vendredi 9 juillet 2021

Evidence-based physical therapy

Read a short article the other day that renewed my interest in this stuff.

Quote:

Originally Posted by New York Times
There’s been a quiet revolution taking place in the field of physical therapy. In the early 2000s, you could go to five different physical therapists for an injury and receive five different treatment plans. Some would have advised targeted exercises to strengthen muscles or classic treatments, like heat and cold packs.

Others might have relied on “voodoo treatments” like ultrasound, lasers and electrotherapy, despite the fact that experts weren’t really sure how — or even if — they worked. Today, many of those techniques have been set aside as the science has slowly accumulated that they don’t accelerate healing. You may still find them in some offices, however, as the field has struggled with a lack of uniformity and a lingering reputation for pseudoscience, leaving patients unsure whom to trust.

In addition to these grossly pseudoscientific ideas, it appears much of what people in the fitness industry in particular thought they knew about stretching, hip mobility, muscle tightness, etc. doesn't have a whole lot of scientific evidence behind it. Maybe I'm just ignorant of the progress that's been happening the past decade(s).

I was directed by a stranger to PainScience.com and I was fascinated by Paul Ingraham's breakdown of the supposed causes of common aches and pains as well as fitness routines that many people accept uncritically. Though not a medical professional himself, Ingraham has studied chronic pain for decades and once served as the assistant editor of ScienceBasedMedicine.org. The site has many citations. The section on stretching is worth a read.

I follow a lot of "fitness doctors" on social media and they seem to be bringing new things to the table, or at least schools of thought not widely accepted yet, like applications of the biopsychosocial model to strength training. Most of them appear to be very skeptical of the conventional practice of attributing pain to tissue damage, muscle imbalance, and posture and some don't think that lifting with your back is that bad because it doesn't seem to be avoidable.

Bit of a crude video below, but I think it illustrates well the competing schools of thought.

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Thoughts?


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