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  • I point out that the beating about the head that is about to occur doesn't actually hurt because teammates do it.

    Context.
    Though it isn't as prevalent as it once was, a girl basketball coming to the sidelines after a game winning shot may get a slap on the backside from her coach or teammates. There is nothing about this slap this in any way startling or offensive. And it certainly isn't interpreted by the player as painful.

    Yet if this same girl is walking the hallways between classes, a slap on the backside is interpreted in a completely different way.

    Comment


    • Ken,

      I'd also say that if nobody were waiting at home plate the batter would be very disappointed. His feelings would be hurt. He wants to be hit on the head by those proud of him.

      I relation to that other thing about certainty - I need to remember that therapists (being human) would prefer that I were.
      Barrett L. Dorko

      Comment


      • Hi Barrett!

        I'd also say that if nobody were waiting at home plate the batter would be very disappointed. His feelings would be hurt. He wants to be hit on the head by those proud of him.
        That is exactly right. I often refer to gestures of approval as being more powerful if there is actual physical contact.

        Whether it is a "high five," "chest bump," or "pat on the butt," these gestures carry far more feeling than if we were simply to tell a player "nice job."

        Below is an example of the goalie "helmet butt."

        Apparently, Wayne Gretzgy started this ritual several years ago, and now just about every team salutes their goalie this way after a victory.
        Attached Files

        Comment


        • Interesting posts above.

          As much as I dislike/am indifferent to sport, I think the butt slapping, hugging and other stuff that goes on regularly is the bonding bit, sort of HPSG stuff.

          Without it the team would probably fracture.

          Nari

          Comment


          • I see that neither Patrick nor Evanthis have bothered to read the McGlone paper yet. They might want to.
            Or not, if they want to remain staunchly mesodermalist in their thinking and treatment approaches.
            No. I've said many times that I don't place any particular significance on the embryological origin of tissues. So I'm neither ectodermalist or mesodermalist.

            Staunchly mesodermalist. You really don't seem to be able to see any of this stuff from a non polarized perspective. That can't be a good thing.

            Anakin:
            you're either with us, or against us
            Obiwan:
            only a sith deals in absolutes

            Comment


            • Beautiful thread!

              Thanks Diane, Evan, Patrick et. al :clap1:
              Jan K. Huus
              "Curiosity happens when we feel a gap in our knowledge" - somewhere on SomaSimple

              Comment


              • I like the ectodermal/mesodermal distinction not only because of the embryologic connection, but also because only one of these can signal.

                Isn't that important?
                Barrett L. Dorko

                Comment


                • Originally posted by PatrickL View Post
                  No. I've said many times that I don't place any particular significance on the embryological origin of tissues. So I'm neither ectodermalist or mesodermalist.

                  Staunchly mesodermalist. You really don't seem to be able to see any of this stuff from a non polarized perspective. That can't be a good thing.
                  Still haven't checked it out. Neither of you. OkyDoky then.
                  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


                  • Barrett, the skin, facial bones, hair and nails can't signal. Therefore the signaling capacity of the nervous system is not attributable to its ectodermal origin. We've done this debate to death. My point is straight forward and can't be logically refuted.

                    As john had suggested previously, the ecto/meso divide is a heuristic. I try to avoid those.

                    Diane, if that paper has some specific points that support your argument, please go ahead and quote them.

                    Comment


                    • But the nerves sure can, and do, and keratinocytes, which are epidermal cells, express the exact same receptors, respond to substance P, CGRP, etc.
                      The point is, just because teeth can't signal does NOT rule out nerves and skin signalling, or Schwann cells, endoneurium, and adrenal medullas having a very close up and personal relationship to the nervous system. So your debate is absurd Patrick. You've closed off an entire line of thinking because a few specialized bits don't adhere to the general principle. And you accuse me of being "certain" - sheesh.
                      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


                      • The point is, just because teeth can't signal does NOT rule out nerves and skin signalling, or Schwann cells, endoneurium, and adrenal medullas having a very close up and personal relationship to the nervous system.
                        close and personal relationship? way to anthropomorphize cellular activity! Please don't attempt to lump together other types of ectodermally derived tissue's signaling capacity with the signaling via action potential generation, as if they collectively reflect a default signaling capacity of ectodermally dervied tissues. All cells can signal each other in some form. Neuronal signaling is by far different to any other type.

