Do kindly let any of the kids at the Manual Medicine Group know that you're interested in Integrative Manual Therapy coursework and certification. Our friends are also offering a Certification in structural rehabilitation. That program spans two years. The current block starts 2009 and ends 2011. The final certificate will be furnished by Westbrook University USA. Of course, if enough people locally are interested in completing coursework, we can likely manage to bring our friends over to do the courses here. You'll let us know when you're aching to do that, right?
And now, a direct invite from our friends abroad:
Dear Friends and Colleagues -
We are pleased to introduce the Integrative Manual Therapy (IMT) course and clinical skills calendar for 2009.
IMT treatment techniques are hands-on manual therapy techniques, which involve gentle manipulative techniques to promote tissue repair, normalize structure and restore function. IMT can be and is practiced around the world by physiotherapists, osteopaths, chiropractics, acupuncturists and Chinese medicine practitioners, occupational therapists, naturopaths, massage therapists, physical trainers, and Western medical physicians.
IMT was developed by Dr. Sharon Weiselfish Giammatteo, PhD, PT, IMT,C. over the past 30 years. Sharon is a physiotherapist, an expert in the field of manual therapy and a PhD in the field of neuro-rehabilitation who developed this work to offer solutions for complex patients.
In 2009, Balance Health in conjunction with the Connecticut School of Integrative Manual Therapy in the USA will continue to bring cutting edge manual therapy courses to Hong Kong, as well as continue our efforts to support the IMT community in HK with free IMT Learning Evenings throughout 2009.
We are also pleased to announce that in September 2009- April 2011, we will run a 9 weekend part-time certification program in Structural Rehabilitation with Integrative Manual Therapy in Hong Kong. This program is certified through Westbrook University and the Connecticut School of Integrative Manual Therapy in the USA. This certification program is ideal for both new as well as more experienced manual practitioners. Please see the attached flyer for more details on this program. Further details about this program will follow in the near future.
The following is the 2009 IMT course and clinical skills training schedule for HK:
IMT Courses for 2009
1. The Brain: Beyond Cranial Therapies
Date: Friday May 8-Sunday May 10 (9am-5pm)
Instructor: Sharon Weiselfish Giammatteo, PT, PhD, IMT, C. and Thomas Giammatteo, DC, ND, PT, IMT,C.
Course Description: This 3 day lab course will present all new material for the assessment and treatment of acute and/or chronic or difficult neurologic patients, including:
* How to address clients with pain, disability and disease who can be affected via working on neural and brain tissue.
* How to use techniques, critical thinking, clinical skills, application and integration which is ‘beyond cranial therapies'
* How to assess and treat all clients with neurologic insufficiency, whether they present with spinal dysfunction, headaches or migraines and/or neurologic diseases.
* The techniques presented are appropriate for the treatment of pediatric, adult, geriatric, acute and/or chronic patients.
* How to palpate biologic rhythms (motilities) for neural and other tissues.
* An introduction to Nutritional Wellness for the nervous system: a guide to supplements and dietary intervention for improved genetic potential.
Pre-requisite(s): Any Cranial Therapy Level 1 and Level 2 from any instructor
Booking deadline: April 10, 2009
Cost: HKD 5300 (if pay before March 27); HKD 5800 (if pay after March 27)
2. Visceral Manual Therapy for Lung Disorders and Oxidative Stress
Date: Friday October 16 - Sunday October 18 (9am-5pm)
Instructor: Sharon Weiselfish Giammatteo, PT, PhD, IMT, C. and Thomas Giammatteo, DC, ND, PT, IMT,C.
Course Description: This 3 day lab course will present comprehensive material for manual therapy practitioners for the assessment and treatment of Lung Disorders and Oxidative Stress with Integrative Manual Therapy. This course was developed to address all pulmonary problems, including: respiratory distress in infants and children; asthma; bronchitis; bronchiectasis; emphysema; chronic obstructive pulmonary disease (COPD); atelectasis; sick building syndrome; mold syndromes; chronic fatigue syndromes; oxidative stress and mitochondrial disorders; and more. Persons with severe pulmonary insufficiency are known to have multiple systems breakdown because of the secondary problems which occur due to poor oxygenation, hemaglobin insufficiency and mitochondrial issues affecting oxidation of tissues. This material can be used in conjunction with IMT’s Respiratory Rehabilitation course.
Pre-requisite(s): IMT’s Respiratory Rehabilitation course is recommended, but not required to attend this course
Booking deadline: September 18, 2009
Cost: HKD 5300 (if pay before Aug 28); HKD 5800 (if pay after Aug 28)
IMT Learning Evenings:
* IMT Evenings are free of charge. IMT Evenings welcome both advanced and new students to IMT. Some lab time will be integrated into each evening. All IMT evenings will be held at Balance Health in Central at 3-5 Arbuthnot Rd, 27th Floor, Suite 2705, Universal Trade Centre.
