dr siff
interesting comments and highly accurate most of the tests appearing in
assessment books etc are neither appropriate nor are they scientifically
proven. one only has to look at the inadequacies of trying to properly
aseess the si joint with the so called multitude of tests available on the
market (oops need to be careful with that one). i have yet to treat a
textbook patient perhaps im not using the textbook tests that we all pay
fortunes to add to our plethora of techniques. sorry for being so cynical
but why as a profession are we devoid of using our three most useful pieces
of eqpt ie our eyes,hands and most importantly our ears.
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, October 02, 2000 4:29 AM
Subject: Treating Musculoskeletal Problems
> If any one thing that characterises the resolution of musculoskeletal pain
> and dysfunction, it is the large number of different approaches which
enjoy
> some measure of success. It has never been established that there is
> definitely one best method of treating problems of the back, shoulder,
legs,
> arms, yet the claims of many qualified and 'informal' therapists suggest
that
> they alone have developed methods that are far better than any others. In
> fact, some of these therapists use such a mixture of different methods,
that,
> given sufficient time, effort and psychological stroking, they have to
> produce some progress.
>
> Some of these therapists, especially those with informal or self-awarded
> 'credentials', spend an inordinate amount of time applying an extensive
> collage of muscle and other tests borrowed from physical therapy,
> chiropractic and elsewhere. These tests are by no means universally
accepted
> or corroborated by science. They are often applied in static postures and
> assessed by palpation, finger pressure or home-made combinations of string
> and putty, but they seem to create an aura of thoroughness, scientific
> precision and reproducibility that impresses clients into parting with
tidy
> sums of money. The fact that research has shown something like one third
of
> all such strategies to work because of a placebo effect ensures that there
> will always be a significant number of satisfied clients to perpetuate
some
> healing myths.
>
> At the opposite end of the scale, there are some therapists and even
> individuals who never bother to rely on any therapists, who simply
advocate a
> rather generalised exercise, stretching and lifestyle regime in many cases
of
> musculoskeletal disorder. They apply few if any tests, advise clients to
> work within sensible ranges of exercise intensity, modified by basic
> perceptions of pain and effort - and lo and behold, they, too enjoy a very
> significant degree of success!
>
> This leads us to question if most functional tests, other than basic
> palpatory assessments and those reported by the client in normal
"functional'
> activities, generally are a waste of time in the treatment of most
> musculoskeletal disorders (excluding fractures, pathological disorders and
> serious medical conditions). Are these static muscle tests for
identifying
> "weak", "unfiring", "imbalanced" and "lazy" transversus abdominis, rotator
> cuff, multifidus, piriformis, psoas and other 'key' muscles generally
> redundant or do they play an essential role in treating musculoskeletal
> problems? Do exercises based upon such "muscle testing" methods
definitely
> enjoy a greater level of success than very general regimes based upon a
> thorough classical medical 'interrogation' of the client?
>
> Dr Mel C Siff
> Denver, USA
> [log in to unmask]
> http://www.egroups.com/group/supertraining
>
>
>
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