Announcement

Collapse
No announcement yet.

New Here... aren't most people who post in this section? :)

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • #61
    Originally posted by caro View Post
    Hi Curious and welcome.

    I too am a massage therapist. Karen lines (another MT) gave some good advice in post #13. Take your time, give yourself time.

    It'll kind of go like this :

    :angry:, :cry:, :sad:, , , , and finally

    :teeth:

    Happy reading.
    How long until you get to the third face? It's been 6 or 7 years for me.

    Comment


    • #62
      If they only want chiropractic, then that is what they will get. If they choose both chiropractic and bodywork, then I'll incorporate those as needed for their particular situation. But, if someone only wants soft tissue work, then soft tissue work is what they will get.
      So the patient dictates what their treatment will be? I would be concerned that this approach might hamper clinical reasoning.

      In any case, it sounds like you "work on" people. I've moved away from the "operator model"- as it is often referred to on this board-mostly because much of the research on chronic pain recovery identifies restoration of an internal locus as a key to long-term improvement in pain and disability. No manual, exercise or CAM approach that I'm aware of has been shown to have a significant long-term effect on outcomes for patients with persistent pain problems. If anything, the problem is getting worse.

      As I heard Barrett Dorko say recently, "They're not calling it a neurobiological revolution for nothing," or something like that.

      In the short term, no doubt, many manual techniques that meet the expectation of the patient will provide results, but I worry that relying on this approach to care turns patients into long-term patients, not people with long-term relief from their pain.

      This approach has its benefits, not the least of which is a steady stream of reliable return patients. It also makes us feel good about ourselves for "helping people".

      See here for more on the operator versus interactor model of care.
      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


      • #63
        Originally posted by Randy Dixon View Post
        How long until you get to the third face? It's been 6 or 7 years for me.
        Depends on how dedicated you are to figuring it out. If you just read little chunks here and do not dig into the bulk of the literature referenced...I suspect you will not move forward very fast.

        FYI...I figure I'm at . Still trying to figure out how I apply what I know to be true, in a healthcare environment that is utterly broken where volume of patients seen is championed and truthful approaches viewed with disdain and often....anger.

        Ahhh death. I'm certainly not :teeth: with it yet....

        Comment


        • #64
          Yes John, I was wondering about allowing the patient so much input into method. Heck, I can manipulate anything, and at one time I taught others. I will; never do that to another again.

          I think the idea of a toolbox has been addressed here.
          Barrett L. Dorko

          Comment


          • #65
            Originally posted by John W View Post
            In the short term, no doubt, many manual techniques that meet the expectation of the patient will provide results, but I worry that relying on this approach to care turns patients into long-term patients, not people with long-term relief from their pain.

            This approach has its benefits, not the least of which is a steady stream of reliable return patients. It also makes us feel good about ourselves for "helping people".
            Ah John..always putting words to my thoughts with such clarity. I actually attempted to relay this message to a therapist the other day.

            It didn't go well.

            Comment


            • #66
              Originally posted by John W View Post
              So the patient dictates what their treatment will be? I would be concerned that this approach might hamper clinical reasoning.

              In any case, it sounds like you "work on" people. I've moved away from the "operator model"- as it is often referred to on this board-mostly because much of the research on chronic pain recovery identifies restoration of an internal locus as a key to long-term improvement in pain and disability. No manual, exercise or CAM approach that I'm aware of has been shown to have a significant long-term effect on outcomes for patients with persistent pain problems. If anything, the problem is getting worse.

              As I heard Barrett Dorko say recently, "They're not calling it a neurobiological revolution for nothing," or something like that.

              In the short term, no doubt, many manual techniques that meet the expectation of the patient will provide results, but I worry that relying on this approach to care turns patients into long-term patients, not people with long-term relief from their pain.

              This approach has its benefits, not the least of which is a steady stream of reliable return patients. It also makes us feel good about ourselves for "helping people".

              See here for more on the operator versus interactor model of care.
              I guess you could say the patient dictates in the quest for a specific type of care, because I do want them to be active in their care, and that is why I am open to the patient letting me know the care they are interested in, but, it does not mean that I won't give my opinion as to the best way to treat (in my experience). And, most patients are open to my recommendations. However, I am not going to refuse care (unless there is a specific contraindication) if I think I can create another plan of action that will still generate positive results.

              Some of these suggestions regarding active care may come from me, some may come from other practitioners I refer the patient to (as noted previously regarding Applied Functional Science and Feldenkrais practitioners I refer to).

              I also believe if a patient is better and they no longer have pain issues, then I have done well. It happens frequently. Then, new people invariably take their place at some point or other.

              My practice is not all chronic pain issues. Some have pain due to specific issues that get resolved.

              And on the occasion when I have someone who is not interested in taking their health into their own hands, I will provide palliative care as requested. Generally those tend to be bodywork clients who have personal stress issues.

              BTW, thanks for the link.
              Last edited by Curious One; 29-08-2012, 02:42 AM. Reason: - to add a thought.
              C.O. ( gender: ) - LMT, BS(Anatomy), DC
              Music Fog... pick a song to listen to... you can't go wrong.
              Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.

