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Re: RSI and other mythical creatures
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Re: RSI and other mythical creatures - December 4, 2005 3:53:00 PM
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Jon Newman
Posts: 1706
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From: Amherst, WI
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Ginger,
Do you suppose if you treated new therapists (while they were learning to treat patients) that their thumbs would never hurt?
jon
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Re: RSI and other mythical creatures - December 4, 2005 4:03:00 PM
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Diane
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From: Vancouver, B.C., Canada
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My view is that prolonged contact with a patient's painful body/skin, in a therapeutically defined relationship, where care is taken to note changes in a positive direction and move to enhance those changes, be they of greater range and/or less reported pain, palpable relaxation, bigger joint excursion, etc., such elements of a "kinesthetic conversation" will combine in a patient's brain/nervous system to produce pain relief.
I absolutely do not agree that spinal joints are the fountainhead of pain causation, pain maintenance, or pain relief, the be-all and end-all, the alpha and the omega of treatment. It might not be reindeer droppings, but it might be another sort, i.e., bunny doodoo found deep in rabbit holes of perceptual fantasies that have fossilized into belief systems...
And your thumbs must be like shovels by now..
All the best,
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Re: RSI and other mythical creatures - December 4, 2005 4:27:00 PM
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Justin
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From: SD
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Usually just soak in info, but couldn't resist posting my appreciation for Jon's last post (what level would he mob on the students)? As an aside, I don't think that RSI and RSD were the same animal, and CRPS I and II were new names for the latter, not the former (though as my wife often tells me I would be wrong).
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Re: RSI and other mythical creatures - December 4, 2005 5:46:00 PM
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ginger
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Joined: February 26, 2005
From: Melbourne Victoria
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Jon, No.
Justin , RSD RSI, CRPS are all euphemisms for "Dunno", labels made for those who haven't yet understood the nature of these complaints.
Dianne, Huh?
marching through the snowwwww, in a one horse open sleighhhhhh, ore the fields we goooo, laughing all the wayyyy.
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The Grand Pediculator
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Re: RSI and other mythical creatures - December 4, 2005 5:51:00 PM
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Diane
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From: Vancouver, B.C., Canada
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Ginger.. sorry come across so nit-picky, exacting and corrective all the time, but that should be "dashing" through the snow, not "marching"..
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Re: RSI and other mythical creatures - December 4, 2005 7:29:00 PM
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ginger
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From: Melbourne Victoria
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Well it must be your turn for a carol then Dianne
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: RSI and other mythical creatures - December 4, 2005 8:05:00 PM
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nari
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From: Australia
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justin
You are right - serves me right for doing a post when talking to someone else!
Apologies.
Nari
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Re: RSI and other mythical creatures - December 6, 2005 3:15:00 AM
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FLAOrthoPT
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Joined: May 8, 2004
From: West Palm Beach
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yeah but Syndromes are really a name for a whole bunch of things, so it IS appropriate. Bursitis is very specific and can tell you the exact structure involved that may be causing pain, but impingement tells you why it is happening. If you have someone who has poor posture and works on computer ALL day and drives long distances and arm outstretched on mouse in car, etc, and they develop burning in shoulder, numbness in arm, discomfort, sure you can say possible brachial plexus irritation causing the pain, but it is more than that, it is a whole syndrome of impingement both muscular and vascular and neural, etc etc. I think syndromes are very important to discuss, but not to hinge a diagnosis on, I agree. I think we as therapists, though, should not only treat the mechanical inflammatory source, if that is even possible, but treat the underlying syndrome. So why the nay nay on the syndrome discussion?
Frosty was a snow man-
Ben
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Re: RSI and other mythical creatures - December 6, 2005 3:37:00 AM
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JSPT
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From: Michigan
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As far as I know RSI (repetitive stress injury) has been defined as a condition in which the microstructure of a tissue is damaged due to chronic low-level stress, such as subacromial impingement.
Correct me if I'm wrong, but Reflex Sympathetic Dystrophy (Not RSI) is much different that what I think we're discussing. RSD is thought to be a condition of heightened sympathetic response characterized by extreme pain, redness, and hyper-irritation of the affected body region.
The most common onset is after trauma, such as the lower leg being affected after breaking the ankle. But yes, Nari, RSD is now referred to as CRPS Type 1 or Type 2.
http://familydoctor.org/238.xml
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16319634&query_hl=1
I won't even get into the validity of this syndrome, its treatment, or its diagnosis, but I wanted to make sure we were all talking about the same thing.
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Re: RSI and other mythical creatures - December 7, 2005 6:12:00 AM
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MPT
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From: Syracuse, New York
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Ginger,
Thank you for describing your technique in more detail.
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Re: RSI and other mythical creatures - December 7, 2005 8:04:00 AM
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nari
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From: Australia
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Might ease some confusion if we did stop talking about the condition called RSD - CRPS1 has not been called that in papers for a long time.
It should be recalled that a syndrome is a name for something which is not well understood,and its 'cause' is not established and documented, just as fibromyalgia is a syndrome, and zillions of others. Debates on syndromes can be useful but I can't see this debate going anywhere at all.
Nari
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Re: RSI and other mythical creatures - December 7, 2005 11:21:00 AM
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ginger
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From: Melbourne Victoria
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Nari , I see what you are saying about syndromes, though a discussion about individuals experiences on fibomyalgia would make interesting reading, a new thread perhaps. Been exceptionaly busy with pre-christmas arrangements added to a swell in patient numbers , hope you are surviving the silly season, I wish you a happy and safe festive season to you and all the forum.
Cheers
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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Re: RSI and other mythical creatures - December 7, 2005 8:53:00 PM
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pablo w
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From: Canberra
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Hi Ginger,
CRPS I and CRPS II are far from "dunno" conditions. Have a search for CRPS on Rehabedge for a summary of some research on the condition.
Pablo
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Re: RSI and other mythical creatures - December 8, 2005 12:58:00 PM
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ginger
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From: Melbourne Victoria
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Pablo, the common thread that links CRPS RSI RSD and many others is that these collections of signs and symptoms are not well understood by those looking for an answer founded on pathology. I lifted this from a google searched article on CRPS,
"The underlying neuropathology is complex and, as yet, still defies adequate explanation in physiological terms"
What links them from a physical perspective is that each and every case I have ever seen and treated, whose "diagnosis" from a Doctor of medicine, is CRPS, RSI, RSD, etc, have spinal joint hypomobility with attendant inflammatory irritation of adjacent nerves giving referred pain and other symptoms. There is no pathology as such.All get better when appropriate attention is paid to turning off the protective tone around the relevant spinal joints.
So I say again, these syndromes are medicines way of saying I don't know, couched in jargon to allay fears that those very doctors of medicine don't have an answer.
Prove it for yourself, next time you have a RSI or CRPS patient, check passive mobility and palpable tenderness of the neurologicaly relevant spinal joints. Mobilise them. Check with me if you want more detail on the how, happy to expand the mobilisation story for you. Check the symptoms immediately after the spinal joints have lost significant tone of paravertebral muscle.( easy to achieve with continuous mobs ) Notice that those symptoms improve and you are on the way to curing the "syndrome".
Jingle bells, jingle bells....
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Ubi est mea anaticula cumminosa?
The Grand Pediculator
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