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

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Ideomotion

The Persistence of Memory

Barrett L. Dorko, P.T. Seek out that particular mental attribute which makes you feel most deeply and vitally alive, along with which comes the inner voice which says, This is the real me, and when you have found that attitude, follow it. ~ William James There are many questions when I teach or write about the movement that I use in an effort to resolve abnormal neurodynamics. So many, that I feel I must make another effort to speak of this movement, hoping that at least one metaphor or classic explanation resonates with the therapist’s understanding and their experience with…

Without Volition: The Presence and Purpose of Ideomotor Movement

Barrett L. Dorko, P.T. The Presence of Ideomotor Movement Though it is rarely spoken of in discussions about human movement, descriptions of ideomotor activity are present in the medical literature beginning in 1852 when The Proceedings of the Royal Institution reprinted a lecture by William Carpenter. He identified ideomotor as a third category of nonconscious, instinctive behavior, which also included excitomotor (breathing and swallowing) and sensorimotor (startle reactions) activity. Ideomotor movement is secondary to thought, and it begins in the cerebrum. The discovery of its presence and descriptions of intricate studies demonstrating its manifestation conducted in the 19th and 20th…

The analgesia of movement: Ideomotor activity and manual care

Barrett L. Dorko, P.T. There is a certainty common to many of those who focus on manual means for pain relief: we are certain that the body naturally and perpetually moves in a way that promotes health and optimal function (called inherent movement). This motion is often easily observed, but at times is only palpable. We are certain that our methods of manipulation should take this movement into account, and thus we typically employ our hands, not in an effort to create shapes or impose forces, but as instruments of perception and communication. First and foremost, we look for and…

Asking Why: Evolutionary Reasoning and Manual Care

Barrett L. Dorko, P.T. In 1990 I wrote an essay about a young boy who’d been sent to me with an acutely painful neck. After turning it quickly left he experienced a great deal of pain and found that any attempt to return it toward the front felt even worse. I described the boy’s dilemma and then wrote: In Arlington Virginia The Old Guard marches before the Tomb of the Unknowns. Its members are remarkably the same in every respect. The precision of their movement is matched by the perfect stillness of their erect postures. They seem to embody composure…

A Sense of Things

Barrett L. Dorko, P.T. In 1992 I did a presentation for The International Federation of Orthopedic Manipulative Therapists about the potential effect of manual care upon the therapist. I spoke of stretch-activated ion channels in the therapist’s hands, reflexive effect and my personal experience of increasing sensitivity as I remained in the clinic year after year. Geoffrey Maitland, the highly respected founder of manual care in Australia, moderated the session and he addressed the 700 therapists gathered as I took my seat. “I don’t know about you,” he said, “but that was beautiful music to my ears.” I was pleased,…

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