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  • ??? Simple Contact - Ideomotion Contraindications

    The more I read about myofascial unwinding, strain counter strain, ideomotion and simple contact - the more I become intrigued about its application in regards to time and place.

    I used myofascial unwinding/ideomotion for the first time in my life - clinically - today. The patient had long standing hip pain. I talked her off the proverbial cliff regarding past implanted nocebos and then listened to her body. I let her left heel rest in my hand and felt it begin to move, I followed. When she came to end ranges, I lightly added over pressure into a gentle stretch.

    It worked wonders. Her body essentially released itself and she left happy.

    I wonder, with these techniques.

    When do we use them, when do we not use them?

    There are the obvious answers but its not the obvious that makes me curious.
    "Physicians are many in name and title, but few in reality." --Hippocrates

    "Do not take life too seriously. You will never get out of it alive." --Elbert Hubbard

  • #2
    Originally posted by Anthony Close View Post
    ...and then listened to her body. I let her left heel rest in my hand and felt it begin to move, I followed. When she came to end ranges, I lightly added over pressure into a gentle stretch.
    Blue and Red seem fundamentally opposed.

    Glad that your patient responded to your input.

    To answer your own bolded question, I have not met someone since attending the SC course this Spring who I would avoid using SC with.

    Respectfully,
    Keith
    Blog: Keith's Korner
    Twitter: @18mmPT

    Comment


    • #3
      I think that with ideomotion, it is all about the patient, the patient subconsciously "moves" him/herself at the rate, speed, direction that the brain wants to move. I have found that even though the patient's tissues move or "release" in a direction that is the opposite of what the restriction is, the end result is decreased tension in that originally restricted direction of movement.

      I find this to be an art form and have watched Barrett's videos over and over, much how I have watched Kobe Bryant's footwork over and over to learn new basketball skills.

      Overpressure is the therapist telling the patient's body what we think they need to do. i think that the patient's nervous system may or may not like it. This is when reading minds would be a nice skill to have.:angel:

      Simple contact could be for everyone. just maybe not always on the location of a patients symptoms. It might also be possible that other clinicians touching body parts far away from the location of symptoms are doing some sort of simple contact but call it regional interdependence.

      Rex
      Rex Fujiwara, MPT,OCS
      Physical Therapist
      www.painsciencecenter.com

      Comment


      • #4
        Originally posted by keithp View Post
        Blue and Red seem fundamentally opposed.

        Glad that your patient responded to your input.

        To answer your own bolded question, I have not met someone since attending the SC course this Spring who I would avoid using SC with.

        Respectfully,
        Keith

        True. Is it okay to add slight over pressure if it isn't causing discomfort?
        "Physicians are many in name and title, but few in reality." --Hippocrates

        "Do not take life too seriously. You will never get out of it alive." --Elbert Hubbard

        Comment


        • #5
          Originally posted by Anthony Close View Post
          Is it okay to add slight over pressure if it isn't causing discomfort?
          Why do you want to?

          What is your rationale for doing so? Is the patient telling you that they feel that they need to go there and can't or are you assuming they need to go farther? If you reason (somehow) that they need to go farther, in which directions and how do you come to that conclusion? What is the goal is to be achieved by passively 'stretching' the patient in this manner?

          How does your story change when in one instance you trust their ideomotion while you impose your own movement on them the next?

          Respectfully,
          Keith
          Last edited by Keith; 09-10-2013, 01:36 PM.
          Blog: Keith's Korner
          Twitter: @18mmPT

          Comment


          • #6
            I proceed with caution in the following circumstances:


            Psychiatric History
            Poorly controlled Epilepsy
            PNES http://en.wikipedia.org/wiki/Psychog...eptic_seizures
            Vestibular disorders
            Where there is risk of bleeding or emboli
            Osteoporosis
            End of life care

            Bear in mind issues of informed ongoing consent from the patient or appropriate adult

            Unresolved apprehension in members of the Multidisciplinary Care Team or Relatives is a contraindication as far as I am concerned.

            As is insufficient imaging and other investigations, I rarely have trouble getting these done nowadays.

            Also signs of transference or persistent belief that I have magical powers in anyone over the age of 7.

            Remember that your own ideomotion will be affected by your knowledge of anatomy and physiology and your preconceived ideas if any about what is happening to the nervous system you are already engaged with if they can see hear or smell you.
            Last edited by Jo Bowyer; 09-10-2013, 12:59 PM.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • #7
              Anthony,

              There's a lot here.

              I'll begin: Why the overpressure? What in the hell do you think you're stretching?
              Barrett L. Dorko

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              • #8
                Another question:

                Since when is an instinctive movement contraindicated, painful or not?

                There's also in this the implication that ideomotion is somehow sometimes not present. That's like saying the heartbeat is sometimes not present.
                Barrett L. Dorko

                Comment


                • #9
                  Originally posted by Barrett Dorko View Post
                  Another question:

                  Since when is an instinctive movement contraindicated, painful or not?
                  When it interferes with performance in world class sport.
                  Last edited by Jo Bowyer; 09-10-2013, 01:44 PM.
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • #10
                    I guess it's not a problem here then.
                    Barrett L. Dorko

                    Comment


                    • #11
                      Originally posted by Barrett Dorko View Post
                      Anthony,

                      There's a lot here.

                      I'll begin: Why the overpressure? What in the hell do you think you're stretching?
                      I don't think I am stretching anything in particular. Perhaps mobilizing the joint. Of course, after I asked the client if they felt as if it needed to go further. They said, "yes". The client then asked to go back to that position later.
                      Last edited by Anthony Close; 11-10-2013, 02:41 AM. Reason: Spelling
                      "Physicians are many in name and title, but few in reality." --Hippocrates

                      "Do not take life too seriously. You will never get out of it alive." --Elbert Hubbard

                      Comment


                      • #12
                        Originally posted by Jo Bowyer View Post
                        Remember that your own ideomotion will be affected by your knowledge of anatomy and physiology and your preconceived ideas if any about what is happening to the nervous system you are already engaged with if they can see hear or smell you.
                        Thank you for your response Jo.

                        I like this quote of yours. It is so true. It is easy to understand how my own beliefs and ideas would influence the process.
                        "Physicians are many in name and title, but few in reality." --Hippocrates

                        "Do not take life too seriously. You will never get out of it alive." --Elbert Hubbard

                        Comment


                        • #13
                          Mechanical hyperalgesia that is not altered by movement, position or touch.

                          Eric
                          --------------------------------------------------------------
                          Body is imbued with mind, and mind is embodied.

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                          • #14
                            Originally posted by Milehigh View Post
                            Mechanical hyperalgesia that is not altered by movement, position or touch.

                            Eric
                            Would you expand on that Eric?
                            "Physicians are many in name and title, but few in reality." --Hippocrates

                            "Do not take life too seriously. You will never get out of it alive." --Elbert Hubbard

                            Comment

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