Movement Science Podcast

As I mentioned in an earlier post, it has been too long between podcasts.  Fortunately, getting into the swing of things was made possible by an interview with physical therapist Barrett Dorko.  To listen to this thought-provoking interview, please feel free to download it here or on iTunes (there is a direct link to my iTunes podcast on the right hand column below). Remember you can stream the audio or download it directly. 

(on a logistical note - I hope to place the podcasts directly on a single page but am still working out the kinks!)

Barrett is not only an experienced manual physical therapist, but is also an accomplished speaker. He has been invited to speak at ten national conventions of the American Physical Therapy Association and has conducted workshops at state chapter meetings and private institutions throughout North America. He currently teaches a workshop titled Simple Contact, and has appeared in over 200 cities since 2004. Barrett’s writings are designed to influence the teaching of manual care and his work is commonly used to emphasize the nature of gentle handling and sound scientific reasoning in the clinic. In 2004 Barrett served as the Prestige Day Speaker for the physical therapy program at Cleveland State University, which is one of the highest honors given in his profession.

This podcast gave me an opportunity to discuss numerous topics with Barrett including:

• The concept and utility of the ideomotor effect in pain management and rehabilitation
• The emergence of evidence supporting the ideomotor effect in rehabilitation
• Barrett’s essays which have provided thought-provoking insights into clinical reasoning.

If you trudge through some of the threads on SomaSimple.com, you will quickly find that Barrett and the gang on that forum have both strong and informed opinions about various issues within the fields of movment.

I will freely admit I have come into a few heated discussions and even anticipate a few more down the road.  However, what simply cannot be argued or disputed in any format is the relentless pursuit Barrett and his moderators have in trying to make our professions better.  It is this passion Barrett has that drove me to have our conversation today.

I hope you will visit Barrett’s website as well as SomaSimple.com.  However I would also encourage your participation in other arenas of ideas including the forums on RehabEdge.com and EvidenceinMotion.com.  These are all emerging as powerful and inexpensive ways for us to share ideas and truly move our professions forward.

Once again, I’d like to thank Barrett for appearing on the podcast.  As always, if you have questions or comments, feel free to post them here or contact me via movementscience@gmail.com.

References:

McCarthy S, Rickards L, Lucas N. Using the concept of ideomotor therapy in the treatment of a patient with chronic neck pain: A single system research design Int J of Osteopathic Med. 2007;10:104-112

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Getting these podcasts out is becoming energizing and addicting. This process has caused me to reexamine my opinions and attitudes about a great many things. 

I’m pretty willing to dish out criticism of individuals and treatment paradigms that don’t seem to be in sync with common sense or science-based clinical reasoning. However I’ve come to realize that the only thing keeping me from being “just another jerk with a microphone”, is the ability to get my facts straight before banging that drum. 

Episode two gives me another opportunity to reexamine my attitudes toward the chiropractic profession.  This is my first interview, and I was fortunate to land a very good one in the form of a conversation with Allen Botnick, DC.  For those of you who are not familiar with Allen, let me give you a little background.

Allen graduated from Life University College of Chiropractic back in 1996.  After a disappointing experience in the profession, Allen has dedicated his life to educating individuals about the facts and fallacies of chiropractic.  He has placed particular emphasis on the challenges facing the chiropractic educational system and frequent indoctrination that occurs within the profession.  He has an internet forum  known as ChiroTalk devoted to this cause, and his experiences with the education and training of chiropractors are well documented.

Allen has since left the profession but remains active within the field of movement science.  He is currently working on a biomechanical approach to chest stabilization.  The following is an excerpt from his project:

Proper vertebral movement has been linked to proper posture, appropriate back range of motion and improved mobility. Spinal mobilization has been a treatment technique utilized in physical therapy clinics, chiropractors offices and osteopathic physicians practices for years. Often, the ability to mobilize the spine, is completed in the office while the patients continue to “need adjustments” in between their visits. If utilized independently by patients at home on their own, the chest stabilization product could be an enhancement to a full spinal manipulation done by a professional in the clinic. With rising co-payments and decreasing access to therapy and chiropractic healthcare benefits, patients will be more apt to try home devices that are issued under the direction of a licensed professional.

With co-payments reaching $20-40/visit levels, the estimated price of $150.00 pays for itself with only a few trips to the therapist, doctor or chiropractor.

The inventor of this product, Allen Botnick DC, used it to cure himself of chronic asthma that he had since childhood. After six weeks of use the asthma changed to cough variant asthma and completely resolved using mineral supplementation, omega 3 fat and an anti-inflammatory diet. In addition to asthma, it is expected that this approach may prove to be an effective treatment for idiopathic costochondritis. Dr. Botnick seeks business partners for funding and research collaboration. A pilot test in pediatric asthma is scheduled. For more information please contact him at aljbotnick@yahoo.com.

After completing the interview and reviewing the podcast, my core beliefs regarding chiropractic are essentially unchanged.  They have a big hill to climb and time is quickly running out on them.  However, I believe it is equally important to make sure we understand the current state of chiropractic if we are to effectively counsel our colleagues and patients.   Labeling them as “quacks” may be an efficient way to dismiss a patient’s curiosity, but it may not be the most productive approach.

My challenge to you is to visit forums like ChiroTalk and websites such as ChiroBase to make sure you keep an informed opinion about the field of chiropractic.  Chiropractors are not going away, and many are well meaning providers trying to pull out of the professional nosedive.  The more we understand their role within the field of movement science, the sooner we can all move forward and continue to elevate our standards of care. 

Until next time, keep moving and don’t stop learning!

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Ok folks here we are - my first podcast. This episode explores the relationship between motor learning, motor control deficits, and low back pain. I hope you enjoy my rookie effort and will hang in there as I continue to improve this new feature of my blog. Please let me know if you are having difficulty dowloading the podcast and I will get the bugs worked out asap! I hope to be up on iTunes soon so this should add an additional level of functionality to the show.

Topics include:

• Recent editorials in the BJSM on the role of lumbar stabilization in low back pain
• Basic motor control theory and the process of motor recovery following an injury including a reduction in cognitive regulation, decrease in visual dependency, and improvements in sensorimotor adaptability
• How pain influences motor behavior including local and affective influences on muscle activity
• An overview of what we know and don’t know regarding motor control interventions
• How this information has influenced my approach in the management of low back pain

Articles cited:

Allison, G., & Morris, S. (2008). Transversus abdominis and core stability: has the pendulum swung? British Journal of Sports Medicine, 42 (11), 630-631 DOI: 10.1136/bjsm.2008.048637

Hodges, P. (2007). Transversus abdominis: a different view of the elephant British Journal of Sports Medicine, 42 (12), 941-944 DOI: 10.1136/bjsm.2008.051037

Cook, J. (2008). Jumping on bandwagons: taking the right clinical message from research British Journal of Sports Medicine, 42 (11), 563-563 DOI: 10.1136/bjsm.2008.048629

Mulder T, Neinhuis B, & Pauwels J (1996). The Assessment of Motor Recovery: A New Look at an Old Problem J Electromyogr Kinisiol, 6 (2), 137-145

Hodges, P. (2003). Pain and motor control of the lumbopelvic region: effect and possible mechanisms Journal of Electromyography and Kinesiology, 13 (4), 361-370 DOI: 10.1016/S1050-6411(03)00042-7

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