Dates/Times and Topics of IMT Evenings:
1. Topic: Motility Testing for Lymph, Liver, Colon and General and Specific Allergies
A specific and objective hands-on diagnostic tool to discern how food products, supplements, herbs, homeopathic remedies, etc. are being utilized and integrated into the body. New and specific ways to test for common allergies like dairy, egg and gluten sensitivities will be shown.
Date: Thursday March 19, 6:30-8:30pm
2. Topic: To be determined
Date: Thursday September 24, 6:30-8:30pm
3. Topic: To be determined
Date: Thursday November 19, 6:30-8:30pm
All course information, including course descriptions, venue and payment information can be viewed at www.balancehealth.com.hk. Please note that the booking deadline for all courses will be one month prior to the course date. The registration for all courses can be made through Balance Health. For more information, or to request a registration form, please contact Santi Chan at Balance Health at 2530-3315 or at santi@balancehealth.com.hk.
We look forward to seeing you all at either an IMT course or an IMT Evening in the near future.
Kind Regards,
Jennifer M. Lewin, L.Ac (USA), MAOM, IMT,C.
and
Carla Bekker-Smith
the Manual Medicine Group may be reached via assist@truecaremed.com
Monday, February 9, 2009
Sunday, February 8, 2009
the mechanism of muscle energy techniques
Picked this up from out discussion forum.
Hope this proves useful.
We're also hoping we could share more with you on the 22nd of February, in PASIG. The posting for that sharing session (some call them workshops) appears on this site as well. for registration, Harold can be reached at 09274515589 and via this site.
Back to the that discussion -
Re: Osteopathy For All RE: MET
> David
The terms Post isometric relaxation (PIR) and reciprocal inhibition (RI) are no longer valid in the strictest sense, since these mechanisms have been shown to not be responsible for the effects of MET.
In the 3rd edition of my MET book (Elsevier 2006) Gary Fryer PhD Bsc(Osteopathy) ND has a chapter on the research evidence relative to MET which explains why PIR and RI, while valid concepts in themselves, are not involved in MET's efficacy - but that the increased tolerance to stretch that follows an isometric contraction (of agonist or antagonist) results from some other process(es).
One suggestion that has emerged from the background of research into endocannabinoids (Mcpartland et al) suggests that these endogenous hormones, which are up-regulated following MET (and a variety of other bodywork modalities including myofascial release) and which are analgesic and anti-inflammatory in their actions (along with producing a mild euphoria) may offer a partial explanation.
Other possible mechanisms involve the effect on associate muscles of either compression or light stretching on ligaments, which offers possible explanations for the efficacy of both MET and indirect methods such as strain counterstrain. (Solomonow 2009)
To answer your actual query:
In the sense that contraction involving agonist or antagonist muscles relative to a joint restriction will induce changes that allow easy mobilisation, it doesn't really matter which you use, or whether you induce a co-contraction, or indeed whether you don't use a contraction at all but employ rhythmic pulsating contractions (Ruddy's approach) - which is my preferred method since it also has the benefit of helping encourage enhanced proprioceptive function in the joint while simultaneously improving local circulatory and drainage features.
I hope this clarifies the issues you were asking about.
It simply means that the explanation for how MET works is in need of updating.
It does not change the practicality of its' application a jot
They after all built some of their original work (or Mitchell senior did at least) on Ruddy's pulsed approach ('rapid resisted duction' he called it)
Ruddy's approach (originally developed to treat the intrinsic eye muscles! but that's another story), was to engage the restriction barrier, and to then have the patient produce 20 or so minute rhythmic contractions (in the space of 10 seconds), towards the barrier, against practitioner resistance.
After which the new barrier would be engaged and so on....or the joint would be free.
In my own work I use Ruddy's directions as a starting point but do not restrict the directions of the pulsed effort to his 'towards the barrier' - injunction.. ..some very odd directions sometimes work brilliantly.
The pulsed efforts are the barest initiation of effort, no actual movement taking place.
His strong directive was 'no wobble, no bounce'
Leon
REF:
Fryer G 2000 Muscle Energy Concepts –A Need for a Change. Journal of Osteopathic Medicine. 3(2): 54 – 59
Fryer G 2006 MET: Efficacy & Research IN: Chaitow L (Ed) Muscle Energy Techniques (3rd edition) Elsevier, Edinburgh
Ruddy T 1961 Osteopathic rhythmic resistive duction therapy. Yearbook of Academy of Applied Osteopathy 1961, Indianapolis, p 58
Solomonow M 2009 Ligaments: A source of musculoskeletal disorders.J Bodywork & Movement Therapies 13(2): IN PRESS
Smith, M., Fryer, G. 2008 A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group Journal of Bodywork and Movement Therapies 12 (4), pp. 312-317
McPartland, J.M. 2004 Travel trigger points - Molecular and osteopathic perspectives Journal of the American Osteopathic Association 104 (6), pp. 244-249
Hamilton, L., Boswell, C., Fryer, G. 2007 The effects of high-velocity, low-amplitude manipulation and muscle energy technique on suboccipital tenderness International Journal of Osteopathic Medicine 10 (2-3), pp. 42-49
McPartland, J.M. 2008 The endocannabinoid system: An osteopathic perspective Journal of the American Osteopathic Association 108 (10), pp. 586-600
Magnusson M Simonsen E Aagaard P et al 1996a Mechanical and physiological responses to stretching with and without pre-isometric contraction in human skeletal muscle Archives of Physical Medicine & Rehabilitation 77:373-377
Magnusson M Simonsen E Aagaard P et al 1996b A mechanism for altered flexibility in human skeletal muscle. Journal of Physiology 497(Part 1):293-298
Hope this proves useful.
