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  • #16
    Walt, there's no way you can "equivalent-ize" the issues, or find any real common ground. One approach (SC) has scientifically congruent underpinnings. The other (MFR) doesn't. That's the difference. No matter how you slice it, or no matter that you both can juggle.
    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


    • #17
      Hi all,

      Walt,
      here is is a link to the brainstem structures.

      The Hind-brain or Rhombencephalon

      These structures are known as places of many autonomic and unconscious systems. It is well known that conscious places are located higher.
      But, these pathways and nuclei are mandatory for inputs and outputs. There is not really other ways that allow our "free will" to self expression.

      It just means that all stimuli travel through unconscious structures.
      And these unconscious structures have all freedom to send or not the informations they receive in another places.

      Simple Contact is just a bit of communication with these mandatory structures involved in all emotions/movements and feelings.
      Simplicity is the ultimate sophistication. L VINCI
      We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

      Everything should be made as simple as possible, but not a bit simpler.
      If you can't explain it simply, you don't understand it well enough. Albert Einstein
      bernard

      Comment


      • #18
        Bernard

        It rather alters the concept of 'free will' as well. Our wonderful decision-making processes are probably at the mercy of what is churning around in the rhombencephalon which we haven't a clue about.


        Nari

        Comment


        • #19
          Barrett -

          I haven't had a chance to be on the forum for a couple of days due to other stuff, I'm just now reading your response.

          You understand that when pain has a mechanical origin (no, this does not necessarily preclude the other two origins) that movement will be necessary to resolve it, don't you?
          Do you understand that not all movements are alike or have the same origin and purpose?
          yes



          Do you understand that ideomotion not only expresses us but also moves us toward comfort i.e. a reduction in mechanical deformation?
          From what I read, I understand that ideomotion describes facilitating motion in someone based on our bias - not thier original movement. Or at least suggesting that motion based on the person's subconscious (like downing rods).

          Do you understand the consequences of not being permitted to move instinctively toward comfort?
          Do you understand the importance of instinctive behavior and the consequences of its suppression?
          yes

          These are good questions but they don't answer the original question -
          The main question I have releates to how you utilize a concept in phychology that is used to describe a manipulative/suggestive form of activity to a therapy that helps people reduce their pain as a PT
          from the questions above it still appears to me that you are suggesting that you identify to a patient that they have pain and that they don't move properly - then what - you tell them how to move? Still sounds more like a counsilor/hypnotherapist than a PT to me.

          For the others that have commented - if you practice phsychology than ideomotor sounds like it explains alot, if you practice physical medicine than ideomotor doesn't give you a basis to treat or an explaination (or at least one that I can see - that's why I asked Barrett).

          MFR sees undiagnosed fascial restrictions (an anatomical/physical problem) as the main point of therapy. I can see how a fascial restriction may hinder someones motion and how releaseing that fascia can effect someone's motion. This is all on a physical nature not a phsychological construct.

          I'm just trying to see the bridge that Barrett uses - not question it's effectiveness, because obviously he has helped many people.

          Dave

          Comment


          • #20
            Dave, the following is my paraphrased version of a post originally presented by Andrew Ball, once upon a time on another forum. Maybe it will help.

            Simple Contact is not a treatment at all. It is in the end a comprehensive treatment approach. It is difficult to describe in text because it does not involve the application of a technique designed to alter impairment, rather it changes the environment so as to remove disability, thereby removing functional limitation, thereby removing impairment.

            Specifically it accomplishes this through no more than touching the patient over areas of high neurodensity so as to facilitate the patient through movement patterns that they are just aching to be allowed to execute – and they would do so if they weren't perceived to be potentially socially unacceptable for them to perform without ‘permission,’ and even more strange for them to do in public. Simple Contact gives the patient the permission/invitation to do so. Without disability, functional limitation is alleviated. Without functional limitation, impairments are alleviated extremely efficiently and quite dramatically. Therefore, Simple Contact is as much a disability model as it is a therapeutic approach.

