Posts tagged featured
Many Orthopedic Surgeries Don't Work

Unlike drugs, orthopedic surgeries can be sold to the public before they undergo any rigorous testing to ensure they are safe and effective. Thus, millions of surgeries for knee, shoulder and back pain have been done without the support of any research to confirm they actually work. Recently, a significant amount of such research has been completed, and it has found that many popular surgeries work no better than a placebo. And yet many of these surgeries are still done, at the rate of hundreds of thousands per year. 

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Is Movement Therapy Rocket Science?

Pain and movement are pretty complicated right? In a sense yes. But in another sense no. Pain and movement are not complicated, they are complex, which is a different animal.

Imagine you are Elon Musk trying to send a rocket ship to the moon. What sort of thinking process, analysis, modeling, research, predictions, and methods of control would help solve this problem? How would that process be different from solving the problem of say, raising a child? 

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Three Reasons It Matters Why A Treatment Works

Why exactly does someone feel better after massage? Or acupuncture? Or foam rolling? Or a chiropractic adjustment, or wearing K-tape, or doing mobility drills, or a hamstring stretch? There are some good answers to these questions, and the interesting thing I’d like to point out in this post is that quite often, the therapist doesn’t know them. Or even care about them

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A Systems Perspective on Chronic Pain

We can better understand the complexity of chronic pain, and its relationship to other multi-symptom disorders, by learning something about systems theory. The basic idea is that chronic pain is often driven by dysregulation of a “supersystem” that coordinates defensive responses to injury. The supersystem results from dynamic interaction between different subsystems, most notably the nervous system, immune system, and endocrine system.

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Graded Exposure

Graded exposure is a key concept in understanding how to reduce pain caused by movement. It's a very common sense idea, and one that most people kind of know at some level, because there is profound truth to it. But it's also an idea that most people will probably fail to put into practice in a systematic way. Here’s a brief discussion of what it is, why it works and how to do it.

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Play, Variability and Motor Learning

I recently had the privilege of attending a continuing education class at Athletes Performance in Arizona, which is one of the top athletic training facilities in the country, run by Mark Verstegen. It's a beautiful facility, with a nice grass field, an amazing workout room, and lots of elite athletes walking around and training. It was a very fun atmosphere and I was all geeked out. There are many things that I would like to write about from this experience (including the excellent DNSclasses that I was attending while there), but for now I just wanted to make a few brief observations about the way the athletes spent their time.

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Developmental Movements: Part One

Infants develop movement by progressively learning a series of fundamental movement patterns, which form the building blocks for more complex movements. For example, while lying on the ground and sitting in various positions, an infant learns to stabilize her head so she can see the world. Her head stabilization skills are a building block for the postural control required in standing and walking. While reaching to grab interesting objects, she learns the arm/trunk coordination patterns that are also used to crawl and walk, and eventually throw and climb.

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Pain Science Confusion

In recent years, pain science has become far more widely known, and that is leading to some interesting conversation and also confusion in the fitness, massage and manual therapy communities. Lorimer Moseley and David Butler have been charismatic and influential teachers on this issue. A good example of their work is found in the popular book Explain Pain, which uses neuromatrix theory as a theoretical background. Moseley provides a very accessible and entertaining talk about pain science in this recent DVD video.

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Some Problems with Movement "Correction"

Moshe Feldenkrais said that to "correct is incorrect." He was referring to efforts to correct someone's movement patterns. Which is kind of a strange thing to say for a guy whose method was largely about making people's movement more efficient. What did he mean and what does this say about efforts to correct movement? I think his message is that it is preferable to show clients different options or choices for how to move, than to tell them their current movements are wrong and require correction.

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How Does Foam Rolling Work?

Foam rolling is very popular. Athletic trainers use it as a part of the warm-up. Physical therapists use it as part of their treatment strategy, often to improve extensibility of “short” tissues. There is very limited evidence about what benefit, if any, foam rolling confers. But there are a few studies showing it leads to short term increases in range of motion that are not accompanied by strength loss. (This is interesting because stretching interventions tend to show increased range of motion that are associated with a loss of strength and power.)

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Extreme Performance or Optimal Health? Pick One!

Many of my clients will ask my opinion about whether a particular sport or activity promotes movement health. Yoga, running, swimming, weight training, ballet, soccer, gymnastics, crossfit. (People are especially interested in whether these activities will be healthy for their kids.) It’s an interesting question because almost any physical activity you can think of has costs as well as benefits.

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