Announcement

Collapse
No announcement yet.

Are things getting hot on twitter?

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Here is the pathway for innocuous input. Innocuous = non-threatening, non-"dangerous".
    I.e., NON-nociceptive.

    Stay away from the dorsal horn, at least try to. Duh.


    [YT]Ulwydmt4igA[/YT]
    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


    • If you go after deep receptors you'll go too deep, too soon. If you think about nervous system as whole and go after only surface receptors, at least at first, you won't. Period. I'll bet the farm.
      I still think you're reading too much into what i've written. if a PT moves a patient, and the intent is inclusive of activation of deep mechanoreceptors, it does not necessarily follow that the PT is going for them preferentially over skin receptors.

      You continue to talk straight passed the points i have been making, because you seem to want to assume the worst. You assume i'm arguing for a "go after deep receptors first approach". To clarify, exploring ROM doesnt mean pushing rom beyond limits of tolerance. where did you get the idea that I'm arguing for a "achieving ROM" approach?

      When you treated my shoulder in quebec, your skin stetching merged into longitudinal traction of my whole arm as it hung from the table (i was in prone), and then you dragged it into some shoulder flexion. All I'm arguing is that if you're going to move a patient passively in the manner you did to me, it doesn't make sense to ignore or simply deny that your passive maneuvering of my shoulder included activation of deep mechanoreceptors. And it doesnt make sense to ignore or deny that said deep mechanoreception might form part of the sensory /discrim input that influences threat processing.

      Is it that bigger deal to acknowledge that? Do you think that PTs are so hypnotized by "joint only approaches" that they have to be snapped out of it with a "skin only" approach? I'm sorry but i dont think that is the way forward. Don't get me wrong, if was to meet a PT and i was to set about "ectodermalizing" their approach, i would be disappointed if he/she couldn't wrap his/her mind around it and decided to stick with his/her preferred "mesodermal" approach.

      However, I'd be equally disappointed if the PT swallowed the "ecotdermal" story hook,line and sinker without ever getting to the point of questioning the assumed irrelevance of mechanoreception from deeper tissues.

      Teaching PTs to be interactors, to be knowledgeable about the nervous system and skin, to be empathetic, to be sensitive, to be science based should lead PTs to "skin first" approaches, not "skin only" approaches.

      Comment


      • My point is that if you even bother thinking about them you are already going too deep.
        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


        • Why? Would acknowledging that the movement, like the movement you applied to my shoulder involves activation of deep mechanoreceptors automatically make you a PT zombie, incapable of empathy, incapable of gentle handling, destined to be a thoughtless operator, churning through patients, blaming the patient when outcomes are poor, congratulating yourself when treatment works?

          Of course it wouldn't. I think your view on this is pessimistic as opposed to reasonable. I think we can use existing treatment models to steer the profession in a better direction. You seem to want to wipe the slate clean and start again.

          Comment


          • I give up.
            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


            • This would be an interesting and I'm betting, revealing experiment.

              Get a big bunch of physical therapists from all sorts of cultures and countries together in a big room, all sorts of different ages and levels of experience. This randomizes them. Have three groups, selected randomly.

              They all have the same task: treat a patient. Let's pick a shoulder patient. The objective is to reduce patient's pain/increase their range of movement.

              1. Group one is asked to figure out some way to treat their patients, using manual therapy and pain education, and (...this is very important) to think only about their patient's ectodermal derivatives.

              2. Group 2 is asked to do manual therapy, period. However they were taught by their profession in the conventional way.

              3. Group 3 is a control group. Told to do nothing. Everyone just sits there. They don't even talk. No interaction.


              This would be a psycho-physical experiment, to examine how these therapists work, and what their patients' outcomes would be, according to what ideas were planted in their heads, beforehand.
              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


              • Originally posted by wicked slow
                At some point though you did think about them. So even though you are not making them a conscious consideration, the associative pattern is still happening under the conscious level. If we are expanding the range of what a thought is, then it has to include those previous synapses. Can consciousness resolve these ideomotor influences?

                Aren't we all in to deep? So its better to know about it but not think of it. But if I am not thinking about it, am a still thinking about it
                You can build a new neurotag and think with that instead.
                That is kind of my point - conspicuity issues aside.

                You can compartmentalize earlier corruptive training off from what you "do" with your hands, think different thoughts, "operate" more "interactively" based on new information. To be sure, you can never get rid of earlier thinking but you can learn over top, use new ideas, allow earlier operational sets of info to go extinct by not replicating them every day.

                If this weren't true, clinical pain science would have no basis. Patients wouldn't be able to learn their way out of being reactive and helpless before their own pain. Instead, they do.

                So, what's to stop our profession, or at least members in it, to learn new stuff and use it, think about it, stuff that works better and results in less hurt done to patients in the name of "treating" them? Nothing except being unable to get off whatever neurotag one's brain is stuck on (e.g., Patrick, I suspect), or bandwagon effect at the collective level.
                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


                • I don’t know about you, but I find these discussions addictive. They seem to catalyze our thoughts. I wasn’t able to post the past couple of days and my mind is running to catch up.

