Dear Frank
I was also disappointed to read your response. I have completed McKenzie
A-D, have passed the credentialling exams and have completed a 3 week
clinical placement. I have read the evidence-based McK papers, and am
well-impressed by the ability of the centralising phenomenon to identify and
treat symptoms of discal origin. However, I also work in chronic pain
management (4 years experience) and work closely with a brilliant clinical
psychologist. The whole issue of facilitating recovery from low back pain
is complex. We all have anecdotal stories of "cured patients".
The placebo effect is powerful. A confident therapist speaking in glowing
and positive terms is going to be more likely to help their patient - I
would guess that you fit into this category.
There is NO DOUBT that two of the main reasons that patients seek help is :
a) anxiety regarding the nature of the problem
b) fear that pain equals harm
As you know, in the hands of a competent McK therapist - both of these
issues are dealt with well ........ and you are addressing psychological and
cognitive issues. Wether we like it or not, every single therapist is
dealing with psychosocial issues - but the skill with which we do it is
highly variable.
Can I suggest that you read Gordon Waddell's brilliant book - "The Back Pain
Revolution" or either of the Physiotherapy Pain Association's two yearbooks
(especially as the first one is dedicated to whiplash and fear-avoidance!)
Linda K
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>; <[log in to unmask]>;
<[log in to unmask]>
Sent: 22 May 2000 02:47
Subject: Fwd: [McKenzieStudy] Fwd: strange centralization/ Lotus or
padamasana pos
> In a message dated 5/21/2000 12:12:32 AM Eastern Daylight Time,
> [log in to unmask] writes:
>
> > McKenzieStudy - http://www.McKenzieStudy.org
> >
> > Dear Ian,
> >
> > Ssorry to have to say this, but it's sad to see that so many PTs, and
> > especially the MTs, seek refuge under psychological-philosophical
shelters,
> > not to be confronted with their inability to diagnose and treat pts.
> > physically. I should know: I've been a PT/MT for years (and still am),
> > working with all kinds of models and theories, because we lacked the
> > practical knowledge and skill. And boy, was (yes: was) that frustrating
at
> > times!!
> >
> > I had already once looked into McKenzie's book, but thought: "What the
heck
> > is this?", and put it aside, thinking it was nothing new, nor any more
> > effective. Some months later, after I had almost given up on PT/MT as
an
> > effective way of treating pts., and in fact had decided that I didn't
wanna
> > be a PT/MT any longer, I came across it again, and started
reading.....and
> > reading.....and reading..... I just couldn't stop!! Again I thought:
"What
> > the heck is this?" But now in a different way. This made sense! Was
that
> > possible then, after all other methods of spine therapy had been
nothing
> but
> > disappointing? This author didn't just come up with all kinds of vague
> > theories, but offered practical diagnostic AND treatment "tools", based
on
> > an approach that was based on or backed up by dozens of researches and
> > studies!
> >
> > While reading, it felt as if I for years had studied the human body
like as
> > if I had studied all kinds of computer software applications, but never
had
> > gotten to the operating system... And this Kiwi made the operating
system
> > clear!
> >
> > I remember saying to myself: if this doesn't work, I'm gonna quit
> > definitely! The results with the first three pts. were nothing less
than a
> > GREAT relief: there IS a way to treat pts. with PT effectively! You CAN
> have
> > many pts. that after three to five visits tell you that they are as
good as
> > painfree, even after having had backpain for years!!! And you CAN have
many
> > pts. that you can discharge, and that stay away, after the prescribed
> series
> > of visits (McK. is often "hands off"), because they (agree they) can
now
> > really(!) control their own backs (and not because they were in fact
> > disappointed in the efficacy of the given "treatment").
> >
> > It's amazing to see that the committee's here in the Netherlands that
are
> > talking about the same subject you are referring to, all consist of
MTs.
> And
> > none of them has done the McK. course! I won't say that psychological
> > factors do not play an important role. But how on earth am I supposed
to
> > treat them psychologically? Don't we have the psychologists and
> > psychiatrists for that? Cause it can go quite deep: I sometimes advise
my
> > pts. to see one of those, if I feel that they are depressed, or in any
> other
> > way under constant psychological stress, especially if they are ready
to
> > admit that their back is not really their problem, but their state of
being
> > in general is. But am I to treat that? What are the (semi)shrinks
supposed
> > to do then? Recent research has shown that "Talking without drugs" as
by
> far
> > not as effective to treat depression as "Talking with drugs" is. Is a
PT
> > then supposed to take up the role of (semi)shrink? No way.
> >
> > If PT in any or every form is not effective in treating backpain, it
should
> > be abolished. End of story.
> >
> > There is light at the end however: take a look if you like at
> > www.McKenziestudy.org , and click on "Can an Educational Booklet Change
> > Behavior and Pain in Chronic Low Back Pain Patients?" (don't forget to
> first
> > read the first sentence of "Discussion"). Realise that this group of
pts.
> > were not treated, supervised or guided by a (McK.) PT, but had to do it
all
> > just by themselves, with -only- McK.'s book "How to treat your own
back".
> >
> > (By the way: I am interested in David Butler's website, but the URL you
> gave
> > doesn't lead to it. Any other website address?)
> >
> > Regards,
> > Frank Conijn
> > Member of the review panel of the Dutch committee for the development
of
> > clinical guidelines for whiplash related injuries
> > Amsterdam
> > The Netherlands
> >
> >
> >
> >
> > ----- Oorspronkelijk bericht -----
> > Van: <[log in to unmask]>
> > Aan: <[log in to unmask]>; <[log in to unmask]>
> > Verzonden: zondag 21 mei 2000 0:41
> > Onderwerp: [McKenzieStudy] Fwd: strange centralization/ Lotus or
padamasana
> > pos
> >
> >
> > In a message dated 5/20/2000 9:06:39 AM Eastern Daylight Time,
> > [log in to unmask] writes:
> >
> > > here is a personal reply to Dr sood if anyone is interested in
commenting
> > !
> > > Prepared for the feedback positive or negative ! .......No replies
from
> > Dr
> > > Sood to any communication as yet but here goes!
> > > Insert contains no love bugs or love handles !
>
>
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