Monday, September 29, 2008

Cutting or bleeding edge?

Hurricane Ike came and went, but it almost feels like he's still hanging around the Gulf Coast. The devastation was truly remarkable particularly for places like Galveston and the Bolivar Peninsula. If you've never been through a good sized hurricane, I wouldn't recommend it. My Alma mater, UTMB - Galveston, is finally getting back on its feet, seeing patients, and teaching PT students again. My thoughts are with them and any other folks devastated by this storm. We finally got the lights turned on and life is returning to normal, which for me means getting back to blogging on a more regular basis. The clinic has never been busier so there is definitely plenty to talk about.

For a self-proclaimed "ortho-guy" I certainly have been immersed in a great deal of neuroscience this year. I had a brief yet spirited set of interactions with the folks on SomaSimple, and currently enrolled in a class titled "Neurosciences in Orthopedics" at Texas Tech. I have to admit the study of neuroscience is really filling in a lot of gaps in my understanding of orthopedic conditions.

Neuroscience is creating some very novel therapeutic inventions. The paradigms of neuroscience are building on theories such as David Butler and Lorimer Moseley's work on pain as well as Michael Shacklock's neurodynamics. The exploration of neuroscience arises from an understanding that traditional orthopedic paradigms aren't always hitting the therapeutic bullseye. For example what explains the persistent symptoms of lateral epicondylalgia or anterior knee pain? These conditions often defy objective diagnositic testing and treatments based on the traditional tissue-healing inflammatory model. I would encourage anyone interested in learning more about these approaches to visit the sites listed above.

As with any treatment approach, I remain cautiously optimistic. As my father, a practicing family physician and medical veteran, often cautions me: It's good to be on the cutting edge, but avoid getting caught on the bleeding edge. New and different aren't synonymous with correct and irrefutable. We must continue to develop our understanding of human function without strictly adhering to old paradigms. At the same time, we must be prepared to embrace emerging theory without getting caught-up in the latest fad. At the end of the day, sound theory supported by strong evidence will continue to guide the best practitioners of this profession. I believe the field of neuroscience will meet the test of both theory and evidence and continue to provide salient answers.

One final note, I hope to make more regular contributions to my blog and appreciate everyone hanging in there with me. I'm in the midst of balancing my contributions to this blog with teaching, studying, treating, and recovering from coastal natural disasters! As this semester rolls on, I hope to contribute more regularly. Thanks and have a great weekend!

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