Myofascial unwinding?

[markelmarcel]

So, I was having some neck pain the past couple of days (a chronic issue that I usually self treat with exercise, etc) and asked my coworker if she would be able to do some MT on me to try to relieve some tension. She worked on my neck for about a half hour doing some different mobes, stretches, etc and then she told me to relax my head. I went through all these crazy head motions (seemingly I thought she was guiding me through a series of movements simply to make sure my mobility was unrestricted) and after the fact she told me she had done myofascial unwinding. My coworker is a very articulate PT with 20 years of experience (and a great mentor for a new grad!) and I'm always fascinated by things that are not "traditional medicine".

So, she told me she had done a short course on it and that although she wasn't sure about the alleged science behind it, she's used it on some patients with neck pain and they seem to get relief. I found it absolutely fascinating and just wondered if anyone else had ever had an experience with it, be it a coworker or seminar, etc.

The PT who came up with it is named John Barnes. Although I admit it's like voodoo magic, I found it pretty cool at the same time. Subsequently, I read this article (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091471/pdf/ijtmb-2-3-10.pdf) and found the information interesting.

The analytic part of my brain tells me this is complete insanity and the, I guess, more spiritual side of me finds it absolutely fascinating.

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[noyceguy]

If it works, use it. Later, you can always find out why.

 

[Fiveoboy11]

There's variance in everyones practice patterns. This is just a guru who labels his or her particular spin on how they provide manual treatment. And I think the profession of physical therapy is trying to minimize practice pattern variance in favor of evidence and clinical practice guidelines with individual adjustments based on the patient, as this in theory should yield better outcomes.

Your co worker was doing joint mobilization and stretches to your neck, not "magic" guru PT. You really don't have to sign up for all the weekend courses, and use it on all your patients because it "works."

Check out these clinical practice guidelines for neck pain. I'll post it here, it is based on categories (page 27), gives impairments and symptoms for the categories and recommended interventions. See which group you belong to, then compare it to what your co worker did, and/or consider following the guidelines to see which is the most mystical. Please make note of the "neck pain with mobility deficit" category, is this you? Does the recommendations of interventions that worked on you match?

http://www.orthopt.org/ICF/Neck Pain Clinical Guideline - JOSPT - Sept 2008.pdf

 

[markelmarcel]

Oh, I'm very familiar with the clinical guidelines and most definitely feel that this is what we should be focusing on when treating patients. I just found the technique interesting since I had never heard of it before and had wondered if anyone else had come across it. I think that evidence needs to be at the forefront of all of our practice patterns, no matter what the situation. And, I'm glad that more and more clinical guidelines have been coming out to help us move the profession in the correct path.

To answer your question of comparing myself to the clinical guidelines, that's where the fun lays. Not all our patients fit into perfect little categories, so it's a good thing we all can practice (hopefully) good judgement. Although sometimes I have restrictions in mobility, I have hypermobility throughout my body and more often than not my neck pain is associated with my lack of devoting time to stabilizing therex. That's why I found the unwinding interesting, because if one were to examine my cervical spine they wouldn't really find any restrictions. Often times I feel like my muscles are tight and need stretched but I never feel like I can elongate them enough to feel a stretch. I chalk my symptoms up to the potential of my muscles being fatigued due to the work they do to try to maintain my head upon my wobbly body 😉

 

[AlanWattsBlues]

The PT who came up with it is named John Barnes. Although I admit it's like voodoo magic, I found it pretty cool at the same time. Subsequently, I read this article (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091471/pdf/ijtmb-2-3-10.pdf) and found the information interesting.

That linked article mentioned ideomotor movement, which is a term I associate with Barrett Dorko of SomaSimple fame. Looks like John Barnes and MFR have been discussed over there in some detail:

http://www.somasimple.com/forums/showthread.php?t=1841
http://www.somasimple.com/forums/showthread.php?t=6054

Seems like the MFR world might be a bit of a hot mess. Also, if the "unwinding" that you found interesting is in practice the same thing as what Dorko teaches (though with a different explanatory mechanism), it might be more worthwhile to follow up with Dorko to learn more. The guy seems to pretty much lay all his cards out on the table.

 

[Fiveoboy11]

I'd read this too as it's pretty funny.

http://quackfiles.blogspot.com/2005/12/please-release-me-let-me-go-mfr.html?m=1

Witchcraft sorcery with a really big spoon.

 

[jesspt]

Barrett Dorko = clinician scientist. John Barnes = litigous anti-scientist and spreader of "treatments" that have not been held up to scietific rigor and lack prior plausibility.

 

[jesspt]

If it works, use it. Later, you can always find out why.

Do not fall into this trap. Ever.

 

[noyceguy]

Do not fall into this trap. Ever.

Only a Sith deals in absolutes.

 

[Sheldon]

Barrett Dorko = clinician scientist. John Barnes = litigous anti-scientist and spreader of "treatments" that have not been held up to scietific rigor and lack prior plausibility.

How to do you feel about Barrett's rational re: not conducting any research about SC but relying on his "premise?"

 

[jesspt]

How to do you feel about Barrett's rational re: not conducting any research about SC but relying on his "premise?"

I'm not sure that Barrett has ever stated his rationale for not conducting research re: Simple Contact/Ideomotion. He could, I'm sure, list numerous references for the occurence of ideomotion, and many of these can likely be found on www.somasimple.com. I do believe he published a case series or case study on the use of ideomotion to treat neck pain several years back. And, he's not attached to a large research institution, so conducting a large-scale trial would be fairly daunting. At least his premise does not defy the laws of physics as some (myofascial release) seem to.

As an aside, I don't use either Simple Contact or Myofascial Unwinding. But I have learned a great deal about pain science/pain physiology from Barret's writings over at Soma Simple.