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.










































-----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/