that function.

I have been referring to the nervous system in more macro terms in order to convey my approach in general terms. I will be glad to break it down in to a more micro level. I will post more info ASAP. But in general, I am not just talking about proprioception and recruitment. My goal is to guide a patient to restore position, and respiratory function to allow the nervous system to function how it wants. I am not trying to force or coerce it. I think you were interpreting my comment as the body can only function in biofeedback type activity. That is not my understanding, Feedforward mechanism and encoding for motor planning involves many systems. I am not only considering proprioception, but since we are asymetric beings living on earth, functioning as bi-pedal upright beings, who need to breath, proprioception is a key component. But you cant talk about breathing without understanding you have just included effects on the autonomic nervous system, and other systems as well. Sorry I dont have the other info at the present time.
I appreciate the effort you've made to accomodate me (us) here.. What would be even greater would be if you put the primary focus/emphasis (square one, so to speak) with the nervous system, and explained your technical interventions from its perspective, rather than discussing muscles as if they had any effect on anything, as if they were anything except mesodermal bungee cords carrying out actions dictated by the ectodermal nervous system.

(As you probably have figured out by now we are trying to correct the course of the whole profession by insisting the horse go in front of the cart. Many of us are here to de-brainwash ourselves - cognitive rehabilitation is a major focus here. Some of this will splash on you. It can't be helped - besides we freely use water pistols. )

Jason, killer post!
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 13-07-2006, 04:12 PM   #165
christophb
Arbiter
 
christophb's Avatar
 
Join Date: Oct 2004
Location: Seattle, WA
Age: 40
Posts: 695
Thanks: 10
Thanked 15 Times in 8 Posts
Default

Nice post Jason, You've inspired me to try and diagram that idea.

Tufte

Chris
christophb is offline   Reply With Quote
Old 13-07-2006, 07:55 PM   #166
Randy Dixon
Senior Member
 
Join Date: May 2006
Posts: 552
Thanks: 5
Thanked 83 Times in 45 Posts
Default

Slide C: The nervous system controls the muscles.
Slide D. We can actively modulate the nervous system.

See, it really isn't as simple as it looks.
Randy Dixon is offline   Reply With Quote
Old 13-07-2006, 09:16 PM   #167
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

Raulan says: : "...we are asymmetric beings living on earth..."

It is exactly this kind of writing or speaking that I feel obscures the issues surrounding theory that we seem not to be able to pry from the grasp of the PRI practitioners. If we wrongly "assume" that they're concerned with asymmetry maybe it's because they won't stop bringing it to the fore. I "assume" we are asssymetrical because it is a successful adaptation within the evolutionary process. If that's the case, movement toward symmetry would be a bad idea.

When I treat a hairdresser with pain I work to get them to create a system with a greater adaptive potential and more accurate knowledge of what efficient functioning is known to be. It's not that complicated and takes about 10 minutes to teach. Therapists can learn the basics of teaching this in even less time. The multiple courses and elaborate terminology invented by Hruska seem unnecessary to me. The word "invented" is important here.

Raulan, I agree we "live on earth."

Is it necessary to say this? I mean, where else?
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com

Last edited by Barrett Dorko; 13-07-2006 at 09:19 PM.
Barrett Dorko is online now   Reply With Quote
Old 14-07-2006, 02:55 AM   #168
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Diane- I agree that muscles only do what they are told. Having said that, Isn't it fair to look at muscle function as a manifestation of the nervous system. And allow that to be a way of understanding patterns of neurological functioning. I dont see a problem with talking about muscle function, tone, length, leverage, position, inhibition, if we are all on the same page of understanding that all of this is driven, and reflects the nervous system. I don't want to do that to the exlcusion of understanding neurobiology. Which is an area that I am still learning, I know I am behind the curve in that area in comparison to most members here.

When I evaluate a patient I have serveral areas that I want to understand. I look at musculoskeletal system for position, knowing that the only reason they are in this position is because the ectoderm directed the mesoderm, (and with the case of respiration) affected the endodermic system. I want to understand why the ectoderm has developed a pattern of directing muscle, and function that is creating pathology of connective, or muscular tissue etc.
I want to assist the patient in patterns of movement that will avoid pathology.