            Pain has only 2 origins: chemical irritation, or mechanical deformation. (or both). Movement logically, is the only thing that will alleviate the pain of mechanical deformation. Consider now how PT has traditionally treated with respect to the ICIDH framework. Manual therapists, for example, would assume that by mobilizing/manipulating, prescribing exercise, they can decrease pain and improve range of motion. And in fact frequently they can, but it misses the point. What if the impairment they were claiming to treat wasn’t causing the functional limitation, causing the disability? There is frequently a lack of correlation between findings from medical imaging and symptomology. Perhaps another structure is the impairment truly limiting the patients’ function and abilities. Where else might mechanical deformation be occurring? An increasing body of evidence (far beyond what I can write about here) is suggesting that it is in the nervous tissue itself. This is an abnormal neurodynamic. It’s easy to diagnose from the history alone. There is an absence of relevant pathology and the patient with this problem will describe distinct alterations in their discomfort dependant upon position and use. Thus the origin of pain is mechanical deformation. Careful functional assessment may reveal some cause for the eventual complaint of pain but causes exist some distance in both place and time from the origin of the pain.

            Shift gears for a moment:
            Whenever a movement unhesitatingly and immediately follows upon the idea of it, we have ideomotor action. Every mental representation of a movement awakens to some degree the actual movement which is its object; and awakens it in a maximum degree whenever it is not kept from so doing by an antagonistic representation present simultaneously to the mind.” - William James

            Ideomotor movement is a category of nonconscious, instinctive behaviour which also includes excitomotor (breathing and swallowing) and sensorimotor (startle reactions). It is well documented, it’s presence never disputed, but it seems to have been forgotten by the therapy community. Ideomotor movement, if allowed full expression, is the movement that will reduce pain originating from mechanical deformation. You do this all the time. Ever shift in your chair to relieve pressure on your backside without consciously being aware of it? Culture and society restrict a patient’s expression of movements that would alleviate their pain. That by definition, is a disability. The fact that this disability leads to functional limitations of inability to walk, reach, sit etc. is obvious. The impairment that results is of course pain!

            Enter Simple Contact. The idea goes that the true disability is the patient living within a culture that disallows the pain-relieving ideomotor movements that may alleviate ‘mechanical deformation’ in the nervous system. It does so by removing the cultural/sociological barriers created by our stand up straight, sit still, pull your belly in culture. It provides the patient a safe environment to move without culturally imposed norms of what constitutes acceptable forms of movement.

            Pt traditionally tried to treat impairment to impact function, then it evolved to target function with the hope of impacting disability. There are limitations to this left to right approach. Pathology, Impairments, Functional Limitations, and Disabilities all combine to define the patient’s condition. One doesn’t always lead to the next in line. However, every disability has an underlying functional limitation, which has an underlying impairment. This is the basis of the Hypothesis Oriented Algorithm (http://www.ptjournal.org/PTJournal/M...v83n5p455.cfm).
            Simple Contact suggests a similar treat from right to left approach. It suggests a change from the traditional approach to care (treat the pain in an attempt to get an improvement in ability to sit or reach to restore the patient to full occupational functioning) to a model of treating at the disability level, so as to remove cultural barriers to movement within a safe and protected environment, which impacts the functional limitation (can’t reach, sit) secondary to pain, to finally remove the impairment of pain.


            Eric
            Eric Matheson, PT

            Comment


            • #21
              Thank you Eric. I'm grateful for Andrew's explanation and can't disagree with it but I'm pretty sure most in my classes would get lost in there somewhere.

              Dave,

              To put it simply, you're WAY off.
              Barrett L. Dorko

              Comment


              • #22
                Nice work Eric.

                Dave,
                As I suggested in the MFR thread, you have to look at the scientific databases also. The web, while convenient, is heavily weighted toward to the more popular implications. A proper understanding of ideomotion cannot be gained from this alone.

                Luke
                Luke Rickards
                Osteopath

                Comment


                • #23
                  That is a good summary of ideomotion, Eric and Drew.

                  Dave,

                  Until you are able to understand how a brain functions and its supremacy in everything we interact with, including the emotion of pain, you may not ever understand ideomotion and Simple Contact, or much of what therapy is and could be. To remain isolated in a fantasy world is your choice. But is it fair to patients whose knowledge of the body and brain is very limited???

                  Nari

                  Comment


                  • #24
                    Nari, Dave is probably working on how unfair it is to talk about something his own knowlege of is very limited.. (even though he claims to be an OT and I've been under the impression that OTs had a lot more info about the brain than PTs did.. maybe I was wrong. Wouldn't be the first time I've been wrong and needed to alter course slightly..)
                    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


                    • #25
                      Originally posted by Diane
                      Wouldn't be the first time I've been wrong and needed to alter course slightly..)
                      Diane, this is precisely what makes you such a brilliant clinician. You care more about truth than belief and are more than willing to alter course when necessary. For someone discerning like yourself, I expect this is rarely a huge shift, but more a refinement in direction. Others need a radically different map. We can thank people like you for providing one.

