A PROCESS APPROACH IN MANUAL AND PHYSICAL THERAPIES BEYOND THE STRUCTURAL MODEL – FORUM 3

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Hi All
A warm welcome to all on this cold and dark London evening. Please feel free to remark, ask and contribute to the discussion.
Your certificate of attendance will be available to downloaded at the end of the forum (1 hour Learning with Others).

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Hi All
A warm welcome to all on this cold and dark London evening. Please feel free to remark, ask and contribute to the discussion.
Your certificate of attendance will be available to download at the end of the forum (1 hour Learning with Others).

[sue]

I find the article useful and helpful.’ That said, I think that working structurally can also ’support recovery processes’.
I have a couple of questions :
re the model of the ‘three recovery processes’ – (repair, alleviation of symptoms, and adaptation) I understand what you mean by ‘repair’ and ‘alleviation of symptoms’, but am having difficulty grasping what you mean by the ‘adaptation process’ and how one works with it. For example, page 3 of your article refers to a pt immobilised following an ankle fracture and after subsequent removal of the cast ‘functional recovery would be dependant on adaptive tissue changes and CNS plasticity……..(and) in this example a functional recovery is associated primarily with adaptive processes ’
It may be obvious, but would you mind just spelling out briefly what you mean here, thanks. Do you mean the therapist works to encourage any useful adaptations and to remedy/ change those adaptations that are not useful/ no longer useful?

page 4 of your article , referring to the diagram – ‘the recovery associated with alleviation of chronic pain is represented by the overlap between alleviation of symptoms and adaptation. Often chronic pain is associated with central sensitisation, a process related to neural plasticity and adaptation’ — is the ‘desensitisation’ process what you are calling ‘adaptation’?

[Karlos1377]

Do you find you are met with a lot of opposition from other health care professionals (who come from a biomechanic background) when describing the process approach?

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Immobilisation following an ankle fracture it would result in multisystem adaptive changes affecting vascular, lymphatic systems, connective tissue and muscle tissue and motor control. Subsequently, the individual’s functional recovery after removal of the cast is also associated with adaptive biomechanical/physiological tissue changes, e.g. muscle hypertrophy, and central nervous system plasticity/adaptation.

[sue]

Do you mean the therapist works to encourage any useful adaptations and to remedy/ change those adaptations that are not useful/ no longer useful? – e.g. muscle hypertrophy?

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Adaptation is the long-term physiological or structural change in the body in response to a change in the environment, i.e. beyond homeostasis
Pain experience can become chronic through neural plasticity – a form of adaptation in the system

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Karlos
Yes, there is a lot of resistance to A Process Approach, although many therapists who work under a Structural Model unknowingly use a Process Approach.

[sue]

Do you mean the therapist works to encourage any useful adaptations and to remedy/ change those adaptations that are not useful/ no longer useful? – e.g. muscle hypertrophy?

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Sue
Do you mean the therapist works to encourage any useful adaptations and to remedy/ change those adaptations that are not useful/ no longer useful? – e.g. muscle hypertrophy?
Essentially, Yes

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Sue
Examples of adaptation:
A sun tan
Memorising and remembering
Learning a new movement
Muscle strength increase by resistance training
Connective tissue changes due to physical changes

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Sue
It is interesting that osteopaths don’t learn about adaptive processes. This gives rise to a lot of implausible forms of management..

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Sue and Karlos
Let me know if you would like to continue/have more questions

[caithnessosteopathicservices]

To me, process approach seems to be mainly what I do and physios do but maybe with one exception which is we mobilise and reposition joint muscle fascia to allow it to heal. With out this step How can the self healing occur. just mobilization of all forms ,met, cs fascial ect alone equally will not produce long term results. Is this paper designed to help us reflect our practices? To provoke discussion?

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If you don’e have any further questions the certificate can be downloaded from here:
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Thanks for joing the forum and hopefully you’ll join future ones..
Eyal

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caithnessosteo
As I have said before many therapists unknowingly use a process approach
What do you mean by reposition joint muscle fascia to allow it to heal? How can you do that?
Your question – Is this paper designed to help us reflect our practices? To provoke discussion? Yes to all.

[sue]

By the way there seems to be a delay in my receiving your responses. re ‘implausible forms of management’ – I get your point. However, I think it is often difficult to define what is and isnt ‘plausible’ given that science is not (yet?) always able to explain why things work or not.

[PhilYoung]

I am curious about your usage of the word process. This would have a specific set of meanings within psychotherapy did that approach inform your choice of terminology?

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Caithnessosteo
To help healing you need movement. reposition joint muscle fascia is a very structural approach…
From Article:
Osteopathic management often seeks to identify and remove the obstacles which may impede self-healing. It is believed that obstacles to self-healing can arise from faults, misalignments or imbalances within the body’s structure. By removing these structural obstacles damaging stresses can be minimised and physiology improved.
In Process Approach the management is aimed directly at supporting the recovery processes rather than indirectly through influencing biomechanics, structure/anatomy or posture as in the Structural Model.

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Philyoung
Yes, to a point. Process to me is something about multiple sequences of events that are interrelated, complexity, uncertainty, no start or ending, etc
.

[sue]

re ‘Yes, to a point. Process to me is something about multiple sequences of events that are interrelated, complexity, uncertainty, no start or ending, etc’
reminds me of the chinese medicine book ‘the web with no weaver’

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Welcome back Sue…

[caithnessosteopathicservices]

Hi do we get a response?

[caithnessosteopathicservices]

Sorry, there is a delayed in downloading on our side.

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Hi All
Thank you for joining this forum. Hope you found it useful.
Your certificate of attendance can be downloaded from here:
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Regards,
Eyal

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caithnessosteo
Look at the thread further up, your Q was answered…

[caithnessosteopathicservices]

It seems a shame not to use structural approaches within process approach.

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