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From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 26 January 2001 10:53
Subject: Validity of Therapies
>Dear all
I am that soldier who has spent hard earned cash on all the fashionable
courses ( Mulligans, trigger points etc etc). One thing that I've noticed is
that the techniqes ALWAYS work for the instructor on the course, even on
subjects who've had bilateral leg pain for 10 years type-of-scenario. With
a few exceptions, when I try 'em at home on similar patients, they rarely do
what they're supposed to do. The only thing that I consciously do
differently from the instructors is that I don't tell the patient what they
should feel before I do the technique. I ask them to tell me afterwards
instead (obviously looking out closly for any non verbal pain responses
which would indicate pain or distress). I don't tell them all the stories
that you hear on the courses about 2 year's worth of pins and needles going
away in one session or return of full movement years after a compound
fracture. I just do the technique, check objective signs and ask in a non
leading way about subjective complaints. In a way, this has been a sort of
an (uncontrolled, admittedly)experiment on my part as to the reproducibility
of the effects of these techniques. I have come to the conclusion that a
lot of the positive effects that we see from the use of many manual therapy
techniqes are as a response of strong suggestion and patient conditioning on
behalf of the therapist. I'm not blaming the therapist (as I say, I've been
that soldier) but I think we have to be a lot more analytical of the whole
input we give to our patients and not just the physical or mechanical one.
Anyone looking for a research topic on manual therapy out there, I think
this would be a great one!
Emilie McGrath
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