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About Diane Jacobs
I’ve been a physiotherapist for close to 50 years and a manual therapist for about 35. I started out with a diploma in PT from the U. of Saskatchewan, in 1971, at age 20. In the 70’s I worked in hospitals, and continued attending university, because I liked learning everything about everything. My professional interest remained wanting to be a manual therapist, but this was delayed until the 80’s.
About manual therapy and me
In the 80’s, suddenly manual therapy became very trendy – courses popped up everywhere, and I became swept up in the rush. A lot of it was orthopaedic manual therapy, which I wasn’t very suited for, so I opted for immersion in the osteopathic slow kinds, mostly through the URSA Foundation (now closed), a small but good manual therapy school in Edmunds, Wa. There I learned traditional treatment models with the usual biomechanical explanatory models. I opened a solo practice in Vancouver and made a decent living, paid off my mortgage, happily helped many hundreds of people with only my hands and brain and what I thought I “knew.”
Nervous system consideration
At the end of the nineties David Butler, a PT from Australia came to town to teach therapists about nerves, sensitivity in the nervous system, and pain mechanisms. I realized that this was likely what I’d been treating all along – I wasn’t affecting tissue targets, probably I’d been unknowingly treating peripheral nerves the entire time. Everything started to make a lot more sense. I hauled out anatomy books and started learning all the nerves. Butler’s methods only really dealt with the deep nerve trunks – but there were scads of cutaneous nerves, everywhere, that no manual therapy teacher had ever mentioned before! They were a lot longer, had more perilous routes through more body wall layers, and were much easier to access and figure out how to handle.
Dermoneuromodulation is born
By about 2005 I had a name for all this – DermoNeuroModulation was born. In 2006 Angela Busch and some other colleagues at U of S, and I, started a single subject research project to study the method. In 2010 we presented the results to the profession at CPA Congress in St. John’s Nfld.
Meanwhile, one blank spot remained – I didn’t understand yet how cutaneous nerves disseminated into skin. In 2007 I managed to convince the people at the anatomy lab at UBC to allow me to find out. They agreed that this particular anatomy was not well-examined – skin was usually simply removed and discarded, as was its neural content. I was provided a specimen and taught to dissect. I uncovered all the fascinating cutaneous rami of the medial, lateral and anterior arm, all the way up into the axilla and down to the wrist. It was a watershed moment; visualizing the cutaneous rami in all their numerous physicality allowed me to understand how skin contact between the practitioner’s hand and the patient’s body could be woven into a new narrative of manual therapy. I gained a much deeper appreciation for the skin itself, as a relatively thick organ, and its role as a protector of the organism around which it is wrapped. I saw how the explanatory biomechanical language I had been taught was internally logical and provided a treatment scaffold on the one hand, but on the other, mounted an irrelevant conceptual barrier from the perspective of the patient who cared only about having painful movement experience addressed. People started asking me to teach in 2007. So, since then, I’ve created a treatment manual, have done some writing about world of manual therapy, from my perspective, and have agreed to teach DNM to physiotherapists and massage therapists. Teaching has taken me to a number of places in Canada, the US , Europe, and Brazil.
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In 2005, excited about the prospects of my profession taking on pain science and learning to work with people with new depths of understanding, I helped form a special interest group in Canada, PTs interested in pain science. Eventually the Canadian Physiotherapy Association formally recognized our group as the Pain Science Division, in 2008. I served as its communications liaison until 2014.
Retired from practice and teaching.