Many of my frequent readers know I am heavily into Pain Science Education. I often describe to patients that their movement/pain are related and when their nervous system is under threat, it "locks down" an area.
Once this alarm in the CNS is reset, pain and movement thresholds improve, thus function and motion rapidly change. This is another way of looking at rapid changes in motion.
- rapid motion gain is a change in movement threshold, not due to fascial/capsule deformation or "lengthening" of muscles
- there are cases of true derangement reduction that get rapid changes
- think anything with a meniscus (knee, TMJ, UMT in the wrist)
- the patient had the movement all along, but either
- did not know how to access it - motor control
- was not allowed to use it by the CNS due to protection and low pain thresholds
The key(s) to the lockdown
- positive interaction, assurance that most conditions have rapid results, and chronic conditions can also get results, albeit slow but sure
- education on what pain is and is not
- various resets (repeated loading, light IASTM, mob/manip, etc)
- motor control strategies/corrective exercises that are pain free
- a HEP that continues the reset and closely resembles it
- education that the patient is able to and must self treat to remain better
The keys must be applied often enough to reset the CNS alarm repeatedly so pain and movement thresholds remain elevated. In rapid responders, being symptom free and for 48-72 hours clears someone for a recovery of function repeated motion exam. I will discuss this next week, as it's often a topic of Q&A.
Keeping it Eclectic...