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  • Originally posted by Jason Silvernail View Post
    dswayze-

    Not exactly impossible, but you've got to push pretty hard, if you read Threlkeld's 1992 paper you'll see that:
    Manual Therapy and Connective Tissue - Threlkeld

    Unless of course you are placing between 24 and 115kg of force (at bare minimum) on the patient - in which case of course it's possible. But how hard are we pushing with our little ASTYM tools today?
    One word for that kind of "therapy" - ouch.
    Hi Jason,

    I'm aware of the Threlkeld paper, however, it's getting dated (16 years) and I'm not aware that any significant amount of evidence that would make this definitive in one way or another.

    Do you k(not) (hehehe) see any inherent value in tissue remodelling as a desired therapeutic effect to increase clinical outcomes?

    DS

    Comment


    • Hi ds,

      These sorts of questions and comments (a sampling from thread so far) are fine to ask but consider starting a new thread (or chime in on the link BB provided in post #30) simply because the list (10 steps to understanding pain) posted in this thread has little to no relevance to your points in my opinion.


      Do you k(not) (hehehe) see any inherent value in tissue remodelling as a desired therapeutic effect to increase clinical outcomes?

      Even a better question still, is why wait until "pain" arises when you can prevent, correct and maintain better function?

      I guess you're not into prevention and SCREENING for NMS disorders.

      Just so I'm clear here does the panel:

      1) reject the theory behind of IASTM and its intended outcomes?

      2) See's no theoretical/practical value in addressing fibrotic tissue in movement dysfunctions and pain syndromes?
      Last edited by Jon Newman; 22-01-2008, 05:16 AM.
      "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

      Comment


      • Originally posted by Jon Newman View Post
        Hi ds,

        These sorts of questions and comments (a sampling from thread so far) are fine to ask but consider starting a new thread (or chime in on the link BB provided in post #30) simply because the list (10 steps to understanding pain) posted in this thread has little to no relevance to your points in my opinion.
        Ouch.

        Comment


        • DS-
          Jon's right - we are talking about a topic separate from the consensus. There's an ART thread here. I'd be happy to move some of our posts about connective tissue and manual therapy and continue our discussion if you'd like. Please post there if you'd like to keep going. I certainly have more to say - starting with the fact that the age of a paper in basic science says little about the strength of it's conclusions. Especially since I'm not aware of the work being updated - but I'd love to be proven wrong.
          Jason Silvernail DPT, DSc, FAAOMPT
          Board-Certified in Orthopedic Physical Therapy
          Fellowship-Trained in Orthopedic Manual Therapy

          Certified Strength and Conditioning Specialist


          The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

          Comment


          • I can cut off the thread at some take off point and paste the cut part into a separate thread. Let me know if you'd like me to do that..
            Diane
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            • Originally posted by Jason Silvernail View Post
              DS-
              Jon's right - we are talking about a topic separate from the consensus. There's an ART thread here. I'd be happy to move some of our posts about connective tissue and manual therapy and continue our discussion if you'd like. Please post there if you'd like to keep going. I certainly have more to say - starting with the fact that the age of a paper in basic science says little about the strength of it's conclusions. Especially since I'm not aware of the work being updated - but I'd love to be proven wrong.
              Sounds good. I also realize that old papers can see be good; Watson and Crick comes to mind. But unless you somehow suggest that the paper you presented is in that league, then I doubt very much that those conclusions are irrefutable.

              Comment


              • I can cut off the thread
                Moved to the ART thread.
                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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                • These posts that have been moved on to here have nothing to do with ART. There is talk of remodelling connective tissue and breaking connective tissue which is not what ART is adressing.

                  It has been shown several times and I think I have posted links to the articles on PubMed - that with repetitive strain you will see adhesions in the tissue - which is nothing like severe scarring - but IMO they could cause restriction of motion and contribute to some sort of entrapment of neural tissue in the muscle or atleast increased mechanical stress on this tissue.

