Another reason therapists don't know

[Jo Bowyer]

dad dancing
nounBRITISHinformal
awkward or unfashionable dancing to pop music, as characteristically performed by middle-aged or older men.
"for optimum embarrassment of offspring, dad dancing is best performed to REM's Shiny Happy People"

[Jo Bowyer]

ballet
dad ^ dancing.

Gives you an idea of how I looked...

I find that difficult to believe Blaise. The thing about dad dancing is that it causes maximum discomfort to everyone except the offender(s)

[Barrett Dorko]

Jo,

Dad dancing is an excellent way to embarrass your children. I would know both as an offender and offendee.

Something else I've heard: "I do some improv in order to relieve the pain from ballet."

Do you suppose that there might be a lesson in there?

[Jo Bowyer]

Someone has put together this collection of proponents of the noble art. The first example has an infant seated in a high chair to the left of frame.

http://dancingdads.tumblr.com/

[Josh]

I apologize for not responding sooner, no computers or phones allowed in a turkey blind.

In regards to conscious volitional movement: After screening a pt for red flags and assessing how they move. I assure them that moving will not hurt them and then we work on easing into the painful motions or should I say fearful motions. I do this with a patient and ask them to be aware and conscious of the movement to promote understanding and self-resolution, Barrett does this but states he allows the patient's (sub/unconscious/instincts) to guide them. Thats where we differ.

At the end of a session; if I told my patient you feel better because i removed cultural barriers to your own instinctual movement generated at a subconscious level in your brain, by interacting with your system through touch in a non-coercive manner, I'd have some confused skeptical patients.

Does the debate come down to the question Do we have knowledge in regrads to how a patient should move through training, research, education to help resolve pain. Or Does the patient have the knowledge at a sub/unconscious level to resolve pain, that happens to be culturally suppressed? I'd argue that they have fear because of the unknown, we address this through education, guided conscious movements, not by removing culturally suppressed ideomotion.

[Bas Asselbergs]

Thanks Josh.

At the end of a session; if I told my patient you feel better because i removed cultural barriers to your own instinctual movement generated at a subconscious level in your brain, by interacting with your system through touch in a non-coercive manner, I'd have some confused skeptical patients.

First of all, I do not think I would ever say anything with that kind of certainty anymore. All I will tell a patient, is that when they feel relief (either immediate or later) it is thanks to their own nervous system's processing of all inputs.

I'd argue that they have fear because of the unknown, we address this through education, guided conscious movements, not by removing culturally suppressed ideomotion.

It is not a case of "either/or". Again you imply that education is NOT part of SC.

The explanation should never be more than: a reduction of pain may be because of a change in mechanical nociception, reducing fear, deep understanding of the neurophysiology of pain, instinctive movement, validation of the complaint andsoforth.
Maybe they just like Barrett's tie, or the view from clinic windows.

Our own explanation inside our head can be much more detailed.

BTW, "how a patient should move" is not something anyone can know - that patient in front of you is simply unique. There is no ideal or "proper" movement in this context.

[Barrett Dorko]

In the last couple of places I worked the patient saw a housekeeping cart sitting next to a 100 pound overweight clinic director staring at a computer while a country western music video played loudly. What a country!

I'm not kidding.

What happened to the twisted finger and hammerlock analogies? Why are they never mentioned? Instead, you get a supposed explanation dreamed up by someone who thinks they know which way people are suppose to move and correct.

Yes Josh, I'm speaking of what you've written here. I don't think you're a bad person. For all I know, you're a great, great therapist. I'm beginning to wonder about the motivation of your colleagues aware of all this writing though.

They are aware of it, aren't they?

[Josh]

Barrett I have no idea what the last part of your post means. Motivation, awareness, colleagues?

[Josh]

Bas thanks for the reply and I can agree with most of it.
I think we can use neurodynamics, biomechanics to give them a starting point as to how a pt MAY move to reduce mechanical pain. Is that fair?

[advantage1]

In the last couple of places I worked the patient saw a housekeeping cart sitting next to a 100 pound overweight clinic director staring at a computer while a country western music video played loudly. What a country!

I'm not kidding.

Who wouldn't have a protective repsonse witnessing this.

[Barrett Dorko]

Josh,

They never post here. I've spent years remaining very quiet at work after seeing that other PTs are disinterested and, with over 6000 students around the country, a total of 27 actually registered here and virtually none of them have said anything.

