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Re: When did PTs start learning manipulation?
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Re: When did PTs start learning manipulation? - March 11, 2004 7:13:00 AM
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Ron
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I don't know an official time line, however this is my two cents.
In the early 60's Dr Cyriax introduced into the states maniplative therapy for "physiotherapists" I was trained in the late 70's, perhaps before you were born Chrioortho (could'nt resist). To be fully certified in Cyriax techniques took 4-6 years and was demonstrated by written, oral and technique competancy. Dr Cyriax published some of his most important works in the 40's. These works, Vol 1-2 Othopaedic Medicine, were our textbooks.
Dr Cyriax believed in three principles
1) All pain arises from a lesion
2) All treatment must reach the lesion
3) All treatment must exert a beneficial effect on the lesion
His exam techniques were logical and concise, treatment was likewise and most often involved manipulative techniques.
Although some consider his works outdated, they have and continue to serve both myself and patients well.
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Re: When did PTs start learning manipulation? - March 11, 2004 8:10:00 AM
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mato_tom
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[QUOTE]No offense taken chiroortho. Here's to the world wide future of manual treatment, from all branches of the 'family tree' of practitioners.
(Imagine me raising a glass..) [/QUOTE]
please i think i have the best toast available...imagine us PTs as the toasters........
heres to you.........heres to me.........and if we should ever disagree.....screw you..........heres to me.
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Re: When did PTs start learning manipulation? - March 11, 2004 8:23:00 AM
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chiroortho
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LOL, mato, good for you.
Yes, I am somewhat familiar with Cyriax' work, and his approach in essence makes good sense to me. I had no idea that he introduced his work to PTs back in the 60's.
In particular, his focus on identifying and addressing the pain generator is great.
My best.
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ChiroOrtho
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Re: When did PTs start learning manipulation? - March 11, 2004 3:49:00 PM
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Diane
Posts: 1507
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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However...long before Cyriax, waaaaaaay before that, PTs were taught manipulation,(I don't know by whom) especially if they were associated with the British army.
I think that goes way back to bfore WWII and maybe before WWI and maybe back to before the Boer war... I don't think they make it all the way into the history books about PT, which tend to focus on hospitals and women in PT.
Many of these Brit army trained PTs, all guys, usually decided to move to Canada, Aus, probably the US... opened private practices, and some went on to teach manipulation to non-army PTs. There are different "streams" of manipulators in PT, the Cyriaxians, the army guys, the Maitlanders, etc etc.
Diane
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Re: When did PTs start learning manipulation? - March 11, 2004 4:08:00 PM
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chiroortho
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Very interesting...wasn't aware of all this. I, in my ignorance, thought the PT-manipulation movement (no pun intended) started in the 80's or so. Don't know why, just kind of had that impression.
Thanks for the information. Diane, you sound as though you're up on the hx of all of this.
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ChiroOrtho
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Re: When did PTs start learning manipulation? - March 12, 2004 10:46:00 AM
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sinistre
Posts: 22
Joined: May 23, 2002
From: Norway
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If I remember correctly - please correct me if I'm wrong - osteopaths (bone settlers) were doing manipulations before chiropractics were thought of. PT's learned from osteopaths - since chiropractors were being all secretive.
Hey ChiroOrtho - do you believe you can cure sterility by manipulating a lumbar segment? I saw one chiro site that stated sterility could be caused by a sublux at L2/L3 or around there... Just curious...
PT's (specifically manual therapists) manipulate spinal segments mainly to improve movement - not improve viceral function.
[This message has been edited by sinistre (edited March 12, 2004).]
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Re: When did PTs start learning manipulation? - March 12, 2004 11:00:00 AM
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chiroortho
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Sinistre,
Yes, I do believe that osteopathy antedated chiropractic.
No, I don't believe that chiropractic can cure sterility by manipulating anything...if research happens to prove otherwise, great. But until then, I don't base my approach to patient care solely on faith (belief).
Thank you for your response.
