|image from adluge.com|
There's nothing wrong with old school, when it's retro or the novelty is still there. However, when old school beliefs hamper the progress of Modern Manual Therapy, it's time to update.
Here are 5 Updates to Old School Terms
1) Muscle Energy Technique
- I've always taken a page from Stanley Paris, saying we should use our own professions terms, you don't see osteopaths using our terminology do you?
- the connotation behind MET is that it's something special, when in reality, it's just fancy PNF
- most of what makes it fancy, based on Type 1 or 2 lesions, is all just nonsense anyway, isometrics prime a movement pattern, or decrease increased tone and facilitate decreased tone, period
- let's stick to PNF and isometrics - not really a modern update, more like let's go retro and stay there
- I have used joint mobs for over a decade with great success and still use them every once in a while
- however, the idea that you can isolate or deform certain parts of the joint capsule to improve particular osteokinematic motions needs to be updated
- how many studies showing it takes thousands of pounds of force to deform fascia need to be done before schools adopt a modern take?
- even though I may still call them joint mobs, in my head, I just think of the techniques as joint stimulation
- bombarding the CNS with novel, non-threatening input is a better way to envision the mechanisms behind the improvements in mobility
|never gets old|
- referencing the same studies on mechanical deformation not being likely without forces much greater than our techniques allow, let's view all soft tissue techniques as tone changing
- look at every mobility and motor control issue as a tone problem
- soft tissue work, IASTM, or any other similar technique either facilitates decreased tone or inhibits increased tone, it's that simple
- no matter how hard you press, you're not breaking up scar tissue
4) Adverse Neural Tension
- typing that made my eyes burn!
- both patients and clinicians think something about the nervous system can shorten
- the reason why neurodynamics is a better term because it shows the nervous system is dynamic, can stretch, slide, glide, and be compressed - it's resilient!
- pain/paraesthesia is all about sensitivity, certain motions and positions may bias a particular nerve, but if light IASTM or compression wrapping completely improves ROM, nothing is actually "tight"
5) Manual Therapy
- let's all view manual therapy, exercise, repeated motions, PNF, taping, etc, as inputs
- manual therapy is like a shortcut directly to the CNS, thus changing the output of pain and altered motor control
- these views are reduce the "magic hands" idea behind many techniques that make patients think they need passive treatment in order to be "fixed, repositioned, or put back into place."
- think of manual therapy like food, improved output with novel, non-threatening input
Even if you still use old school terms, don't use old school explanations. It makes a modern clinician's job more difficult. If even 20% of clinicians adopted these rules, maybe those of us fighting the good fight would not have to vomit in our mouths every time we hear, "My pelvis is rotated."
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...