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  • Originally posted by Barrett Dorko View Post
    Of course I know the theory. Wouldn't it be nice to see some evidence that it's close to reality? This is nothing more than a regurgitation of a decades-old idea, an idea that hasn't panned out.

    Am I off base here?
    Well, in all due respect, the evidence presented in motor learning theories greatly surpasses the depth and breadth of evidence that you bring for SC. Also, the aforementioned "theory" is of known neurophysiological processes. It also provides a tenable concept of how "insidious" mechanical deformation occurs with potential concomittant chemical irritation. Am I off base here? What exactly is your argument? That mechanical deformation cannot cause pain?

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    • Originally posted by kongen View Post
      How would one go about to seperate this "defensive" neuromuscular imbalance from the original "defect" one? What about maladaptive pain behaviour on top aswell?

      Anders.
      That's the million dollar question. When you have a nerve that isn't functioning properly without obvious signs of classical pathology (i.e. NCV tests, neurodynamics etc) and there's a lack of proper sensorimotor integration it's clear that the information being provided to and/or from the brain to the rest of the CNS/PNS/ANS isn't reliable.

      I would assume that the defense and defect can be occuring simultaneously and be indistinguishable. Hard to say clinically. What do you do figure this out?

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      • Originally posted by Luke Rickards View Post
        Hi there,

        I have a few questions.

        What is the difference between this process of motor learning etc etc, as it relates to exercise (ie repetitive movements) and thus improved function with supposedly less pain, compared with the idea that the same process leads to NM imbalance and thus pain?

        I'm not sure I can see how the "consequently" fits here - the former statement doesn't seem to lead at all naturally to the later (unless, perhaps, the tissues have hypertrophied considerably - possible, but an unlikely contributor for most patients)
        Why would that have to be hypertrophied? You're simply changing length-tension relationships of the muscles which impacts and the surrouding neurovascular bundles. A shortened, tonic muscle with increased gamma bias is more likely to "squish"/compress/narrow the tunnels that the nerves travel in and affect motor units, etc.

        I'm not sure I understand the position ascribed to nociception on this continuum. "Excessive facilitation patterns of certain groups and inhibition of others", "plastic changes at the sensorimotor cortex", "the brain trying to maintain a degree of allostasis/homeostatis" and "develop[ment of] compensation and substitution strategies" may in fact occur as a result of nociception, instead of the other way round.
        Classic case of chicken or the egg. My personal opinion is that in absence of blunt trauma, functional losses precedes pain states.

        Re: It now seems evident that something else is going on besides 'proper motor control'.[/QUOTE]

        One study would hardly prove conclusive. I would also say that the best motor learning strategies were also likely not found to be used thus negating the validity, at least to a degree, the conclusions of this study.

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        • Hi dswayze,

          My personal opinion is that in absence of blunt trauma, functional losses precedes pain states.
          Can you provide an example of this for us?
          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

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          • the evidence presented in motor learning theories greatly surpasses the depth and breadth of evidence that you bring for SC.
            I think you may have a narrow view of what motor control is. It takes into account goals, end state comfort, context, etc and I think SC can fit nicely into the explanation. My issue with motor control is therapists who like the control part.
            Christopher Bryhan MPT

            "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
            Daniel Kahneman - Thinking Fast and Slow

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            • Originally posted by christophb View Post
              I think you may have a narrow view of what motor control is. It takes into account goals, end state comfort, context, etc and I think SC can fit nicely into the explanation. My issue with motor control is therapists who like the control part.
              I realized that I may have touched on a sacred cow there so I'll leave it at that. At the very least it seems like SC therapists are trying to facilitate the "inhibited" nonconcious movements which I would say is more in the realm of OT or psychology.

              I'd say with 4 university courses in motor learning/lifespan development, 6 courses in exercise physiology, fitness testing and training, external (envrionmental) influences on exercise physiology and 5 years of clinical experience that I know my motor control and exercise physiology theory vey well.

              Jon

              It's difficult to provide evidence of my opinion on the matter, but what about EMG testing of supraspinatus, for example, that shows inhibition (greater than 10% which would typically account for dominance) and is substantially weaker than the opposite side? Loss of function occurs, could result in a strain, subsitution strategies requiring increased deltoid/trapezius action, loss of vector forces stabilization the humerus in the glenoid, etc... (end result is mechanical deformation or a decrease in tissue tolerance which would "break" under seemingly unchanged loads (work, exercise, blag blah)

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              • Hello dswayze,

                Your credentials are wonderful but it would be more useful for readers here if you apply them. Knock over any sacred cows (as you see them) you can; don't back off now. It's sort of the credo here.

