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  • GregLehman
    replied
    At its very simplest I think the rationale is based on how important you think Nociception is to the pain experience

    Movement "flaws" create compensations which lead to nociception

    Address the movement flaw and ameliorate nociception.

    All these models assume Nociception is occuring and is the primary driver of pain

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  • GregLehman
    replied
    I am familiar with some of the speakers. Spina I've known personally for more than a decade and we talk regularly. He doesn't really discuss pain science. His approach is similar to how I train athletes and is primarily for training strength and mobility. Much is based on mechaniotransduction. I wrote a blog on fascia and stretching the power of what manual therapy is capable of doing. Dr Spina responded at length if you care to read. http://www.thebodymechanic.ca/2012/1...s-dorsi-sling/

    Many of the other speakers probably know pain science. I know Charlie Weingroff does ( a review of his course can be read here (http://www.thebodymechanic.ca/2012/1...-and-the-sfma/). However, i would hesitantly suggest that many would think their approaches are consistent with pain physiology science.

    They seem to recognize that pain is an ouput of the brain in response to a threat. They recognize that nociception influnces movement and motor control. But a common biomechanical theme that links their approaches is the belief that there is an optimal way for the body to move.

    Deviations from optimal movement at one joint are assumed to influence movement at another. Perhaps negatively. Altered movement at some distal joint will then create nociception. They will probably recognize that that nociception is not sufficient for pain but may still contribute to it

    Obviously this is the faulty biomechanics causes nociception theme. What this theme seems to do is use pain science to knock a simple structural pathology (arthritis, bony deformities) idea behind pain and replace that with the altered "function" or "bad" movement causes nociception and perhaps pain.

    And again, I think they would suggest these biomechanical flaws causing nociception ideas are still consistent with pain science. I know with certainty that at least one of the speakers recommends Explain Pain as required reading.

    Assuming everyone is Moseley/Butler fan, Whats interesting is the huge difference in opinion on "optimal" movement's relationship to pain or injury between those speakers and many people here on this board

    Discussion among opposing views would certainly be edifying

    Apologies to anyone if my simple summary misrepresented viewpoints

    Greg

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  • John W
    replied
    ...but what is most important to me is a patient's understanding of their pain...
    I agree, and there's a growing body of evidence, including RCTs, demonstrating how important this is. One of the first questions that I asked over in that ongoing thoracic ring thread was something along the lines of "What are they teaching these patients about their pain?" I can't imagine reconciling adjusting or conveying that you are adjusting a person's body part-by whatever means- with a defensible explanation of the pain experience.

    This strikes me as an clear case of attempting to place a square peg into a round hole- and rather forcefully at that.

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  • advantage1
    replied
    I'd simply like to know what posture needs to be restored and why?

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  • Keith
    replied
    Originally posted by Bas Asselbergs View Post
    Anyone still teaching specific palpatory tests, structurally focused "fixes" for biomechanical "dysfunctions", talks about balancing muscles, is clearly showing that they are NOT applying a deeper understanding.
    Originally posted by PRPerformance1 View Post
    A pretty fair assessment.

    Is this a general statement or are you including all of the previously discussed practitioners (post #13) in that group?
    Bill, thanks for engaging in conversation.

    I only have experience with Mr Hruska's teachings (of the presenters listed above). And while I understand he makes no claims regarding pain, aren't most of the case studies presented on his site pertaining to the treatment of a patient in pain? All one of my patients would have to do is read through the PRI website and see things like this article about preventing injuries in cycling with a PRI approach or this one that argues that "QL pain" is the result of a L AIC/R BC pattern to fall prey to the assymetry=pain mode of thought (despite assymetry's pervasiveness in asymptomatic individuals - which you know). While I understand that PRI teaching has shifted more toward discussing the ANS (based on my readings of Zac's blog - keep up the great work, Zac), does this not speak, indirectly, to what some might find as in conflict with a "deeper understanding"? Does the PRI approach not include a structural focus for biomechanical/postural dysfunctions and talk of restoring balance in muscle activity?

    Some might wonder if they are reading 'lip-service' acknowledgment of the NS; I will simply state that it seems as though I am reading very mixed signals.

    I am not arguing that the approach does not have merits in helping a patient learn to breathe better and move in novel ways. It is great for that...and in my experience, symmetry will improve. Sometimes a change in breathing patterns and novel input is enough to positively influence a painful neurotag. I get that - but what is most important to me is a patient's understanding of their pain; I fail to see how a quick trip to the PRI site by a patient would provide them with any useful information with an honest appraisal of the complexity of their pain experience.

    I know that you and Zac each have more experience than I (only 3 classes), and I don't want to make this a PRI thread or a bash-fest of those who utilize the techniques taught by Mr Hruska (so, if that is a concern, I welcome a PM), but any brief input that you might offer would be appreciated.

