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How does skin move during movement?

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  • How does skin move during movement?

    Is there much research on the movement of skin during movement? I have been performing DNM in a way that "mimics" my client's movements that are creating discomfort. Usually starting DNM in the direction with the movement that provides relief ( Or how I feel the skin would move during that movement), then working towards the movements that causes discomfort. At the moment it is more of an educated guess but I have noticed success (small sample size in comparison to others).

    Sorry if this is a redundant topic

  • #2
    Given the geometry of the organ that you've chosen, how would anyone discover this?

    Isn't active motion preferable over passive movement? Don't we know something about that?

    If there is a limitation to DNM it is that it asks for an "educated guess" often enough. There may not be the emphasis on instinctive, unconsciously generated motion that Simple Contact asks for.
    Barrett L. Dorko

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    • #3
      Originally posted by tldillman View Post
      Is there much research on the movement of skin during movement? I have been performing DNM in a way that "mimics" my client's movements that are creating discomfort. Usually starting DNM in the direction with the movement that provides relief ( Or how I feel the skin would move during that movement), then working towards the movements that causes discomfort. At the moment it is more of an educated guess but I have noticed success (small sample size in comparison to others).

      Sorry if this is a redundant topic
      There isn't much to my knowledge..
      Sounds like you are using an approach similar to Brian Mulligan's MWMs, NAGs and SNAGs.
      Diane
      www.dermoneuromodulation.com
      SensibleSolutionsPhysiotherapy
      HumanAntiGravitySuit blog
      Neurotonics PT Teamblog
      Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
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      @WCPTPTPN
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      @dfjpt
      SomaSimple on Facebook
      @somasimple

      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

      “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

      "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

      "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

      Comment


      • #4
        Originally posted by Barrett Dorko View Post
        Given the geometry of the organ that you've chosen, how would anyone discover this?
        I don't think anyone has ever done any studies on this, but it shouldn't be that hard really.
        I'm sure there would be variety between subjects to have to add up and account for.

        Isn't active motion preferable over passive movement? Don't we know something about that?
        I know that's PT religion belief, but I'm not religious.

        I'm pretty sure the patient's brain doesn't care at that point if relief is coming from moving the nerves and un-deforming them from within or without.

        Plus you can save yourself a lot of time and the patient a lot of angst and money doing some sensory rehab, or as Adam Meakins calls it, symptom modification testing, prior to doing motor rehab. Of course neither will work for that subgroup of anxious, extistentially angsted-out catastrophizers for which cognitive functional therapy is likely to work better.

        If there is a limitation to DNM it is that it asks for an "educated guess" often enough. There may not be the emphasis on instinctive, unconsciously generated motion that Simple Contact asks for.
        I did a dissection of cutaneous rami (of lateral cutaneous nerve of the arm) disseminating through the skin organ once upon a time.
        Hard to believe it was ten years ago.. you may or may not recall this. I wrote about it extensively.

        But I digress.

        The skin organ is mighty thick, is what I came away with as a lasting impression. On a dead person it's not very mobile, because rigour mortis. However, gaining an appreciation for how thick it is makes it easier to see how easily the surface can be moved by an outside force relative to the bottom, which is firmly attached to the body.
        It's as though we all wear a stretchy inch-thick suit around us, filled with jello or something else quite deformable. Actually fat globs that reside in compartments but are still very mobile.
        Piercing through all this are neural structures (cutaneous rami) the size of a hefty cotton thread, easily visible to the naked eye. When they get to the surface they arborize horizontally forming receptive fields (to see those you would need a microscope). They are long, oblique and spaced about an inch apart on the lateral side of the arm, allowing for more movement therefore greater neurodynamics, and on the medial side, much closer together, shorter, and coming out in all directions, tethering the skin tighter to the body.
        My takehome from that was that skin organ on the outsides of limbs moves better than skin organs on insides of limbs.
        I also came away with the impression that cutaneous rami follow the direction of hair growth on the body. Or maybe the other way around.
        Diane
        www.dermoneuromodulation.com
        SensibleSolutionsPhysiotherapy
        HumanAntiGravitySuit blog
        Neurotonics PT Teamblog
        Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
        Canadian Physiotherapy Association Pain Science Division Facebook page
        @PainPhysiosCan
        WCPT PhysiotherapyPainNetwork on Facebook
        @WCPTPTPN
        Neuroscience and Pain Science for Manual PTs Facebook page

        @dfjpt
        SomaSimple on Facebook
        @somasimple

        "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

        “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

        “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

        "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

        "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

        Comment


        • #5
          Diane,

          What you have said makes a lot of sense. I don't think that "active" as opposed to "passive" motion is a "religion." I think there's some research on this. Ideomotion (an instinctive reaction to pain) is active. I'm thinking of home programs of motion to offer when I'm not around. In Ohio, this is the way to go. I know that students expect such things, and I suppose you've found the same.

          Anyway, I haven't found that I can know which way the skin moves with movement, and it might be painful. The characteristics of correction are what I have to go on.

          There's a notion that the skin is fractal. It's at the bottom of the list of essays on my website.
          Last edited by Barrett Dorko; 30-03-2017, 12:50 AM.
          Barrett L. Dorko

          Comment


          • #6
            I'm pretty sure it is a "religious" idea based on the idea that the purpose of a brain is to initiate movement. The sensory NS couldn't care less probably. Large fibres from either skin or muscle are still going to inhibit nociceptive input provided there are enough inhibitory interneurons to be activated by them, in the dorsal horn. If movement is not available because of pain inhibition, it's easy enough to hack the NS at the level of the spinal cord via skinput.
            Moving skin will move nerve.
            As you pointed out, characteristics of correction will tell a practitioner which way skin wants to move if they are unable to feel tiny resistance for themselves. The most important thing is to not hurt people with treatment.
            According to me.
            Diane
            www.dermoneuromodulation.com
            SensibleSolutionsPhysiotherapy
            HumanAntiGravitySuit blog
            Neurotonics PT Teamblog
            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
            Canadian Physiotherapy Association Pain Science Division Facebook page
            @PainPhysiosCan
            WCPT PhysiotherapyPainNetwork on Facebook
            @WCPTPTPN
            Neuroscience and Pain Science for Manual PTs Facebook page

            @dfjpt
            SomaSimple on Facebook
            @somasimple

            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

            Comment


            • #7
              Well Diane,

              I would say that "hurting" while being treated and experiencing pain because of what is done are two different things.

