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  • #31
    Originally posted by Barrett Dorko View Post
    proud,

    He's called it "ultra-bullshit" in the past, and I remember thinking "he won't get away with that." I didn't swear during lecture time but I did say "hell" several times. I heard about that.

    When I wasn't lecturing, I chose my words from my own emotion, I guess.

    In my experience, Butler has done a remarkable thing. He was a great running back, but he didn't run around a much larger defensive lineman in some cases - if you get my reference.

    Of course, I actually wrote him in 1990 and he allowed me to attend his course in Chicago for free a few years later.
    If I get the reference...how about posting on say.....a site like EIM and asking them about their alliance with Kintecore....

    That's what I am talking about.

    Comment


    • #32
      proud,
      I'm telling you that Butler has become a theoretician on learning theory, and that's where I think he's run aground as far as advancing clinical practice in PT. This doesn't diminish his contributions in advancing the concept of the abnormal neurodynamic. These are very important.

      I'm disappointed, but not all that surprised, that he's joined the crowd in taking what I suppose those in academic circles would consider the more "respectable" and "polite" approach to changing the way PTs approach the patient with a primary complaint of pain. This desire to win the "Miss Congeniality" prize among PT academics makes me vomit a little in my mouth when I witness it. I still feel some faint nausea when I think back on the time I spent there. There's a profound lack of intellectual courage in PT academia, with a precious few exceptions.

      I find Adam Meakins refreshing in a "guys bullshitting in the locker room" sort of way. But, it may be that he's over-compensating just a bit, at times. He's, in a sense, the anti-Butler.
      John Ware, PT
      Fellow of the American Academy of Orthopedic Manual Physical Therapists
      "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
      “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
      be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

      Comment


      • #33
        And, Barrett, Aussie PTs over the age of 50 who wear green pants are allowed to utter "bullshit" in public approximately six times per year, but only one of those can be at an international conferance.

        Jules Rothstein didn't need to use profanity. He was that good.

        You're welcome, Johnny.
        John Ware, PT
        Fellow of the American Academy of Orthopedic Manual Physical Therapists
        "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
        “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
        be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

        Comment


        • #34
          proud,

          All that can be said, by me anyway, I've said. I've asked and even acted nice. Against my better self (whatever that once was), I've been utterly defeated. Finding people who were unused to thinking, reasoning, reading and arguing has been fairly easy, no matter how well educated.

          Firms like the one mentioned invented a condition and came up with a way of treating it.

          It's over, as far as I'm concerned.
          Barrett L. Dorko

          Comment


          • #35
            Well perhaps I'm delusional but I believe if we had a few more "curmudgeons" rather than the typical kumbaya approach...we may see some changes.

            I recently engaged Adriane Louw over at EIM and was somewhat astounded (in a negative way) by what he had to say. Despite my desire to just tell him I thought he was way off (he was at least from my vantage point)...I was intimidated by his academic profile and chose to dis-engage at his apparent behest (he apparently is too busy with research to engage in blogs and "would not be returning"...)

            That's a problem going forward I'd say.
            Last edited by proud; 20-03-2017, 01:35 AM.

            Comment


            • #36
              The longer I practice I have come to observe that there are those interested in health business and those interested in health care. Those running health businesses would like to have a bunch of robots that don't think or question, and stick to the unit generating treatments of the day. Numbers up, processes "work" = success to some. Those in health care, often think, read, reflect to improve their patients' care. This often flies in the face of health business so the road gets tougher and tougher. Most get beat into submission and give up questioning and conform and our patients get worse. I think this "business" flows over into academia as well and contributes to some of this.

              Comment


              • #37
                Proud,

                I read Adriaan's responses.

                I don't really know what to say, other than that I am disappointed.

                Comment


                • #38
                  Originally posted by Mikal Solstad View Post
                  Proud,

                  I read Adriaan's responses.

                  I don't really know what to say, other than that I am disappointed.
                  Yes, I was really quite flabbergasted by some of his responses. It almost seemed like he lacked any insight whatsoever.

                  Like his comment about a work-out that "hurts so good"...as if that somehow is comparable to a persistent pain scenario.

                  Honestly, I expected more from someone of such esteem.

                  Edit: Having stated the above, I am aware that social media is not everyone's "gig" and I think Adriaan is on the older side so perhaps his comfort level with that sort of engagement rendered his points less effective than had we been sitting side by side. I just have to imagine his knowledge base is far better than what was conveyed over at EIM.
                  Last edited by proud; 20-03-2017, 08:18 PM.

