I don't think we're actually getting any closer to understanding each other.

You say regarding withdrawal: "I don't think we necessarily plan it, but we have learned it and I believe it is conscious and under our control."

The fact that this is an instinctive reaction (Wall et.al.) means that we have in fact not learned it but were born knowing how to do this already. It is therefore unconsciously driven though we may be aware of its presence and not necessarily its origin in ourselves. We can certainly learn to suppress its expression though the motor planning remains and will probably show up minimally as an isometric contraction, but I'm going over old ground here.

Then you ask: "...is pain merely the symptom?"

When is pain anything other than a symptom? Deformation becomes symptomatic in all tissue eventually, that's why we shift positions in order to avoid the consequences of stasis. We do this instinctively. Is that beginnig to sound familiar? Why should we teach patients to ignore this? What's therapeutic about that?

You suggest: "Perhaps if you could really say what you are postulating, in simple terms..."

I have simply suggested that in the case of excess mechanical deformation pain relief follows instinctive movement, whether inflammation is present as a complicating factor or not. This is not a complicated issue nor have I stated it in an obtuse or vague manner. This point is expanded upon in hundreds of essays I've had published elsewhere (barrettdorko.com and rehabedge.com). Your inability to follow this surprises me.

The point you seem to be missing is that manual care might be more effective if it recognized that motion and promoted its expression-not if it sought "symmetry" or the thrapist's notion of normalcy. I seek self-correction as expressed by the patient. This movement has certain characteristics and those who provide gentle manual care usually have some sense of these. Perhaps you don't.