??? Posture, anatomy and teaching

[bstrah]

...

[Diane]

As long as you don't have a definite deadline, just keep reading. There is plenty here to chew through.

[Bas Asselbergs]

This thread has a lot of interesting discussion and links to articles and other threads:
http://www.somasimple.com/forums/sho...hlight=posture

[Luckbox]

Tortora

[Karen L]

Please, please, please stick to the curriculum. Anatomy and physiology is a core subject that needs to be taught well and learned well.

Posture and kinetics is for the kinesiology class if you have one. Core belonging to Exercise and Rehab class if you have it. Do them a huge service by helping them grasp the basics of the cell and especially neurological cell types and functions. Really give thought to an enriched explanation of the integumentary system and the cutaneous/subcutaneous nerves present. Ask DIANE for that info. Massage targets neuro, endocrine, immune make sure they at least firmly grasp the basics of these systems.

It will only confuse and derail students if you introduce the neuroscience world view we have here to students that don't have a solid in the basics. Feel free to encourage them to investigate the board for themselves but don't filter what you see here through to the students. You can't deconstruct posture until you learn the components of it first.

Tortora & Derrickson 12th is a good book, as is the student learning guide. Guyton & Hall 11th is stellar if not a bit too rich. I highly recommend Grant's Atlas of Anatomy over Netter but we didn't have a choice in our school.

Good luck you have a vital role in these people being safe therapists.
Karen L RMT

[Jon Newman]

Originally Posted by bstrah

Through no fault of my own, I've been invited to teach some undergrad anatomy, physiology etc to massage therapists.

Are you just filling in a for a few lectures or teaching a course for the whole semester? Are you being asked to establish learning objectives, create lesson plans, etc.?

[John W]

I highly recommend Grant's Atlas of Anatomy over Netter but we didn't have a choice in our school.

I'm so glad to hear that there's someone else out there in the manual therapy world who prefers Grant's over Netter. I've never understood why PT, nursing and other "allied health" programs prefer to use the "dumbed down" Netter version of anatomy.

[Karen L]

Bob you are an exercise physiologist. Do you also have professional massage therapist training in addition to being a Feldenkrais instructor?

Being hired to teach massage therapists is a big responsibility. Your success is your students success. I am a recent grad of a very expensive program in Canada and I can tell you with the utmost confidence, even if you do not believe in the theory it is your professional responsibility to follow the massage curriculum. That is what your students are paying for and the faculty is paying you for. Go ahead and teach them how to use Pub Med and how to think critically as they analyze what they are learning. That will help prepare them for the barrage of pseudoscience they will be subject to later.

Through no fault of my own, I've been invited to teach

Did you want the job or is it being forced on you somehow? Were you asked to teach A&P as well as postural analysis and orthopedic assessment 101 or just A&P?

I think they're in part expecting me to get out the plumb-line and explain why "tight muscles" and the like are relevant.

It sounds like you have concluded it is not relevant? When and how did you come to this viewpoint. Feldenkrais?

The 'etc' stuff (like: "postural analysis", "orthopedic assessment 101") is what's concerning me.

Is the concern, conflicting beliefs between what you learned in University/College exercise physiology and then learned outside. Do you see a problem with assessment in manual therapy? What do you want to say about the stuff.

I am speaking as a former student, when anyone said X is what I have to teach and Y is how it is done in the real world, I wanted to scream. There has to be a standard of practice. Teach X critical thinking then point them at Y. If there are flaws in the explanation the profession needs to deal with it.

Unfortunately there isn't one or two must reads to fix the problems of the massage industry. It is culturally flawed having accepted, thrown out, hand me down theories and cobbled together 100 year old anecdotes.

When manual therapists, including massage therapists shift toward neuroscience based explanations and take up the research of people like Lorimer Mosely, D Butler, VS Ramachandran, A Damasio, R Melzack and Wall, among others the public will be properly served.

