Rey Allen shared a blog post from Zac Cupples (here) in the Pain Science in Osteopathy forum quoting: “There are so many different techniques that we utilize, and we all have our biases as to which ones we like (and that’s ok). The important thing to understand is that all the interventions we provide operate under a similar framework; sensory input to facilitate a desired output and perception. So when deciding which technique is best to apply, pick the one’s that you can perform the best, that the patient believes will work the best, and allows the patient to take care of themselves as soon as possible.”
Michael Fleischmann commented that the statement: ‘That the patient believes will work the best’, didn’t sit well with him, and Monica Noij indicated that “exercise” (and by suggestion the implication of being asked to do some) for her and her patients wasn’t regarded as a friendly (or brain-friendly) word.
Meanwhile Cory and Sandy at 22:15 in (here) in reference to the Cochrane review of various interventions for the treatment of non-specific low back pain (no one intervention is better than any other) indicate that the best intervention is the one which you (as clinician) and the patient *wants* to use, with an equally possible beneficial outcome.
Then there’s Chris Littlewood on the Clinical Edge podcast with David Pope (here) telling us that surgery is no better than exercise, injections and manual therapy aren’t helpful, but painful shoulders *need* an exercise intervention otherwise 40% of the population will still be in pain 12 months later. I hope Monica never has a sore shoulder! But that’s not based on any paradigm of scapulohumeral rhythm or impingement because they’re as useful as the special tests for the shoulder, which apparently aren’t valid and shouldn’t be used to direct a treatment intervention.
All that clinical excitement pretty much over a weekend…and that’s just the tip of the iceberg.
The contradictions bogging us all down are endless.
The myth of over-pronation with Ian Griffiths and Jack Chew on the Physio Matters podcast (here) nicely preceded the article showing that even if over-probation was a ‘thing’ (it isn’t), it has no effect on lower limb mechanics anyway (here) – what!? so my flat feet won’t cause me knee pain and back pain…
Ignorance really is bliss – the Dunning-Kruger scale says so.
For now I’ll remain in my uncomfortable position on top of the fence taking in the shenanigans and toss a coin.