A simple situation

[Barrett Dorko]

When I can't use the cruise control the nervous tissue in my right lower quarter reveals its sensitivity. As the blood flow diminishes, danger signals are sent to my brain. When they accumulate sufficiently, my brain decides to output pain that I feel is focused in my right knee and then spreads. This perception met instinctively with movement and manual pressure in various reachable places and seat adjustment.

About 10 seconds after walking about, the pain markedly subsides. I usually stop the car first.

I think that this is a wonderful example of an abnormal neurodynamic responding to ischemia secondary to mechanical deformation and not much more.

How did I get like this?

What does it matter?

[Barrett Dorko]

Another way of looking at this by one of our esteemed colleagues, probably a superior, supervisor or actual boss:

That's just a weak knee. If you did some work on the Cybex you'd get better. I've seen it happen a million times.

What they're thinking: There's money in that knee. A lot of money.

[John W]

What they're thinking: There's money in that knee. A lot of money.

I don't think the thinking is quite that venal, but my guess- and I can only speculate- is that what you're suggesting is the only rational explanation for their motivation.

Their thinking is so muddled, off-base and built on irrational and indefensible concepts, that I don't think it's quite accurate to assert that they're thinking about the money.

They don't know what the hell they're thinking.

Don't ya think?

[Ken Jakalski]

Hi Barrett!

That's just a weak knee. If you did some work on the Cybex you'd get better. I've seen it happen a million times.

You've addressed what many high school athletes, from my experiences, are told when they go to area PT's.

This "weak muscle meme" is so ingrained that coaches are often advised about how to modify their training programs to allow for a more "balanced" approach to muscle development.

[Barrett Dorko]

This is a madness (yes, I said it) that has proven to be a way that provides more income than any other. If anyone thinks the managers are considering anything other than the bottom line they should think again.

They should also provide an answer that doesn't include "it works."

Now, am I rational when I consider this peripheral driver to be an abnormal neurodynamic?

[Ken Jakalski]

Maybe the "muscle madness" just won't go away because it's so easy to validate via a changes in strength. Though improved strength (balanced muscle groups) may not remove pain, such strength changes are perhaps the concrete and verifiable things that patients cling to.

I've heard the following on more than one occasion:

"You should be fine because we now have achieved the optimal balance of quad to hamstring strength."

[Sheffphysio]

Originally Posted by Barrett Dorko

Now, am I rational when I consider this peripheral driver to be an abnormal neurodynamic?

Yes, totally rational. However unusual.

Ken

[QUOTE]You should be fine because we now have achieved the optimal balance of quad to hamstring strength."/QUOTE]

I've heard this on many occasions....... and I have no idea what it means.

[Richard Finn]

Originally Posted by Barrett Dorko

This perception met instinctively with movement and manual pressure in various reachable places and seat adjustment.

About 10 seconds after walking about, the pain markedly subsides. I usually stop the car first.

I think that this is a wonderful example of an abnormal neurodynamic responding to ischemia secondary to mechanical deformation and not much more.

I like to do small pelvic movements "borrowed" from Feldenkrais while driving or flying. No wrecks so far!

[Barrett Dorko]

Done already. As yet, I've found such things helpful but only to a limited degree.

Stuck in traffic I can only do so much, and if walking were an option I'd choose it. But I still feel an increased sensitivity two days later without driving. I'm not seeking a solving of this problem, only an opinion about the reasonableness of my conclusion regarding an essential diagnosis.

[nari]

I reckon the essential diagnosis is spot on. Anything else doesn't make any sense.

Nari

[Barrett Dorko]

Thanks Nari, I'm sure, as always, descending inhibition plays a role.

But when relief follows movement so consistently I think that a case can be made and a method will follow rationally.

[zimney3pt]

Interesting that often we don't realize that when we do "strength training" exercises that maybe the increase strength is of little value in a situation such as this.

However the improved health of the tissues in the area because of movement, increased blood flow to the area, changes in circulatory system with training and cellular changes in mitochondria of muscles allowing the muscle to be more efficient to do same work (so maybe they leave a little extra blood for the nervous system in the area) may have some reasoning behind a significant change on the symptoms with a diagnosis such as this. Also providing a reason "why it works" for some patients even if that quad/hamstring ratio doesn't ever seem to match that proverbial normal.

[smith]

[QUOTE=Barrett Dorko;134993]

About 10 seconds after walking about, the pain markedly subsides. I usually stop the car first.

I think that this is a wonderful example of an abnormal neurodynamic responding to ischemia secondary to mechanical deformation and not much more.

What no inflamatory cycle? That's outrageous, ha!

[lakeab]

I think that this is a wonderful example of an abnormal neurodynamic responding to ischemia secondary to mechanical deformation and not much more.

or...

Initially, ischemia secondary to mechanical deformation may have been sufficent input to produce the experience of pain. Based on that experience , your nervous system has now learned to produce pain when ever it feels that its in that same context. It will continue to produce the same output until your nervous system is satisfied that the context has changed.