Dr David McGrath

Spine Physician

MB BS (Hons) FAFOM, RACP, FAFMM
Master of Pain Medicine

Order and Disorder

Order is a complex notion. With respect to spinal dynamics we can take a simple definition. An ordered movement is one which allows all of the involved components (muscles,,joints,blood flow) to remain within current structural limits. All of the parts remain "comfortable" or maintain a stable relationship to other parts.
Using this "disturbance" and "relationship" notion of order we can construct a simple table of possibilities.

ActivityRelationship	Order	Disorder
Active	a	b
Inactive	c	d

Active refers to sets of components which are engaged through our movement patterns and life. Inactive refers to sets of components which are not activated in our movement patterns. Sets of components are joints,muscles and nerves.
Using this concept, the degree of comfort in life is the probability of being exposed to ordered patterns as compared to disordered patterns. The probability of being in comfort is a/(a+b). We could further define a perfect niche as b=0. That is utopia. Active=Order
Conversely, the probability of being in discomfort is b/(a+b).

Now comes the interesting bit. How do we improve the odds of being in comfort?

There are several possibilities.

1. Active disordered components can be parked out of the way into the "d" cell. That is, they become disordered inactive. This leads to this table.

ActivityRelationship	Order	Disorder
Active	a	0
Inactive	c	b+d

Harmony is restored. Comfort=a/(a+0)=1 or 100%

2.Inactive BUT ordered components can be re-activated moving back into the "a" cell.

ActivityRelationship	Order	Disorder
Active	a+c	b
Inactive	0	d

This is an improvement. The probability of remaining in comfort is now (a+c)/b.

3. In reality, a combination of 1 and 2 are needed as it difficult to fully isolate disordered components or activate all of the ordered components.
In addition, by attempting strategy 1 or 2 it is possible to make matters worse by damaging ordered components (some of "a" cell into "b" cell ) OR by reactivating disordered inactive components ( some of "d" cell move into "b" cell ). Both of these situations are common in therapeutic interventions.

4.There is one more possibility, which applies to acute situations. Acutely damaged components may heal when they are not activated. That is, some "d" cell components can move back into the "a" cell via the "c" cell. This leads to the strategy of "leave well enough alone".

Recursive Restructuring aims to move "c" into "a" and "b" into "d" while allowing some "d" to drift back into "c". This maximizes the comfort ratio a:b.

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