We're also hoping we could share more with you on the 22nd of February, in PASIG. The posting for that sharing session (some call them workshops) appears on this site as well. for registration, Harold can be reached at 09274515589 and via this site.
Back to the that discussion -
Re: Osteopathy For All RE: MET
> David
The terms Post isometric relaxation (PIR) and reciprocal inhibition (RI) are no longer valid in the strictest sense, since these mechanisms have been shown to not be responsible for the effects of MET.
In the 3rd edition of my MET book (Elsevier 2006) Gary Fryer PhD Bsc(Osteopathy) ND has a chapter on the research evidence relative to MET which explains why PIR and RI, while valid concepts in themselves, are not involved in MET's efficacy - but that the increased tolerance to stretch that follows an isometric contraction (of agonist or antagonist) results from some other process(es).
One suggestion that has emerged from the background of research into endocannabinoids (Mcpartland et al) suggests that these endogenous hormones, which are up-regulated following MET (and a variety of other bodywork modalities including myofascial release) and which are analgesic and anti-inflammatory in their actions (along with producing a mild euphoria) may offer a partial explanation.
Other possible mechanisms involve the effect on associate muscles of either compression or light stretching on ligaments, which offers possible explanations for the efficacy of both MET and indirect methods such as strain counterstrain. (Solomonow 2009)
To answer your actual query:
In the sense that contraction involving agonist or antagonist muscles relative to a joint restriction will induce changes that allow easy mobilisation, it doesn't really matter which you use, or whether you induce a co-contraction, or indeed whether you don't use a contraction at all but employ rhythmic pulsating contractions (Ruddy's approach) - which is my preferred method since it also has the benefit of helping encourage enhanced proprioceptive function in the joint while simultaneously improving local circulatory and drainage features.
I hope this clarifies the issues you were asking about.
It simply means that the explanation for how MET works is in need of updating.
It does not change the practicality of its' application a jot
They after all built some of their original work (or Mitchell senior did at least) on Ruddy's pulsed approach ('rapid resisted duction' he called it)
Ruddy's approach (originally developed to treat the intrinsic eye muscles! but that's another story), was to engage the restriction barrier, and to then have the patient produce 20 or so minute rhythmic contractions (in the space of 10 seconds), towards the barrier, against practitioner resistance.
After which the new barrier would be engaged and so on....or the joint would be free.
In my own work I use Ruddy's directions as a starting point but do not restrict the directions of the pulsed effort to his 'towards the barrier' - injunction.. ..some very odd directions sometimes work brilliantly.
The pulsed efforts are the barest initiation of effort, no actual movement taking place.
His strong directive was 'no wobble, no bounce'
Leon
REF:
Fryer G 2000 Muscle Energy Concepts –A Need for a Change. Journal of Osteopathic Medicine. 3(2): 54 – 59
Fryer G 2006 MET: Efficacy & Research IN: Chaitow L (Ed) Muscle Energy Techniques (3rd edition) Elsevier, Edinburgh
Ruddy T 1961 Osteopathic rhythmic resistive duction therapy. Yearbook of Academy of Applied Osteopathy 1961, Indianapolis, p 58
Solomonow M 2009 Ligaments: A source of musculoskeletal disorders.J Bodywork & Movement Therapies 13(2): IN PRESS
Smith, M., Fryer, G. 2008 A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group Journal of Bodywork and Movement Therapies 12 (4), pp. 312-317
McPartland, J.M. 2004 Travel trigger points - Molecular and osteopathic perspectives Journal of the American Osteopathic Association 104 (6), pp. 244-249
Hamilton, L., Boswell, C., Fryer, G. 2007 The effects of high-velocity, low-amplitude manipulation and muscle energy technique on suboccipital tenderness International Journal of Osteopathic Medicine 10 (2-3), pp. 42-49
McPartland, J.M. 2008 The endocannabinoid system: An osteopathic perspective Journal of the American Osteopathic Association 108 (10), pp. 586-600
Magnusson M Simonsen E Aagaard P et al 1996a Mechanical and physiological responses to stretching with and without pre-isometric contraction in human skeletal muscle Archives of Physical Medicine & Rehabilitation 77:373-377
Magnusson M Simonsen E Aagaard P et al 1996b A mechanism for altered flexibility in human skeletal muscle. Journal of Physiology 497(Part 1):293-298
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