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The Clinician's Manual by Barrett L. Dorko, PT

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ANT

Barrett L. Dorko, P.T.

I m often asked to demonstrate in some fashion that adverse neural tension (ANT) is a viable, essential diagnosis in a typical orthopedic practice. I m surprised at the question really, and, considering the wealth of research done over the years, I can t imagine that anyone would question the reasonableness of this thinking, or its significance in relation to a typical day in the clinic. I realize that I have a very strong bias in this direction, but it s an informed bias.

Perhaps I should do here what I often do as a teach workshops on the subject and its management with Simple Contact, I ll ask some questions.

When someone reports that their pain has spread across several dermatomes, what is the most likely carrier of the nociceptive activity? Answer: The nervous tissue

Sympathetic tone will increase when which of the following tissues is mechanically deformed beyond its tolerance: muscular, connective or nervous? Answer: The nervous tissue

When any body part is pulled tautly either as the end result of trauma or prolonged positioning, which of the various tissues within the part will the brain notice first, protect first, and try to relieve first. Answer: The nervous tissue

When somebody has a slow, spreading onset of pain while in a prolonged position, and that pain is slowly relieved after changing position, what tissue is the most likely to account for that? Answer: The nervous tissue

When pain worsens through the night, what tissue is most likely to have been provoked by the autonomic changes consequent to normal sleep? Answer: The nervous tissue

When there is a legitimate complaint of pain yet no significant findings with imaging, typical physical exam, EMG or NCV, what might still be producing widespread and persistent symptoms unresponsive to rest, meds, time, strengthening, stretching, enforced postural correction or secondary gains? Answer: The nervous tissue

When we move, it must follow us without stretching, it must float within its bed, and it must be constantly dosed with blood. Any less than that and we ve got symptoms. Ideomotor activity is our first defense against any compromise in this tissue. When therapy truly begins to address this fact, I feel that many of our mysterious problems are going to grow smaller.

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