Monday, March 14, 2011

Wisdom from Brian Green

"10 years years from now we might find out that leaving it alone is the best treatment".

Absolutely Brian, and you have Dr. Lederman to back you up!  Page 170 of "Neuromuscular Rehabilitation in Manual & Physical Therapies,( 2010)":

"The injury response is a positive healty response and not a motor dysfunction or pathology.  Acute musculoskeletal injuries should be left alone- the body knows best.  The patient should be encouraged to keep active".

That sounds a lot like when I speak of "training around the injury", or "training at the periphery of function", no?  That does NOT mean throw out all your manual therapies, but it does mean keep it puroposeful and functional and keep the athlete actively involved whenever possible (e.g. FMR, Mulligans).  That was the basis of my (now defunct) ankle rehab book.  But a simple example- let's say an athlete sprained their ankle and dorsiflexion is painful.  But you want to preserve function.  You ask them to squat and they lean to the contralateral side because it hurts.  Simply move the involved foot forward and have them stagger squat, as it requires less dorsiflexion.

No comments: