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Neurocentric Approach to Massage Therapy


Active and Passive approaches to Treating Mechanical Deformation of Nerve Tissue


Manual Therapy and specifically Massage Therapy in BC is traditionally seen as a passive method of treatment for muscles and joints for the relief of painful conditions. We are taught to release fascia and muscles, press on knots and mobilize stuck joints. We do this by pushing, pulling and twisting these tissues without great thought to the underlying reasons that these body parts are feeling restricted and tight. Most of the underlying methods that we use in our toolbox are developed on a poor or even non-existent foundation: Castles in the sky if you will.
What I propose is an approach to these people’s painful conditions that put the nervous system first. Specifically, I’m looking at pain that originates from a mechanical deformation of nerve tissue and that can change with position or movement.  It is important here to look at the origin of the painful experience as opposed to cause. What do I mean by that? By origin, I mean it as the point or place where something begins, arises, or is derived. With pain there are only four origins where pain may arise from. 
Cause, on the other hand, is something that brings about an effect or a result. To look for the cause of someone's pain can result in thousands of reasons each reason giving little illumination on how to proceed with treatments.  Alternatively, the origins of pain give us a clearer path to resolution. 

From Barrett Dorko the originator of Simple Contact: 

“Almost without exception therapists interviewing a patient in pain begin to try and figure out how this patient came to be the way that they are. They work to create a story that explains this and then search for evidence. This is called looking for the cause, and I think it’s a tremendous waste of time. It’s a great black hole, and I suggest you stop doing this as soon as you possibly can.” 

I find that if you understand the four origins of pain you will have the best chance of success with your patients.
Specifically, I would like to look at pain that originates in the mechanical deformation of nervous tissue. This type of pain is an abnormal neurodynamic and can be changed with position or movement. If the mechanical stress on the nerve is not corrected it can result in neuritis or even a neuroma. 

What I hope to achieve with this course is to provide my students with a way to better understand how painful conditions arise and how we can successfully treat these conditions with passive movements that target peripheral nerves and active movements that empower the patient to help themselves achieve a resolution of their pain. This active treatment is based on Barrett Dorko’s Simple Contact. An approach and method of treatment that attempts to remove the barriers of self-correction. With simple hand placements, we let the patient guide the movement towards unloading mechanically deformed nerve tissues in the body. This is achieved by allowing ideomotion to express itself. This may resemble other treatments such as fascial unwinding or Cranial Sacral Therapy but is based on a stronger base of plausibility and has greater outcome predictability. 

The second part of the course looks at passive treatments that are based on Neurodynamics.  Neurodynamics is a method popularized by David Buttler and Michael Shacklock who are two prominent Physios from Australia. Concurrently, here in BC, a very similar method called End Range Loading was developed by David DeCamimilis DC. These methods are well researched as Manual Therapies go.

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