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  • #31
    Stay on it longer, Baecker, much longer, and try to get it from a few different directions. I think the "bean" is entrapment of the most medial superior cluneal nerve.
    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

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    • #32
      Originally posted by Diane View Post
      Stay on it longer, Baecker, much longer, and try to get it from a few different directions. I think the "bean" is entrapment of the most medial superior cluneal nerve.
      What is entraping it? Also, the bean may just be a fatty nodule. Is there one on the other side?

      Comment


      • #33
        What is entraping it?
        It's own neural tunnel.
        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


        • #34
          Originally posted by Diane View Post
          It's own neural tunnel.
          Neural tunnel is composed of the infrastructure of the nerve, the interfascicular epineurium and individual fascicles which become stretched and perhaps contract as well? Much like the chinese finger trap? Barnes has been using this analogy for years as it relates to proposed fascial restrictions.

          In your model which occurs first, compression, elongation (stretch) then contraction or what? How exactly does the entrapment occur?

          I think I understand that the DNM is designed to "tell" the nervous system to let go of the entrapment or is it to tell the pain signal to stop, or at least reduce so the body can move and thru moving change the entrapment?

          Comment


          • #35
            Neural tunnel is composed of the infrastructure of the nerve, the interfascicular epineurium and individual fascicles which become stretched and perhaps contract as well?
            I'm not so sure they "contract" so much as they may perhaps "engorge" then not be able to "drain." The vascular supply to the nerve is embedded right in between the walls of the epineurium and perineurium (if I recall correctly), with tiny feeder vessels going in (vasa nervorum) at intervals. Drainage isn't so good in there, when a structure is undergoing mechanical deformation of the traction sort. Shacklock has examples/images of this in Clinical Neurodynamics.

            Much like the chinese finger trap? Barnes has been using this analogy for years as it relates to proposed fascial restrictions.
            I think he's misusing the fingertrap analogy then. I think the Chinese fingertrap is a good way to show neural tension. I'm not so sure it depicts fascial restrictions. Why would there even be fascial restrictions (on a nerve at least) unless there is some sort of motor dysfunction creating the conditions for adverse tension, first?

            In your model which occurs first, compression, elongation (stretch) then contraction or what? How exactly does the entrapment occur?
            Well, see above.. I think there are mechanical issues in the tissues, but only secondary to motor dysfunction, tertiary to some sort of nociceptive input that is abnormal, but which is not registered as "pain" by the system. The system goes through several steps, tries to solve the problem at a cord level, by tensioning some of the voluntary musculature, but without adequate movement of the organism, matters continue up to and including microglial activation, and eventually upregulation occurs and "pain" is perceived. "Entrapment" happens as a result, not as a cause, I think. And there are vascular issues all the way along, I think - too much, not enough of bloodflow/drainage, inside the walls of the nerve.

            I think I understand that the DNM is designed to "tell" the nervous system to let go of the entrapment or is it to tell the pain signal to stop, or at least reduce so the body can move and thru moving change the entrapment?
            DNM helps the somatosensory cortex to downregulate the "pain" (and indirectly, reflexively, these tender, hard or engorged bits one can find here and there, like this "bean place" where the superior cluneal nerve must change layers of body wall and cross over a bony ridge) so that movement without pain is again possible. Once movement is possible, the person must move to improve, or the situation could revert. Tape works too. I don't think fascia is to blame for anything, and I think using it as a target tissue or forming a treatment construct with fascia at the center, is
            wrong, misleading.
            Last edited by Diane; 27-07-2008, 01:06 AM.
            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


            • #36
              Thanks for the clarification of your model Diane. Johns finger trap slide does show proposed impingements of the vascular supplies to the tissues which in turn leads to engourgement and compression...then the fascial restriction. So by further shortening the tissue via manual techniques one "unkinks the garden hose" and fluids flow more easily beginning the correction of the problem/dysfunction. I understand you do not like his theories we have been all through that.

              Comment


              • #37
                Originally posted by Diane View Post

                DNM helps the somatosensory cortex to downregulate the "pain" (and indirectly, reflexively, these tender, hard or engorged bits one can find here and there, like this "bean place" where the superior cluneal nerve must change layers of body wall and cross over a bony ridge) so that movement without pain is again possible. Once movement is possible, the person must move to improve, or the situation could revert. Tape works too.
                One of my doubts is this one, suppose you have the tender spot down your finger (in a balloon technique i.e.), and you move your hands over the skin for down the tightness and pain feeling, and when you obtain this, you wait for a few minutes.... Is this time the necessary time for the brain changes, on the somatosensory cortex, the "image" of this part of the body that we are treating? And why do we need this time and no more or less? (i haven't found this answer searching it here). Thus, when we feel the tissues relax, i suppose that patient's brain has changed this treated part in its "virtual body" (somatosensory cortex) and reduces the protective measures (pain, tenderness, tightness...) in the part of the body we are treating... is this OK?

                Comment


                • #38
                  Hi Nabor,
                  One of my doubts is this one, suppose you have the tender spot down your finger (in a balloon technique i.e.), and you move your hands over the skin for down the tightness and pain feeling, and when you obtain this, you wait for a few minutes.... Is this time the necessary time for the brain changes, on the somatosensory cortex, the "image" of this part of the body that we are treating?
                  I don't know, possibly.

                  And why do we need this time and no more or less? (i haven't found this answer searching it here).
                  There's no point in moving away from a place until that place changes somehow, in a way that is relevant to both patient and treater, i.e., less tender for patient and softer for treater.

                  If it softens but doesn't get less tender, I would start to suspect the patient of maybe having something more neuropathic as opposed to merely neurogenic I didn't pick up on, who somehow passed through the interview.

                  Thus, when we feel the tissues relax, i suppose that patient's brain has changed this treated part in its "virtual body" (somatosensory cortex) and reduces the protective measures (pain, tenderness, tightness...) in the part of the body we are treating... is this OK?
                  That's a good hypothesis. I'm sure there have to be changes there at the top before any others can occur with any endurance. Changes have to happen in other parts of the brain, like maybe the medullary nuclei - maybe the microglia throughout the brain and cord are signalled to down regulate their ion channels, need time to go into a different state (back into their "cages"...). Anywhere there is a somatotopic representation, there needs to be changes - the chemistry, the physiology have to have time to change.

                  This is not a good treatment choice for those who are impatient.
                  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


                  • #39
                    Just downloaded and browsed the manual...thank you Diane for making this available; I'm very interested in learning more! :thumbs_up


                    Tony Friese, PT
                    Tony Friese, PT
                    Vestibular Rehabilitation Competency 2006
                    Wausau, WI

                    Comment


                    • #40
                      I guess I'm now 8 more posts and 29 days away from being able to see this manual... I hope it's well worth the wait

                      Comment


                      • #41
                        Hi Tony, you're welcome, hope you enjoy.
                        Yup, Jenny, not much longer!
                        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


                        • #42
                          Thanks. Wait I can't access it yet. This is my 10th post. Do I have to wait?

                          Comment


                          • #43
                            Just a bit longer sille.
                            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


                            • #44
                              Thanks. This forum is great. Now I have even more to read.

                              Comment


                              • #45
                                I really appreciate the effort all of you put in to clarify things, explain and provide help in this forum! Very interesting reading. I have to become more active in here, so i can access more of everybodys expertice! Thank you all!

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