An example. A patient with right sciatic pain. This patient demonstrates a fowardly oriented hemipelvis on left side, with hypertonic left illiacus, and psoas, left glute max, right add. mag. Long, weak, hyperotonic left hamstring, right QL very hypertonic. This pelvic position creates a state of left AFER ( acetabular-femoral external rotation), and right AFIR (acetabular-femoral internal roatation). This state of AFIR on the right leads to deep hip external rotators being on long tight, and overused state, and compression of the sciatic nerve with the obturator internus. This situation was developed by this patient through funtion, driven by the ectoderm. I don't deny that simple touch could relieve this symptom, but how does that change the established neuro pattern. With PRI concepts I would assist the patient in retraining neuromusclar patterns to inhibit the above mentioned muscle groups (chains) to avoid pathology. If that happens did this not really come from a change in the ectoderm? If you tell me muscles are only bungee cords controlled by the ectoderm, but I concentrate on the end result (changing the timing, firing rate, inhibition) of those mesoderm tissues, and succeed in releiveing the symptom. Then I have been modulation the ectoderm.
I understand that the epidermis is embryonically tied with the nervous system. But why is touch the only way to moderate that system? Can't it be done by asking the ectoderm to change the communication to the muscles through function?
Thank you for your patience, I am learning a lot, I am not the best writer, and I hope to convey my message clearly. I will be blunt and tell the group I don't break this down to the level you do. In my clinical experience I have gained a tremendous amount of awe for the nervous system, and I have come to trust and respect it. I have found success in working with it and viewing it through its interaction with the mesoderm, but always knowing that it is th ingition, timing system, and inhibitory to an engine (muscle) that would do nothing without it.

Last edited by Raulan2; 14-07-2006 at 04:55 AM.
Raulan2 is offline   Reply With Quote
Old 14-07-2006, 03:13 AM   #169
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,212
Thanks: 3,316
Thanked 6,520 Times in 2,962 Posts
Default

I agree that muscle function is a manifestation of the nervous system, I'd even go so far as to say that muscles are just puppet strings for the nervous system. All I'm saying is.. why focus on strings? Why not find out what sort of difficulty the puppeteer is having?

Usually there is some simple issue, (e.g. tenderness, neural tension) somewhere in the tissue that will easily neuromodulate and voila, muscle function (output) is suddenly all straightened out along with decrease or elimination of that other output, pain. I guess getting the ectoderm to change output to the mesoderm without any sort of diagnostic or therapeutic hands-on contact can be accomplished by some individuals.. I never had much luck doing that in 35 years, which is why I switched over to what I do now.

As long as you are aware of it (the NS, or ectoderm), are working with it and not against it, it may well be cooperating with whatever it is you do, even if you aren't putting it uppermost in your mind or trying to work out a better theory for why your system works.. however, I think taking the time to learn to put nervous system considerations ahead of muscle considerations would lead to a whole lot of future generations of people who learn from you/others who teach your system not ending up confused or lost up a conceptual blind alley.
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

Last edited by Diane; 14-07-2006 at 03:23 AM.
Diane is offline   Reply With Quote
Old 14-07-2006, 03:31 AM   #170
Jason Silvernail
Clinician and Researcher
 
Jason Silvernail's Avatar
 
Join Date: Dec 2005
Location: El Paso, TX
Age: 40
Posts: 4,277
Thanks: 346
Thanked 966 Times in 286 Posts
Default

Raulan-

I appreciate your effort to explain the fact that you feel muscles are driven by the nervous system, and that in order to change muscle function, you must approach the nervous system. I don't think anyone would disagree with that.

I am intrigued by your complex sciatica example. I hate to keep coming back to this topic of assessments, but I don't feel you've addressed it just yet. I do know you have your hands full with the questions, so I'll wait my turn.
You mention in great detail the slight misalignments of joints that are causing alterations in muscle functioning that "compress" the sciatic nerve. I am still interested in your assessment of the reliability and more importantly, validity of this assessment. Given the already-mentioned copious research demonstrating the poor reliability/validity of other static posture and position assessments, how can you be at all certain that the patient has these supposed misalignments and supposed poor muscle function?
How can you tell if a muscle is hypertonic vs hypotonic? How can you tell if someone has a forward hemipelvis (whatever that means)? Etc, etc.

Can you address at least in ballpark terms what you feel the reliability is for these judgments? And, the validity in terms of whether or not these supposed findings are present in someone who is asymptomatic or if these findings can discriminate between those in pain and those not in pain? Since you admitted earlier that the type of asymmetry in function or position that you're looking for and treating is present in those without pain, I'm guessing you've already surrendered the validity argument. While that does make the reliability issue moot, I'd still be interested in your response.

It seems you are trying awfully hard to explain in intricate detail why things we have no reason to believe we can actually find exist and how they explicitly cause the patient's symptoms. It's just quite a bit of a reach, and it seems as if, in opposition to Occam's razor, you are trying to explain a phenomenon in the most complicated and implausible terms, rather than the other way around. This is what we mean by "cart before the horse".

Thanks.

Jason.
__________________
Jason Silvernail DPT, DSc, FAAOMPT
Board-Certified in Orthopedic Physical Therapy
Fellowship-Trained in Orthopedic Manual Therapy

Certified Strength and Conditioning Specialist


The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.
Jason Silvernail is offline   Reply With Quote
Old 14-07-2006, 04:58 AM   #171
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Barrett-
Quote:
When I treat a hairdresser with pain I work to get them to create a system with a greater adaptive potential and more accurate knowledge of what efficient functioning is known to be.
Do you mean that you help them gain a knowledge of how to correct a compensatory pattern of functioning neurologically?
Raulan2 is offline   Reply With Quote
Old 14-07-2006, 05:58 AM   #172
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

No, I never attend to what people call "compensatory patterns."

I pay attention to the resting posture of the hips and the autonomic state.
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com
Barrett Dorko is online now   Reply With Quote
Old 14-07-2006, 07:24 AM   #173
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,212
Thanks: 3,316
Thanked 6,520 Times in 2,962 Posts
Default

Jason wrote,
Quote:
You mention in great detail the slight misalignments of joints that are causing alterations in muscle functioning that "compress" the sciatic nerve.
To that I would add one little word.. allegedly causing alterations.
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 14-07-2006, 07:40 AM   #174
BB
Arbiter
 
BB's Avatar
 
Join Date: Mar 2004
Location: Vancouver, WA
Posts: 3,587
Thanks: 349
Thanked 322 Times in 136 Posts
Default

Hi Raulan,
Thanks so much for participating here.

Quote:
I want to understand why the ectoderm has developed a pattern of directing muscle, and function that is creating pathology of connective, or muscular tissue etc.
I want to assist the patient in patterns of movement that will avoid pathology.
This is I think an important part of the distinctions being made. Patterns creating pathology of tissues means tissue stress. It appears that you are basing your rationale upon tissue stress. Tissue stress is not sufficient nor is it necessary for pain (Moseley).

And you may say, well we are looking at the same thing from different perspectives. But the next sentence "assist the patient in patterns to avoid pathology" is problematic, and makes the difference in perspective clear. If you are basing you advice on avoidance of tissue stress, you are often creating an unnecessary fear or avoidance of movement (there is actually a really good discussion from louis gifford on the pps website about this very topic as related to mckensie approach). And since tissue stress is not sufficient nor necessary for pain, avoiding "pathology" does not mean avoiding pain, nor is it necessary to avoid pain.

In other words, tissue stress theory is not a sufficient explanation for why what you do works. You need an explanatory model that is more broad, one that explains pain, one that starts with an n and ends with euroscience.

Cory
BB is offline   Reply With Quote
Old 14-07-2006, 10:33 AM   #175
Randy Dixon
Senior Member
 
Join Date: May 2006
Posts: 552
Thanks: 5
Thanked 83 Times in 45 Posts
Default

I had a fairly long post in mind composed from earlier when I briefly looked in on this thread, since then though I think an important line has been passed. Raulan stated that he realized that the effect of his treatment was due to changes in the nervous system, that he wasn't actually affecting tissue property. Isn't this the basic understanding that people on this list have been hoping others achieve?

"When I evaluate a patient I have serveral areas that I want to understand. I look at musculoskeletal system for position, knowing that the only reason they are in this position is because the ectoderm directed the mesoderm, (and with the case of respiration) affected the endodermic system. I want to understand why the ectoderm has developed a pattern of directing muscle, and function that is creating pathology of connective, or muscular tissue etc.
I want to assist the patient in patterns of movement that will avoid pathology."-Raulan

I think that if we remove that last sentence he is asking the same question of himself that is being asked of him. Why (and how) does this happen? The last sentence causes some resistance here, because most feel that the individual knows that movement better than the therapist ever can. I think that if the answer of "Why and How does it happen" is understood the rest following that will fall into place.

I think as others have noticed, that using muscle tone,temperature, movement and positioning to assess a condition is a good ectodermal approach as well as a mesodermal approach and that using movement, touching, positioning and breathing can lead to positive nervous modulation. So that no one here is going to be surprised if there are some good results. There is going to be questions about palpating bony structures with issues of accuracy, reliablity and validity but also with the reasoning. If the root of the dysfunction is neurological, then it would make more sense to assess the neurology with the bony parts only incidental to that. Wouldn't it?

From Raulan's questions I have a a question/comment. Raulan asked why some people with similar conditions remain asymptomatic and some don't, Jon replied:

"People begin to have pain, (of the type most relevant to PT), when their sensitive tissue has been mechanical deformed beyond a certain threshold. They seek help when it is beyond their tolerance. Perhaps that helps answer those questions."


I don't think this answered the question, it is really just a rewording of the original question, or perhaps just taken one step further. Why do some people have lower tolerances than others? I don't think we know the answer to that one satisfactorily. Why is TMJ pain almost always one-sided? It's the same nervous system.

Anyway, I'm glad that Raulan has thick skin and will stick around long enough to actually make the exchange meaningful.
Randy Dixon is offline   Reply With Quote
Old 14-07-2006, 11:24 AM   #176
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,735
Thanks: 2,080
Thanked 628 Times in 451 Posts
Default

My view on Randy's sentence, which is a highly important one:

People have thresholds and tolerances of pain that vary from one person to another. To me, it depends on whether their systems are OK, subcritical or critical, as to when the incoming messages are interpreted as pain. Someone who is in a subcritical state ( lots of deadwood around, including emotional issues) can tip readily into a critical state if the systems are threatened; once in a critical state, it takes very little indeed to fire the whole system up. (high sensitivity)

But someone in an OK state can almost get away with murder - compressed nerve/s and other exciting things found on MRI that nobody knew about. The system does not go up in flames because it is stable and nonsensitive. Kick it around for a few months and the organism can go from OK to critical fairly rapidly.

