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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 probably
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.
A reasons that I often hear (and occasionally give) as to why research findings are ignored is that "why should I care, what I am doing seems to work so well?". I cannot argue with this statement too much, except to ask; "if you knew more about the information that challenges your beliefs, might it not allow you to improve what you do?"
Postural observation and assessment has always played a role in my evaluation and treatment. I am fully aware that bad posture does not equate to present or future pain. The research is clear on this. My own observations of people confirms this as well, as I have seen people with perfect posture suffering the types of pains that I attribute to the soft tissue tightness that leads to pain syndromes. And, I have seen folks with terrible posture with no history of the type of pain that I would expect they would suffer.
Posture plays only a part of what I look at and for. I doubt that my practice will change much as a result of this study. But, my mindset might. It may cause me to search deeper into the body before I move into treatment.
I'd love others to read through the article and share your thoughts.
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 probably
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.
A reasons that I often hear (and occasionally give) as to why research findings are ignored is that "why should I care, what I am doing seems to work so well?". I cannot argue with this statement too much, except to ask; "if you knew more about the information that challenges your beliefs, might it not allow you to improve what you do?"
Postural observation and assessment has always played a role in my evaluation and treatment. I am fully aware that bad posture does not equate to present or future pain. The research is clear on this. My own observations of people confirms this as well, as I have seen people with perfect posture suffering the types of pains that I attribute to the soft tissue tightness that leads to pain syndromes. And, I have seen folks with terrible posture with no history of the type of pain that I would expect they would suffer.
Posture plays only a part of what I look at and for. I doubt that my practice will change much as a result of this study. But, my mindset might. It may cause me to search deeper into the body before I move into treatment.
I'd love others to read through the article and share your thoughts.
Views: 262
Replies to This Discussion
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Permalink Reply by Boris Prilutsky on
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Dear Walt.
if you disagree with me then I am assuming that you do spend procedure time 45-1hr on soft tissue mobilization.my apologies for globalization. Should say ,most of physical therapists in US trained as well dividing procedure time as follow:
ultrasound 12-15 min. electrical simulation 12-15min., therapeutic exercise 15-20min including passive stretching,hot/cold application 10-15min,gait training if needed , functional activities, but most really barely spending time for massage therapy. You can ask how I know it?I know a lot of physical therapists (more than 150attended my seminars) and all of them stated to me a)only lately some,not most schools including into the curriculum massage therapy as a discipline.I mean physical therapist never where trained in massage therapy and who choose to learn it taking CE on the subject including post-isometric relaxation techniques. For some reason they call it Vladimir Janda techniques. Originally it was propose by his teacher Karl Lewit.in my opinion this is important fact to know.
I am writing it with good intentions.it just reality. We as a massage therapist dealing with soft tissue dysfunctions in different way than physical therapists. And of course our all procedure time we spent on doing so.this was the point of my previous post.
Best wishes.
Boris
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Permalink Reply by Walt Fritz, PT on
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Boris,
My intent was to say that your generalization of PT's was inaccurate, at least in my case. But the generalization was pretty accurate overall, as most PT's, even manual therapy "experts" spend much less time than you or I do in soft tissue evaluation and treatment.
As a student PT, while we did receive massage instruction, it was quite lame. Soft tissue evaluation was nearly non-existent. Specialization after graduation allowed me to deeply explore this work. Now I spend my entire day treating and teaching myofascial release to MT's, PT's, etc.
Walt
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Dear Walt.
I'm very happy that in general we agree on this. Again I believe that you open up very important discussion that all can learn.I personally did learn that out there much more data then I thought. I mean data not really applicable to methodology that we are all practicing. thank you for bringing it up.
Best wishes.
Boris
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Permalink Reply by Janet on
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Spending so much time with the left side of my brain, it is so hard to believe that "the emotional component to pain and injury will always...evade...research and reasoning, no matter the explanation." It's hard for me to give up on explanations even when I continually shoot holes in a lot of what I read. I guess I need a lot of order and safety in my life. I'm working on forgoing the explanations and just living in the moment.
Walt Fritz, PT said:The emotional component of pain and injury will always remain the elusive component; the one that eludes all clinical research and reasoning, no matter the explanation.
Walt Fritz, PT
www.myofascialresource.com
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Janet,
"Always" may have been too extreme a word for me to use. I like to throw these concepts out there to myself, question my beliefs, see how they fit/feel, and move on. I may never get the answers I am seeking, but I feel it is worthwhile to keep trying.
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Permalink Reply by Stephen Jeffrey on
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Hi Walt
I also, would like to thank you for putting this article "out there" as this has particually fitted and felt very good:)
Only since coming to this site have I learned how to chalange myself like this, and on occasion its fair to say, I have felt "some" were doing it in a unnecessarily provocative way in relation to energy work. However this proved to be a chalenge I could meet and master, and am now benifitting from.
Research articles are now on my "to do" list .........only taken me 10 yrs....LOL
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Stephen,
Research-averse therapists certainly can do wonderful work with wonderful results. The curse of questioning has always been mine. I do feel that I am a better therapist as a result of searching out research which confirms my beliefs, as well as that which challenges or conflicts with my beliefs.
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Well bless your cursed soul Walt :) ......your web site is fantastic.
Walt Fritz, PT said:Stephen,
Research-averse therapists certainly can do wonderful work with wonderful results. The curse of questioning has always been mine. I do feel that I am a better therapist as a result of searching out research which confirms my beliefs, as well as that which challenges or conflicts with my beliefs.
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Thanks, Stephen. A new and improved version coming within the next week or two.
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Permalink Reply by Tracey Dawson on
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This article supports the notion of balance. Balance of the physical, mental, spiritual self leads to a more harmonious whole. Mid-way through reading the article, I was reminded of the book "Molecules of Emotion" by Candace Pert. I recommend reading it for an understanding of how our bodies hold on to every emotion that we experience.
My interest and experience with Traditional Chinese Medicine makes me look at my clients as a whole. Pain is a sign of an imbalance. I can work the soft tissue and joints to get them relief, but their diet, exercise, and lifestyle choices along with their mental/spiritual state are what influence their longterm health more so than any structural abnormality and I have limited control over those aspects. We are adaptive creatures to be sure.
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