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  • #61
    No, ANdy. You are immiscible with the stupidity and hubris that dominates in physical therapy.

    So am I.
    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


    • #62
      it's my opinion that this is due to the nature of my job and will just recur. I don't think I'm being fixed, but simply that the spinal manipulation helps to disengage the sympathetic system and allow the muscle to relax (coupled of course with the soft tissue massage and trigger point dry needling I talk my wife into!).
      Mark,

      Sounds like the castrophization of pain... Where you left scratching your head in confusion after your conversation with that PT? It is so tough for many to "get it". Part of it for me is to find a better story or metaphor that my patients can relate to.

      Rex
      Rex Fujiwara, MPT,OCS
      Physical Therapist
      www.painsciencecenter.com

      Comment


      • #63
        Thanks Rex, I was confused about that whole conversation, and even borderline angry, good research out there staring that PT in the face and they don't really care to pick up on it, just keep focusing on experience and tools.
        Mark Powers, PT, DPT, OCS
        "Language is not neutral. It is not merely a vehicle which carries ideas. It is itself, a shaper of ideas."-Dale Spender

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        • #64
          Originally posted by MPowersDPT View Post
          Thanks Rex, I was confused about that whole conversation, and even borderline angry, good research out there staring that PT in the face and they don't really care to pick up on it, just keep focusing on experience and tools.
          I've never understood the fascination with "in my experience..." and "another tool in the toolbox" in physical therapy.

          I've already written about "experience" here -- http://blog.theravid.com/patient-car...xperience-cut/

          In regards to the toolbox, is that how we really want to brand ourselves? As mechanics who reduce the lived experience of pain to the equivalent of a broken axle or a flat tire that needs a specific hammer or saw to resolve it?

          The profession would be much better off if we ditched the hubris and started working with patients instead of working on them, because as it stands were flying dangerously close to the sun with some of the claims PTs make.
          Kenneth Venere PT, DPT
          @kvenere
          Physiological

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          • #65
            It boils down to what has been mentioned before, many years ago, by Barrett.

            We have always lacked a deeper model that frames our profession.
            Our profession was born from observational (interpretations of perceptions) assessments and outcomes, and has simply remained mired in that. Our schools are sorely lacking in both development of critical thinking and providing access to the neurosciences so badly needed in our understanding.

            One small ray of hope is that our pain science educators of our university programs are working together (yeay!) to increase the pain neurosciences components in the curriculi of all PT schools. Our own Pain Sciences Division is playing a role in that.

            In the mean time, Dr. E. continues to try and mold all new science to fit his idea of what PT should be, rather than the other way around. Much like a guy we know from LinkedIn
            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


            • #66
              Originally posted by John W View Post
              Yes, I agree that there's a larger problem, but I think that this physician has identified the reason why critical thinking is so rare.

              I think we've got a little hubris going on in our profession, too.
              Well I'm sure that link will not end up on Dr. E's blog...

              Although Dr. E's history of championing one thing and doing the opposite would suggest it could.

              Great find John. It certainly fits the Dr. E dilemma extremely well. Of course, Dr. E would not think so whatsoever. I'm near positive of that.

              Comment


              • #67
                I've never understood the fascination with "in my experience..." and "another tool in the toolbox" in physical therapy.
                I think that clinicians use the term "in my experience" because we should be evidence based. If we do not do research our "experience" is considered evidence, well the lowest level of evidence. But for our experience to be considered evidence, we need to take into consideration every patient that we treated. For some reason, most forget about the ones that didn't improve.

                As for another tool in the toolbox.... I think that it goes in line with the bio-mechanical view of treatment. We are joints that act like gears, muscles that act as pulleys, fascia that act as anatomy trains, ligaments that act as hinges, nerves that act like wires (I use this as a pain metaphor), the brain acts like a computer mother board (I use this one too)....

                No wonder we need tools to treat people.



                Rex
                Rex Fujiwara, MPT,OCS
                Physical Therapist
                www.painsciencecenter.com

                Comment


                • #68
                  Found on Facebook, Matthew Danziger as I recall: Nociception affects motor output: a review on sensory-motor interaction with focus on clinical implications.

                  Excellent one for all the somasimpletons. :angel:
                  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


                  • #69
                    Originally posted by John W View Post
                    Yes, I agree that there's a larger problem, but I think that this physician has identified the reason why critical thinking is so rare.

                    I think we've got a little hubris going on in our profession, too.
                    What a great read, John. Thanks.

                    I appreciate the 'header' on his page: cardiac electrophysiologist, cyclist, learner.