Does that make sense?

Nari
nari is offline   Reply With Quote
Old 14-07-2006, 02:05 PM   #177
Jon Newman
Enjoy a moment of whimsy
 
Jon Newman's Avatar
 
Join Date: Dec 2005
Posts: 9,024
Thanks: 5
Thanked 59 Times in 45 Posts
Default

Hi Randy,

I agree that my response only took that observation one step closer. But it is one step closer to what PTs ought to be researching more intensely (or at least paying attention to what others are researching) in my opinion. The threshold and tolerances that I'm specifically interested in are perception thresholds, not necessarily whether an AP has been produced. Additionally, I'm interested in the "binding" of inputs in the process of perception. These areas of study are far more helpful in my understanding pain than what's on offer from PRI (and many others) right now. The concepts and approaches being advocated by PRI very well may turn out to be helpful but without including how sphenoid/temporal unevenness and it's correction (for example) affect physiology, it is less interesting to me. This assumes that one can accurately detect and correct these things to begin with.
__________________
"I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

Last edited by Jon Newman; 15-07-2006 at 05:39 AM.
Jon Newman is offline   Reply With Quote
Old 14-07-2006, 02:17 PM   #178
Bas Asselbergs
Physiotherapist
 
Bas Asselbergs's Avatar
 
Join Date: Jul 2004
Location: Canada
Age: 62
Posts: 4,658
Thanks: 2,022
Thanked 1,533 Times in 671 Posts
Default

Raulan, as you may have noticed, I am not arguing effectiveness of PR as a treatment. But I do need to echo myself and Jason in particular with regards to these questions :

"Could you let us know how to objectively measure temporal bone position and ribcage kinematics? I assume that "objectively" refers to a reproducable, valid and reliable test."

"Regarding "Myokinematic Functional Performance Grading" - have there been any reliability or validity data determined for these findings? "

Thanks.
Bas Asselbergs is offline   Reply With Quote
Old 14-07-2006, 03:02 PM   #179
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

Randy says: "I think that if the answer of "Why and How does it happen" is understood the rest following that will fall into place."

The "how" we might answer adequately if we know the deep model accurately and the "why" we might speculate upon but will never know for sure. These questions too closely approximate the "How did you get to be the way that you are today?" question that is simply impossible to answer, even by the person who got that way. See Ubiquity by Buchanan.

We need to ask: "What are you doing to stay the way you are and what can you do now to get out of this fix?"
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com
Barrett Dorko is online now   Reply With Quote
Old 15-07-2006, 02:41 AM   #180
BB
Arbiter
 
BB's Avatar
 
Join Date: Mar 2004
Location: Vancouver, WA
Posts: 3,587
Thanks: 349
Thanked 322 Times in 136 Posts
Default

I found the link to the Gifford discussion I mentioned above. Aches and Pains Online, not pps.

Here is the link to the discussion (sorry, I still don't know how to hyperlink here):
http://www.ppaonline.co.uk/mckenzie.html

cory
BB is offline   Reply With Quote
Old 15-07-2006, 02:42 PM   #181
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

While in Orlando a few weeks ago I met a therapist at the McKenzie Institute booth. She was very cordial and filled me in on Robin's current schedule. He no longer flies to teach anywhere but there's a meeting of his students in New Zealand soon that they all seem to be looking forward to. It's titled "The Evidence Mounts." I have the feeling that they're referring exclusively to the evidence they like but I might be wrong.

I would love to have some his instructors join us here as Raulan has so that we can get some answers to the questions that rise inevitably from an essay like Gifford's. I know I've personally invited a few here, including the woman in Orlando. So far, nothin'.

If science is about asking the hard questions of another's theory and then getting an answer, well, this would be just about the only place on the web for therapists to do so.

Why do the McKenzieites so carefully stay away?
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com
Barrett Dorko is online now   Reply With Quote
Old 17-07-2006, 05:18 PM   #182
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Bas & Jason,

The following link will Describe all of the assessments for assessing temporal position. Although we are still in the process of of studies for validity/ reliability. Please read this page. The theoretical explanation for each test is described. Please let me know what you find that does not make sense with respect to anatomy or physiology.
http://www.posturalrestoration.com/r...ursenotes_id=7
Raulan2 is offline   Reply With Quote
Old 17-07-2006, 05:52 PM   #183
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,212
Thanks: 3,316
Thanked 6,520 Times in 2,962 Posts
Default

Quote:
Horizontal Upper Extremity Abduction
Patient lies in supine with knees flexed to flatten the lumbar spine. Passively take the patient’s arm into horizontal abduction while securing the shoulder joint with one hand and maintaining forearm supination with the other hand.
A positive test is indicated by limited horizontal abduction of one extremity when compared to the other. Less than 30° is considered limited.
This reads awfully like an upper limb neural tension test to me.

