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  • #61
    Diane
    I'm pretty sure the brain doesn't much care about embedded receptors unless they start to signal crankiness because their internal milieu is off, chemically. Not mechanically, chemically.
    Are there not ruffini endings dispersed through tissues other than skin? Can't you accurately estimate the position of your shoulder if someone moves it passively? Which receptors are activated when my ankle painlessly clicks as I move it through df/df? I don't know how you can be sure about which receptors the brain cares about most. I don't think that conceding that we don't know which receptors the brain preferentially attends to should be used as a justification to try to build treatment models that target deeper receptors. I suspect that you think that such a concession would lead to such justification. I understand your view that it is potentially easier to guard against the propogation of such treatment models if we develop new models (like DNM) that completely close the door on the old models.
    They are dearly beloved to other people here, maybe not you.
    Who then? Do these people get a chance to defend themselves?

    Comment


    • #62
      Patrick, if I am not mistaken, the kinesthesia is rather strongly driven by the skin and less by the deeper proprioception.
      I can not find the study that so elegantly demonstrated that, but I distinctly remember seeing it on SS.
      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


      • #63
        Originally posted by PatrickL View Post
        Diane

        Are there not ruffini endings dispersed through tissues other than skin?
        Ruffinis are only in skin as far as I know. They look sort of like GTOs but according to Purves they aren't the same.

        Can't you accurately estimate the position of your shoulder if someone moves it passively?
        Yeah, and what matters to me is if I want them to do that or not, especially in a pain situation.

        Which receptors are activated when my ankle painlessly clicks as I move it through df/df?
        Why would it matter?

        I don't know how you can be sure about which receptors the brain cares about most.
        The most threatening ones in any given moment.

        I don't think that conceding that we don't know which receptors the brain preferentially attends to should be used as a justification to try to build treatment models that target deeper receptors. I suspect that you think that such a concession would lead to such justification.
        That is exactly the swamp manual therapy is already stuck in, and needs to emerge from.

        I understand your view that it is potentially easier to guard against the propogation of such treatment models if we develop new models (like DNM) that completely close the door on the old models.
        More like put some steps under the front door so that no one has to climb in through the windows anymore.

        Who then? Do these people get a chance to defend themselves?
        Yes, of course. There have been at least two huge threads, if you recall.
        Last edited by Diane; 15-06-2014, 04:33 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


        • #64
          Originally posted by Bas Asselbergs View Post
          Patrick, if I am not mistaken, the kinesthesia is rather strongly driven by the skin and less by the deeper proprioception.
          I can not find the study that so elegantly demonstrated that, but I distinctly remember seeing it on SS.
          The Proske and Gandevia 2009 paper didn't say muscle spindles weren't important, they said Ruffinis in skin were more important than joint receptors for kinesthetic feedback.
          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


          • #65
            Yes, of course. There have been at least two huge threads, if you recall.
            One of the problems with this debate, and the previous ones like it, is that anyone who questions your view that the brain "doesn't care" about subcutaneous receptors is necessarily defending the idea that these receptors are a valid specific target for manual therapy. You add to this that these receptors are "beloved" by those who you assume are attempting to make a case for their specific targeting. That is to imply that those who are questioning you are doing so from an emotional rather than thoughtful perspective. That's an error on your part, I think.

            The Proske and Gandevia 2009 paper didn't say muscle spindles weren't important, they said Ruffinis in skin were more important than joint receptors for kinesthetic feedback.
            That's not accurate. The paper suggested that in areas of the body where there is less muscle tissue, and therefore less spindles, such as the fingers, the brain probably relies more heavily on kinesthetic input from the skin.

            Comment


            • #66
              Can't you accurately estimate the position of your shoulder if someone moves it passively?
              Yeah, and what matters to me is if I want them to do that or not, especially in a pain situation.
              Do you think it is your skin receptors that inform your brain about where your shoulder is in space when someone moves it passively? Whether you want then to it not is important for other reasons.

              Comment


              • #67
                Ruffinis are only in skin as far as I know. They look sort of like GTOs but according to Purves they aren't the same.
                So if I'm reading you right, you argue that the only mechanoreception derived from subcutaneous receptors that the brain "cares about" is from those receptors that are attached to peripherally sensitized (by inflam soup)afferents?

                How do you judge where your non inflamed/non painful shoulder is in space if someone moves it passively?

                Comment


                • #68
                  Quote:
                  I don't think that conceding that we don't know which receptors the brain preferentially attends to should be used as a justification to try to build treatment models that target deeper receptors. I suspect that you think that such a concession would lead to such justification.
                  That is exactly the swamp manual therapy is already stuck in, and needs to emerge from.
                  I agree. As I've said before, there's not much point in making stuff up in an attempt to drive change in the profession.

