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  • Ref First, do no harm

    Great blog from Lori today

    http://www.bodyinmind.org/clinicians...in-management/
    Adam Meakins
    www.thesportsphysio.wordpress.com
    Do not mock a pain you have not endured

  • #2
    Moseley's last paragraph is the strongest language I've heard from him yet:

    I think it is time for a fundamental shift here. There is no doubt that chronic pain is a serious health issue. There is also no doubt that an individual’s understanding of their problem modulates their pain. I believe we should no longer avoid what our medical colleagues hold sacrosanct – to first and foremost DO NO HARM. We should hold accountable ourselves and our colleagues. We should hold accountable our professional societies in whose magazines some A-grade therapeutic trollop is advertised, and we should hold accountable our conference committees who ‘give the people what they want’ even if what they want is a con – a con that leaves some people waiting for their back to blow, crumble, crush or pop. We can do better and I think we should.

    What I appreciate most about the SomaSimple participants is the commitment to integrity, to really understanding how the body works as best we can, and not to BS ourselves, our colleagues, or our clients/patients. To really hold ourselves to the highest standards.

    It is frustrating to me, as a massage therapist, to see my profession dominated by magical thinking and predatory misinformation. Our professional organizations and magazines are steeped in it. There's lots of money to be made selling snake oil.

    Conventional medicine has a lot to answer for, too. Every day I listen to people who have been told they are broken, damaged. People who have been told by their doctors that they will always be in pain. Or some 50 year old guy is told he has 3 herniated discs and has the spine of an 80 year old. "I'm a mess," he told me. Of course he believes it. His doctor told him so.

    Or the 35 year old strapping young lad who works out at the gym 3 days a week, dances frequently, and has occasional low back pain. He finally decided to see a chiropractor who told him he has 13 subluxations, 11 rotated ribs, a tilted pelvis and a short leg and he'll need 18 months of chiropractic treatment to straighten him out. He's got his X-rays, with scary looking lines drawn here and there to make it look like his spine is a jumbled mess, on his cell phone so he can show them to friends and keep reinforcing to himself what a mess he is.

    Every day clients come in telling me they are full of trigger points and their fascia is tight. Their concept of what is going on in their body is a tangled knot. It takes a lot of patience and diplomacy to try to gently untangle it. I want to strangle the doctors, chiropractors, physical massage therapists, and massage therapists who have told them these awful stories about themselves. It's hard to counteract because it seems so real and reasonable to them and that's what everyone around them is saying. I'm not confident that I'm all that successful at getting the point across. I'm afraid that what I tell them is so foreign, so counter to what they've been told, what they've believed, that I have a feeling I'm not getting through to them. I'm not sure how to do that.

    Comment


    • #3
      Hi Alice

      Originally posted by Alice Sanvito View Post
      I'm not confident that I'm all that successful at getting the point across. I'm afraid that what I tell them is so foreign, so counter to what they've been told, what they've believed, that I have a feeling I'm not getting through to them. I'm not sure how to do that.
      I, and im sure many others here, are in excatly the same 'boat' as yourself

      I think this photo I saw on twitter of Layne Norton (a strength and conditioning coach) neatly sums up our predicament, and highlights that its not just the manual therapy industry that the bull shit and snake oil merchants infest

      Keep fighting for the good, honest and noble quest

      Cheers

      Adam
      Attached Files
      Adam Meakins
      www.thesportsphysio.wordpress.com
      Do not mock a pain you have not endured

      Comment


      • #4
        I commend Lorimer for writing this. He has the power to make a change. It's great to see a scientist use their influence to make a positive change in the treatment of pain. However, I can't help but think of Carl Sagan's words when dealing with the charlatans in our midst:

        “One of the saddest lessons of history is this: If we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It’s simply too painful to acknowledge, even to ourselves, that we’ve been taken. Once you give a charlatan power over you, you almost never get it back.”
        Rob Willcott Physiotherapist

        Comment


        • #5
          Not a bad post. Certainly some decent points. Roger Kerry posted a good one too.
          Always learning.

          Comment


          • #6
            Originally posted by advantage1 View Post
            I commend Lorimer for writing this. He has the power to make a change. It's great to see a scientist use their influence to make a positive change in the treatment of pain. However, I can't help but think of Carl Sagan's words when dealing with the charlatans in our midst:

            “One of the saddest lessons of history is this: If we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It’s simply too painful to acknowledge, even to ourselves, that we’ve been taken. Once you give a charlatan power over you, you almost never get it back.”
            And the charlatans know this.
            Jess Brown, PT, OCS

            Comment


            • #7
              Insofar as the massage therapy profession is concerned, nothing can and will be done.