Roulan, it is interesting to these descriptions, and thank you for bringing them here for us to look at. I can't help but note the lack of concern for the peripheral nervous system threading through all the body parts however, and no doubt contributing a lot to the organism "behavior" observed in lack of range, etc. Do you think this omission will ever be addressed by/in this system?
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Old 17-07-2006, 06:03 PM   #184
Jason Silvernail
Clinician and Researcher
 
Jason Silvernail's Avatar
 
Join Date: Dec 2005
Location: El Paso, TX
Age: 40
Posts: 4,277
Thanks: 346
Thanked 966 Times in 286 Posts
Default

Hi Raulan.
Thanks for posting the link.

I see a lot of subjective assessments of joint position or movement in the descriptions, and this is really the issue we're talking about.
I can cite a lot of study evidence that evaluates the reliability of these sorts of assessments - not just for spinal position, but things like leg length, ilac crest height, etc - which seem a very valid comparison to the techniques described on this page. The problem is the poor reliability intra and inter examiner for these measures. I take it from this page that the reliability data simply do not yet exist for these measures. That's OK, as long as there's a plausible theory that we're working from. I haven't really seen that on the site.

Validity is a whole separate issue, and might be best approached by asking if the assymetric findings that PRI therapists look for are found in asymptomatic people. In other words, could you tell someone in pain from someone without pain from the findings? Since you admitted in your post on July 13th that many people with assymetry don't have pain, then that is what I mean by surrendering the validity argument.

Nothing on the site is inconsistent with anatomy, it's the physiological explanation that's flawed.

Do you see what I mean?
Thanks for your ongoing participation and response, I appreciate your effort and patience.

Jason.
__________________
Jason Silvernail DPT, DSc, FAAOMPT
Board-Certified in Orthopedic Physical Therapy
Fellowship-Trained in Orthopedic Manual Therapy

Certified Strength and Conditioning Specialist


The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.
Jason Silvernail is offline   Reply With Quote
Old 17-07-2006, 08:08 PM   #185
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Diane, the horizontal abduction test determines the resting position of the scapula on the rib cage, and therefore determines the position of the rib cage. The position of the rib cage can determine how the periphery function. So instead of just understanding neural tension. I want to understand the underpinnings of what is leading to that tension. In my mind this is not an omission, rather an understanding that truly takes into consideration the neuro-musculoskelatal system. If the horizontal abd test is indicating neural tension how better to reduce that than to restore rib cage position, and kinematics to allow proper peripheral limb movement and reduce neural tension.

Jason, When I stated that some people have symptoms and some don't, There obiously is a threshold that leads to pain. I understand your argument that testing position cannot predict who wil have pain. What objective assessment do you use? Is it valid and reliable? I am open to new ideas!

Barrett, Your comment about "invented terms" disturbed me. From you essays you refer to William Carpenter coining the phrase Ideomotor Movement. Did he not invent this term. When one comes to an understanding of somenthing that has never been described, the you are inventing a term. Mr. Hruska has Invented the descriptions of polyarticular chains, that are different than Meisier', and others. If you are the first to do so I consider that science. Then that term/theory can be challenged, and researched. Why do you have a problem with that?
Raulan2 is offline   Reply With Quote
Old 17-07-2006, 09:22 PM   #186
christophb
Arbiter
 
christophb's Avatar
 
Join Date: Oct 2004
Location: Seattle, WA
Age: 40
Posts: 695
Thanks: 10
Thanked 15 Times in 8 Posts
Default

Quote:
Diane, the horizontal abduction test determines the resting position of the scapula on the rib cage, and therefore determines the position of the rib cage.
Hello Raulan,

It would seem that there could be a few things that could contribute to this. How was it determined that the resting position of the scapula reflects the position of the ribcage? As I was reading this I couldn't help but think of Barrett's "defense or defect" argument Asking Why. So, how did the ribcage become defective or malpositioned? Could the position of the ribcage be in defense of sensitive neural tissue? How did the neural tissue become sensitive?

Really looking at this there could be many factors, how is it possible to know which? I am not sure if it is even possible to know which given the ubiquitous nature of the human body, but trying to arrive at a simple explanation that makes sense appeals to me.

Chris
christophb is offline   Reply With Quote
Old 17-07-2006, 10:14 PM   #187
Jason Silvernail
Clinician and Researcher
 
Jason Silvernail's Avatar
 
Join Date: Dec 2005
Location: El Paso, TX
Age: 40
Posts: 4,277
Thanks: 346
Thanked 966 Times in 286 Posts
Default

Raulan-

Thanks for responding so quickly!

Well, I use various orthopedic tests in looking for musculoskeletal pathology, I think you'll find Josh Cleland's book "Orthopedic Clinical Examination" gives a good summary about validity/reliability of those tests. I use the ones supported by the best evidence. However, many of my patients appear to have pain as a result of mechanical tension in their nervous system, and for this group, there are few tests that are terribly helpful. Some data have been published about upper and lower limb neural 'tension' testing. Since I don't use these examinations to drive my treatment of patients with this particular essential diagnosis, then I think the reliability/validity of the tests are less important. I think Barrett's essay "The End of Evaluation" on his site covers this well.
I'd be happy to discuss any aspect of my practice elsewhere, and be open to your criticism, but I'll let this thread stay about PRI and it's concepts.