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ChiroOrtho
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Re: When did PTs start learning manipulation? - March 12, 2004 11:24:00 AM
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Ron
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Diane, I never considerd myself a
"Cyriaxian", but I kinda like the ring of it.
I wonder if I can put that on my business card?
Cyriaxian, at your service.
Very noble sounding
Thanks
Ron
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Re: When did PTs start learning manipulation? - March 12, 2004 7:36:00 PM
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goodlooks58
Posts: 425
Joined: October 21, 2002
From: CA
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To chiroorthos and others: I still do not see the need of X-Rays when you are dealing with MS problems. I understand that the lay public has been sold the idea that when you have back pain you think about going to a a chiro..and so chiros may be getting a vast majority of spine related pain problems..And I also understand that x-rays may help rule out fractures or any other unknown growths. However, subjective history taking and manual objective findings can give a tremendous wealth of information about the patient's pain condition. Taking pre/post manipulation x-rays and to see the alignment etc..seems like an overkill.
Maybe, we as a society, been overly X-rayed?
Maybe, I need to be enlightened about the over use of X-Rays?
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Re: When did PTs start learning manipulation? - March 13, 2004 1:44:00 AM
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Dr.Wagner
Posts: 1242
Joined: January 24, 2003
From: Indianapolis
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I got my first "taste of manipulation" as a PT by taking myofascial stretches "one step further". Had ZERO to do with mobs.
Then I watched a Phillip Greenman, DO video...then i officially became a DO.
I was quite conflicted primarily because at my PT school, manipulation was the devils work...I still believe, even as a DO, that myofascial stretching is a better long term solution.
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Re: When did PTs start learning manipulation? - March 13, 2004 3:20:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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[QUOTE]Originally posted by goodlooks58:
To chiroorthos and others: I still do not see the need of X-Rays when you are dealing with MS problems. I understand that the lay public has been sold the idea that when you have back pain you think about going to a a chiro..and so chiros may be getting a vast majority of spine related pain problems..And I also understand that x-rays may help rule out fractures or any other unknown growths. However, subjective history taking and manual objective findings can give a tremendous wealth of information about the patient's pain condition. Taking pre/post manipulation x-rays and to see the alignment etc..seems like an overkill.
Maybe, we as a society, been overly X-rayed?
Maybe, I need to be enlightened about the over use of X-Rays? [/QUOTE]
goodlooks,
I agree that xrays are overdone, and my profession is a major "overdoer"...I'm particularly troubled by my (thankfully few) colleagues that do "pre- and post-xrays"...not only useless, but an unnecessary exposure to ionizing radiation to boot, not to mention expense.
That said, goodlooks, xrays have become standard of care in many NMS cases...there are algorithmic protocols starting to evolve that are helpful in the "cover your backside" department...and the Canadian C-Spine Guidelines are very helpful relative to whether or not to obtain cervical films after trauma (there are other guidelines as well, but I won't bore you). Dr. Wagner has, I'm sure, long ago had these guidelines committed to memory in his ED work.
It might interest you to know that I have seen a hangman's fracture (C2 traumatic spondy), many AAA, a multitude of compression fx, lymphoma X 1, osteopenia/osteoporosis nearly qd, a number of osteoblastic met CA from breast/prostate, etc. So xray is indispensable as a first line diagnostic tool, but as I wrote in an article about 15 years ago, I'm troubled with the use of the words "xray" and "routine" used in the same sentence.
Thanks for responding.
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ChiroOrtho
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Re: When did PTs start learning manipulation? - March 13, 2004 3:31:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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Dr. Wagner,
It might be of some interest to you that when I was in training I met a young DO-to-be that was doing clerkships nearby and I asked him to check my neck because I guess it was sore at the time...anyway, he gave me some OMT, and it was very impressive; so impressive in fact that I tried to copy it for a while but did a lousy job so I quit trying...don't ask me to describe it because I can't. We exchanged manipulations and thoughts. Great first (and only) experience with OMT. Impressive.
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ChiroOrtho
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