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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