Interesting that you bring up the idea of a threshold for pain, I couldn't agree more, I have heard this concept described as "adaptive potential". How can this be measured, and knowing the issues with reliability and validity we brought up earlier, how does aiming treatment at these findings address pain relief?

J
__________________
Jason Silvernail DPT, DSc, FAAOMPT
Board-Certified in Orthopedic Physical Therapy
Fellowship-Trained in Orthopedic Manual Therapy

Certified Strength and Conditioning Specialist


The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.
Jason Silvernail is offline   Reply With Quote
Old 17-07-2006, 10:19 PM   #188
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

Carpenter came up with a single term over 150 years ago that has stood the test of time and thousands of studies. He did this to make a known phenomenon clearer, not to obfuscate.

The plethora of terms often invented by those who propose we see things never before noticed doesn't help. It is the sort of thing done by those who have a preconceived notion of dysfunction and then try to find evidence to bolster their argument. New terms multiply as rapidly as the courses invented to teach them.
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com
Barrett Dorko is online now   Reply With Quote
Old 17-07-2006, 11:05 PM   #189
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,735
Thanks: 2,080
Thanked 628 Times in 451 Posts
Default

Raulan,

Something you might like to think about: how does a scapula and ribcage "know" to present as a defect/defence? They are structures that can only move as directed by the nervous system; they can be seen as 'slaves' or as Diane puts it, 'puppets' on a string. They know nothing about initiating a contraction or a pull this way or that; it is not in their duty statement. They are in the Army, where NCOs do only as they are directed.
Therefore treating the rib cage and scapula directly can achieve results; but Army privates can only follow orders from the top brass (the nervous system) - not from us. So unless the top brass is addressed....the solution may not last very long, unless we are lucky and incidentally include the Boss.

Nari
nari is offline   Reply With Quote
Old 17-07-2006, 11:15 PM   #190
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

I am going to get my water gun out. Mr. Hruska did not have pre-concieved notions. He has many years of experience and through disciplined observation, and dilligent research internationally, he described manifestations of neuro-muscluar patterns, in way that has not been described before. How do you do that without new terminology. You may not agree with our philosophy, but when trying to describe neruo-musculo-skeletal expression and also consider the effect of respiration, sympathetic/parasympathetic, and autonomic nervous system, there werent terms available. I dont think that obfuscates anything, but rather allows for understanding. But the real test will be the test of time. My money is on those terms being around in 150 years.
I guess why some people have a hard time being in this forum is they cant tolerate criticism. I will say that to newcomers there is an evident collective arrogance of the group. No offense, but I don't see where this arrogance is derived from. Personally I don't care to engage in "deconstructing " anyone else or their approach. I may know that their theory doesn't work for me, I would rather promote and advance my own theory, but I appreciate that if you can't take a few bumps and bruises then you really aren't meant to be a scientist. My purpose of responding here was to try and legitimatley answer your questions, and hopefully add to the body of knowledge of our profession. I am glad there are others who are trying to shift our profession away from the status-quo that has been so stagnant to true advancement. I would like to challenge Mr. Barrett who is obviously a gifted writer to not limit himself to essays, but to use his talents in peer reviewed journals. I also hoped that I might challenge those in the group with enough interest that they might attend one of our courses. You all seem to be against attending courses. You may not agree with everything, but I hoped you would realize that what PRI is promoting would at least be thought provoking in a unique way, and not another course in how to mob a shoulder. I took a chance on attending Mr. Dorko's course based on one word in the title that referred to the nervous system. Please understand that there are others out there who are considering the nervous system, but we describe from a different perspective. I would like to invite any members here to attend a course and then continue our discourse. Thanks for inviting us here, and I will try to respond as time permits.
Raulan2 is offline   Reply With Quote
Old 18-07-2006, 12:01 AM   #191
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

Raulan,

You attended my course because of one word in the title? You didn't look carefully at the writing here and on my site as was encouraged in the course brochure? It seems that I get most of my students in the same way; seemingly disinterested in doing the work necessary to avoid attending a course taught by anybody with an idea or scheme. That is a recipe for disaster in continuing ed and I suspect it's happened countless times.

