Gathering place for osteopaths
Addicted to [the] crack?
We've been focusing heavily on HVT work since September and I've begun to notice a strange side effect in my self and others. It seems with cavitation comes satisfaction.. a little thrill and a trickling release of endorphins. I don't know if it's the amateur in me with my amazement that it actually worked, or if there is something more going on. I have not noticed the same response from soft tissue or articulation (or any other techniques).
I've spoken to other students and I know I'm not alone in this! Some commented they get this response from being HVT'd.
Has anyone else noticed this? I wonder what impact this has on technique choice..
Replies to This Discussion
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Permalink Reply by Jody Jakob on -
Satisfaction comes in at least two ways for HVT's. One as you mentioned is the release of endorphins the other is the sudden release and reduction of muscle tension in the associated segment due to a reflex muscular nervous arc. Resetting of the muscualtr thermostat so to speak.
One can get addicted to this quiet easily and in my humble opinion practitioners who treat patients often and reccomend well being sessions (and here I am talking mainly about Chiros...if any Chiros care to take issue, please respond) are simply hooking their patients on a buzz that they do not necessarily need.
Over the years I have treated a number of patients who came to me to get "off" of cracking their neck or dorsals or lumbars or even tmj.
In every case we were successful in weaning them off their addiction!!! (as far as was reported)
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Permalink Reply by Rich Moore on -
I think on a personal level, as a fellow student, the 'crack' is an indicator of "doing it right" and gives some immediate feedback about ability, however inaccurate it is in reality.
With much of what we do, measuring the effect is difficult but the 'crack' gives us something to focus on.
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Permalink Reply by Jody Jakob on
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Some group names....
Monkeys A troop, barrel
Mules A pack, span, barren
Osteopaths, A clique,
Otters A romp
Oxen A team, yoke
Pigs A drift, drove, litter (young), sounder (of swine), team, passel (of hogs), singular (refers to a group of boars)
Porcupines A prickle
Rabbits A colony, warren, nest, herd (domestic only), litter (young); specific to hares...A down, husk
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Permalink Reply by Dick Wyatt on -
I gave up HVT-ing completely in...aah, '03 possibly? The cranial I was doing was better.
It bothered me for a while. Not only the crack, but the whole gamut of normal osteopathic experiences changed very quickly. The techs, the patients, the skills, the remits...treatments became very quiet, and I stopped using a plinth. Everything changed.
I weaned myself off, of necessity - but it wasn't easy to reject all those years of comradely slog whilst we were drumming all that HVT stuff into our little pointy heads; nor the years since. Still, I now undercut all the need for HVT completely, and this leads to a much better resolution of a pt's problems. Too, the remit I can now undertake is so vast, the previous approach seems quite laughable!
Best with it
Dick
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Permalink Reply by Steve on -
Like Dick Wyatt, I gave up using HVTs long ago, although in my case it was in favour of Neuromuscular Technique (NMT) after reading Chaitow's classic text on the subject. The discovery of Travell & Simons' Myofascial Pain & Dysfunction: The Trigger Point Manual cemented this approach in my mind - here were 1500 pages, with meticulous scientific references, strongly suggesting that the vast majority of what osteopaths treat is to be approached via the soft tissues.
These days I'm incorporating NMT with gentle "energy" work - whatever that may mean; relaxing, de-sympathetico-toning stuff anyway - based on Polarity Therapy.
The only time I HVT now is if I encounter a "crack addict", who has made it clear that they won't be satisfied unless they get their fix. (I only get these junkies once in a blue moon, fortunately.) They still get the usual NMT treatment but I'll work in a couple of cracks along the way. Usually they've been so over-manipulated that zero force is involved; just position the levers and the joint cracks all by itself!
I think Alan Stoddard used to write about patients with "positional neurosis" - an obsession with the position of their bones and whether they were "in" or "out". I consider it my professional duty to educate my patients out of these nonsensical beliefs - it's part of what I call "spinal mythology". (More's the pity that so many osteopaths - and chiropractors - have perpetuated such ludicrous concepts.)
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Permalink Reply by Quatermass on -
Hi Steve,
"The only time I HVT now is if I encounter a "crack addict", who has made it clear that they won't be satisfied unless they get their fix."
Although I think in general it's a greatly over-rated technique, especially in chronic contexts, I'll use HVT from time to time, according to circumstances. But when I get patients of the kind you mention above, I tell them I'm not their man.
"I think Alan Stoddard used to write about patients with "positional neurosis" - an obsession with the position of their bones and whether they were "in" or "out". I consider it my professional duty to educate my patients out of these nonsensical beliefs - it's part of what I call "spinal mythology". (More's the pity that so many osteopaths - and chiropractors - have perpetuated such ludicrous concepts.)"
I find this misconception to be extremely frequent, and as you say, unfortunately perpetuated by practitioners who should know better if they are at all qualified to put their hands on patients. Paradoxically perhaps, I happen to believe that much spinal dysfunction has a positional element; it is however, a very long way from being the "main thing".
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Permalink Reply by Noel Adams on -
A patient of mine that I treated using medical acupuncture and manipulation, responded very well to treatment. I joked with her that she was becoming a "treatment junkie...showing all the sings of loving the needles, and been addicted to the crack".....she went on to train as an acupuncturist, and her husband is an osteopath (not me)
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Permalink Reply by Clement Rhein on -
Yes, I confirm Ronan, not with me personally but with some patients, it does bring them satisfaction.
Yes you can get addicted. The more the joint is HVTed, therefore forced to move more regardless, the more it will become hypermobile. I think the body as a consequence, tightens the muscles governing that joint to bring proper range of movement back. This tightening causes stiffness, and this feeling of needing an HVT.
In fact, it can officially be termed an addiction. the more you do it, the more you feel you need it. It took me a while to wean off self manipulating my neck. (use to do it 10 maybe 15 times a day! — I thought that I was getting quite accurate actually :-)).
I have the same view as Robert regarding patient demanding a certain treatment, or more of a certain technique actually. "Go see my colleague up the road, he's not qualified, doesn't know what he's doing, but he'll sure crack the hell out of you" I'll tell them. Patient's feel they know better sometimes, and forget who's done the training. Personally, I get ride of those, I feel they don't deserve my time.
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Permalink Reply by Anna Quillfeldt on -
I am trying to find info on this... whether manual therapy is actually addictive? i think cavitation might have some addictive nature. I think its becasue its a fast, audible fix. It is something people are sure has worked, or caused change. Of course, it could have chemical addictions too, however I think it might me more psychological. Unfortunately, no one would publish this info easily... at risk of driving clients away. Anyhow, please let me know if you find any info on this... Its a very interesting concept!
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Permalink Reply by Anna Quillfeldt on
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haha I want to call mine "Bend and Snap osteopathy" but probably shouldnt! :)
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Permalink Reply by Theodore Jordan on -
[the] crack addiction: isn't that the primary reason behind the success of chiropractic?
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Permalink Reply by Fink on -
Hi Clement
The more the joint is HVTed, therefore forced to move more regardless, the more it will become hypermobile. I think the body as a consequence, tightens the muscles governing that joint to bring proper range of movement back. This tightening causes stiffness, and this feeling of needing an HVT.
Do you have a reference for that?
Patient's feel they know better sometimes, and forget who's done the training. Personally, I get ride of those, I feel they don't deserve my time.
Patients do know what they want - it just isn't always the right thing. Perhaps they deserve the time it takes to have their problem explained in a way which encourages them to take some responsibility for their own health & reduces the need for intervention - cavitation or not.
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