1. Manual therapy is not a "thing" - it's an intrinsic behaviour evolved from social grooming in vertebrates and conceptualized by human primates, taught from the time humans could talk, bottom-up/operator style.
2. Manual therapy should be about pain and pain relief.
3. Pain, and relief of pain, is strictly a top-down phenomenon. It occurs only in ectodermal derivatives, specifically the brain. Nerves and spinal cord are antecedent, and very important physiologically, to a emergent pain production.
4. Manual therapy models must adapt, teach about pain, teach top-down, not just bottom-up, and interactively, not only operatively.
5. The senses are the only way into any patient's brain. Talking/education are paramount; furthermore, touching is allowed us; skin receptors have the fastest highway into the brain (DCML), and to its output mechanisms, by any manual therapist, so these should be in sharp focus.
6. People who get stuck in a bottom-up mindset because they ponder far too hard about what deep receptors are where, how to affect them, are going to lose sight of the whole point of touching somebody on their skin, i.e., stress and pain relief.
7. Nociception is mostly irrelevant to the brain and is handled immediately, effectively, automatically, by the internal regulation system, without ever becoming or having to become pain.
8. If anything out in the periphery needs moved, by a manual therapist, it's nerves themselves: neural anatomy is unique, crossing many tissue boundaries, and the connection to accompanying vascular supply is vulnerable to mechanical deformation (e.g., simple inactivity, habitual resting positions, or repetitive strain); enough signalling from these, over a long enough period, will challenge spinal cord cell interaction/immune cell physiology enough to change it, which can give rise to an actual pain situation.
9. Worrying or perseverating about anything else, i.e., receptors that may lie in deep tissue other than nerve tissue, or arguing to include them/it in a treatment or in an explanatory model of manual therapy, is a massive waste of time, and would serve to keep the profession mired in mesodermal mutterings, whereby we see misled therapists misleading ever more therapists into the fogbound foreseeable future.
From this thread at SomaSimple:http://www.somasimple.com/