|
|
Re: Rotexion/Latextion
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: Rotexion/Latextion - June 24, 2005 7:36:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
Geez, steve, where were you a few hours ago? You summed up my whole post in one sentence.
I'm so verbose sometimes...
:)
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
|
|
|
|
|
Re: Rotexion/Latextion - June 24, 2005 12:36:00 PM
|
|
|
FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
Status: offline
|
i have no time to post right now, but i still somewhat disagree, but i did like the erudicious nature of your last post jason...I'll be back-
Ben
|
|
|
|
|
Re: Rotexion/Latextion - June 24, 2005 1:39:00 PM
|
|
|
srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
Status: offline
|
Wow, looks like I started something here. I agree with Jason, Steve, and Alex. I don't dismiss the schooling I received, as it taught more than just complex manual skills, it taught me how to palpate and how to critically think...but I've always kept that skeptical perspective, instead of jumping right in with both feet and embracing a guru or school of thought. Do I use MET or ERS and FRS type dysfunctions, sure I do at times. Do I believe it works the way the gurus say it works, nope. And yes, McKenzie works wonderfully for some patients, but I don't totally buy into the theory there either, especially now that I am reading more about neurodynamics.
Sarah
|
|
|
|
|
Re: Rotexion/Latextion - June 24, 2005 3:28:00 PM
|
|
|
nari
Posts: 1568
Joined: November 14, 2003
From: Australia
Status: offline
|
Jason
A great post!! Encapsulates in what you might call a big nutshell, all the nagging doubts PTs have been sensing over the past few years.
Steve just put it into a smaller nutshell.
I might add:
What we try to do with our patients is to recognise the physiological processes that we see before us, and after that, it doesn't matter too much what we do; be it Sahrmann, McKenzie, Maitland, et al. The diagnosis becomes a suggestion, not a downright leading light which causes us to open up the 'toolbox'...
Nari
|
|
|
|
|
Re: Rotexion/Latextion - June 24, 2005 4:30:00 PM
|
|
|
jbeneciuk
Posts: 112
Joined: November 26, 2004
From: Jacksonville, FL
Status: offline
|
The diagnosis becomes a suggestion, not a downright leading light which causes us to open up the 'toolbox'...
This is a great quote...and I have discussed this with instructors of manual therapy, they also admit that the techniques they are teaching are not the "solution", however as mentioned above, "just a tool in our toolbox"...be it Paris, Mckenzie, Sahrmann, etc...these are not the only way to treat pts...as mentioned earlier by Jason, the fact that some pts respond well to Mckenzie, some pts do not....every pt is individual and while we (especially us on this forum) are dedicating the time to learn from others...that is what I feel makes us good for the profession....my former schooling mentioned nothing of Sahrmanns approach, however my wife surprised me with the text and now I admit I probably use her techniques more than I thaught I ever would...the point I'm trying to get across is that no matter what CEU course we attend, whether we agree or not, it opens all of our eyes to different approaches...new thread in my head dealing with... "how long we stay with one given approach before we decide to change directions and attempt another given approach"...sounds interesting, any thaughts ??
I tend to agree with Ben on the above responses, however Jason & Alex are eating at my sub-conscious...
JBeneciuk
|
|
|
|
|
Re: Rotexion/Latextion - June 25, 2005 9:11:00 AM
|
|
|
Yogi
Posts: 403
Joined: April 5, 2004
From: San Antonio, Tx., USA
Status: offline
|
Steve, right. The pt's presentation guides the eval. to indicate a diagnosis to guide the treatment. There is no other paradigm. True believers close themselves in, there is no such thing as always, or certainty, and i think all of us here agree to that.
Agree with Jason that there is nothing wrong with starting with general techniques first (now, I used to argue differently) for mobs if eval. indicates, and this is where Alex's desire for clinical indicators comes in. This reminds me of the Dx. and palpation thread. Diagnosis and treatment principles might be another thread.
Spfister, I was suprised to read lumbar spine arthrokinematics are inconsistent. The cervical spine normal arthrokinematics is the first thing I look for on a cervical screen. Lumbar screen I use posterior anterior pressures on the spinous process first. The eval I was taught inschool used checked lumbar motions first, which I hardly use at all now.