Your students will be served if you help them reveal the magic themselves and not teach try to them the secrets of how the real world does it. There are no secrets to be had here at Soma Simple. Manual Magic thread

Karen

[nari]

...but I'd feel more comfortable knowing I could say "Well, according to....".

I think that is a very safe way to go, to avoid sounding certain about anything. Once you sound certain, then the students won't question further, and that would be a great pity.

I like Netter for its clarity but Gray's can't really be beaten for detail. What do you plan to recommend for physiology?

It may be helpful to quote David Butler: We treat physiology, not anatomy. Though to keep the peace for the students' supervisors who may or may not believe in anatomy being the prime mover, it could be modified slightly as you see fit.

Nari

[Diane]

Bob, you could do worse than getting Butler's books. They are a tad old by now, but you could chase down the authors he references to see what's gone on in the last 10 years. There really hasn't been a better general text than his. Shacklock's is pretty good but not as expansive. There is nothing better than Explain Pain around yet, anywhere, to my knowlege, that is less mesodermal and better explanation. And all Aus, to boot. Go to the noigroup website to get them direct.

[ginger]

I have often had the pleasure of teaching massage therapists. I find them to be keen as mustard to be given the straight facts, while capable to a large degree of assessing and dealing with some of the more cryptic analyses we do here at SS. I also find in general, no shortage of people with intelligence and sensitive natures.Were I to offer guidance you most likely don't need Bstrah, it would be , as Karen has indicated, basics peppered with personal , clinical insights. This rather than a littany of papers they could get without your help anyway. If the school is any good they will have a reading list as long as the Brisbane river is currently wide.
All the best and have fun, massage students are good learners.

[Karen L]

Bob I am not being adversarial. I appreciate that using the cell phone browser is difficult at the moment. Thank you for sharing you background.

I had difficulty with the phrasing of your questions. How am I to understand a leap from teaching the basics, A&P, to wanting to tip posture onto its head, unless I ask you what you already know and why you think your heart should not be in it.

How are we to answer you with two or three must reads, when we don't know what revolution you intend to set off in your classroom. You say your were dissatisfied with clinical practice and lumps of clay for patients. What information do you think will change that reality for your students.

I thought perhaps some of you might empathize with the prospect of being a round peg in a square hole. I don't much fancy teaching MFR, MET, CST and the like, which are (were?) s.o.p. when I went through.

It is great that you have recognized the problem with those modalities. It is not always apparent, people arriving in the threads hold those opinions by default.


Bob search the threads for the neruromatrix if pain. There are three or four including this one: http://www.somasimple.com/forums/showthread.php?t=9693 and make sure you find the melzack paper and the mosely paper. Search for: Quinter and this.

The reason I am recommending this information is; you can not raise opposition to these modalities without knowing the base of the pyramid - Pain output. It is the starting point for all inquiry.

If I have caused you to feel like you are holding a flower in a knife fight I really am sorry.
I try to point you at the threads so I can draw better formed questions from you and you can form your own opinion of the material.

I was a student in the first year of the program when I started questioning what pain was and how to treat it. I stumbled across Barrett and found my way here. My early posts are the dogs breakfast but I kept trying to understand. People here were very generous. I was learning the stuff at school and here, it made my life twice as hard, I had to learn three times as much, and I was twice as miserable as my classmates. I was the only one of thirty two students who came this route. I would carry my little stack of journal papers around like a security blanket so I could prove mfr and cst and trigger points were a crock.

As gently and as best I can explain this: your students only have the time and energy for the facts that will get them through school. There is however a place for quality peer reviewed references in that endeavour. But until such time as the governing bodies of massage world wide, change their stance on treating meat instead of nervous systems, you were tasked to teach them mostly about the tissue. Do the best job you can on the basics and strenuously hint or out right say when they are solid in neuro; this is the future of massage and where to find SomaSimple or its like.

If you want help with finding reference material, books, link, threads please feel free to ask. I am sure as we get to know each other mis-communication will become less and less.

