Saturday, February 16, 2008

Interesting Perspectives

I recently discovered the online forum SomaSimple. A collection of very bright individuals including Barrett Dorko, PT and a host of others who challenge many conventionally held paradigms of the orthopedic community, myself included.

Below is a list directly from the website moderator's "Ten Steps to Understanding Manual and Movement Therapies for Pain". I find it a fascinating perspective on the subject of pain as it relates to our daily practice.

There is an interesting irony for me discovering this website. This week I have been referred three individuals in various stages of adhesive capsulitis. Each patient has a remarkably similar ROM deficit including osteokinematics, joint play, end-feels etc... However each patient is remarkably dissimilar with respect to their pain behavior. One is very stoic with a very high tolerance for mechanical mobilization while the other two are...well, not quite as stoic.

This should come as no revelation for anyone. We all experience pain in very different ways and understand that pain behavior can influence outcome. However, there is likely more at play than simply getting our patients to relax enough to tolerate our treatments. Understanding the physiology of pain could allow us to conduct more thorough and effective management strategies of musculoskeletal conditions. This, at the end of the day, should be our aim.

I have doubts (I am after all a skeptic) that a forum is likely to fundamentally alter my approach to my practice. However, I am even more certain I don't have all the answers to every clinical problem that walks through the door. We'll see where the discovery of this and other sites like it lead. I invite you to join in as well and see what's going on.

In the meantime you can also catch me on the Rehab Edge forum for a more conventional or, as one Soma Simple moderator puts it, more "mesodermal" approach. Either way we'll have a good time and hopefully learn something along the way.

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