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When is it time to alter your beliefs?

An article came to my attention within the past few days, one that really challenges what I have been taught and practice. Titled "The fall of the postural-structural-biomechanical model in manual and physical therapies: Exemplified by lower back pain". I've posted the link on my website Research page, #210. I am aware that there always have been, and probabaly always will be, challenges and changes to therapeutic paradigms, but this one is a big one for me. It also challenges much of the information that I was taught about the foundations of Myofascial Release. I'd love others to read through the article and share your thoughts.

Walt Fritz, PT
www.myofascialresource.com

Replies to This Discussion

Permalink Reply by Marion McCall on March 17, 2010 at 7:56pm

Thanks for this, Walt. I have read some of the article, but not all (yet!). We know from doing MFR that it helps people tremendously, sometimes with some very longstanding issues. Whether we want to say that it fits into any particular model is one thing, but to say that it doesn't work is entirely another.

We have all worked on people in whom the smallest changes makes a huge difference in their pain and ROM, yet we have worked on others where we have witnessed what seems to us to be profound changes and yet their pain levels or ROM are not altered much.

I think this just points out that no one fully understands the human body yet. This will not make me change what I have found about the work that I do any more than someone telling me that deep work is always best, or chiropractic adjustments are always necessary.

There are people who seem to have horrible posture or imbalances but no pain. In others, even a small imbalance seems to cause major problems. Some have one-off problems, others have chronic or serial episodes of the same problem.

Is there some other part of the picture that is not yet understood?

When I had a herniated disk, the orthopedic doc at the hospital was interested in what I do with MFR and he asked me to explain it. He told me that they don't understand backs (or soft tissue). As he explained, you can have two people with seemingly identical back issues. One gets better, the other doesn't. They have no idea why.

Keep on with the good work. MFR works, when done well. And you do it well!

Marion McCall

Permalink Reply by Walt Fritz, PT on March 17, 2010 at 8:41pm

Hi Marion,

As I said, this article challenges much of what I was taught. My changes take a bit more than one study. One might ask if similar studies exist that do NOT show the results reported in the study. Knowing the extent and diversity of research, I would bet that one could find conflicting reviews. One study won't cause a huge shift, in me or others. What it does do is create a need to always be re-evaluating, not just our patients, but also how we view our work.

My evaluations include postural assessment. But this is only one part of a larger look and feel. I do believe that posture plays a key role in assessing patterns, some of which can lead to pain or dysfunction. It is much like the MRI studies that I have posted here and elsewhere. They should only be a part of a full workup, not the sole determinant of diagnoses or outcomes.

Walt Fritz, PT
www.myofascialresource.com

Permalink Reply by Stephen Jeffrey on March 20, 2010 at 4:01am

Hi Walt, this research paper is very interesting, (I admit I really struggled understand it , I had to read it through 3 times)
its information is very chalenging, I def think you should post it out on the main discussion forum.

Am going to wait a while before posting more on this papers relevence to my practice, thanks for bringing it to our attention.

Permalink Reply by Walt Fritz, PT on March 20, 2010 at 1:08pm

Stephen,

I've posted this topic on the general forum. Thanks for the suggestion.

Walt Fritz, PT
www.myofascialresource.com