My trouble is my brain doesn't remember complicated sequential stuff, I have to figure it out anew every time. Trig was tough, I'd have to remember the Pythagorean theorum (a2+b2=c2) and one trig function, and then I could figure out the rest. Made test taking a bit more time consuming, but it was figure it out or fail. Rotexion/latextion would be too complicated for me, but I'm no MET expert.
|
|
|
|
|
Re: Rotexion/Latextion - June 25, 2005 1:53:00 PM
|
|
|
Synergy
Posts: 592
Joined: March 11, 2004
From: Texas
Status: offline
|
From what I've seen and also what we were taught in school, the thoracic spine tends to follow Type 1 mechanics, meaning rotation and sidebending go to opposite sides. Again, I realize that motion palpation is under the microscope but to somewhat side with Ben, I still think it applies. It's difficult to toss something aside when you've seen it 'work'.
_____________________________
Chris Adams, PT, MPT
|
|
|
|
|
Re: Rotexion/Latextion - June 26, 2005 2:56:00 AM
|
|
|
SJBird55
Posts: 2438
Joined: May 10, 2004
From: Michigan
Status: offline
|
I tend to think that the reason there are so many theories and approaches is because no single approach provides the desired outcomes 100% of the time.
Patients need to be classified and defined as to when the various approaches do provide the desired outcome.
I really think Childs et al have maybe increased that kind of thinking. If we want to have consistently good outcomes, then we probably shouldn't be using one approach to treatment all across the board with all patients.
The challenge when you've "seen it work" is just the simple fact that you as a provider are going to remember those awesome times that it did work. But if you were to collect data on every single patient, does it really work as awesome as you think? If you capture initial disability and discharge disability - what's the effect size and what's the average discharge disability and the standard deviation? And with that, do you really have a tight standard deviation? I honestly do not believe that we can actually really know that type of information in our heads without truly analyzing it. We're our only "witness" so to speak and "witnesses" aren't completely reliable (as mentioned in that other thread), so technically, is it reasonable to believe that something works based on a "witnesses" account, or would some mathematical analysis be more helpful in substantiating the claim?
|
|
|
|
|
Re: Rotexion/Latextion - June 26, 2005 3:48:00 AM
|
|
|
MPT
Posts: 161
Joined: April 4, 2004
From: Syracuse, New York
Status: offline
|
Great posts. I have felt like this for sometime now. It surprises me sometimes how quick many therapists buy into these theories.
Manual techniques can be effective, but I do not feel that we are good at determining who they will help and who they won't. This is why I am very excited about clinical decision rules and I feel they offer us the best way of narrowing down what treatments are most likely going to help each patient. This is what I feel (at least in my practice) is often missing. Many times I find it difficult to predict with any certainty what treatments will work on what patients. Some of this may be due to lack of experience but I think a lot is due to the many unreliable tests we use in your evaluation
_____________________________
Where am I
|
|
|
|
|
Re: Rotexion/Latextion - June 26, 2005 5:14:00 PM
|
|
|
jma
Posts: 2414
Joined: August 24, 2000
From: NY
Status: offline
|
Sounds like the FRS and ERS that I learned using, Principles of Manual Medicine by Philip Greenberg. It blew my mind away.
|
|
|
|
|
Re: Rotexion/Latextion - June 26, 2005 7:27:00 PM
|
|
|
Synergy
Posts: 592
Joined: March 11, 2004
From: Texas
Status: offline
|
JMA,
I think you meant Philip Greenman. :)
I have that book and that's one of the texts we used during school and very informative.
_____________________________
Chris Adams, PT, MPT
|
|
|
|
|
Re: Rotexion/Latextion - June 27, 2005 3:55:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
Greenman's text is informative, but for different reasons than many think.
If you see it as a maintenance manual for the body to be studied, it won't get you very far.
If you see it as a list of possible techniques to acheive certain goals, that you can practice and find some things that work, it is VERY useful.
Chris summed up this argument very well "it's hard to toss it aside if you've seen it work"
This is the whole thing right there. The point is, that we remember the times it worked, and not the times it didn't. Also we can't assume it worked b/c the mechanism is what we think it is. And this is what keeps people stalled in the same circles of thought/action.
That's why it's important to question why we do what we do.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.094
|
Printable Version
