Simple Contact Course at Nanaimo

[bernard]

Hi,

Maybe some will post their thoughts?

[Diane]

:thumbs_up Absolutely, once they have been gathered.

Here's one thought that gathered so far.

1. Most therapists use Cartesian theory, methods, techniques, and tackle what they imagine the "problem" to be, from the outside in. (Mobilipulation/mobilization fall into this catagory.)

2. Others have learned neuromodulation. It is less Cartesian, can be inside out as well as outside in, and is much less invasive, invites the patients' brains to be co-participants in the treatment.

3. Barrett's way is almost completely inside out. He is right when he says he does "nothing" to the patient. If the patient is bending their head to the right, he will move his hand to the left side of their head and allow them to try to escape his touch. Because of sensory awareness, this placement (I think) encourages slower movement, more eccentric lengthening than might otherwise occur without outside touch.. but that's all he does.

He didn't teach that, he just showed it. Luke was the keen observer who picked up on Barrett's choice of hand placement. Other participants had their hands on the right side of the head (if the head were bending to the right) which felt a little restrictive.
Diane

[flaviovitor]

Hello Diane,

but SIMPLE CONTACT by BARRETT DORKO is so SOMASIMPLE (:teeth: ), i.e., so simple like that? Scaping from my hands contact? Maybe some education prior to the movement? Maybe some cognitive desensitization or neuromodulation before taking the movement?

What is there of newest for treating pain associated to movement?


Flávio Vitor.

[bernard]

SIMPLE CONTACT by BARRETT DORKO is so SOMASIMPLE

You wrote it! But I'm not sure that Barrett will agree to this phrase. But why not? I'm hoping that a day we will definetely forget our difference and share some experience. :lightbulb

[bernard]

For those that aren't aware of the thoughts of Barrett L Dorko, I made a pdf file of some of his writings.

I think it is more readable this way?

[nari]

I have only just discovered this thread, thanks to Bernard pointing it out to me.

What a good idea. I am still not back into posting mode - I will blame it on jet lag. Good excuse.

The SC course. Ah well...in brief, I found it fascinating and educational. I can also see why there is so much resistance to its implications.

1) It is so very simple, so PTs may think something is missing. (There isn't)

2) It is considered 'not orthodox' / 'alternative' /'weird'. (There is plenty of evidence around to support the theory (just read up on neurophysiology) and probably more than for most of what PTs do in practice).

3) Barrett has good teaching skills, but not high on explanation of WHY something happens. His writings do not help greatly on this aspect, though attending the course improves comprehension of his articles.

4) Seeing SC in action left me a bit amazed that people in the class responded so quickly and resolved their ROM/function impairments as quickly.

5) It is totally nonintrusive. There is no coaxing, pushing, pulling, guiding, resisting, jumping on joints, no asking of people to do movements which may be actually making them worse in the long run;

6) It takes control AWAY from the PT and 'hands' it to the patient. I love this.

7) It probably applies to 80% of the population whom we see. What other single method does this?

8) It takes away the need of a lot of what we do as 'basic physiotherapy' as far as musculoskeletal stuff goes. This scares some PTs.

9) It does not require anything more than comfortable space for two people, and maybe a chair or a plinth. (Think of the money saved)

10) It works. (OK, so that is not evidence, but what is?)

It is part of the neurobiological paradigm that is finally starting to be recognised around the world; and hopefully changing the way a lot of physiotherapy is practised.

I'm starting to evangelise again, so I will stop. I am going to work on a largeish summary of what SC really IS...when I stop falling asleep over the keyboard.

:(

Nari

:note:

[Diane]

I agree with Nari.
What scares PTs a bit and turns off a portion of them, might be the perception that anyone could do this, who has a pair of sensitive hands. No special training required. No need to be brilliant or to prop up the profession up into glorious heights. It's simple and there's no real "need" for outcome studies or "proof" that it "works", because if it does, fine, if it doesn't, (oops picked the wrong patient is all), no harm has been done. I am attracted to how 'Occam's Razor' that is.

In its finest outcome, simple contact could turn into a movement that includes all humanity/people, a 'barefoot doctor' type of treatment that could be applied by anyone anywhere, the poor person's antidote to the chronic pain epidemic sweeping a ever more crowded and culturally circumscribed world. Worst scenario it will remain a quirky footnote in PT history, as PT pushes on to become "all that it can be" by complicating human contact into ever stricter and more rigid classification and management and protocol and clinical prediction rule until finally human contact is so legislated that no one can touch anyone anymore unless they have 12 PhDs/DPTs and a lisence that costs a million dollars a year to maintain.
Diane

[bernard]

Diane,

I was already convinced that simple "things" were able to stop the patient's pain. It was certainly scary, at the beginning, when patients asked: "It's all you're doing to me?!". Many GP/Physicians aren't looking that in a very good manner. It's against the modern principle of Medicine: "The more complex, the more it must cure!"

BTW, I'm not doing Simple Contact but it remains neuromodulation.

[Diane]

Calling simple contact neuromodulation is fine, Bernard. It's like calling brocoli a vegetable. :)
Diane

[bernard]

Diane,

I like brocoli and quite all vegetable. ;)

[nari]

It is definitely neuromodulation, Bernard...a simple way of talking to another's CNS. There are many ways this can be done, too, some more complex than others, but that's OK.