              Trigger points are here to stay. The fascination with fascia.

              What we do in essence, is provide a service that can help a human being experience their physicality minus feeling like they are being chased by a grizzly bear.

              In other words: we can help, albeit fleetingly, reduce their stress and anxiety levels. That is a HUGE thing as Christopher Moyer wrote here.

              However, the other two general effects are well-supported by scientific data and widely agreed-upon by MT researchers. Quantitative research reviews show that a series of MT treatments consistently produces sizable reductions of depression in adult recipients(4). The effects of MT on anxiety are even better understood. Single sessions of MT significantly reduce state anxiety, the momentary emotional experiences of apprehension, tension, and worry in both adults(4) and in children(5), and multiple sessions of MT, performed over a period of days or weeks, significantly reduce trait anxiety, the normally stable individual tendency to experience anxiety states, to an impressive degree in adults(4).
              Not sexy\glamorous\medical sounding\who knows? enough, I suppose.
              Last edited by caro; 30-09-2014, 07:41 PM.
              Carol Lynn Chevrier LMT
              " The truth is, people may see things differently. But they don't really want to. '' Don Draper.

              Comment


              • #8
                Well, re what Chris Moyer wrote, in some ways massage therapy is on a better track research wise from a human primate social grooming perspective. I mean, I'll never live to see the day probably where the PT profession starts doing research on its effects on stress and depression and anxiety. Probably because it is the creator of a lot of it. See Moseley's post about that.
                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


                • #9
                  Originally posted by sheld505 View Post
                  Not a bad post. Certainly some decent points. Roger Kerry posted a good one too.

                  Not a "bad" post. Some "decent" points.

                  Have I misinterpreted the tone of those words Sheld. Comes off underwhelmed and somewhat agitated to me.

                  To be clear...he nailed it. Period.

                  Comment


                  • #10
                    Originally posted by proud View Post
                    Not a "bad" post. Some "decent" points.

                    Have I misinterpreted the tone of those words Sheld. Comes off underwhelmed and somewhat agitated to me.

                    To be clear...he nailed it. Period.
                    I'm not sure how you read that and pick up "agitation" of all things. What, in your interpretation, would I be "agitated" about Proud?

                    "Under-whelmed" maybe. IMO, I will say that Kerry's piece is more balanced and on point. Moselely acts as his way is the only way; really? Aren't there posters here whose TNE approach on patients have not met expectations? It's not just the "patho-physiological" model that fails at times and succeeds at times; TNE does too! Let's get real about this; this is why Kerry's viewpont is more balance/less biased to me.

                    Agitated, no; concerned we've replaced one guru for another and the pendulum has swung too far away from reality, yes.
                    Always learning.

                    Comment


                    • #11
                      sheld, here you go again: equating the plauisible and scientific validity of a framework or model with outcomes.
                      It's not just the "patho-physiological" model that fails at times and succeeds at times;
                      A model is disproven or not. A theory is disproven or not.
                      They do NOT succeed or fail. Only their application by humans to humans can do that.
                      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


                      • #12
                        Originally posted by Bas Asselbergs View Post
                        sheld, here you go again: equating the plauisible and scientific validity of a framework or model with outcomes.


                        A model is disproven or not. A theory is disproven or not.
                        They do NOT succeed or fail. Only their application by humans to humans can do that.
                        Sorry Bas, how about "approach?"
                        Always learning.

                        Comment


                        • #13
                          I am not surprised that Moseley is frustrated by the current crazes for more and more interventions which may be little more than noceboic in effect.

                          I am surprised he hasn't spoken out loudly before about the weird "models" or whatever one wants to call them which are exciting lots of modern PTs. It seems that most are longing to have more and more control over their patients' welfare and health.

                          Nari

                          Comment


                          • #14
                            I loved the part about the thoracic ring.
                            Ringy ding ding.
                            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


                            • #15
                              Originally posted by Diane View Post
                              I loved the part about the thoracic ring.
                              Ringy ding ding.
                              thoracic catastrophiz-ring. I wonder how long it will take folk to 'discover' they've just wasted a lot of money.

                              Comment

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