Sorry for that abrupt response Barrett. I meant to come back and expand a little.
I dont think the application of passive movement is defensible if the intent of the PT is to move the patients limb in a corrective direction eg a PT who decides to mobilize the right c4 on c5 into extension and ipsilateral side flexion/rotation because he/she theorizes that this movement will restore normal mechanics, diminish tissue strain and resolve pain. Passive mashing of imagine trigger points is also indefensible. Passive stretching of muscles with the aim of resolving tightness and therefore resolving pain is indefensible... I could go on and on about the various indefensible applications of passive movement. Each is indefensible because of the PTs erroneous understanding of what role their manual handling plays in any observed changes in symptoms. In these cases (and I'm sure there are other examples) I agree that the use of passive motion follows from the PT's "knowledge" of the type/direction of movement required to "fix" the patient. Passive movement applied from an erroneous understanding no doubt dominates our profession.
But applying passive movement does not necessarily mean the PT is operating under delusions with regards to knowing the corrective movement path. I think a PT can move a patient passively in an explorative fashion, under the understanding that the goal is to provide novel and non threatening input, along with appropriate education about the neurophysiology of pain, non conscious motor output (withdrawal,protection,resolution), the role the culture plays in inhibiting movement etc.
I dont think the application of passive movement is defensible if the intent of the PT is to move the patients limb in a corrective direction eg a PT who decides to mobilize the right c4 on c5 into extension and ipsilateral side flexion/rotation because he/she theorizes that this movement will restore normal mechanics, diminish tissue strain and resolve pain. Passive mashing of imagine trigger points is also indefensible. Passive stretching of muscles with the aim of resolving tightness and therefore resolving pain is indefensible... I could go on and on about the various indefensible applications of passive movement. Each is indefensible because of the PTs erroneous understanding of what role their manual handling plays in any observed changes in symptoms. In these cases (and I'm sure there are other examples) I agree that the use of passive motion follows from the PT's "knowledge" of the type/direction of movement required to "fix" the patient. Passive movement applied from an erroneous understanding no doubt dominates our profession.
But applying passive movement does not necessarily mean the PT is operating under delusions with regards to knowing the corrective movement path. I think a PT can move a patient passively in an explorative fashion, under the understanding that the goal is to provide novel and non threatening input, along with appropriate education about the neurophysiology of pain, non conscious motor output (withdrawal,protection,resolution), the role the culture plays in inhibiting movement etc.
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