I tried it out on my cat but he chastised me, saying that he already knew all about that stuff and has been doing it for years. Quite true, too. :cool:

Nari

[nari]

After reading a few of the posts on RE, it seems that some PTs are having success doing self-initiated SC. This is something I have been playing with as well, and what intrigues me is the change in awareness of the skin and subdermal tissues - it's not so much a SNS change (warmth etc) as just increased awareness of what the tissues feel like, and all I do is touch the eccentric aspect. This is spooky, almost as though going to the SC class and understanding the concept (well, I think I do) makes all the difference.

So what facilitates ideomotion?
Education - neuro stuff of course, and what touch actually does.
Eccentric touching
That 'permission to move' sensation being present.

Still cannot believe Luke's rapid response (about 1 second)...if I had not seen it happen time after time. I can now believe that people can self-hypnotise readily, and make it effective.


Nari

[Diane]

Touch alerts the brain immediately (all those big fast myelinated fibers). When it is the right touch the brain relaxes immediately, and the body follows. I've been reading in that biodynamic embryology book recommended by Luke, that sensory innervation takes place before motor. That means it is a wee bit older than motor, and perhaps has more control somehow over the brain's survival decision making. Just a thought.

[bernard]

Nari,

The eccentric word tortures my mind since it mean "away from" but from what?

Diane,

Nice signature. You're addicted to neurons!
(I'll change mine)

[nari]

Bernard, I don't know. Eccentric is, and always has been, a silly way to describe an action. I have never found a circle as a reference point, unless they refer to the centre of a square or rectangle.....

I might think of a signature too....there will be a few, I think. (Non animal)


Nari

[bernard]

Nari,

Eccentric is, and always has been, a silly way to describe an action.
I agree since there is often a concentric component in every eccentric movement.

But you said it was possible to SC ourselves. I need to know where is the spot of your action?

[Diane]

Bernard, if you bend your head to the right, your hand will go on the LEFT side... that will be the lengthening side for a right side bend. The left side is controlling the descent of your head to the right. It is contracting while lengthening, which is eccentric contraction. If you lift your head back up again using the same muscles, they will be contracting while shortening, and they would be concentrically contracting. Whatever you do with your hands, keep them off the shortening side and on the lengthening side. Works way better.

[nari]

Yes, it does make a difference. Facilitates movement in a more fluid fashion...


Nari

[bernard]

Bernard, if you bend your head to the right, your hand will go on the LEFT side... that will be the lengthening side for a right side bend. The left side is controlling the descent of your head to the right. It is contracting while lengthening, which is eccentric contraction. If you lift your head back up again using the same muscles, they will be contracting while shortening, and they would be concentrically contracting. Whatever you do with your hands, keep them off the shortening side and on the lengthening side. Works way better.

I need to visualize the thing for now.

[nari]

Bernard

Just try it on yourself. The neck is the most accessible part, but I have felt it work on spinal lateral flexing/side bending or whatever they call it.
Not a strong pressure - just enough so you can feel the touch.

Do you like my signature??

Nari

[bernard]

Nari,

Not a strong pressure - just enough so you can feel the touch.
Direction? painful or pain free?

I like the signature of course since it comes from a French guy.

I love these ones from Antoine:

A goal without a plan is just a wish.

Please, draw me a sheep!

ps: put your first name in it so you'll have no more to write it in the future.

[Diane]

Bernard, any direction you want. Mostly pain free but it might hurt a teeny bit for nanoseconds of time.
Feel for warming, softening,(anywhere in the body, sometimes far away from where you are consciously moving) surprise and effortlessness.

[nari]

Yes, I like that wonderful phrase - 'draw me a sheep' and everyone misunderstood and drew a sheep for him...poor little prince.

I have started writing up an essay of sorts on SC - but it is quite difficult, as I do not want to use Barrett's language (I don't like plagiarism) and finding words other than his own is tricky, without losing the gist of the sentence.

Bernard, imagine you are feeling the texture of a very silky material of fine fur. That is about the level of contact, or perhaps a tiny bit more. Luke's contact with me was barely perceptible, and it worked.

Nari

[bernard]

hmmm...

I wasn't clear :D. Sensing something with my hands/eyes is not really difficult but suppose we have a patient with a chronic pain on his R back. Where do you put your hand/s, what is the starting position? (we may suppose that he want to move to the left.)

[Diane]

Barrett often starts with hands on the head. It doesn't have to be on the area that's hurting, anywhere is fine. His only suggestion was that where the skin is firmly adhered (tight) there will be more sensors in the skin. From a practitioner perspective, tight skin doesn't move much so you can feel the patient moving better, not just the skin. Lateral points like shoulders, ears, or illiac crests; front and back of head are good too.

[bernard]

Thanks for these useful explanations, I will try with my wife :angel:. (She likes to try new technique :D)

But how is it possible to self apply it?

[nari]

Bernard, just use your hand, one hand at first; and I would suggest the face is a good start - perhaps the forehead. It might be easier, however, to try it on someone else first (wives/husbands/partners come in handy for experimentation) and just ask the question: "Where do you want to go?" or "How do you want to move?" Barrett says he doesn't hang around with a contact for more than three seconds; if nothing happens, move to another spot. However, he did stay longer than three seconds with some, including me; but I was a hard nut to crack...

Sitting, standing or lying down doesn't seem to matter, but I had better results with people in standing.

Good luck! Remember not to guide, or lead, just follow where she/he goes.


Nari