Our interest in deconstructing theory here may be unique in the profession, and that is a tragedy, I think. Your claim that we are arrogant is simply untrue and belies a tendency to attack the messenger that I've seen elsewhere on this board in the past. NO ONE has said a thing about the person who has advanced the theory proposed, and any personal characterization of those questioning theory is inappropriate.
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com

Last edited by Barrett Dorko; 18-07-2006 at 12:37 AM.
Barrett Dorko is online now   Reply With Quote
Old 18-07-2006, 02:53 AM   #192
Jon Newman
Enjoy a moment of whimsy
 
Jon Newman's Avatar
 
Join Date: Dec 2005
Posts: 9,024
Thanks: 5
Thanked 59 Times in 45 Posts
Default

It took me quite a while before I critically questioned someone or tried to defend myself publicly . While there is a learning curve, one I'm still on and will likely be on for some time, I think calling this process arrogant (and actively avoiding it) is tantamount to aiding and abetting the dumbing down of our profession. Actively engaging in this type of dialogue does not prevent someone from pursuing their own ideas and in fact it is the only way to side step errors in thinking before you build a kingdom on a quagmire.
__________________
"I did a small amount of web-based research, and what I found is disturbing"--Bob Morris
Jon Newman is offline   Reply With Quote
Old 18-07-2006, 03:58 AM   #193
Nick
Arbiter
 
Nick's Avatar
 
Join Date: Dec 2005
Location: Bedford, Nova Scotia
Posts: 718
Thanks: 2
Thanked 10 Times in 7 Posts
Default

Thanks to Raulan for sticking around so long. It actually took quite a while before acknowledging his recruitment efforts

I find the assertion that the people on this board are adverse to courses quite laughable. Probably the most well-educated group that I've come across in some time. Forgive us for being discerning about where and how we choose to learn. I'm quite sure few here will be signing up without some more answers to the questions posed. Again, thanks for you work on this so far.

BTW, I think Barrett's writing gifts would be wasted in peer-reviewed journals.

Nick
Nick is offline   Reply With Quote
Old 18-07-2006, 06:14 AM   #194
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

I did not contend that anyone person here was arrogant, but rather the collective group conveys an I'm right, you're wrong connotation in their communications in this thread and others. I have stuck around this long because I understand that this process is important to advancement of the profession. I guess I am asking this group to be as introspective with the same level of criticism as they of others. Repeated posts directed my direction regarding invalid and unreliable assessments could easily be asked to you. Maybe this is more appropriate in another thread, but I think this group has scientifically based theory and yet lacks some of the same validity and reliability they point out in others.
Nick- Mr. Dorko teaches continuing education courses, so do I. In revealing that I would encourage attendance to a course is that I feel that there is valuable information that is unique compared to the average level of courses out there. I detect that you think my motives are purely monetary. Is Mr. Dorko the only one allowed to be altruistic in his motives for teaching?

Last edited by Raulan2; 18-07-2006 at 06:17 AM.
Raulan2 is offline   Reply With Quote
Old 18-07-2006, 06:34 AM   #195
Raulan2
Member
 
Join Date: Jul 2006
Location: Burley, Idaho
Posts: 50
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Jon- Barrett said something important in an earlier post. That a theory or concept will stand the test of time. Theories, or treatment philosophies, will stand on their own merits, or more importantly fade away to inobscurity based on the lack of science. In my opinion, the best way to advance the collective knowledge is to advance your theory through research, and improved success with patient treatment. The more success you have in a science based philosophy it will elevate this above poorly scientifically based theory and treatments based on "traditions of the past". Have you considered that when you spend so much time trying to deconstruct a theory that you unintentionally give more validity to that school of thought that it deserves? Scientific evidence will be all the deconstruction you need. I wish that at PRI we had completed more of our research, we are actively engaged in this, and a large portion of our proceeds from our courses is set up to ensure that research can continue. I know that some out there make a considerable income through their cont. ed courses, If you could see the car I drive you would understand that if this were my motive, then I neeed to reconsider my career path. I look forward to the discussions we will have in 2-3 years. I really think that many of the concepts here are shared in both of our concepts. I do feel like we have some common ground, and some areas where we are further apart.
Raulan2 is offline   Reply With Quote
Old 18-07-2006, 10:57 AM   #196
Randy Dixon
Senior Member
 
Join Date: May 2006
Posts: 552
Thanks: 5
Thanked 83 Times in 45 Posts
Default

I did not contend that anyone person here was arrogant, but rather the collective group conveys an I'm right, you're wrong connotation in their communications in this thread and others. I have stuck around this long because I understand that this process is important to advancement of the profession. I guess I am asking this group to be as introspective with the same level of criticism as they of others. -Raulan


I can only say Raulan, that you are not the first to make this observation and apparently not the last. I guess some habits just die too hard.
Randy Dixon is offline   Reply With Quote
Old 18-07-2006, 12:18 PM   #197
Bas Asselbergs
Physiotherapist
 
Bas Asselbergs's Avatar
 
Join Date: Jul 2004
Location: Canada
Age: 62
Posts: 4,658
Thanks: 2,022
Thanked 1,533 Times in 671 Posts
Default

Raulan, thanks for that link about the evaluation techniques. I don't see anything different from other manual evaluation "paradigms" - similar if not the same as: cranial osteopathy, orthopaedic manual assessment, even the TMJ eval is right out of well-established techniques taught for many years by Mariano Rocabado PT. None of which shed any light on the validity of the testing for asymmetry and the principles of "restoration" of symmetry.

