2:08. Introduction – Eyal’s background
- Yoga teacher
- Trained in Osteopathy, London ‘82-‘86
- Research: PhD
- Centre for Professional Development for Manual & Physical Therapies
- PhD Supervisor: Functional Rehabilitation Post-Knee replacement
- Fundamentals of Manual Therapy
- Do manual techniques have an effect on the motor control of the human body? … “No”
- Neuromuscular Re-Abilitation
- Functional Exercise Prescription
- How to exercise without exercising
7:37. Identifying the meaningful task
8:14. Active vs Passive Rehabilitation
- Osteopathy almost 100% passive historically
- All manual therapies needed an update
- You can’t learn / enhance / improve movement if you’re not actively doing it
- Passive techniques = input (sensory), but need to be coupled with output (motor)
12:22. Process Approach
- What is a process approach?
- Self-capacity, self-recovery
- Functional Recovery – the ability to return to daily activity in some level of comfort
- 3 overal processes:
- Modulation / Alleviation of Symptoms
- By which process will the person best recover?
- Stimulation for repair / adaptation / modulation
- Acute Disc Injury o/s 2/52
- How will they recover function?
- Limb immobilised – coming out of plaster cast
- How will they recover function
- Adaptation will be focus
18:49. If repair is focus… do you recommend nutrition / lifestyle etc?
- Repair process is robust
- 80% of patient advice is forgotten or remembered erroneously
- Avoid complexity…
20:31. If plaster cast is off – we’re more focused on:
- Adaptation / Remodelling
- Mimicking the motor action as closely as possible
- “Breaking down a task to its components does not transfer back into integrated movement”
- Balance specificity is not transferable
- Exposure is key – repetition & specificity
24:05. MET versus Squat in improving ROM in ankle dorsiflexion
- Adaptation is driven by exposure
- 1998 Stretching Research Paper:
- CORRECTION in the podcast I describe a paper from 1998… but this was it (from 1997)!
- Gleim G, McHugh M 1997. Flexibility and its effects on sports injury and performance. Sports Medicine E1 24(5):289–299
- Stretching as adaptive load
28:15. Moving from Isolation to Integration
- Task specific learning: 2 components:
- These 2 are fully integrated
- Isolation is disintegration
- External focus (goal)
- Internal focus (e.g. arm)
- External focus results in
- more efficiency
- lower EMG
- greater transfer
- Integrate in order to co-ordinate
32:59. Shirley Sahrmann:
- Winging of scapula due to serratus anterior inhibition / weakness
- Push-up with a plus does not help scapula winging
- Functional exercises? Or extra-functional movement?
34:52. Modulation of Symptoms: the 3rdcomponent of the Process Approach
- We often have “pathologies” we’re unaware of
- Can happen reflexively, spinal, higher centres
- Game of Thrones analogy: when it comes to pain it is fantasy land… if you believe it, it’s quite likely to work well!
- Next decade: understanding how people experience pain
37:22. Do we need to focus inwardly our outwardly?
- It’s Fantasy Land so self-care can work for some, but not for all
- Identify the process by which people can get themselves better… then amplify that process
40:01. How far do you go into Psychological Factors in your model?
- Reassurance / cognitive tools / attentive to emotional & psychological state
- Not depth psychology / psychotherapy
41:13. How to find Dr Eyal Lederman
- Eyal’s papers, books and courses can all be found at www.cpdo.net