On Saturday, August 28, 2010, I had the privilege of attending the spine control symposium put forth by the University of Queensland's Centre of Clinical Research Excellence in Spinal Pain, Injury & Health. This was a must symposium for all professionals in the rehabilitation injury who manage low back pain and with the constant growth and debate pertaining to the research in this field, I am truly thankful for such an opportunity to expand my knowledge. As such, I also believe that it is my responsibility to relay that information onto my colleagues and will make an attempt to do so below.
Please be aware that the following information is based on my interpretation of each lecture and therefore, may be subject to "lost in translation". "Spinal Stability: The six blind men and the elephant" ~ Peter Reeves A Reductionist vs Systems approach to management
"Motor Control Changes and Back Pain: Chicken, Egg, neither or both?" ~ Lorimer Moseley Central themes (in red) “pain and spinal control abnormalities result from implicitly evaluated needs of the organism.”
Pain vs Nociception
Quote: It is “seductive” to conclude that recorded activity in c fibers and a-delta fibers will result in pain.
Pain and the Brain
"trunk muscle activity results from the implicitly perceived demands on the trunk."
“we really don’t know whether motor control changes BECAUSE of pain” – it's a chicken and egg argument. Considerations pertaining to the concept of nociception and protective motor control changes:
Considerations pertaining to the concept of pain and protective motor control changes:
Motor control as an output of the brain to the muscles:
Pain as an output of the brain to the muscles:
So consequently, the brain asking itself "How Dangerous is this REALLY?" is in his view, what determines back pain.
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As a health care practitioner with no prior "formal" training in this method of taping, I came away from this seminar impressed with this particular taping system. Here are 2 simple reasons why:
SpiderTech admits that it may work via psychological mechanisms. Yes, that IS correct. While the main therapeutic effects stated are via microcirculatory, structural, and neurosensory mechanisms, SpiderTech admits that psychotherapeutic effects may also occur. That is, through an increased conscious awareness and increased perception of stability, a decreased fear of activity may subsequently result. For those of you who work with elite-level athletes, you will know that psychology plays an important role in high performance and thus, if an increased perception of joint stability results in increased confidence, then yes, SpiderTech may also enhance performance through psychological means. SpiderTech seems to be grounded in sound, scientific principles As a site dedicated to "evidence-informed sport health", I strive to incorporate scientific principles as much as possible. It seems as though this company does the same. I was really impressed with the 2+ hours of scientific information presented to us before we were permitted to utilize the individual tape applications! Though research may apparently be underway to evaluate the efficacy of this taping method, the theoretical principles pertaining to its mechanisms of action via neurosensory pathways most certainly seems plausible. In fact, the certification manual's reference list contains over 70 references from peer-reviewed literature pertaining to the information presented to us. So is this method a psychological intervention in sport? Maybe. But in the event you are presented with multiple interventions to choose from, may I suggest you give these guys a second look. Upon initial glance of the written material, its contents did not seem novel to a contemporary sport medicine professional. I was simply satisfied with the purchase. All the information included within was comprehensible and therefore, since no paragraph required a re-read, nothing new was likely taken away from A & C. Many of its principles have already been incorporated in current practice with athletes and general patients alike and thus, I was eagerly awaiting the DVD in order to form my opinion and share it with anyone reading.
In conjunction with the manual, the first DVD addressed Assessment techniques aimed at evaluating both static posture and dynamic movement patterns, as well as enabling the user to identify potential biomechanical risk factors for injury. The second disc followed the assessment procedure up with Corrective techniques to be utilized based on the assessment results. Assess and Correct bridges the gap between sport medicine and sport performance and in my opinion, empowers coaches, athletes, trainers with the ability to train not only properly, but subsequently EFFECTIVELY. While the content within the manual was straight forward and relatively simple to comprehend, upon second look, its structure and layout may in fact be its "6th man." The coaching cues were well thought of and when used at the right moments can prove to be highly effective for facilitating ideal movement patterns in corrective exercise. As with programming and rehabilitation, the exercise progressions are perhaps more valuable than the exercises themselves. The authors incorporate an effective progression of corrective exercise and as someone who constantly seeks ways to maximize progression while minimizing risk of injury , I would like to recommend that this aspect of Assess and Correct should not go unnoticed. Similarly, the verbal dialogue accompanying the DVD contains highly important, quality information and thus, the instructions given within should also be noted with intent. Lastly, looking back at the soft-tissue guide, this resource is valuable in that it is simple yet comprehensive. The background information and instructions contained within can be readily accessed and therefore, utilized in mere seconds. As a follow up to Assess and Correct, I would like to see the incorporation and differentiation of specific structures involved in the various assessments. Understandably, the importance of efficiency of movement is paramount, yet for the sport medicine practitioner, the ability to identify specific structures involved in movement impairments is vital in the facilitation of sports performance. Thus, its incorporation in an edition specifically for sports medicine professionals, would certainly take this resource to the next level. |