Sunday, January 13, 2013

Immediate versus Long-Term Response

It has been quite a long "layoff" over the holidays, which has allowed for more time to generate new thoughts and formulations...both a blessing and a curse given that time and energy are sometimes in short supply.  However, I thought I would begin the 2013 "season" with a shorter and more "global" rant that centers around perspective...which has often been explicitly explored in this blog, but has always been a consistent undercurrent throughout.  Achieving a proper perspective is a difficult task and is arguably very subjective...based on your own value system, environment, and personal "prism" you may have an approach or attitude that varies greatly from others.  However, if things are expressed conceptually, then the eventual outcome will always be the correct one for you.  Concepts (or frameworks) are effectively neutral and therefore should fit universally across most philosophies. 

A fundamental understanding that needs to be established (whether a care-PROVIDER or care-SEEKER) isthe distinction between Immediate response and Long-Term response.  This will ultimately help in being able to effectively identify what is really happening and what specific intervention is the source of the progress.  Given that most people attempt to combine or "marry" multiple interventions together (in the hopes of somehow extracting all the good from each), it is an intelligent strategy to at least have an understanding of how your system will respond to either or all of the specific interventions. 

In order to project this concept more effectively, I will use a familiar therapeutic example to illustrate the paradoxical behaviour that some interventions may exhibit.  I sue the term "paradoxical" because the general conception is that once a specific therapy is implemented, the response will be immediate and manifest in the same way throughout...but this is relatively simplistic and, more importantly, deceptive.

Trans-Fascial Viscoelastic Stimulation
The adjacent photo represents an example of Trans-Fascial Viscoelastic Stimulation (TFVES).  I have detailed the specifics of the technique in this blog before, but it is essentially a manual massage technique that generates many systemic and mechanical benefit and improvement. 

This technique can be implemented across a braod and diverse range of conditions, pathologies, and considerations. If we use the example of a healthy individual complaining of generalized upper back pain and muscular tension, there are indeed a wide range of treatment options...but the understanding of how the body will respond will ultimately guide the care-seeker towards the most realistic and convenient option.  Further, it provides the professional will much more information from which to formulate a treatment strategy.  Using TFVES (this can also be exported to most forms of manual massage), the immediate response is one of reduction in localized muscular tension and a generalizing decrease in pain.  This is a result of an autonomic response from the hypothalamus as well as a mechanical "pumping" of the interstitial fluid that increases lymphatic drainage and a recycling of metabolic waste.  Therefore, the immediate benefit is release.  This essential phenomenon will continue in the initial stages of treatment and will effectively extend throughout the first few weeks of application.  Once this stimulus has been applied consistently for a longer period of time, it will accumulate and solicit mechanical and structural changes within the connective tissue / fascial network.  Through the process of mechanotransduction, the connective tissue (architectural "scaffolding" of the body) will essentially strengthen.  In other words, the architectural / fascial "sub-failure" that resulted in the initial pain and muscualr tension will have been resolved. 

Sensory stimulation, promotion of interstitial fluid flow, and increase circulation generate the immediate response of releasing muscualr tension and alleviating some general discomfort whereas the long term response is characterized by a strengthening of the structural architecture which contributes to reduction of injury recurrence and a more stable mechanical system.

This brief rant is, of course, a general overview of a much more complex systemic mechanism...but it should provide some insight into the multiple considerations that need to be examined when seeking / formulating treatment.  Although it can be overwhelming when examined to the extreme, once the general concept has been integrated it is actually quite elegantly simple.  As I have recently read and posted in the blog Facebook page: "Simplicity is the ultimate spohistication".  A well-delivered stimulus that is properly and consistently applied will be sufficient to generate a global systemic response from the body and ultimately contribute to it's development and improvement. 

Cheers and Happy 2013! =)

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