                    When I first moved to my current home, I needed a new MD. 5 months into my new job, I was working with a patient who had something bizarre going on: Debilitating weakness and pain with a sudden onset. He had been seen by his MD and sent to PT (while he continued to undergo additional testing). After receiving my own report, this patient's doctor called ME to ask for MY input. He was humble. He spent 15 minutes on the phone with me trying to ask for input to assist with differential diagnosis. In the end, I don't think I helped much...but I remember being stunned by his humility, his accountability to his patient and his honesty about what he did/did not know. He continued to coordinate care for his patient without every 'punting'* to a specialist. Unfortunately, I find this approach to professional behaviors to be lacking throughout the medical professions.

                    Fast forward 6 months later: my patient (who had been in a wheelchair) was moving around very well with a cane after treatment for Lyme Disease...and I had a new primary care physician.

                    If I was in Kentucky, and in need, I would go to see Dr. John as well.

                    Respectfully,
                    Keith

                    *He continued to make referrals to specialists and would defer when appropriate, but he remained involved. Too often, I see physicians think that they job is done once the patient is seeing another, more specialized doctor.
                    Blog: Keith's Korner
                    Twitter: @18mmPT

                    Comment


                    • #70
                      Originally posted by Blaise
                      Looks like someone thought to question him on that...check out the comments section.
                      maybe you inspired them, proud.
                      Well truthfully, I hope Erson reads it and is somewhat inspired to be a little more introspective than I think he is. I having nothing against Erson personally, I imagine he's a good enough fellow with a driven desire to be the best PT he can be. He's displayed high levels of immaturity but unless he's a narcissist, this will improve with age.

                      The thing with Erson is that he speaks out of one side of his mouth often citing the science but then turns around and talks out the other side about "feeling his QL soften"...which is laughable.

                      It's comments like that which make it pretty clear he's either placed the cart way ahead of the horse....or he's willfully ignoring what science has informed us and essentially molding it to fit his world view (as Seb suggested).

                      Only two things would explain that....narcissistic personality disorder or greed.

                      Erson's got some good things going on over at his site, but he really should read that article about hubris closely. On many things....he's way overboard on hubris.

                      Hopefully it's immaturity that explains his anger issues over being challenged.
                      Last edited by proud; 21-09-2013, 05:54 PM.

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                      • #71
                        How old do you think Erson has to get before people stop using "immaturity" as an excuse?

                        How many trips to teach to how many countries?
                        Barrett L. Dorko

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                        • #72
                          Well, I finally figured out how to post a comment through the Disqus platform.

                          It's one thing for a young man like Erson to make some broad brush insult against some nondescript group with whom he generally disagrees, for whatever reason. But his treatment of Jason was just downright impudent. Jason has earned his stripes in more ways the one, so it really bugs the crap out of me that some hot-shot fresh off an international flight from a country that was essentially led by a military junta until 1990 essentially dismisses him as a group-thinker.

                          I mean, who does he think he is? This goes beyond immaturity- way beyond. This is the kind of behavior that, if it happened in my presence, would result in a very close encounter.
                          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


                          • #73
                            I didn't bother to read his response to me but I'm told it was in a similar vein to his original comments. He's earning his reputation as we all are - I'm untroubled by anything he could possibly say.
                            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.

                            Comment


                            • #74
                              Originally posted by John W View Post
                              It's one thing for a young man like Erson to make some broad brush insult against some nondescript group with whom he generally disagrees, for whatever reason. But his treatment of Jason was just downright impudent. Jason has earned his stripes in more ways the one, so it really bugs the crap out of me that some hot-shot fresh off an international flight from a country that was essentially led by a military junta until 1990 essentially dismisses him as a group-thinker.
                              I could not agree more, but I have remained silent in part because I know that Dr Silvernail is more than capable of holding his own here if it meant enough to him to do so.

                              In this instance, the tone of Erson's dismissal of Jason spoke louder (in and of itself) than any rebuttal could...or at least that is how it reads through my glasses.

                              Respectfully,
                              Keith
                              Last edited by Keith; 22-09-2013, 01:46 AM. Reason: ETA: I step away for a minute, and Jason has already replied before me.
                              Blog: Keith's Korner
                              Twitter: @18mmPT

                              Comment


                              • #75
                                If Erson's fans are as tone deaf as he is, I'm thinking they might require a little explication of his remarks.

                                I'm not above doing that.


                                John Ware, PT, FAAOMPT

                                Sent from my iPhone using Tapatalk
                                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

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