                  Comment


                  • #69
                    Originally posted by PatrickL View Post
                    That's not accurate. The paper suggested that in areas of the body where there is less muscle tissue, and therefore less spindles, such as the fingers, the brain probably relies more heavily on kinesthetic input from the skin.
                    Excerpt:
                    Concerning the possible contribution to kinaesthesia from other receptor types, the summary view is that while a good case has been made for some cutaneous receptors, the evidence is less convincing for joint receptors. The cutaneous receptor most likely to subserve a kinaesthetic role is the skin stretch receptor, the slowly adapting Type II receptor served by Ruffini endings (Chambers et al. 1972; Edin, 1992). For kinaesthesia at the forearm, stretch of skin over the elbow during elbow flexion can provide information about both position and movement. Movement illusions generated by stretch of skin of the hand and over more proximal joints, when combined with muscle vibration were greater than when either stimulus was applied on its own (Collins et al. 2005). The authors made the point that this was not just a matter of skin input facilitating the muscle input and that cutaneous input generated by skin stretch contributed to kinaesthesia in its own right. More recent observations have shown that skin input can also have an occluding action. Signals from local, rapidly adapting receptors evoked by low-amplitude, high frequency vibration can impede movement detection (Weerakkody et al. 2007).
                    They talk about fingers later.

                    I think the Collins paper talked about skin stretch conferring movement illusion at the knee and elbow as well as fingers.
                    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


                    • #70
                      More like put some steps under the front door so that no one has to climb in through the windows anymore.
                      Well I think it will be difficult to come to agreement about how best to drive positive change in the profession. I don't see that your approach is purely an appeal to scientific reasoning. I think your approach to driving change in the profession has been, and is based on an idea that we must wipe the slate clean, and start promoting treatment concepts that can't in any way be confused for or contain any elements of erroneous treatment concepts. I think you're like an uncompromising, idealistic and passionate political leader attempting to disseminate a black and white view of a not so black and white subject matter. I think you think the ends justify the means.

                      Perhaps such an approach is necessary to drive a cultural shift for the treatment of pain. Perhaps not. For me, whatever attempts I make to drive change in the profession will be exclusive of the notion of a cns processing hierarchy based on embryological origin of the tissues to which afferents are plugged into.

                      Comment


                      • #71
                        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


                        • #72
                          Concerning the possible contribution to kinaesthesia from other receptor types, the summary view is that while a good case has been made for some cutaneous receptors, the evidence is less convincing for joint receptors.
                          This describes contributions from other receptor types besides spindles, no? Ie spindles are primary contributors, and skin is purported to play a bigger role than joint receptors. There's nothing that suggests that skin receptors play a bigger role than spindles, accept for parts of the body where there isn't much muscle around.

                          I don't see the big deal here. Why wouldn't we have evolved a capacity to integrate mechanical input from cutaneous and subcutaneous receptors for the purpose of kinesthetic awareness? I've asked this before, but if the skin is the primary receptor for kinesthesia (which is not what that paper concludes at all), why dont all those biggest loser contestant who lose 200lbs and have arm skin flopping all over the place lose kinesthetic awareness of their shoulders?

                          I really think that proske paper is erroneously used far too often by you Diane to support a claim about the relative importance of skin receptors over all other subcutaneous receptors during kinesthesia.

                          Comment


                          • #73
                            Originally posted by PatrickL View Post
                            This describes contributions from other receptor types besides spindles, no? Ie spindles are primary contributors, and skin is purported to play a bigger role than joint receptors. There's nothing that suggests that skin receptors play a bigger role than spindles, accept for parts of the body where there isn't much muscle around.

                            I don't see the big deal here. Why wouldn't we have evolved a capacity to integrate mechanical input from cutaneous and subcutaneous receptors for the purpose of kinesthetic awareness? I've asked this before, but if the skin is the primary receptor for kinesthesia (which is not what that paper concludes at all), why dont all those biggest loser contestant who lose 200lbs and have arm skin flopping all over the place lose kinesthetic awareness of their shoulders?

                            I really think that proske paper is erroneously used far too often by you Diane to support a claim about the relative importance of skin receptors over all other subcutaneous receptors during kinesthesia.
                            It's not where they come from, Patrick, it's where they get to that matters.
                            Muscle spindles make it up to the S1 cortex for processing. The others do not.
                            That's the big difference IMO.

                            Furthermore, skin receptors (Ruffinis, other large fibred receptors) make it up there a) faster, which gives the brain more time to compute a response and inhibit whatever it wants, and b) exteroceptively, which you seem to think doesn't matter, but I'm sorry, I will argue to my grave that it matters more to the salience detection system of a brain that has evolved through millions of years of predation.
                            Last edited by Diane; 15-06-2014, 02:51 PM.
                            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


                            • #74
                              Btw ruffini endings are found in the sub-cutaneous tissue, also known as hypodermis, also known as superficial fascia. This layer of tissue is derived from mesoderm.


                              Sent from my iPhone using Tapatalk
                              -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


                              • #75
                                Yes, dermis is derived from mesoderm. The receptors, not so much. Besides, they transduce mechnoreception from the outside of the body, i.e., exteroceptive. Not intero or proprio. Therefore they are valid targets for manual therapy. I.e., ones we "know" we can affect with our hands. The ones inside, not so much or not at all.

                                And please stop calling the cutis/subcutis layer or epi-dermis and hypodermis "superficial fascia" - it's too confusing to all the human primate social groomers who get led down garden paths as a result.
                                Ravensara T and I have discussed this at length and she has presented the case to the anatomy nomenclature people.
                                Last edited by Diane; 15-06-2014, 06:31 PM.
                                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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