Critical Thinking

Why Does _________ Hurt…

I was recently made aware of a youtube video by Thomas Myers (on soma simple).  In this video, Mr. Myers tackles the concept of pain, in a rather unique way.  This post is to provide insight on some of the topics discussed by Mr. Myers.  I would recommend you first watch his video, and read below:

My Analysis (please note this is simply a critique of concepts and not a critique of Mr. Myers):

1:02:   Mr. Myers states, “Pain is sensation accompanied by the motor intention to withdraw.  If you’re not trying to get away from it, it isn’t pain. It’s just sensation“.  

The International Association for the Study of Pain (IASP) is the leading governing authority in the concept of pain.  They define pain as: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”  

The IASP does not appear to draw any conclusion on pain with motor planning/execution.

In the Neuromatrix, as described by Ronald Melzack, action programming appears to be an independent output which may, or may not, occur with an experience of pain.

In my own M.I.P Algorithm for motor control, as presented at AAOMPT 2013, 2014, we have come to a very similar conclusion to Dr. Melzack.

1:18: Mr. Myers discusses how pain varies.  

This is consistent with current literature describing pain to be an individual experience.

2:38: Mr. Myers states: “…tear the fascia off you, off your sternum, which is a place where it very commonly gets stuck down both biomechanically and emotionally”

I performed a quick google scholar search between the years 2000-2014 on “fascia” and “emotion”.  I did not find any articles to suffice or even describe the relationship between “emotion” and “fascia”.  This does not mean they do not exist and I would welcome anyone to share literature showing this.

2:56: Mr. Myers describes a “burning” sensation from free-nerve endings stuck in-between fascial layers, when functional fascial layers move on each other.  He also reports this as a feeling of as”tearing”.  He reports once this tearing takes place, movement will increase between these surfaces.

Anytime I hear “Buring” and “Nerves”, I suspect we must consider “causalgia”. As defined by IASP: “A syndrome of sustained burning pain, allodynia, and hyperpathia after a traumatic nerve lesion, often combined with vasomotor and sudomotor dysfunction and later trophic changes.”  I am not sure I understand completely what is tearing and how this results in movement?  Typically, when we tear or damage cells or tissue, we create an acute inflammatory reaction.  This process is generally not accompanied by an increase in movement.

4:51: There are three types of pain.  1. Pain Coming into the Body  2. There’s pain stored in the body  3. Pain leaving the body

By definition, pain is pain.  Smart et al. have published several articles validating a mechanisms-based classification system for pain and there are 3 mechanisms which potentially could result in pain: 1. Nociceptive  2. Peripheral Neuropathic   3. Central Sensitization

6:36: Mr. Myers states, “When a bone has been broken, when you have a psychological trauma, when an organ has been traumatized, there will be pain stored in that and I believe you have to feel that pain on the way out.”

There are many instances in which tissue injury does not result in pain.  This is well-documented in research studies on cohorts who are asymptomatic and undergo diagnostic imaging.

Advertisements

Categories: Critical Thinking

Tagged as:

6 replies »

  1. I agree with your Joe questioning of and disagreement with this. After all, you present an argument, not an opinion. I don’t see the word “believe” anywhere in what you say. Neither are the words, “In my experience.” Myers may not see any of this. Might you imagine he’d call your comments “unprofessional”?

  2. When attempting to describe a physiological sensation we run into the problem of language and the various interpretations that individuals ( the ‘self’ included) might employ to communicate that sensation. ‘Pain’, ‘hurt’ are purely subjective expressions. Many therapists use the 1 to 10 grading scale to help reduce that protective withdrawal response that contracts the tissue and impedes the therapeutic effect of touch.
    Rolfing was often criticized for very aggressive tissue manipulation. They have evolved. Sustained myofascial release and muscle energy techniques offer approaches that go ‘under the radar’ of various neural receptors so as not to trigger that withdrawal response. The key is to educate and enlist the feedback of the person,using the 1 to 10 scale. Massage need not cause ‘pain’. But if there is tissue dysfunction (a shift off of a homeoststic environment) there will be an increase in the amplitude of the sensation when mobilized or palpated. However, if executed correctly, there will often be heard…. “that’s a good hurt”.

    • Hi Joseph,

      I’m not sure what you mean by this statement “Many therapists use the 1 to 10 grading scale to help reduce that protective withdrawal response that contracts the tissue and impedes the therapeutic effect of touch.” Would you mind clarifying for me?

  3. Joseph, Among other things, your,contention that “contracting the tissue further and impede the therapeutic effect of touch” makes me wonder how you might defend such a statement. There’s more.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s