Graeme,
While I certainly appreciate the offer to have a beer over this discussion,
I'm not certain that we are even in the same bar, so to speak.
I am unaware of anything that might be called "chiropractic science" or
"physiotherapy science" for that matter. Science stands alone. It is a way
of making sense of things and its methods have been well described for many
years. Being a method, it cannot posses any human quality, like arrogance
for instance. The laws of the universe don't care who or where you are,
they are going to display their power in the same way every time.
I readily admit that I don't have what you would call an "open mind" about
many of the therapies floating around out there. It's been my experience
that the "open-minded" readily promote speculations to the level of
evidence. Big mistake. I especially like a passage from E.O. Wilson's
latest book "Consilience: The Unity of Knowledge." He says, "Few claims in
science, and particularly those entailing concepts, are accepted as final.
But as evidence piles upon evidence and theories interlock more firmly,
certain bodies of knowledge do gain universal acceptance. In seminar patois
they ascend a scale of credibility from "interesting" to "suggestive" to
"persuasive" and finally "compelling." And given enough time thereafter,
"obvious."
No objective yardstick exists on which to mark these degrees of acceptance;
there is no body of external objective truth by which they can be
calibrated. There is only warranted assertibility, to use William James'
phrase, within which particular descriptions of reality grow ever more
congenial to scientists until objections cease. A proof, as the
mathematician Mark Kac once put it, is that which convinces a reasonable
man; a rigorous proof is that which convinces an unreasonable man."
What seems only interesting to you may be obvious to me or vice versa, it's
really a matter of what we've studied and, ultimately, trust. I'm a
skeptic, and skepticism is not a position, it's a method. I've found that
it is a method that does our patients the most good because it leads to a
greater understanding of what we do and how it truly affects others.
Thanks again for the invitation. I'm in Ohio, so we might have to wait a
bit for this.
Barrett L. Dorko, P.T.
<http://barrettdorko.com>
At 05:25 PM 12/11/01 +0000, you wrote:
>Barrett,
>
>"Do you really think that standing still while charlatans prey upon the
>unsuspecting, ignorant and ill public is a good idea?
>
>These words you wrote in your last mail I agree with! The public of course
>should not be preyed upon by cons or ripped off by window cleaners claiming
>to be osetopaths.
>
>Apologies for digressing away from the original point about core stab and
>back pain, but maybe I will raise another discussion by this post!
>
>Science is arrogant! If you put a chiropractor, orthopaedic surgeon,
>neurosurgeon, osteopath, acupuncturist, physio and a voodoo witch doctor in
>the same room and presented them all with the same patient complaining of
>back pain; do you honestly believe that they will all agree with each other
>about the best way to treat the condition? Of course not! WHY? Because their
>particular science, whether it be the science of chiropractic, osteopathy,
>physiotherapy etc, is different! Their theories are different, their
>treatments are different!
>
>Let me give you 2 examples of where therapies (charlatans if you like) have
>let "the unsuspecting, ignorant and ill public" down.
>
>1.
>I have recently treated a patient with a herniated disc. She showed (to me)
>classic signs of a disc rupture. I sent her for a scan and thank you MRI, it
>proved to be a PID. This woman had previously been seeing a chiropractor for
>her bad back. ?500 later she was no better and came to me. The chiro
>couldn't detect one of the most common of back complaints.
>
>I am not saying I am a genius, we all know the classic signs for a PID, but
>the chiro didn't spot it yet continued to take her money. On the other side
>of the coin, I happen to know that this chrio has fixed problems other
>therapies (conventional and alternative) have failed to cure, with
>remarkable results.
>
>2.
>Three years ago in America a large random selection people were asked if
>they had any back complaints. The ones who said no were given an MRI scan.
>These scans were showed to a group of leading neuros. Of these people with
>NO back complaints they wanted to operate on 30% of them!!!!!!!!
>I believe the phrase was "charlatans prey upon the
>unsuspecting, ignorant and ill public"
>
>The public are all prey of false diagnosis, both from conventional and
>alternative. Not one practioner can honestly say they are right and everyone
>else is wrong. But they do. You have to ask yourself, if money was taken out
>of the equation would this still be the case?
>
>We should all keep an open mind about other therapies and not necessarily
>discard them as nonsense - that would be arrogant surely?!
>
>Barrett, how i would love to have a beer with you and talk about this. I
>hope i have set up a lively debate - in the interest of the paying public.
>
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>-----Original Message-----
>From: - for physiotherapists in education and practice
>[mailto:[log in to unmask]]On Behalf Of Barrett Dorko
>Sent: 11 December 2001 15:57
>To: [log in to unmask]
>Subject: Re: Core Guru Cognitive Dissonance
>
>
>Graeme,
>
>I disagree with so much of your post that it's hard to know where to begin.
>
>You say that when science disagrees with the unsupported claims of a fad it
>is being "arrogant." This is classic postmodernist dogma and is responsible
>for advances in health care such as crystal healing and Therapeutic Touch.
>Do you really think that standing still while charlatans prey upon the
>unsuspecting, ignorant and ill public is a good idea? Would you rather we
>all just be nice while medicine descends toward supernaturalism? When
>should the claims of another be publicly refuted?
