Barrett L. Dorko, P.T.
In The Tao of Pooh, (Penguin 1982) Benjamin Hoff describes the "uncarved block" as a basic Taoist principle referring to things in their natural state.
Hoff feels that Winnie-the-Pooh himself is the epitome of this... "From the state of the Uncarved Block comes the ability to enjoy the simple and the quiet, the natural and the plain. Along with that comes the ability to do things spontaneously and have them work, odd as that may appear to others at times. As Piglet put it in Winnie-the-Pooh, "Pooh hasn't much Brain, but he never comes to any harm. He does silly things and they turn out right."
Manual care typically takes the form of either direct or indirect techniques designed to restore movement and function primarily, and then to (hopefully) reduce pain as a consequence of this restoration.
Manipulation of the joints and most forms of massage employ direct pressure in an effort to alter connective tissue restrictions discovered during examination. Strain-counter strain, muscle energy, and positional release more often employ the patient's own motive force or the alteration in muscular function that might be obtained with special forms of passive positioning. It seems that some complex combination of these techniques and theoretical constructs is increasingly popular, resulting in a practice that includes a variety of methods used in order of the therapist's personal preference. The hierarchy of technique is calculated to include what "works" first and careful consideration of its reasonableness is far less important. At least, this is what I notice as I travel to teach.
Imagine Winnie-the-Pooh as a therapist. The popular forms of manipulation including heavy pressure and intricate passive positioning would never appeal to his quiet and unassuming nature. He would be unlikely to judge the evident weaknesses in others. He would probably shy away from the exhortations and effort necessary in the practice of sports medicine, and he would not want to direct the practice of other therapists as an administrator in a large clinic.
Actually, in many ways, Pooh sounds like he's in charge of my own practice.
Following the naturally occurring order of things (the uncarved block) is not how you would describe manual care today. In fact, it more commonly seeks to alter the situation by means of external force or what might be called deception i.e. the unnatural shortening of contractile tissue in order to "re-set" the muscle spindle. I'm not suggesting here that either of these methods is ineffective.
But coercion of this sort tends not to honor the self- corrective mechanisms inherent to our recovery from trauma. In fact, when traditional manual care is augmented with the common cultural admonitions to appear a certain way, there is little room left for the acceptance, quiet contemplation and introspective discovery that typifies natural processes. Instead of the unique movement that would spontaneously appear (as odd as that may seem) and lead toward pain relief and normal functioning, manual care is more likely to promote someone else's idea of range and strength irrespective of the patient's goals and desires. Often enough, we are left with someone who looks better and performs closer to our standards, yet is not feeling all that relieved.
But there are carvers who approach an uncarved block as if it already contained an ideal shape within. Their technique might be described as doing the least amount necessary to reveal the naturally occurring contours, and they would handle the materials with respect and expectation.
Pooh doesn't fret, calculate or pontificate, he just is, and he leaves those other qualities for Eeyore, Rabbit and Owl. As a therapist, Pooh might not actually do anything all that dramatic or impressive. But as Hoff points out "Pooh doesn't think about it, he just does it. And when he does, he doesn't appear to do much of anything. But Things Get Done."