    Respectfully,
    Keith

    Leave a comment:


  • Johnny_Nada
    replied
    Is it fair to say:

    "more free on line learning about methods/systems/processes' doing the same thing while providing different explanations for exercise, hands on interventions and body positioning, mentioning the nervous system for pain relief and injury prevention while engaging in the practice of reference and letter bombing"

    Leave a comment:


  • advantage1
    replied
    I try to change how people move, how they think about moving and get them to explore new movement patterns.
    I'm willing to bet that's how most of us go about assessing and treating patients in pain. What I have encountered in clinical practice is that the term posture is used to imply that their is an ideal posture or norm. Also, many patients assume that when we mention posture it means sitting straight. So I avoid this term. It tends to lead to discussions about pelvic alignment or specific positions of the scapula etc. All ideas with little evidence linking them to pain. So yes, discussing movement and exploring movement is helpful to the patient.

    Leave a comment:


  • PRPerformance1
    replied
    Originally posted by Bas Asselbergs View Post
    Anyone still teaching specific palpatory tests, structurally focused "fixes" for biomechanical "dysfunctions", talks about balancing muscles, is clearly showing that they are NOT applying a deeper understanding.
    A pretty fair assessment.

    Is this a general statement or are you including all of the previously discussed practitioners (post #13) in that group?

    Bill

    Leave a comment:


  • Barrett Dorko
    replied
    To succeed in the world it is not sufficient to be stupid, you must also be well-mannered.

    Voltaire
    Please note that I didn't say stupid - Voltair did. In a case like this I prefer willfully ignorant and unwilling to state and defend your premise.

    Leave a comment:


  • Bas Asselbergs
    replied
    No, I disagree: walking the walk shows first and foremost a deeper understanding of the fractal nature of human interaction - especially when pain gets thrown in.

    Anyone still teaching specific palpatory tests, structurally focused "fixes" for biomechanical "dysfunctions", talks about balancing muscles, is clearly showing that they are NOT applying a deeper understanding.

    I really do not give a hoot what they do with their patients - they are very likely very empathic people, with gentle hands and manners. But that has nothing to do with what they SAY and present.

    Leave a comment:


  • Cupplesperformance
    replied
    Originally posted by John W View Post
    There's a find line between "appreciation" and "lip service". I'm hearing a lot of the latter lately. When I see more "walking the walk", then I'll be more inclined to acknowledge appreciation for the nervous system.

    The "thoracic ring" thing as described by LJ Lee does not meet the defintion of appreciation of the nervous system in my opinion. Not even close.
    While I have not read their thorax book yet, if the Pelvic book is any inclination I would agree with you John. They wrote a nervous system chapter and did not mention much after that in terms of treatment, which was quite disappointing for me.

    What exactly would constitute "walking the walk?" It is hard to see if most anyone practices what they preach until you see them actually practice, interact with patients, etc.

    Leave a comment:


  • John W
    replied
    It seems that at least a bulk of the group speaking appreciates the nervous system; so let's learn, discuss, and debate what is said once it is said.
    There's a find line between "appreciation" and "lip service". I'm hearing a lot of the latter lately. When I see more "walking the walk", then I'll be more inclined to acknowledge appreciation for the nervous system.

    The "thoracic ring" thing as described by LJ Lee does not meet the defintion of appreciation of the nervous system in my opinion. Not even close.

    Leave a comment:


  • PRPerformance1
    replied
    Originally posted by Cupplesperformance View Post

    It seems that at least a bulk of the group speaking appreciates the nervous system; so let's learn, discuss, and debate what is said once it is said.
    Well said.

    Always proud my son.

    Bill

    Leave a comment:


  • proud
    replied
    Originally posted by PRPerformance1 View Post
    I have a curiosity when referring to the practitioners as meat experts and closet organizers.

    Is it your contention that they are not considering the influence of the nervous system in their approaches?

    Bill Hartman
    Well I will concede that the title was indeed provocative and that I titled it in that manner by design.

    I will also say that perhaps referring to the presenters as "meat experts" was likley more harsh then it should have been. As John stated, it was a bit tongue in cheek really.

    I respect all my colleagues and especially those who are invested in what they do. Respecting a colleague and agreeing with their premise are quite different though.

    I will also be clear on something. I am really only familiar with the SFMA crew from a "taken the course" perspective. I recently attended the SFMA in Toronto with Dr. Plisky and I really liked the guy. Smart, engaging and a good presenter. But without a doubt there was barely a passing platitude towards the nervous system in that presentation and my efforts to find it within the SFMA group in general has been quite futile. So yes...I think they have some work to do with that model of evaluation...it is way overly meaty and participants are owed better than that in my estimation.

    Some of the others I've followed for a while (Diane Lee...being a fellow Canadian PT for 20 years). I think the thoracic ring idea (debated here on a seperate thread...is waaaay wrong). I know it's not Diane Lee presenting but the two share the concept.

    Will I be tuning in to the presentations? You bet...perhaps my perspective on the other presenters will change after. That's why I said it should be quite interesting...
    Last edited by proud; 16-01-2014, 09:50 PM.

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  • advantage1
    replied
    It seems that at least a bulk of the group speaking appreciates the nervous system; so let's learn, discuss, and debate what is said once it is said.
    Sounds fair.

    Leave a comment:

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