>
>No one has said that the training proposed by the core stability people
>wouldn't strengthen muscles in some fashion. It's a matter of degree and
>toward what end. The evidence that this is a good idea for the treatment of
>backache is the issue here and I notice you didn't mention that.
>
>You've mistaken disagreement in the scientific community (the only way it
>ever truly progresses) for cynical, self-serving negativity. These aren't
>the same thing.
>
>Barrett L. Dorko, P.T.
><http://barrettdorko.com>
>See "What Went Wrong: Postmodern Thought and Physical Therapy Practice"
>here for more on this.
>
>
>
>
>At 03:16 PM 12/11/01 +0000, you wrote:
> >Being a discussion group I realise the importance about bouncing theories
> >off each other and challenging some of them, but are we maybe taking this
>to
> >a little bit of an extreme?
> >
> >Call it what you want, "core stability "has been an "in" fad for a while
>now
> >and many fitness regimes have made a lot of noise about it's importance
>e.g.
> >pilates, yoga. Then science seems to get in the way and make a
>controversial
> >maybe "arrogant" statement claiming "it is all "B.S" so stop wasting our
> >time"
> >
> >Hey, improving ones " core stability" is a training method that activates
> >and trains T.A amongst other things, which can only have a positive effect
> >for those we are trying to help -THE PATIENTS!
> >
> >If you take someone who hasn't done one bit of exercise in their life and
> >you give them even the simplest form of ab. exercises, they can't fail but
> >to increase strength and stability!
> >
> >On the strength of that how can you argue with it's effectiveness? If you
> >gave similar exercises to an elite group of athletes, sure it would barely
> >train them at all, but if certain exercises help certain people, why waste
> >time trying to argue against it?
> >
> >We are here to help people and be positive. Negativity gets us no where!
> >
> >
> >
> >
> >
> >
> >
> >-----Original Message-----
> >From: - for physiotherapists in education and practice
> >[mailto:[log in to unmask]]On Behalf Of [log in to unmask]
> >Sent: 10 December 2001 23:25
> >To: [log in to unmask]
> >Subject: Core Guru Cognitive Dissonance
> >
> >
> >Now that more and more scientific evidence is emerging to show that
> >deliberate attempts to activate transversus abdominis, to "suck in the abs"
> >or to use various related tricks to enhance "core stability", balance and
> >strength, it is interesting to note how some disciples are starting to
> >defend
> >the long-promoted beliefs of their gurus.
> >
> >In psychology, the action of defending or believing in something that you
> >know or sense to be uncorroborated or untrue is called "cognitive
> >dissonance". Increasing numbers of folk are beginning to hear or read the
> >evidence of scientists such as Dr Stuart McGill that these ideas about
> >enhancing core performance and abdominal control are incorrect or
>misleading
> >at best, so the gurus and their followers are now being called upon to
> >respond and answer for their educational misdemeanours.
> >
> >So far, what I have heard from these sources does not include any
> >acknowledgment of error or possible misinterpretation. Instead, I have
> >heard
> >nothing more than an unhealthy abundance of cognitive dissonance,
> >smoke-screening and evasions, which is not all unexpected, since whole
> >empires of fitness courses, lectures, products and advertising have been
> >built on these fragile foundations and the egos creating these misbeliefs
> >have been too vast to admit error.
> >
> >Thus, we hear remarks like the following:
> >
> >"When we advise sucking in the abs, we really mean tightening the abs,
> >bearing down and not really out or pulling in a little just to activate the
> >TVA, but not enough to promote trunk flexion."
> >
> >"We mean that you must just suck in the abs a little at the beginning of
>the
> >exercise, because correcting the initial posture will set up the
> >circumstances for correct activation of the trunk muscles later in the
> >movement, which may include a little bulging of the abs."
> >
> >"Most people do not reflexively activate their TVA in starting a lift, so
> >that this TVA activation method reprograms these people so that the TVA
> >becomes more automatic in reacting correctly in future lifts or later
>stages
> >of the exercise."
> >
> >"When we advise activating TVA, it is because it automatically also
> >activates
> >the diaphragm, which really is just as important in stabilising the core.
> >We
> >just cure the TVA because many other muscles are involved and this cue
> >integrates activity of all the muscles need to stabilise the core."
> >
> >"What Dr McGill's research has shown is not really at odds with what we
> >teach; it is just another way of achieving the same ends. Science and
> >practice don't always have the same language or way of describing events.
> >In
> >fact, we are just saying the same thing in different ways. Both of us are
> >right."
> >
> >As the King of Siam said in the "King and I" movie, "etcetera, etcetera,
> >etcetera.." ! Have some folk been attending courses by a latter day Dr
> >Spock (not the Star movie hero) of politically correct child fitness gurus
> >upbringing, where they have learned that it can be very damaging to tell a
> >child that it is wrong? Egos are to be preserved above all - if they are
> >not, we could be ruining the child forever and society will pay the price!
> >
> >Maybe others would like to share their experiences regarding this issue and
> >how the guru gang is coping with the rising tide of critical analysis and
> >disproof of their fitness and rehabilitation legends. Over to you!
> >
> >Dr Mel C Siff
> >Denver, USA
> >http://groups.yahoo.com/group/Supertraining/
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