In the video below we utilize treating the scapula generally to highlight concepts of patient positioning, leverage, control, implicit learning, and explicit learning. The aim is to further discuss these concepts so that you, the consumer of this information, may have a greater understanding of the concepts in action.
The active search for motion dysfunction in a presenting patient is one that may very easily become complicated. A patient arrives and provides their subjective symptoms and then a manual osteopathic practitioner has a need to identify the motion dysfunctions that a patient displays. There are a very large amount of motion tests that may be performed by manual osteopathic practitioners (see here for a book preview with examples) and this is the crux of the challenge we will discuss here…there are so many tests that it may be cognitively challenging to figure out what the heck to do.
Here we demonstrate a method using the knee as a wedge/fulcrum for vertebral extension that is described in may early osteopathic books. The aim is not so much to demonstrate the method as it is often too strong with the amount of leverage that may be created, the aim is more to use the method to highlight overarching components that guide treatment. We identify lever/wedge/screw, palpation with something other than the hand (the knee in this case) while recognizing that it is not as sensitive as the hand, multisensory integration (keep your hands and eyes on the prize), as well as the use of implicit and explicit learning.
Here we speak about the application of treatment with respect to what types of thoughts might be useful to effectively pay attention to change in treatment. The general overarching concept is that motion dysfunction is identified as a motion that is different than expected and treatment is the process of minimizing that difference. We touch on cognitive load broadly as well as the concept that complicated thoughts may not be the most effective during treatment.
Here we take some time to discuss the process of identifying motion dysfunctions through a standard algorithm while engaging the concept that macro identifies micro. We also discuss the processes of implicit and explicit learning in so far as a practitioner may purposely trim pieces from an assessment over time as they may not provide useful information outside of specific circumstances.
Classical Osteopathy in Ontario 