                  Comment


                  • #39
                    Boy, that response from Adriaan at the EIM blog was downright petulant. Very disappointing to see him resort to that kind of condescension. I hope all the appearances at international conferences and cocktail parties with the intelligentsia aren't going to his head.
                    John Ware, PT
                    Fellow of the American Academy of Orthopedic Manual Physical Therapists
                    "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
                    “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
                    be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

                    Comment


                    • #40
                      As the other poster on that thread questioning and being critical of dry needling I was almost offended by the way Adriaan played the "ivory tower" card. Good to know what he thinks of clinicians.
                      I may not be as smart as most people, but I'm sure as hell not as dumb....
                      "The views expressed here are my own and do not reflect the views of my employer."

                      Comment


                      • #41
                        proud, Adriaan is younger than I am. And thus younger than Barrett (rim shot).
                        I thoroughly enjoyed talking with Adriaan about NTE and the research on that - gained some very valuable information.

                        I did not like the inclusion of the suggestion "do whatever works" - which seems to be the basis for his rather lazy response to you in that comment thread. Very disappointed as well.
                        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


                        • #42
                          When I first saw Adriaan's picture I was guessing he wouldn't please everybody. Of course, I've been wrong before. As long as I predict things, this will occasionally happen.

                          I think that doing whatever works is remarkably powerful. It doesn't make any sense, but that makes it no less powerful.

                          To use a sports analogy, just because a player (that values a certain size) doesn't play well, that makes them no less the weight or height they were born to have. This is where conditioning and training have a role. The combination of nature and nurture reveals itself in sport. Adriaan Lowe probably shouldn't have revealed himself so clearly.

                          Never have made such a mistake, I really can't relate.
                          Last edited by Barrett Dorko; 21-03-2017, 07:01 PM.
                          Barrett L. Dorko

                          Comment


                          • #43
                            A similar kind of thing happened at a CSM conference a few years back in Chicago. Kathleen Sluka, a renowned pain researcher here in the US, did a presentation that included video of a clinical interaction with a patient who had persistent low back pain. The only thing I can remember from that presentation was her instructions to the patient. She asked this poor woman, who was obviously in some discomfort and anxious, to "bend over as far you can" and after she did, she then asked her if she could bend over any farther. This is when Cory Blickenstaff and I looked at each other in dismay. How could a therapist who is so knowledgeable about pain ask someone who is obviously in pain to perform a movement that is sure to increase their pain? Where is the disconnect?

                            To be clear, I don't think Adriaan would have given the same verbal commands to this patient as part of his clinical reasoning process. But his willingness to do "whatever works", even if it increases pain- or a produces the proverbial "good hurt"- is hardly distinguishable from what Dr. Sluka did. Is it not?

                            Whatever it is, it's not therapy.
                            John Ware, PT
                            Fellow of the American Academy of Orthopedic Manual Physical Therapists
                            "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
                            “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
                            be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

                            Comment


                            • #44
                              If you give researchers a task to "prove" with a financial incentive to "prove" it, you end up with biased researchers. Another pitfall, in my opinion, is trying to prove an intervention's efficacy AFTER claiming it's effectiveness. This leads researchers on a hunt for why it "works" and inevitably you end up back at the non-specific neurophysiologic processes that occur with all interventions. Then they move the goalposts and claim said intervention "works" like all others, it's safe (nobody died yet), so just pay us to teach you and start using it!

                              I wish they started by proving trigger points exist, cause pain, consistently show up in response to specific environments, needles consistently and exclusively modify the environment proven to cause trigger points, etc etc....

                              The primary questions should be: Is this a necessary intervention? Do other less invasive similar interventions exist? Does this promote dependency or self-efficacy?

                              If you answer those questions honestly, you can't subscribe to the TDN intervention.

                              Patient expectations shouldn't be the get out of jail card either. This frustrates me. If a patient demands DN, I would expect any PT to be able to explain the literature shows ischemic compression is equally as effective and safer. Or when a pt want their neck cracked, we should be able to explain gentle mobilizations are equally as effective and don't carry risks like stroke and death.

                              If I remember correctly, I believe a review of manual therapy interventions for LBP tried to quantify the gain attributable to the specific effects of the intervention, and came up with 3%. So lets quit spending time and money on the 3% and start actually helping people.

                              Comment


                              • #45
                                the literature shows ischemic compression is equally as effective
                                Isn't that weird, because the pro MTP people hypothesize that TP's are caused by hypoxia/ischaemia.

                                Another primary question could be: is it a low value service type of intervention (if yes, don't bother)
                                Marcel

                                "Evolution is a tinkerer not an engineer" F.Jacob
                                "Without imperfection neither you nor I would exist" Stephen Hawking

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