                        You're assuming that all ectodermally derived tissues have by default a signaling capacity that mesodermally derived tissues do not, and that some cells have specialized away from that capacity... therefore facial bones, and teeth are the exceptions to the rule. I'm simply stating that the capacity for specialized signaling such as AP generation cannot not be attributed in any substantial manner to it's ectodermal origin. The exceptions to your rule, raise doubt about its veracity, and should form the basis for a less certain stance.


                        So your debate is absurd Patrick. You've closed off an entire line of thinking because a few specialized bits don't adhere to the general principle. And you accuse me of being "certain" - sheesh.
                        See above. the exceptions cast doubt on the "rule". Your certainty is unwarranted. The ecto/meso division should not in my view underpin any paradigm shifts that the profession undergoes. It just isn't necessary. I don't think it will anyway, as i think your certainty in debating and attempting to spread your message, is actually counter productive.

                        if im being certain, it is only that im certain that we need to be less certain. I don't think you are capable of changing your stance. You have too much invested, and that investment must be defended.

                        Comment


                        • So certain Patrick.. so certain aren't you?

                          The real difference (IMO) between mesoderm and ectoderm derivatives is not even the AP capacity. It's in function.
                          Ectoderm, 2% of adult body. Mesoderm, 98%
                          Ectoderm, 100% responsible for life of organism. Mesoderm, meh, you can live without a lot of that.
                          Ectoderm, uses 20% of all available oxygen and glucose. Mesoderm, the rest.

                          Can you spot the disproportionate importance/usage of fuel? Ectoderm uses up fuel like mad, because it's turned ON, all the time. Mesoderm uses far less fuel.

                          Here is the next bit of reasoning:
                          Ectoderm/nervous system cares mostly about its fuel and fuel supply. If anything happens to its fuel lines, it will have a fit. Add to that, no lymphatics inside nerves. Uh-oh, double jeopardy. Back-up can happen with some little kinked hose.
                          Next: It evolved, and not with a particularly good design. The spinal cord is the oldest bit but lacks a fierce amount of hard drive. I.e., it is not what you could describe as very "smart." It's reflexive, just like it was 500 million years ago when it first evolved.
                          The rest of the body adapted just fine. But not that ancient old spinal cord. So it's a bottle neck of an unfortunate sort. Plus, because it came first, it takes over easily, before the brain even knows what's going on. By the time the brain knows what's going on in the periphery, in terms of nerves feeling grumpy, it's often too late - the spinal cord has tightened up muscles, the autonomics have changed blood flow, tension is breaking out all over the fractal.

                          And you think ecto/meso considerations have nothing to do with anything? I beg to differ, strongly.

                          Meso ecto distinction might not be completely right, but it is less wrong.
                          Last edited by Diane; 24-06-2014, 03:04 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


                          • The real difference (IMO) between mesoderm and ectoderm derivatives is not even the AP capacity. It's in function.
                            Ectodermal derivatives do not share a common function. This argument is meaningless.
                            Can you spot the disproportionate importance/usage of fuel? Ectoderm uses up fuel like mad, because it's turned ON, all the time. Mesoderm uses far less fuel.
                            No. neural tissue uses fuel like mad, not "ectoderm". Ectodermally derived tissues vary greatly in the amount of fuel they consume (neurons vs teeth). The high proportion of energy consumption (by neural tissue specifically, not "ectoderm" generally), reflects the energy used to keep na+/K+ pumps pumping. Big deal. If a person is running, the proportion of oxygen being consumed shifts significantly to muscles. this O2 energy consumption stuff doesnt add anything to your view that ectodermally derived tissues are attended to preferentially by the CNS.

                            the nervous system and "ectoderm" are not synonymous. It's wrong to speak as if they are.

                            And you think ecto/meso considerations have nothing to do with anything? I beg to differ, strongly
                            of course you do. You have a cemented view that nervous system = ectoderm. But it doesnt. Its simply a derivative of the ectoderm.
                            Ectoderm/nervous system cares mostly about its fuel and fuel supply.
                            you explicitly group the two as synonymous in this sentence. And again with the anthropomorphizing of cellular/system action? How can you attribute a "caring" quality to the nervous system?

                            Meso ecto distinction might not be completely right, but it is less wrong.
                            less wrong relative to what? and less wrong for what purpose?