                Can you expand on the inhibition aspect of your example?
                "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                Comment


                • Last I heard, there is no gamma bias in human beings. Among many other things, I find your actual knowledge of the deep model rather mystifying.

                  Now you're trying to compare your work, whatever it may be, to Simple Contact - something you obviously don't understand to speak of.
                  Barrett L. Dorko

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                  • At the very least it seems like SC therapists are trying to facilitate the "inhibited" nonconcious movements which I would say is more in the realm of OT or psychology
                    Do you think "unconscious" and "nonconscious" are the same thing?
                    Diane
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                    "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

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                    • Hi,
                      You're simply changing length-tension relationships of the muscles which impacts and the surrouding neurovascular bundles.
                      Doesn't that happen every time you contract a muscle under load?

                      Again- What is the difference between this process of motor learning etc etc, leading to NM imbalance and thus pain, compared with exercise (ie repetitive movements) and thus improved function with supposedly less pain?

                      functional losses precedes pain states.
                      Really? The reason my patients stop bending over is because it hurts. Are you talking about function here, or impairments (which are often of indeterminate clinical significance)?
                      Luke Rickards
                      Osteopath

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                      • It wasn't my intention to imply you do or do not know about motor control, rather it needs to be taken into a broader context... pain and the science of.
                        Christopher Bryhan MPT

                        "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
                        Daniel Kahneman - Thinking Fast and Slow

                        Comment


                        • If control and muscular balance, or lack thereof, caused pain wouldn't ballet dancers be free from mechanical pain?

                          These people need an enormous movement reportoire and have an obvious abundance of control to perform their art. I've been told that this is a population that experiences a high degree of mechanical pain, however, sometimes even having their own PTs on staff.
                          Cory Blickenstaff, PT, OCS

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                          • Originally posted by Luke Rickards View Post
                            Hi,
                            Doesn't that happen every time you contract a muscle under load?
                            Yes. But it usually doesn't stay at that length and returns to its pre-contracted state. In deafferented states or overfacilitation the gamma bias of the spindle is set so that the tension remains constant and the mechanoreceptors and such are "reset" to a new normal resting length. This in turn leads to the aforementoned hypoxic states to important neurovascular bundles which starts to irritate the tissues as cell transport functions become comprimised as well leading to a cascade of changes cellularly leading to eventual inflammation and or lysis. Mechanical and chemical irritation ensues. Whether or not this manifests itself perceptually as pain or clinically significant depends on a lot of factors naturally, not the least being the general health of the person.


                            Again- What is the difference between this process of motor learning etc etc, leading to NM imbalance and thus pain, compared with exercise (ie repetitive movements) and thus improved function with supposedly less pain?

                            Really? The reason my patients stop bending over is because it hurts. Are you talking about function here, or impairments (which are often of indeterminate clinical significance)?
                            I'm a little confused by the nature of the question. Neuromuscular imbalances can be caused by and CORRECTED by therapeutic exercises/movement patterns depending on a good clinical assessment and objective data tracking (videography, EMG, VO2max levels, RQ values, etc). And, it makes sense that the correct PRESCRIPTION of exercise could help alleviate mechanical pain on a lot of levels, one of them being increasing overall tissue tolerance. Did that answer your question?

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                            • Originally posted by BB View Post
                              If control and muscular balance, or lack thereof, caused pain wouldn't ballet dancers be free from mechanical pain?

                              These people need an enormous movement reportoire and have an obvious abundance of control to perform their art. I've been told that this is a population that experiences a high degree of mechanical pain, however, sometimes even having their own PTs on staff.
                              Because in this case, the amount of training, performance exceeds amount of rest and recovery. Again, coming down to tissue mechanics, when tissue load exceeds tissue tolerance will result in tissue failure -->mechanical deformation, chemical irritation etc.

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                              • but what about EMG testing of supraspinatus, for example, that shows inhibition (greater than 10% which would typically account for dominance) and is substantially weaker than the opposite side?
                                That is all the problem with strengthening: inhibition doesn't equate with weakness. An inhibited muscle is not weak. Strengthening will create a typical and greater imbalance, IMHO.
                                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

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