[Karen L]

Dear Bob,

The thread Gradient is a good place to look at the problem with change. You are in an admirable and enviable position to be. Try not to leave footprints though.
Barrett in the Gradient:

Promoting change, as Machiavelli points out in the quote that begins this thread, is both difficult and dangerous. Let’s begin with what makes it difficult.

The stability of today’s orthopedic model in manual therapy is undeniable. The purveyors of its establishment have created a foundation of knowledge that is unassailable when understood with the sensibilities of a primary biomechanical mindset. It has served countless patients well when they are in need of correction that is largely visible, palpable and may often be reduced to a mathematical formula involving angulation and leverage.

As has been discussed in Nate Mosher’s companion thread, we have approached the management of pain in an order that is quite the reverse of what would be logical, especially given what we now know about the working of the nervous system. I agree entirely with a comment such as “It's like looking through a telescope backwards” (from Diane Jacobs) and the case for this view has certainly been made to my satisfaction.

If you begin to deconstruct the myofascial and musculoskeletal model you will need to replace it with something. I suggest learning as much as possible from Diane's passion; the peripheral cutaneous nervous system, the CNS, the skin. I would also suggest reading Barrett's essays and learning his style. There is much to learn about the metaphors Barrett favors.

It will be a long process, but it is worth the time to be here.

Karen

[ginger]

When teaching massage therapists, one of the essentials I find is Unlearning. Unlearning that for instance the site of a complained of pain problem is necessarily the site of the problem. Whoops I'm late

[vancouverRMT]

Thanks Karen,

I have recently started with students in their 6th term clinic inreach. Your posts are helping me in my careful approach to educating on how the nervous system affects pain. We are graduating people with a outdated curriculum designed to help pass the boards, not how to interact with another human.

[Karen L]

Mike if is not to far out on a limb you could find Diane's Balloon technique drawing and orange balloon jpg picture in the threads and share it in Clinic. By term six they should be sufficiently ready for the radicalism.

Why don't they teach this in Physio school?

There is no reason why it can't be but the material needs to be introduced within a firmly planted foundation of the neuroscience explanation. It goes for PT and massage.

Karen

[decahedron@hotmail.com]

Brunnstrom's Clinical Kinesiology
F.A. Davis

Good Chapter on Standing and walking. You might even like what she has to say.

"A perpendicular or rigid standing posture is assumed when one is standing at attention or told to stand up straight. The weight is shifted posteriorly so that a lateral plumb line falls through the ear, tip of shoulder, center of hip and knee, and very close to the axis of the ankle joint. This is an unnatural posture requiring conscious effort, increased contraction of muscles and increased energy expenditure.
Unfortunately, perpendicular posture has been equated with good or desirable posture. This has come about because of translation errors and misinterpretation of the work of Braune and Fischer (1889). This position was used by the authors to locate points on the body coordinate system. This position was called 'nomalstelling', meaning upright reference, not normal posture. Comfortable relaxed standing was called 'bequeme haltung', meaning comfortable hold"

Another good book is Orthopedic physical assessment by David J. Magee, Saunders
Posture and Gait are also covered well.

[decahedron@hotmail.com]

I have just graduated from a massage therapy program. It does seem to me that each instructor brings their own set of beliefs, practices and prejudices into the classroom. However, how can a school teach a single integrated approach when the textbooks do not even agree. For example, Magee uses several sources and often those sources do not agree. So when a single text book can't come to the discussion with out adding to the confusion how can a school teach it otherwise. To pick a way and teach it that one way would be detrimental to a student who goes out into the real world to find that there are a myriad of ways and beliefs. Each student must find their own way, both through the schooling and in the real world. The best thing a teacher can do is teach the way they believe, introduce competing beliefs and above all else, teach the student to THINK clinically with basis in Anatomy, Physioloy and science... Test, treat and re-test then look at the results.