Saturday, September 23, 2006

Missing? Or just cognitive "hemi-neglect"?

It seems most everyone in the orthopaedic branch of my profession is overly focused on mesoderm of one kind or another as if it had control of its own behavior, ignoring the nervous system as simple background noise. I thought this attitude was chiro driven, a memeplex to which PT had fallen prey, but I don't think so anymore - I think it's just naivité/simplistic thinking all round, like drawings of five year old children conforming to a predictable style. Ortho PT bases itself on what it has learned from its roots, the century-ago thinking of army gym trainers, masseuses, and orthopaedic doctors. (Who knows where chiro got its memes from?)

When the nervous system is considered at all in orthopaedic thinking, it seems to me it's only ever in terms of its output, and then only into muscles, that which can be "controlled" through acts of strengthening or will, i.e., "neuromuscular." There is rarely any work done or books written about the other side of the coin, sensory input, or what can happen to actual sensory fibres of nerves, physically, except for Shacklock and Butler. No one ever considers skin, how innervated it is, how sympathetically driven it is, how kinesthetically sensitive all the various levels of brain function are, how completely obedient the various levels of output (including pain output, motor output) are to miniscule amounts of sensory input, how the brain immediately engages with it, interprets it, expresses new output as a result. An understanding of sensory input into an intact NS from another nervous system could make our lives as PTs/professional human primate social groomers way easier and less cumbersome, and abolish a whole lot of excessive trappings/techniques/treatments. Something huge is missing!

My concern is about a significant perspective which is simply lacking in this whole mesodermally mad cognitive world we work in. The ortho part of the profession seems to only recognize half a picture, like the world certain stroke patients live in, those who ignore half the food on their plate because they can't perceive it, just aren't aware it exists. Most PTs have either wittingly or unwittingly decided to accept this state of affairs as normal! Sometimes I despair. That's all.

No comments: