Thursday Thoughts: Why Do You Think Your Ortho Patients are Immune to Neuro Rules? | Modern Manual Therapy Blog

Thursday Thoughts: Why Do You Think Your Ortho Patients are Immune to Neuro Rules?


One of the biggest disservices done in today's PT curriculum is that ortho and neuro are taught as completely separate courses with little to no integration.
I know why it is done that way, normally it is two completely different instructors/professors, perhaps with some active clinical work, perhaps not. The courses are usually not the same semester or even year. It took me over a decade to start using the "Neuro Rules" on my "Ortho" patients.
Here are questions I pose at each The Eclectic Approach Seminar
  • Would you stretch a stroke patient with high tone quickly?
  • Would you stretch a TBI patient with high tone as hard as you could?
  • What about mashing? Would you smash the area of highest tone and tenderness in a stroke patient as hard as you could, thinking you were breaking up scar tissue or trigger points?

The answer to all of these questions is no of course! So why do sports and ortho PTs think any of the above is ok for their patients? Can you somehow take the neuro out of the musculoskeletal?
The converse is true for Neuro and Pediatric PTs. OMPT Techniques are for anyone with a neuromusculoskeletal system, not just "ortho" patients. I have used very light IASTM and mirror box with some adults with mild CP with very good functional results. Granted, the difference between an "ortho" patient and a "neuro" patient is ortho patients typically have a condition that can be reset rapidly, and a "neuro" patient is either a slow responder, or someone who needs continuous reinforcement due to some underlying pathology.
This is why I love to use PNF in my patient population - because there is some underlying movement dysfunction, that needs to be facilitated. It's not just for neuro patients, as we learn in school. I certainly did not learn PNF in ortho class, that's for sure!

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...






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