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  • #46
    Over the years I've found that for some reason people will choose a "favorite" position to allow their patients to get into before they employ Simple Contact.

    Personally, I don't have one, though I often find myself sitting quietly at the patient's head while they're supine, the characteristics of correction popping up all over the place but relatively little motion to see.
    Barrett L. Dorko

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    • #47
      I have not yet developed a favourite position either, and will often use 3-4 in one session in no pre-chosen order.

      In the beginning I felt more comfortable in the standing and sitting postions, only because the movement was more dramatic and thus appeared more impressive and effective. Now I work in supine more often. I am finding that the finger tips of one hand on the lumbar SPs or PSIS and the other at the medial malleolus and/or 1st MTP is an extremely effective contact for encourgaing external rotation at the hip.

      Luke
      Luke Rickards
      Osteopath

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      • #48
        I love sitting and feeling my head go all over "heaven's" half acre. More successful on myself at the moment - am not always quiet enough inside for my patients yet. getting better. I love the pauses in my head/neck's motion, as if the system says: "Wait here for a bit, this needs to soften for a moment"....Funny, the mention of "orthopaedic/neuro": I also noticed when I let my own head/neck gently correct, I get some very smooth, but noticable joint "pops" on occasion. It is of course, a gentle action, moving into a soft but audible pop and followed by warmth. No HVLA needed ....
        We don't see things as they are, we see things as WE are - Anais Nin

        I suppose it's easier to believe something than it is to understand it.
        Cmdr. Chris Hadfield on rise of poor / pseudo science

        Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

        We don't need a body to feel a body. Ronald Melzack

        Comment


        • #49
          Luke - I'll PM you about details. Thanks.

          Bas -
          It's so funny you posted that. I spent yesterday in the afternoon trying to correct my chronic but now subacute and painful Lx radiculopathy in my R leg. I just now finished setting up my workstation so I can stand all day now.
          I figured out last night that it was chemical pain, and felt better after a blast of NSAIDs.
          Much better today, but most frustrating for me is that now that I can elicit this motion in my patients, I'm having the most difficulty with it myself. Ironic, huh?

          I'm hoping to have a few attempts at it tonight, since it seems more mechanical today, with my wife to help, since I can't seem to get it going without touch to set it off. While certainly annoying, it sure does make everything in the "Touch and Sensation" essay make personal sense.

          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.

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          • #50
            Jason,
            I know exactly what you mean, it seems much harder for me to treat myself, when I have the rare flare-up of scapular pain from too much computer time.
            As Barrett mentioned, I have a favorite position for my patients(standing), as the results seem more dramatic, but I am slowly gaining confidence and trying the patients in different positions.
            Scott

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            • #51
              Jason, I’ve found the very same to be true, easier to elicit in patients, much more challenging in myself. It does get better with practice, but my learning curve has been long.

              I had an interesting revelation with a "RTC tendonitis" patient the other day. I usually explain too much right away, and I noticed I have a tendency to judge whether people will "get SC" or not and introduce it accordingly. The gentleman from yesterday did not fit my "looks like he'll enjoy SC category" but I went ahead with it anyway, no explanation given. As I expected, there was not much movement going on and I was disappointed and a little worried he would think I was weird. It was then I realized I was weird, but also that I was giving most of the resistance to movement. When I gave him nothing to resist, the characteristics emerged and movement followed. It was such a subtle shift though that it surprised me. He walked out surprised and pain free as well.

              I have printed up a characteristics of correction sheet that I give people, and I am thinking of posting it for deconstruction/ideas (my one act of bravery for the day). It seems to be working as I have had more patients with "ah ha" moments while doing self-ideomotion. Plus I personally don't like to talk about it while doing SC, I haven't learned to multitask that yet.

              Chris
              Attached Files
              Last edited by bernard; 06-07-2006, 04:58 PM.
              Christopher Bryhan MPT

              "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
              Daniel Kahneman - Thinking Fast and Slow

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              • #52
                Those are some excellent descriptions Chris, not weird at all. Brief and to the point, which will be easy for patients to take in. I on the other hand wanted to read more, hope you keep writing these!

                eric
                Eric Matheson, PT

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                • #53
                  These are good ideas, Chris. Keep 'em rolling.

