I suffer a bit of an internal conflict at times. As a crusader for a holistic approach to pain and helping those people with pain, I've adopted a fairly flexible, dynamic, biopsychosocial approach to my interventions. I've become more concerned with how my interactions are influencing a person's cognitions, nervous or endocrine system than I am with how my interactions are influencing the ability of the inferior articular facet of C4 to glide in a supero-antero-lateral direction on the superior articular facet of C5. Frankly I find the whole premise of accessory movement testing a bit silly at times, especially in working with people with chronic pain problems. However, I also recognize that there are times when a manual approach to treatment works, and in fact part of my job is to teach the traditional approach to manual therapy to graduate clinicians who wish to upgrade their skills in the area. Don't get me wrong, I really enjoy what I do, but I think it's probably time to expand our understanding of how manual therapy or even exercise works, especially when dealing with chronic pain.
Thanks to my colleagues Susan Tupper and Neil Pearson (both PSD executive members), I was given the chance to riff a little on potential mechanisms behind the effectiveness of manual therapy and exercise in chronic pain at the recent National congress of the Canadian Pain Society in Niagara Falls, Ontario. I recorded only my 20-minute segment of the hour-long presentation and have posted it for your viewing pleasure. Here's hoping this doesn't constitute copyright infringement...right?
If you wish to download and watch the presentation along with my recorded narration, you can do so by right-clicking on this link and choosing to save. I welcome your comments.