              Comment


              • #67
                Originally posted by Curious One View Post
                And on the occasion when I have someone who is not interested in taking their health into their own hands, I will provide palliative care as requested. Generally those tend to be bodywork clients who have personal stress issues.
                I suppose this pertains to the chiropractor definition of palliative care, because I seriously doubt you'd be qualified ( as a non-medical human primate social groomer) to provide medical palliative care.
                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


                • #68
                  Originally posted by Diane View Post
                  I suppose this pertains to the chiropractor definition of palliative care, because I seriously doubt you'd be qualified ( as a non-medical human primate social groomer) to provide medical palliative care.
                  You would seriously be correct. I am in no way qualified to provide medical palliative care.

                  Such a poor choice of wording on my part.

                  I should have said... In those instances I will provide care which consists of working to relieve pain or tension, in order to make the patient/client comfortable and improve their quality of life.
                  Last edited by Curious One; 29-08-2012, 02:52 AM. Reason: - typo
                  C.O. ( gender: ) - LMT, BS(Anatomy), DC
                  Music Fog... pick a song to listen to... you can't go wrong.
                  Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.

                  Comment


                  • #69
                    If I can offer a recommendation at this point. CO has introduced himself...at this point I don't believe it too bold an assumption to assume he is a he.

                    It looks as though CO has enough posts to get into the Sounds of Silence. If he were to trick around there and read some old posts/threads, I believe there would be a better chance of this not being the last thread on which he participates here.
                    Rod Henderson, PT, ScD, OCS
                    It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

                    Comment


                    • #70
                      Originally posted by Curious One View Post
                      You would seriously be correct. I am in no way qualified to provide medical palliative care.

                      Such a poor choice of wording on my part.

                      I should have said... In those instances I will provide care which consists of working to relieve pain or tension, in order to make the patient/client comfortable and improve their quality of life.
                      No prob. It does reveal a tendency I've noted before, though, that chiropractic likes to impersonate the medical profession a lot, including using all the same words but bestowed with untraceable, chiro-only meanings.
                      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


                      • #71
                        Hi john,

                        . No manual, exercise or CAM approach that I'm aware of has been shown to have a significant long-term effect on outcomes for patients with persistent pain problems. If anything, the problem is getting worse.
                        Do you have any research showing a robust, long term positive effect for ANY intervention for persistent pain problems? We are far from establishing long term and powerful improvements with the treatments within the neuroscience revolution framework.

                        Greg
                        Greg Lehman BKin, MSc, DC, MScPT
                        No letters allowed learned on weekends.
                        Physiotherapist
                        Chiropractor

                        Comment


                        • #72
                          Originally posted by Diane View Post
                          No prob. It does reveal a tendency I've noted before, though, that chiropractic likes to impersonate the medical profession a lot, including using all the same words but bestowed with untraceable, chiro-only meanings.
                          Actually, it was a personal perception, that was poorly misplaced. I am not sure I have ever heard any chiro-specific wording to that effect.


                          I use palliative to mean:

                          pal·li·ate
                             /ˈpæliˌeɪt/ Show Spelled[pal-ee-eyt] Show IPA
                          verb (used with object), pal·li·at·ed, pal·li·at·ing. 1. to relieve or lessen without curing; mitigate; alleviate.
                          C.O. ( gender: ) - LMT, BS(Anatomy), DC
                          Music Fog... pick a song to listen to... you can't go wrong.
                          Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.

                          Comment


                          • #73
                            Originally posted by Greg Lehman View Post
                            Hi john,



                            Do you have any research showing a robust, long term positive effect for ANY intervention for persistent pain problems? We are far from establishing long term and powerful improvements with the treatments within the neuroscience revolution framework.

                            Greg
                            Work by Moseley has shown the best long term outcomes are associated with pain education. The difference between pain ed and other kinds of interventions don't show up at first. At first all seem about as effective or ineffective. The trend lines really start to move apart at about 6 months down the road. This is old stuff, about 8 - 10 years ago.
                            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


                            • #74
                              Originally posted by TexasOrtho View Post
                              If I can offer a recommendation at this point. CO has introduced himself...at this point I don't believe it too bold an assumption to assume he is a he.

                              It looks as though CO has enough posts to get into the Sounds of Silence. If he were to trick around there and read some old posts/threads, I believe there would be a better chance of this not being the last thread on which he participates here.
                              My mistake for not pointing it out, although it was mentioned in this thread previously. I am a female.

                              And, yes, I do agree that it is getting close to the last thread I participate on at the rate this is going. I am wondering why people are even invited to join, at this rate.

                              The forum might be better off in stating... please... leave, in their welcoming pages.
                              C.O. ( gender: ) - LMT, BS(Anatomy), DC
                              Music Fog... pick a song to listen to... you can't go wrong.
                              Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.

                              Comment


                              • #75
                                People just turn up here, most of the time.
                                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

                                Working...
                                X