                  From a few posts ago,

                  Patrick:
                  I simply stated that if/when perpendicular force is applied, I think the sense of pressure that one feels is more likely derived from receptors in the skin (most likely ruffinis or pacinian) than receptors in deeper tissues.
                  Would you say that the sense of deeper pressure from stronger stimuli is most likely due to increased activation of the same receptors in the subcutaneous/superficial tissue from outside stimuli, the engagement of more receptors in the subcutaneous/superficial tissue from outside stimuli, the same or more receptors being stimulated both from external and in this case more internal (inside to outside) stimuli from deeper layers (counter-force), any combination of the above, or any other scenario?

                  Diane, I’ve been wanting to hear your thoughts on this: what is your explanation for why the experience that follows strong stimuli feels different from that which follows light stimuli? By the way, we can argue that stronger stimuli can still be described as 'gentle' (at least as to the way it's introduced).

                  Still, you won't catch me doing perpendicular pressure except in very specific circumstances. Not as a rule. Not when a perfectly good lateral stretch receptor is so handy everywhere in hairy skin.
                  1. I don't see how we can avoid perpendicular pressure during manual therapy.
                  2. perpendicular pressure should have the capacity to 'stretch' subcutaneous receptors as well.
                  3. what are the exceptions that you are talking about? and why are these cases exceptions in your opinion?
                  4. Who is to decide what is the optimal force parameter, us or the patient's response to the parameter?
                  -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 Evanthis Raftopoulos View Post
                    Diane, I’ve been wanting to hear your thoughts on this: what is your explanation for why the experience that follows strong stimuli feels different from that which follows light stimuli? By the way, we can argue that stronger stimuli can still be described as 'gentle' (at least as to the way it's introduced).
                    Too much info for the nervous system to process favourably (for the patient) in too short a time and too small an area. See spatial and temporal summation. See post 124.

                    We should be jet planes coming down on a patient on a long runway, low angle of entry, not helicopters plunking down then pressing down.

                    1. I don't see how we can avoid perpendicular pressure during manual therapy.
                    2. perpendicular pressure should have the capacity to 'stretch' subcutaneous receptors as well.
                    3. what are the exceptions that you are talking about? and why are these cases exceptions in your opinion?
                    4. Who is to decide what is the optimal force parameter, us or the patient's response to the parameter?
                    Use dycem and drag skin around instead of pressing right into it. Or worse, trying to press right through it in some useless (and noxious to the patient) quest for getting at some elusive deep mechanoreceptor. Don't you see how nervous systems (a lot of them, mine for sure) would just hate that?

                    I don't know what exceptions you are talking about.
                    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


                    • Still, you won't catch me doing perpendicular pressure except in very specific circumstances.

                      Comment


                      • Ah, thank you Mikal.
                        OK,
                        1. anterior cutaneous nerves at the sides of the sternum
                        2. some little thingy that resides in the acromioclavicular notch that is inaccessible but for a pencil eraser.

                        Those two. That's it.
                        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


                        • Nothing except being unable to get off whatever neurotag one's brain is stuck on (e.g., Patrick, I suspect), or bandwagon effect at the collective level.
                          I'm sorry but this is a little bit humurous for me. How many times have I stated that I'm not arguing from the perspective of "I still think traditional treatment models are valid". I am not stuck on some neurotag. Ive stated several times that my practice had been altered significantly by what I've learned from info here at ss.

                          I think you'd find Diane that the way I treat would look very similar to what you do. I largely have you to thank for that. So thanks. But please, stop accusing me if being "stuck on a neurotag" or other accusations that boil down to you thinking that I mustn't be seeing things clearly if I'm asking the questions in asking. The difference between you and I is that I concede that deeper mechanoreceptors are likely activated during treatment, so I acknowledge that likelihood. That doesn't mean I specifically attempt to target them. You simply put your head in the sand and pretend that any mechanoreceptors other than cutaneous ones are either not activated by your touch, or if they are, their activity is irrelevant to any observed outcomes. It's a point blank denial, based on what? Your own (in my view unreasonable) concern that acknowledging the potential influence of deep mechanoreceptors will derail attempts to right the profession?

                          Perhaps you needed to take the stance you've taken to unlearn that which you had been taught. Have you considered the possibility that there are other people out there who don't? Perhaps all your hard work has resulted in the collating of info that makes it easier for PTs to understand the importance of a nervous system/skin first approach to treatment and apply it without having to adopt your black and white stance?

                          Comment


                          • Sure PL, whatevs.
                            I give up.

                            Mikal, I thought of one more - 3. Pelvic floor
                            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


                            • You give up? You give up on what? I've stated a reasonable case, and you keep responding as if I'm misunderstood or deluded, or stuck on a square or something. That is frustrating. I understand the position you've taken (to purge your mind of a
                              consideration of any influence of sensory/discrim input from spindles, joint receptors, gtos, fascia). I just don't agree that your reasoning justifies the position.

                              Comment


                              • Go ahead and think whatever you want. I don't care.
                                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

                                Working...
                                X