Barrett L. Dorko, P.T.
Try not. Do or do not. There is no try.
Touching another can be done in many ways. Traditional manual therapy seems to be mainly about coercing tissue in one direction or another. Whether that s done with great force or gently, slowly or rapidly, I don t really think it makes a whole lot of difference.
Of course, my colleagues in the manual therapy community might consider this heresy. But there isn t much in the literature that indicates manual intervention is all that effective, much less necessary for recovery from painful problems. More heresy, I know.
So if I don t think that manual care is all that important, why do I refer to myself as someone who does it? Well, I should explain that I think that movement is the thing that generates relief, and I m convinced that the movement most likely to help must come from the patient, not the therapist. In short, it s an active movement, not a passive one. It s been my experience that touching another with my hands is an excellent way of eliciting that active movement, thus my respect for handling of some sort and my self-description as a manual therapist.
We can split active movement into that which is consciously and unconsciously driven. It s the latter that we ordinarily inhibit in an effort to control our appearance or hide the expression of what it is we re thinking. Since touching another need not include the usual admonitions to change or move as directed, it is perfectly possible to handle another with an attitude that accepts and thus amplifies what the touchee is already doing. That is, what they re doing unconsciously.
I realize that what I m describing here does not include a protocol of some sort or a specific sequence of technique. Instead, I m offering some ideas about what to consider before touching begins. Some consideration of what the materials to be altered actually consist of and what they might already be doing is essential if technique is to be effective in the way we want it to be. This is especially true if you want your force not to exceed what is necessary.
The quote from Yoda above describes something about Simple Contact that is not common to traditional manual therapy. It is that the clinician should not try to examine or coerce the tissues in some fashion that reveals the system s deficits or ability to go where the therapist wants it. Instead, Simple Contact seeks only to enhance the patient s awareness of their desire to move, however subtly. It manages this by giving the already ongoing movement something to resound against. Think of your own heartbeat. It is unlikely that you are at this moment aware of it, but anything placed lightly on your chest wall could easily make you so. Whatever is placed there should not try to interfere with the beat as it is naturally occurring or changing. It should, in fact, resonate i.e. go along with the cycles of movement. This shift from something that the movement resounds against to something it resonates with is perhaps the only technically difficult thing about the technique of Simple Contact itself.
In my experience, this is not all that difficult. But it does require a clear understanding of the materials handled and the activity present within them. When ideomotor activity is expected (it should be in any living person) and when the therapist understands what it takes to depolarize nervous tissue secondary to touch, no trying to elicit movement is necessary, and, in fact, any trying may divert the patient from the necessary task. As soon as the therapist tries to get something, the patient s sense of that (and it is always acute) elicits either a cooperative or protective stance. Neither is likely to help much.
So, consider what Yoda tells us, and let your hands flow wherever the person you re touching takes you. When you are doing that, you ll see what I mean.