"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Friday, September 3, 2010

Empathy and Physical Therapy

Author and advisor to world leaders Jeremy Rifkin talks about Mirror Neurons (and more) that may explain how humans relate to each other.

His presentation begs the question:

If babies cry because other babies are crying, not because they are hurting or hungry, and their behavior is due to their "mirror neurons" that what implication does that have for our chronic pain patients in physical therapy.

How much chronic pain behavior is learned behavior, not mechanical?

Foe example, if I am treating a chronic pain patient who is anxious and depressed and I respond to him with empathy, optimism and encouragement will his mirror neurons cause his mental status to improve?

Can we measure his improvement clinically (without an MRI)?

Dr. Rifkin goes on to draw many other conclusions from his data on mirror neurons and the video is worth watching for his compelling arguments, scientific data and the interesting animations.


  1. Love this video and blog post Tim. It links evidence to management theory - both management of our patients and management of therapist's we work with and/or employ.
    I may steal this video for a blog post within my company :)
    Tyler Keeter PT, DPT, MHA

  2. I have enjoyed this video clip in the past and it should bring lots of questions and thoughts to any practitioner viewing it. Remember though "mirror neurons" make up is about 25% of the brain neurons. So there is another 75% of those 100 billion neurons we need understand as well.

    An interesting article showing evidence of how we present the intervention has an effect on the outcome.

    Joel E Bialosky, Mark D Bishop, Michael E Robinson, Josh A Barabas
    and Steven Z George. The influence of expectation on spinal manipulation induced hypoalgesia: An experimental study in normal subjects. BMC Musculoskeletal Disorders 2008, 9:19 doi:10.1186/1471-2474-9-19

    This article is available from: http://www.biomedcentral.com/1471-2474/9/19

  3. Thanks Kory,

    It's great that you've provided a link. Along those same lines a group from the same school (University of Florida - home of the Fightin' Gators!) has published an article in the August 2010 JOSPT called the "Dynamic Nature of the Placebo Response"
    Steven Z. George, Michael Robinson
    Vol 40(8):pp452-454.

    Spinal manipulation may benefit from what George et al call the "Context of Treatment" even if the actual manipulation is ineffective.

    The article abstract is available here:



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