                  Again - that pain will probably in some individuals lead to a chronic pain problem. And I suspect chronic pain will contribute to a decline in the intramuscular environment as well - causing more of those adhesions.
                  Ole Reidar Johansen, Musculoskeletal Physiotherapist
                  "And if you gaze for long into an abyss, the abyss gazes also into you." - Nietzsche

                  Comment


                  • Hi Ole,

                    DSwayze made this comment:

                    Kim, if you've ever done active soft tissue manual therapy techniques, such as ART, the practitioner and the patient feels and knows when they are breaking up fibrous adhesions.
                    which is I believe why the posts landed on this thread.

                    Do you feel there is a similarity between the instrument assisted STM interventions and ART or 2 separate mechanisms at work?
                    Cory Blickenstaff, PT, OCS

                    Pain Science and Sensibility Podcast
                    Leaps and Bounds Blog
                    My youtube channel

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                    • Originally posted by BB View Post
                      Do you feel there is a similarity between the instrument assisted STM interventions and ART or 2 separate mechanisms at work?
                      Instrument assisted STM usually try to really break tissue, create bleeding and inflammation. With ART you don't want that.

                      Naturally there is a lot of other stuff going on: there's the skin stretch (I've come to agree with Diane - but I think it's OK to inflict some discomfort / pain in patients because it's in a different context and non threatening to the patient). There's the movement the patient does - there is usually a great deal of learning in that. There's a lot of nerve gliding - there are separate protocols for treating nerves which are similar yet different.

                      Ole Reidar Johansen, Musculoskeletal Physiotherapist
                      "And if you gaze for long into an abyss, the abyss gazes also into you." - Nietzsche

                      Comment


                      • May 10th I am going to Stomennano,italy to see what ART is all about )http://www.activerelease.com/seminar...tSeminarId=198. To me ART looks like a great form of manual care, though the quality of the course will depend a great deal on the theoretical framework being presented. I m guessing it will be slightly too mesodermal for the average somasimpler, though absolutely edible.


                        I love Dianes theoretical framework, though my soul is just too restless for those prolonged lateral stretches.

                        Comment


                        • Birger told me I'll only be there on the 18th for the neural entrapments. As for theoretical framework - not much it's 90% practical - which should put you back in touch with some forgotten anatomy.

                          Originally posted by Kriskul View Post
                          I love Dianes theoretical framework, though my soul is just too restless for those prolonged lateral stretches.
                          I'm also a bit too restless for prolonged stretches - however I suspect that doing some repetitions of shorter durations will be equally - perhaps even more effective. Why? Most of our senses are phasic and they'll adapt to what ever you throw at it. Taking a short break and coming back in will "force" the brain to sit up and pay attention.
                          Ole Reidar Johansen, Musculoskeletal Physiotherapist
                          "And if you gaze for long into an abyss, the abyss gazes also into you." - Nietzsche

                          Comment


                          • Most of our senses are phasic and they'll adapt to what ever you throw at it.
                            This is why skin stretch must not be viewed or practiced as a static stretch. Constant movement, variation in pressure is crucial. This is also of the tougher technical aspects to "get." If you were to have me do DNM on you and then Diane that would likely be a notable difference. Her constant movement is very perceptible if minute.
                            Cory Blickenstaff, PT, OCS

                            Pain Science and Sensibility Podcast
                            Leaps and Bounds Blog
                            My youtube channel

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                            • Her constant movement is very perceptible if minute.
                              Yes. It wouldn't be a very interesting kinesthetic conversation if it consisted of the same word over and over.
                              Luke Rickards
                              Osteopath

                              Comment


                              • Ok - I didn't gather that from the manual she wrote. Good stuff.
                                Ole Reidar Johansen, Musculoskeletal Physiotherapist
                                "And if you gaze for long into an abyss, the abyss gazes also into you." - Nietzsche

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