Thursday Thoughts: Neuro Patients, Ortho Patients or Just Patients? | Modern Manual Therapy Blog

Thursday Thoughts: Neuro Patients, Ortho Patients or Just Patients?

Based on my pal Dr. Charlie Weingroff's Training=Rehab title, one of the catch phrases of The Eclectic Approach is Ortho=Neuro.

Once you delve into Pain Science, and realize the CNS rules the roost, any treatment you can think of can be rationalized in a scientific manner. So we realize that all manual therapies, exercises, repeated loading strategies are all inputs designed to change an output.

I think more and more clinicians are coming around to this hopefully, but I know it is far from the majority. Let's take this one step further and also view patients not as ortho or neuro patients, but just patients.

There are orthopaedic conditions so to speak, or at least conditions you would see in your typical outpatient ortho clinic, like shoulder pain, back pain, etc (no diagnoses here!). Also, there are conditions you would see that you classify as neurological, like CVA, SCI, CP, etc... however, they all have neuromusculoskeletal dysfunction of some kind.

I love it when a Peds or Neuro specialist wanders into my course, and ends up realizing, these techniques will work on my caseload! That's the "A-Ha" moment I am striving for. It may be harder to change the output of certain neurological conditions but the nervous system is very plastic. With the right inputs, who knows what can happen? So yes, IASTM can be used on CP patients, PNF can and should be used on all caseloads. Who couldn't use a little facilitation enhanced by touch?

Those of us in outpatient ortho could learn a lot from our neuro/peds colleagues and vice versa.

Keeping it Eclectic...


  1. Mohammed KaderbhaiOctober 13, 2014 at 3:57 AM

    Hey just wanted to say I enjoyed reading this post, Its something i have been thinking about for at least the last 6-7 years, My CV has read for sometime 'Neuromusculoskeletal Rehabilitation Physiotherapist' and I remember attending an interview and being asked why I called myself that, remembering your answers. I actually think most orthopaedic / MSK practitioners would gain quite a lot from attending neuro courses (e.g Bobath Normal Movement) and think of the body as a whole....

  2. Thanks! It's learned as separate topics in school, and then reinforced by continuing education courses. I know we need sub specialities to promote better care, but education and treatment techniques should not be considered specialty specific.

  3. HI Erson,
    Weather its Neuro or Ortho ,IASTM can be applied in all caseload.My student recently is using IASTM on Stroke patient and found good results.
    Thanks for introducing the technique