Monday, November 21, 2005

Neurodynamic Solutions

Michael Shacklock is likely about to wing his way back to Australia sometime this morning, following a final weekend workshop here in Vancouver; he was at the end of a three and a half month tour of European and Western Hemisphere cities spent observing surgeries, consulting neuro researchers, and teaching his own unique vision of treatment of the neural component of the physical movement system. I've just had the pleasure of attending his upper limb workshop and give him credit for not seeming exhausted at all.

Neurodynamics took quite a bad rap after its initial rise in fame in the late eighties, early nineties, mostly in Australia. Shacklock says, "I went back to square one with the concept" because in his view it needed to be redeveloped, revamped, then reintroduced with a much different emphasis. He has succeeded in this regard. Gone are the verbs "stretch" and "tension" from the language used to explain the technique to the patient, although "slide" was allowed to remain. Introduced are many ideas on how to sift through patients to determine which ones are appropriate to test and treat in this manner and which ones are not. Also introduced is the notion of testing and treating at precise minimalist levels that do not irritate, that can be determined through sequencing of application, and how to differentiate neural symptom from tunnel symptom. All this precision requires good therapeutic rapport, and patient education/cooperation; Shacklock provides thorough grounding in how to achieve this.

The class is mostly devoted to developing handling skills: This includes thorough grounding and loads of practical handling tips in applying the standard tests and then in all the many variations that can be adopted, featured in precise categories; first to determine if the problem is neural or interface (differential diagnosis), next to help change the physiology of the nerves themselves if need be, and finally as treatment to address the pathodynamics of neural containers and musculo skeletal interface. Woven throughout is the basis of the concept, the basic science underpinnings and examples from his own many years of clinical practice. In addition to raising a family, running a practice and teaching worldwide, he found time somehow to write a book and produce a CD of real time ultrasound imaging of neural movement at the wrist, shoulder, and ankle.

Michael Shacklock is enthusiastically determined to see that good handling of the peripheral nervous system and spinal cord enjoys the comeback it deserves, and becomes a familiar and preferred treatment choice for all manual therapists. He is confident that this manner of handling patients will produce more precise, accurate research and a strong profession world wide.

Check out his site: (linked through the title of this blog piece). The book is comprehensive and the CD is a marvel. You can see the median nerve at the wrist moving freely in a normal subject, with lateral neck flexion compared to a patient with carpal tunnel. Shacklock is also the author of Moving in on Pain, published in 1995.

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