Practical Science on Movement and Pain
Practical Science on Movement and Pain
Steven Pinker has a thought provoking article out this week called Science is Not Your Enemy. I hesitate to link it, because it discusses politics and religion, which are not the topics of this blog. So, fair warning and read at your own risk! But it had so many great thoughts on anti-science attitudes that I wanted to include some quotes.
I have noticed that some of my colleagues in the bodywork community are somewhat disapproving of using a scientific approach to understanding how the body responds to manual therapy. It is almost like the very mention of science brings a bad smell into the room.
I have heard claims that science isn’t required to know “what works”, because there are “other ways of knowing.” Or that science is reductionistic or simplistic, or doesn’t know everything, or is somehow powerless to understand the real complexities of the human body. I have heard quick associations between science and various unsavory things like nuclear weapons, Monsanto, Big Pharma, or a general lack of empathy and concern with issues of human morality and well-being.
Pinker’s article is an excellent call to put many of these concerns to rest. Here are some quotes I liked in particular:
On the pervasiveness of bias and self-delusion, the hard work required to eliminate it, and the insufficiency of “other ways of knowing” to discover the truth:
The world does not go out of its way to reveal its workings, and even if it did, our minds are prone to illusions, fallacies, and super- stitions. Most of the traditional causes of belief—faith, revelation, dogma, authority, charisma, conventional wisdom, the invigorating glow of subjective certainty—are generators of error and should be dismissed as sources of knowledge. To understand the world, we must cultivate work-arounds for our cognitive limitations, including skepticism, open debate, formal precision, and empirical tests, often requiring feats of ingenuity. Any movement that calls itself “scientific” but fails to nurture opportunities for the falsification of its own beliefs . . . is not a scientific movement.
On the charges of “reductionism” and “scientism” that are often leveled at those who recommend science as the best foundation for knowledge:
Demonizers of scientism often confuse intelligibility with a sin called reductionism. But to explain a complex happening in terms of deeper principles is not to discard its richness.
The phenomena we experience may be explained by principles that are more general than the phenomena themselves. These principles may in turn be explained by more fundamental principles, and so on. In making sense of our world, there should be few occasions in which we are forced to concede “It just is” or “It’s magic” or “Because I said so.” The commitment to intelligibility is not a matter of brute faith, but gradually validates itself as more and more of the world becomes explicable in scientific terms. The processes of life, for example, used to be attributed to a mysterious élan vital; now we know they are powered by chemical and physical reactions among complex molecules.”
. . .
Scientism, in this good sense, is not the belief that members of the occupational guild called “science” are particularly wise or noble. On the contrary, the defining practices of science, including open debate, peer review, and double-blind methods, are explicitly designed to circumvent the errors and sins to which scientists, being human, are vulnerable. Scientism does not mean that all current scientific hypotheses are true; most new ones are not, since the cycle of conjecture and refutation is the lifeblood of science.
[Science] is not the dogma that physical stuff is the only thing that exists. Scientists themselves are immersed in the ethereal medium of information, including the truths of mathematics, the logic of their theories, and the values that guide their enterprise. In this conception, science is of a piece with philosophy, reason, and Enlightenment humanism.
On the disrespect that science often receives even in the context of education:
Though science is beneficially embedded in our material, moral, and intellectual lives, many of our cultural institutions, including the liberal arts programs of many universities, cultivate a philistine indifference to science that shades into contempt. Students can graduate from elite colleges with a trifling exposure to science. They are commonly misinformed that scientists no longer care about truth but merely chase the fashions of shifting paradigms. A demonization campaign anachronistically impugns science for crimes that are as old as civilization, including racism, slavery, conquest, and genocide.
Well said Steven Pinker. As usual.
I find the anti-science bias present in the world of bodywork (and anywhere else) to be upsetting. Not only because it leads to wasted time, money, and effort on scientifically indefensible treatments. (And that is a big thing!) But because the anti-scientific explanations for the efficacy of manual therapy (e.g. “healing energy”) are far less interesting than the fascinating, awe-inspiring, elegant explanations that we are only beginning to understand through science. And which are actually real! In the end, the picture of the body afforded by science is infinitely more interesting, useful, and respectful of the client than the distorted picture created by reliance on tradition, superstition, and magical thinking.
Despite these concerns, I am very encouraged to see on my Facebook timeline and in various other parts of the fitness and wellness blogosphere, that a distinctly pro-scientific attitude seems to be becoming more fashionable. Now maybe I am thinking that because of the self-selected group that I am associating with. Whatever the case, I am noticing more and more people extolling the virtues of critical thinking, becoming aware of their own biases, citing to actual evidence in support of their arguments, confessing the limits of their knowledge, admitting when they are wrong, and spending time and effort critically examining and debunking many claims that have been accepted as truth for far too long.
And with that in mind I would like to link to a bunch of people who seem to be taking a very active role in promoting this pro-science attitude in the fitness and wellness blogosphere. I encourage you to click on the links and check these people out in case you have not already.
This is not meant to be an exclusive list of all the people I think are worth reading on the internet. Nor is it a list of people who are free of bias or error (that is impossible). It is simply a bunch of people who seem especially committed to making sure all their claims can be supported by solid evidence and reason, and to spreading the word about the benefits of critical thinking.
In this respect, you will notice that their posts devote most of their energy not to defending a certain outcome, but to applying a certain process of reasoning to whatever issue they address. Even if you disagree with their conclusions (which you should quite often!), you can learn something by following along with the reasoning process, and thereby improve your own ability to answer whatever question you want to ask. Here they are.
Paul Ingraham has a huge site devoted in large part to examining claims related to manual therapy. Tons of useful info and careful analysis.
Greg Lehman is a PT and chiro who has studied with Stu McGill, done research, and basically forgotten more about the relationship between biomechanics and pain than many movement gurus have learned. He asks great questions at his blog.
Tony Ingram is a physical therapist (and break dancer) who tackles many myths related to pain, movement and physical therapy at bboyscience.com
Ravensara Travillian maintains a website devoted to open education in massage and is active on Facebook dropping her significant knowledge related to physiology and manual therapy. Coolest name ever.
Jason Silvernail is a PT who does not have a blog, but frequently comments on his Facebook page and at somasimple.com. He carries a large weapon.
Mel Siff is no longer with us, but browsing through his archives at the super training forum is to be completely humbled by the man’s encyclopedic knowledge and razor sharp intellect.
Nick Tuminello is a personal trainer who has been on a critical thinking rampage lately on his Facebook page and his blog, where he is discussing the systematic and predictable ways that we deceive ourselves, and how that creates myths in the fitness industry.
Alex Hutchinson is a former physicist who writes a top notch blog on running and fitness.
James Krieger writes at his blog mostly about weight loss, and has done some excellent series taking down low carb dogma and associated gurus.
Armi Legge writes a blog at Impruvism that is extremely well referenced in its claims about health and fitness.
Sol Orwell has a site and a new book which is essentially a massive database of well organized references and analysis in regard to the efficacy of supplements.
Stephan Guyenet is bar none my favorite nutrition blogger. Every post (except “Food Reward Fridays) is a must read.
Thanks to all these bloggers and others who are contributing to our knowledge of how to move better and feel better.
Please let me know some other suggestions for my list. I am sure I have left some worthy candidates out!