You're a rare exception to this and I truly appreciate your presence. The origins of my cynicism are clear, I think, and that few actually participate in these discussions no longer surprises me.

By the way, we've heard all of the excuses for silence and disinterest.

[pedspainphysio]

"They never post here"

SS has taught me a lot... and for this, I am truly grateful... Critically reading and applying literature relevant to my practice has too. SS is but one way for PTs to learn and suits a certain personality. Many of my former students tell me that they find the tone - yes I said 'tone' - at SS to be not conducive to their learning style... this is okay... SS doesn't work for them... this does not mean that 'they' aren't interested. I agree that we have a long way to go to bring the discipline of PT forward. SS is one way that meets the needs of some... not all. Now, because I have mentioned tone, and just in case someone has a strong desire to post the link to that thread, or engage in a huge debate about communication and senders and receivers, all I am saying is that this is what I hear and the 'tone' or the perception of a negative 'tone' is real to many... you need not agree... but this is a barrier for some.

If we want more people here, what do we need to change about ourselves and the way we are trying to bring about change? Clearly, if we after more people posting and discusssing here, then the current way is not working...

And, for the record, I probably read more science than one might consider healthy... but I don't post here much because I need to go to the gym, have dinner with my wife and kids, ferry my kids to soccer and running every night of the week, work, read, sleep, etc... my silence does not equal disinterest.

Back to reading another journal article...

[zendogg]

Luke Rickards uses the term "non-volitional" in his paper, which Barrett cited earlier.

I think we can all agree that our bodies move in ways that we don't consciously control or expect. We just move. The point is we might not move in this way if we take heed of instructions like "sit up straight" from those in authority over us, or who we would like to emulate (e.g. supermodels, classical dancers and other celebrities).

If this behavior is linked to persistent pain, why wouldn't we try to figure out how to intervene in a way that promote its expression? If ideomotor movement is inherent to life, and it's being suppressed, then it follows that the individual is not living a fully expressed life. If we can help someone to live more fully through a more complete expression of their physicality, why wouldn't we? Isn't this what we are supposed to do?

Frankly, I don't understand why this so difficult to grasp. But, I very much appreciate why it's so difficult to implement in practice.

John,

Here is what I find challenging to grasp: We are talking about two movements- Nonconscious (ideomotion) and conscious (biomechanics n stuff). Let's take the example of shifting one's butt when it has become tender due to sitting. We have called this ideomotor motion. We say it is non conscious. I can understand how culture could influence the expression of a movement of this nature, it is overt, visible, and so on. Then we have the minute motions we have also discussed in this thread and called ideomotion. I cannot see how culture or any other authority could have an influence over this motion, particularly because few people even know it is happening!
And if I again point to the butt shifting movement described above, how different is that movement from something done in yoga or a well diversified exercise program?? Yet certainly these people have pain problems.

I personally have a VERY VERY diverse movement repartee for my exercise. I am conscious of considering any one movement as a possible contributor to nociception. I move in mid range, I move in full range. I move in ways that many have never thought of. I still have pain here and there that is persistent and annoying.

What am I missing then?

Nathan

[Barrett Dorko]

Nathan,

What makes you think that a motion is fundamentally different just because it becomes visible? What is the difference between the word said and the word thought?

Isn't isometric contraction typically going to be the word unsaid? Isn't the context of the situation going to change the expression of something?

Haven't you ever watched a movie displaying the behavior of Victorians? Deadwood? Upstairs, Downstairs? Downton Abbey?

Since when is awareness the same thing as reality?

You'd be better off thinking in terms of "not normally planned and countercultural that is accompanied by the characteristics of correction" than that "biomechanical" movement thing you have mentioned. The latter makes no sense to me.

[nari]

I think we can use neurodynamics, biomechanics to give them a starting point as to how a pt MAY move to reduce mechanical pain. Is that fair?

I have thought about choreographed movement Josh is talking about and movement which is free of control.
Neurodynamics is one way to go if it is considered essential by the patient for the therapist to lead, instruct and risk a sort of codependency.

There is the other way, where the patient's essential functioning brain executes the movement/s it needs to turn off a few alarm bells. How do we as therapists, know what those movements are????

Nari