                            If we're talking about a conceptual base for guiding sensible treatment of people in pain, the inclusion of an ecto/meso conceptual division is not "less wrong" than avoiding such a division in the first place. There are more reasonable and less fanciful means to the same end.

                            Comment


                            • Diane,
                              If you mean the protective neural walls of sensory axons, i.e., perineurium (mesodermal, posing a mechanical challenge to blood flow both in and out if on tension for too long), internal macrophages (immune cells), and their most adjacent non-meso walls, endoneurium and Schwann cells (physiologically active), I agree.
                              All that and more. The close relationship of different systems should not be overlooked or minimized. Nervous, immune, lymphatic and so forth. As Francisco Varela once wrote

                              all the cells of the nervous system are surrounded by fluid so that "your brain is literally bathed in the rest of the body's balance"


                              http://www.feldenkraisnow.org/embodiedexperien.html


                              If you include all the ways the two nervous systems belonging to a) therapist, and b) patient interact from the first moment they first lay eyes on each other, through sensing, then I agree.
                              If you mean strictly hands-on therapy, then I disagree. Only a prepared brain will take on and favourably exploit hands-on treatment. It has to want to. It has to have had time to discharge it's own anxiety and forebodings and mount some trust. All the better if part of that can be kinesthetically reinforced, congruent.
                              I don’t disagree with your general message here, and I'm not sure what it is that you are disagreeing with me.There is always ongoing bottom-up information processing, that is my point. And the capacity to adapt to a given stimulus is pre-existing. Top-down processing is part of the adaptation. I think we are in agreement.

                              I'm pretty sure the reason manual therapy always washes out when studied/analyzed statistically for efficacy is because thorough preparation of the patient's (and the therapist's!) brain has not been done.
                              I’m not sure about that. Could it be because its efficacy (in the context of accelerating pain resolution) is not that impressive? Perhaps we should re-conceptualize our outcome measures when it comes to manual therapy.

                              Part of that would be practitioners who explain things from a tissue perspective, likely. The very thing Adriaan Louw says, don't do anymore because it's a nocebo.
                              Diane, you can explain both the tissues perspective AND the neuromatrix perspective. Once again, there is a relational aspect that should not be overlooked. You can explain to the patient the uncertainty of that relational aspect and that takes care of your concerns. IMO this is a more complete and ‘less wrong’ model than completely dismissing the tissues perspective.
                              Pain is experienced in the brain, in many different somatosensory maps/representations."You don't need a body to feel a body" - Ronald Melzack.
                              Because inhibitory mechanisms are either lifted, or not deployed favourably (possibly due to stress/anxiety/mental distraction), spinal cord mechanisms enter positive feedback loop states (many many mechanisms) and perpetuate the pain situation.
                              That does not necessarily support what you said about pain and pain relief being strictly top-down phenomenon.

                              I'm not ignoring afferent fibres. They are the only way to add new input into the pain mess.
                              Then you cannot say that pain and pain relief is strictly a top-down phenomenon.
                              It better not be more nociceptive input, though. In a positive feedback loop that would be the last thing you would want to do.
                              This somehow contradicts what you said before “Nociception is mostly irrelevant to the brain” . If it’s irrelevant to the brain, then why do you care so much not to influence it? IMO it’s OK to even increase a bit the nociceptive input temporarily for the reasons previously stated. Would you tell a patient not to wt bear on the injured limb so that nociception does not increase?
                              Last edited by Evanthis Raftopoulos; 24-06-2014, 01:03 PM. Reason: grammar
                              -Evan. The postings on this site are my own and do not represent the views or policies of my employer or APTA.
                              The reason why an intellectual community is necessary is that it offers the only hope of grasping the whole. -Robert Maynard Hutchins.

                              Comment


                              • Originally posted by Diane View Post
                                Ectoderm, uses 20% of all available oxygen and glucose. Mesoderm, the rest.
                                Neurons are using the disproportionate amount of fuel, not all of the ectoderm derivatives.

                                Ectoderm/nervous system cares mostly about its fuel and fuel supply. If anything happens to its fuel lines, it will have a fit.
                                Again, this is talking about the nervous tissue not epidermis. I don't see how these arguments support the use of the ecto/meso distinction.

                                Comment

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