"Mr. Hruska did not have pre-concieved notions. He has many years of experience and through disciplined observation, and dilligent research internationally, he described manifestations of neuro-muscluar patterns, in way that has not been described before. "
This is a strong claim: almost everything I have seen of PR so far, is a re-naming and re-packaging of previous ideas: Sharmann, even as far back as Vladimir Janda (pseudo-paresis of muscles in adaptive patterns), Rocabado, osteopathy, Neuromuscular Therapy (St. John) etc etc. I take some exception to the idea that this re-packaging is groundbreaking work and that it will stand the test of time.
But I guess I am not surprised.
I am out of this thread - we seem to be communicating with different ground rules.
Bas Asselbergs is offline   Reply With Quote
Old 18-07-2006, 01:27 PM   #198
Barrett Dorko
Writer and Clinician
 
Barrett Dorko's Avatar
 
Join Date: Nov 2005
Location: Cuyahoga Falls, Ohio
Age: 63
Posts: 16,860
Thanks: 1,881
Thanked 3,155 Times in 1,793 Posts
Default

Put the word "arrogant" into the Microsoft Word processor and then ask for synonyms - every word is an insult. I fail to see how telling us that the whole group of regular contributors here conveys arrogance is any better than picking out an individual. In any case, "I'm right and you're wrong" is precisely the sort of thing said commonly in any scientific pursuit. This isn't arrogance, it's careful inquiry - something this board is dedicated to.

It appears Raulan that you are quite often wrong and I don't know why this shouldn't be pointed out each time. I'm with Bas when it comes to the repackaging of other's ideas, and many of these ideas have been proven wrong the past few years. Calling them by a different name doesn't do much more than delay slightly that revelation.
__________________
Barrett L. Dorko P.T.
www.barrettdorko.com
Barrett Dorko is online now   Reply With Quote
Old 18-07-2006, 02:36 PM   #199
Jason Silvernail
Clinician and Researcher
 
Jason Silvernail's Avatar
 
Join Date: Dec 2005
Location: El Paso, TX
Age: 40
Posts: 4,277
Thanks: 346
Thanked 966 Times in 286 Posts
Default Seem familiar???

Randy said it's not the first nor the last time people have leveled that accusation at this group. Interestingly, the folks on Evidence in Motion have had the same experience.

I find it's much more convenient for people to assume the questioners are "arrogant" than to actually address their concerns. This is a very familiar situation, and you really know your profession is full of psuedo-scientists when strident debate and questioning is characterized as arrogance. Give me a break. Why is it every time I have a showdown with someone who can't back up their claims that it always degenerates into them calling me or my group arrogant or unfair? It has happened on several forums now, to include RehabEdge, Evidence in Motion, and now Soma Simple.

I have found that true scientists will be up front and honest and reflective about what they do, and be willing to address ANY question directed at them about their practice. This is true of the people on EIM and it is true of those here. Perhaps that's why these groups get attacked so strongly, the other participants in the debate simply have no recourse. Hopelessly outgunned from a scientific and argumentative standpoint, they retreat with unfounded accusations and ad hominem attacks. Well, I guess that makes sense. They've got nothing else left.

Our professions need MORE of this type of strong debate and questioning, not less. The "tea party" atmosphere in therapy is contributing to a dangerous level of complacency and our scientific background and care of our patients hangs in the balance.
But I guess that's just my "arrogance" showing through again...

J
__________________
Jason Silvernail DPT, DSc, FAAOMPT
Board-Certified in Orthopedic Physical Therapy
Fellowship-Trained in Orthopedic Manual Therapy

Certified Strength and Conditioning Specialist


The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.
Jason Silvernail is offline   Reply With Quote
Old 18-07-2006, 03:17 PM   #200
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 23,212
Thanks: 3,316
Thanked 6,520 Times in 2,962 Posts
Default

Ditto Jason.

What is it about a group of therapists challenging thought processes and questioning fundamental biological underpinnings of treatment concepts that deserves the epithet "arrogant"? Surely deconstruction and finding/studying/learning deep models of the human organism should be embraced by every member of a profession that considers itself "scientific".. or are we all wrong about that?
__________________
Diane
www.dermoneuromodulation.com
SensibleSolutionsPhysiotherapy
HumanAntiGravitySuit blog
Neurotonics PT Teamblog
Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
Canadian Physiotherapy Association Pain Science Division Facebook page
@PainPhysiosCan
WCPT PhysiotherapyPainNetwork on Facebook
@WCPTPTPN
Neuroscience and Pain Science for Manual PTs Facebook page

@dfjpt
SomaSimple on Facebook
@somasimple

"Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

“Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

“If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

"In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

"Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire
Diane is offline   Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
CT postural meme regnalt deux General Discussion 2 06-08-2010 02:44 AM
Postural drainage emad General Discussion 5 25-03-2006 01:17 PM
Postural sway Diane Barrett's Forums 15 25-03-2006 04:04 AM


All times are GMT +2. The time now is 03:37 AM.


Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
SomaSimple © 2004 - 2014