Background:
I have been following Dr. Erson Religioso's blog, The Manual Therapist, for quite some time now. I also recently subscribed to his OMPT Channel section where I have learned quite a few evaluation and treatment techniques to add to my arsenal. Dr. E has training in a plethora of different schools of thought and one of them is the Mechanical Diagnosis and Therapy or MDT for short. Part of his MDT skill-set is a various amount of techniques that he refers to as "resets". He often uses them as part of his evaluation, treatment and home exercise programs. I hope I am saying all of this accurately, at least. Here is a couple videos of Dr. Erson Religioso III, DPT, FAAOMPT explaining the what, why and how related to these resets.
This is Dr. E's video highlighting the his favorite resets, and why they work.
An updated but longer video for Dr. E's favorite resets.
The Toe Pain:
I am currently pursuing a post-professional graduate degree so that means I am still a student (will be one for life) and that I still have finals. A couple Monday’s ago I was sitting around with a few of my classmates while waiting to take a final practical exam. One classmate mentioned that she had a very painful big toe on her right foot. She had been suffering this pain for a day or two since walking around Chicago the entire weekend while wearing ill-fitting footwear. She had only had the pain on one side without any direct MOI besides gradual onset related to the shoes and walking. She had pain with great toe extension when toeing-off in her gait cycle.Dr. E’s videos had been on my mind and I was curious if his resets would really work because they were a foreign concept related to anything I had been taught. I had the idea of doing repeated-end range flexion of the great toe for about 20 repetitions and I asked her if she minded trying out the experiment. She obliged and we went to town with the repeated “resets”.
After I finished with the 20 or so repeats I asked her to stand up and walk around. Alas, she had no pain and no other complaints appeared. I told her that there was a chance that this would be a transient effect and that she may need to repeat this exercise about 10 times every hour. However, her pain never returned that day and hasn’t to date. I believe a week later when I inquired about her toe she mentioned that my “voodoo” had fixed the issue for good. While I don’t think I was doing any magic or voodoo I do think this highlights some merit to these resets on an n=1 level. Half of evidence-based practice is clinical experience and so far my “clinical” experience has been great; although I do wish I had some more extensive training or knowledge about MDT. I was impressed enough with these results that I tried using the repeated ankle plantar flexion reset for my girlfriend’s aunt who has had years of constant heel pain. This was just an offhand encounter at Mother’s Day brunch but it immediately took her symptoms from a wince-inducing 8/10 to a 4/10. I gave her instructions to continue these as a self-empowering home exercise and I hope she sticks to them. I really want to see how she progresses.
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