              We seem to be running into the "locus of control" issue. I tend to allow the patients own instinctive motion to take over after deforming the skin. DNM is added to that. Moving the nerves in the skin cannot be known not to change things, after all - they're connected.

              You probably knew that.
              Last edited by Barrett Dorko; 30-03-2017, 02:24 AM.
              Barrett L. Dorko

              Comment


              • #8
                Originally posted by Barrett Dorko View Post
                Well Diane,

                I would say that "hurting" while being treated and experiencing pain because of what is done are two different things.
                Can you elaborate?
                Diane
                www.dermoneuromodulation.com
                SensibleSolutionsPhysiotherapy
                HumanAntiGravitySuit blog
                Neurotonics PT Teamblog
                Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                Canadian Physiotherapy Association Pain Science Division Facebook page
                @PainPhysiosCan
                WCPT PhysiotherapyPainNetwork on Facebook
                @WCPTPTPN
                Neuroscience and Pain Science for Manual PTs Facebook page

                @dfjpt
                SomaSimple on Facebook
                @somasimple

                "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                Comment


                • #9
                  Diane,

                  I mean that "hurting" and complaining of pain are two different things.

                  Change, after all, is sometimes painful; it sometimes "hurts." Pain is NOT one of the characteristics of correction after all.

                  Of course, I don't do anything. Well, I deform the skin when I'm near them.

                  When I give home programs, well, you know what I offer.
                  Barrett L. Dorko

                  Comment


                  • #10
                    TY for clarifying.
                    Yes, I know what you do.
                    And you know what I do.
                    Diane
                    www.dermoneuromodulation.com
                    SensibleSolutionsPhysiotherapy
                    HumanAntiGravitySuit blog
                    Neurotonics PT Teamblog
                    Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                    Canadian Physiotherapy Association Pain Science Division Facebook page
                    @PainPhysiosCan
                    WCPT PhysiotherapyPainNetwork on Facebook
                    @WCPTPTPN
                    Neuroscience and Pain Science for Manual PTs Facebook page

                    @dfjpt
                    SomaSimple on Facebook
                    @somasimple

                    "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                    “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                    “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                    "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                    "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                    Comment


                    • #11
                      Diane,

                      No doubt, we do different things. I have emphasized defending methods and critical thinking. We can both justify what we are doing but I've overplayed my hand.

                      Our theory is much the same. There's something about origins and interpretation and geometry in there, but your thoughts on that aren't written down anywhere here I've found.
                      Barrett L. Dorko

                      Comment


                      • #12
                        Diane talks about the distinction between "hurt" and a pain experience in this fascinating thread where she responds to Barrett thusly:
                        I would argue that this leads to nociception, which can "hurt", but not "pain" as such.
                        I'm still convinced that "origin" is the best term to describe how the pain experience comes to be. And that's saying something given the powerful debating skills of Patrick.
                        John Ware, PT
                        Fellow of the American Academy of Orthopedic Manual Physical Therapists
                        "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
                        “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
                        be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

                        Comment


                        • #13
                          Patrick is certainly a skillful debater.

                          I stayed here because Ohio State's football team has a chance to have a great season next time. That may not mean as much to Patrick.

                          There are some other reasons as well, but I suppose you can guess those.
                          Barrett L. Dorko

                          Comment


                          • #14
                            Anyway, Tyler, did your question get answered to your satisfaction yet?
                            Diane
                            www.dermoneuromodulation.com
                            SensibleSolutionsPhysiotherapy
                            HumanAntiGravitySuit blog
                            Neurotonics PT Teamblog
                            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                            Canadian Physiotherapy Association Pain Science Division Facebook page
                            @PainPhysiosCan
                            WCPT PhysiotherapyPainNetwork on Facebook
                            @WCPTPTPN
                            Neuroscience and Pain Science for Manual PTs Facebook page

                            @dfjpt
                            SomaSimple on Facebook
                            @somasimple

                            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                            Comment


                            • #15
                              I would really like to impress upon everyone how big and thick this organic diving suit we call skin really is. How neural structure known as cutaneous rami have to disseminate a lot further away from the spinal cord to supply all this.

                              It seems to me ludicrous, still, that anyone would try to defend digging through all this in order to get to "deep" mechanoreceptors, e.g., ones in joints, or fascia, or sutures, or wherever.. just to indefensibly try to defend some archaic tissue-based treatment model from our ancient and by now thoroughly eclipsed by pain science past.
                              Attached Files
                              Diane
                              www.dermoneuromodulation.com
                              SensibleSolutionsPhysiotherapy
                              HumanAntiGravitySuit blog
                              Neurotonics PT Teamblog
                              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                              Canadian Physiotherapy Association Pain Science Division Facebook page
                              @PainPhysiosCan
                              WCPT PhysiotherapyPainNetwork on Facebook
                              @WCPTPTPN
                              Neuroscience and Pain Science for Manual PTs Facebook page

                              @dfjpt
                              SomaSimple on Facebook
                              @somasimple

                              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                              Comment

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