                      Nick
                      Nick Matheson, PT
                      Strengthen Your Health

                      Comment


                      • #26
                        Eric -

                        Thanks for the post I think it has helped me alot to understand simple contact but I think I still have a small problem with ideomotion.

                        From your post it appears (to me anyway) that simple contact is either a blending of therories from Chiropractic, Accupressue, Reflexology and Trigger Point therapy or a cookbook recipie. Let me elaborate:

                        If it is a cookbook recipie than I need to know if these areas of high neurodensity are mapped out and related to either functional problems or specific disfunctions. For example if a patient has pain/disfunction in the hamstrings (this could cause the ASIS on that side to be pulled toward the hamstrings resulting in a rotation of the sacrum from a subluxation of the SI joint as well as a rotoscoliosis of the spine thereby elevating rib heads and causing the patient to complain of shoulder pain and a noticible winging of the scapula) is there a corrisponding area of high neurodensity that you touch and therefore allow the patient to continue a movement pattern that was "stuck"? This would lead me to think it's a cookbook recipie like trigger point therapy with the exception of understanding that pain and disfunction aren't based on a nodule but more on a larger more whole body concept.

                        If it is a blending than it reminds me of the tourque method of Chiropractic. In short (from what I understand) this technique believes that there are only a couple of subluxations in the spine that cause disfunction and therefore if you treat just those areas you will undoubtly treat the whole person. They also couple this with lifestyle changes/education to help the patient change any "bad habits" weather they be from diet or thought processes in an attempt to prevent the problem from reoccuring.

                        I whole heartly agree with the concept that symptoms are just that - symptoms and that the problem may be coming from somewhere else. Leads me to the statement I go by "listen to the symptoms but look elsewhere for the cause".

                        I think I can agree with the core ideas behind simple contact up to the point of ideomotion because as William James points out it is a movement that follows the idea of that movement. To me this means that once we give the patient the idea/suggestion for the movement than the person can perform that movement with the goal of proper movement to prevent/alieviate pain. this to me sounds more along the lines of suggestive or hypnotherapy. Don't get me wrong - it works but not as a physcial modality.

                        To me the only thing I still don't understand - even more now, after your explanation - is how simple contact moves from the physical approach of understanding how to treat the whole person (regardless if it's a cookbook recipie or a blending of different disciplines) to the phsychology or counsciling approch of suggestion/hypnotherapy. I guess for me to get over this point I would have to accept another definition of ideomotion than what I've read about.

                        Thanks again for your explanation.

                        Dave

                        Comment


                        • #27
                          Dave,

                          There is no mention of subluxations in Simple Contact. Where did you get that impression in what Eric posted or that you've read about ideomotion?

                          Have you obtained the Spitz book I recommended for a better understanding of the topic?

                          Personally, I don't tell my patients how to move except when prescribing specific choreographed exercises that I believe may be helpful.
                          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                          Comment


                          • #28
                            No Dave, there is no cookbook. Even if there were, it wouldn't make it any easier to do than it already is.

                            Your example of the patient with a dysfunctional hamstring makes too many assumptions. For instance, why would a rotoscoliosis of the spine thereby elevating rib heads cause the patient to complain of shoulder pain? Is this rule that applies in all cases of rotoscoliosis?

                            When you suggest that "it (SC) works but not as a physical modality," are you also suggesting that physical modalities can work only through physical means?

                            Eric
                            Eric Matheson, PT

                            Comment


                            • #29
                              Dave

                              How can it be a cookbook recipe when the PT does 'nothing' except follow?
                              Trying to make connections between SC and TPT, reducing subluxations, reflexology, and other dubious mapped-out methods is not the way to go. Seriously. There are no maps for SC, only territory.

                              Please read the relevant material which has been listed to death. You sound interested, and a knowledge of modern neurophysiology is a must. Otherwise it's floundering in the whirlpool, looking for maps....doesn't work too well.


                              Nari

                              Comment


                              • #30
                                Hi All,

                                It is well known that we are now very small minded and perhaps fully simple minds, why not?

                                No really matters for me. I do not care about statements that hadn't been proven.

                                So Dave, I'm doing already "phsychology" and hypnotherapy with you! Danger!!! Every word I write, touches your brain and you can't escape and you're changed for the rest of your life.

                                That's the magic of Neurosciences.
                                Simplicity is the ultimate sophistication. L VINCI
                                We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

                                Everything should be made as simple as possible, but not a bit simpler.
                                If you can't explain it simply, you don't understand it well enough. Albert Einstein
                                bernard

                                Comment

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