                  I might suggest that a therapist doesn't say a word at all during SC - nothing, until the movement ceases. Do we really want to 'interfere' with what awareness the patient is about to, or is experiencing, or has just experienced?
                  I would have 'instinctively' thought we shut up until resolution has finished.

                  Just an idea...

                  Nari

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                  • #54
                    On the other hand, I often talk a great deal while people move. The subject matter is eclectic as well.

                    It's also common for me to be perfectly quiet. I have no idea what triggers what. I will often interrupt myself to say something about what I'm sensing or to ask what people are feeling. I find myself repeating the theory behind the work with a new analogy. To me, it often becomes something like the writing I do each morning. I don't know what's going to show up next.

                    I will admit that I've been known to say exactly the wrong thing at the worst possible moment. I try to avoid that, but, well, such a thing will never disappear entirely. Not until I'm no longer able to talk at all.

                    That should do it.
                    Barrett L. Dorko

                    Comment


                    • #55
                      Hi!
                      Ihave to saythat iam quite impressed with your results using SC,but for how long does your pos results last?
                      Do your patients learn SCon them self to be able to take controll of their own problems.?
                      Do you consider Sc as an active or passive approach?

                      RIN(Still in doubt!)

                      Comment


                      • #56
                        RIN,

                        The follow-up of patients after discharge from physiotherapy is always interesting; particularly those who have only experienced SC. I'd like to know that, too.

                        Ideally patients learn to become aware of instinctive corrective movements themselves, and physios will become redundant. But that is not a welcome thought for the muscle/joint aficionados...

                        There is nothing passive about SC - the therapist does nothing. Therefore it is 100% active.

                        Nari

                        Comment


                        • #57
                          Hi RIN,

                          I consider Simple Contact to be as active of a therapy as you can get and still be providing manual therapy. Of course their movement (palpable or visible) and our understanding of the mesoderm, ectoderm and recognition of aberrant presentations is the crux of the therapeutic interaction and that, in my opinion, makes us the professionals we are.
                          Last edited by Jon Newman; 07-07-2006, 01:44 AM.
                          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

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                          • #58
                            ...and given my reductionist philosophy, the knowledge we have in varying depths is that important aspect of patient/therapist interaction, be it tactile or verbal or both, that many others fail to realise, including our peers and superiors, still clinging to the meme that we treat only mesoderm in a physical sense.

                            When can we become Pain Pathologists??

                            Nari

                            Comment


                            • #59
                              Jason, Scott: maybe I'm just so much more self-centered than you two....
                              Mind you, I have done trancendental meditation in the 70's before I became a physio and I think that may have an effect on getting myself quiet inside for me. I haven't always been able to bring that "older" skill to override my more recent well-established and trained professional mind-set of "I gotta think this out- deduce, investigate, find the problem" - this mind set is a big and noisy fortress to level. Gotta find that secret tunnel...
                              We don't see things as they are, we see things as WE are - Anais Nin

                              I suppose it's easier to believe something than it is to understand it.
                              Cmdr. Chris Hadfield on rise of poor / pseudo science

                              Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

                              We don't need a body to feel a body. Ronald Melzack

                              Comment


                              • #60
                                RIN, your question needs a bit of clarification. What do you mean by active? Physically strenuous? Or is it motion? Or is it a living, sensing, heart-beating, neurons-firing being? Am I inactive/passive when I am experiencing non-moving hands on my neck? Even when I am still, I am perceiving, processing and cells are in motion; and thus changing. The division between passive/active is for me no longer a valid one. I get massages on occasion, (because I CAN) and I can tell you that "just" lying there is a world of wonderful physical activity! A HVLA manipulation is also NOT passive.
                                Maybe we should focus more on what is "inviting" motion and what is "forcing" motion, then on active versus passive.
                                And what little I know of SC, it IS very active in a visible way.....
                                We don't see things as they are, we see things as WE are - Anais Nin

                                I suppose it's easier to believe something than it is to understand it.
                                Cmdr. Chris Hadfield on rise of poor / pseudo science

                                Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

                                We don't need a body to feel a body. Ronald Melzack

                                Comment

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