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the shizzle => diet, training and injuries => Topic started by: mctrials23 on March 04, 2015, 02:28:16 pm
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As I near the ripe old age of 28 I am starting to think more and more about my long term health and mobility. Since I started climbing again I have been a lot more focussed on non-climbing exercises to build strength outside of my twice a week wall sessions and. Some of this is purely for strength and general antagonistic training and other areas address flexibility and mobility.
Things like deadlifts have shown me deficiencies in my lower body and especially ankles. I have had minor back issues for about 10 years now but they come and go in short amounts of time and I can't pinpoint what triggers or fixes them. I injured my shoulder about 6 months ago.
Basically I feel like I am in need of a general once over from an Osteo / Physio to try and fix some of these issues once and for all. One of the things that seems to become more apparent the more I read is that just because you cannot move A very well doesn't mean that B is not the cause or even F.
Can you get someone to check all parts of the body for range of movement, imbalances, postural issues, scar tissue impingements etc? Have any of you had it done?
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Osteo or a GOOD physio (or good Osteo for that matter) could help? Mine helped sort out my herniated discs - but spent alot of time working on my thorasic spine - which in his words has probably not moved since I was a a teenager... Back problems probably linked to poor posture giving over S shaped spine - as top of back was inflexible etc...
Theres a fair ammount of snake oil going on I suspect , but it seemed to make sense...
TT
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Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?
It basically covers whole body movement, flexibility, mobility etc. and shows you ways how to address them on your own.
I know there is a bit of controversy regarding a lot of the material out of the Crossfit corner, but if you don't take everything for face value but use your own head too, there is some really good stuff in there which might be able to help you.
I also doubt that there is a "one stop solution" that will fix everything right now and forever. It is probably much more of an ongoing process and just as in climbing you'll have to keep working on to maintain a healthy body.
Just a thought ... ;)
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Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?
It basically covers whole body movement, flexibility, mobility etc. and shows you ways how to address them on your own.
I know there is a bit of controversy regarding a lot of the material out of the Crossfit corner, but if you don't take everything for face value but use your own head too, there is some really good stuff in there which might be able to help you.
Do you mind summarising, as mobilityWOD seems to be a bit of buzzword atm?
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Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?
I've used a few bits and bobs on that site already. He seems to know what he is doing. The crossfit association I think is just because he does crossfit and as a result helps a lot of them. I can't imagine he is a crossfitter that just dabbles in the mobility stuff. Seems like his day job.
I also doubt that there is a "one stop solution" that will fix everything right now and forever. It is probably much more of an ongoing process and just as in climbing you'll have to keep working on to maintain a healthy body.
Thats kind of why I want to do this now. Lots of people with these issues are talking months / years of work to get to where they should be. I'm pretty heavy for a climber so I fear that the more stress I put on my body from climbing as I get into the harder grades will be quite likely to find any big issues.
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Osteo or a GOOD physio (or good Osteo for that matter) could help? Mine helped sort out my herniated discs - but spent alot of time working on my thorasic spine - which in his words has probably not moved since I was a a teenager... Back problems probably linked to poor posture giving over S shaped spine - as top of back was inflexible etc...
Theres a fair ammount of snake oil going on I suspect , but it seemed to make sense...
TT
Tom, I thik your spine has moved rather a lot and that your osteopath is talking utter drivel.
excessive / reduced cervical or thoracic lordosis is not a triffling injury but I'm yet to be pursuaded of having someone 'crack' your neck / back is a good idea: my extensive tests with spinal manipulation have highly statistically significant results of pretty instant death. (usually in poultry, the odd rabbit and so on).
I'm not sure how an osteo could address a herniated or bulging disc, isn't that what reiki is for? :-[ :-\ :lol: :popcorn:
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Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.
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I would suggest seeing a good physio, or possibly more than one depending on areas of concern as they tend to specialize in different areas. Probably a shoulder specialist would be best as this is probably the most complex joint and of greatest concern to a climber.
I'd also recommend the Supple Leopard book. Contains many different ways of bringing on your pain face breaking down knotted up muscles with a massage ball and interesting things to do with rubber bands and a cut up bike inner tube. For Paul my take on the book is that it spends a fair chunk showing good posture for standing and many gym exercises (squats, deadlifts, turkish get-ups etc) and analysis on what mobility issues you have depending on which way you fail to do the exercise correctly. The second half of the book is split into ways to break down and mobilise/stretch the areas of concern the first half of the book told you about to restore range of movement...
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I'd second the motion to find a recommended physio/osteo, what you're essentially after is a functional movement assessment or functional movement screening. If you want more depth than 'Supple Leopard' for DIY work on this subject I can recommend this book as an excellent resource:
https://wordery.com/stability-sport-and-performance-movement-joanne-elphinston-9781905367429?currency=GBP>rck=UFpDZkw4dlpWZkdyN1dlckFhWDNZbUFyUlZGRFdraFh1bjJ2MUIrVkFLdnA3Z0xwRk1NcVdhaUNOQmRoQzE0OS9GbW1waGFlSlczUVkwV01pam9jN2c9PQ&gclid=Cj0KEQiA99qnBRDnrYCkt4ClzZABEiQAvqPaLAeI0IDLoCnJKjcFoDOEPjMQsare9ApmpO8Y1MYAZQAaArRe8P8HAQ (https://wordery.com/stability-sport-and-performance-movement-joanne-elphinston-9781905367429?currency=GBP>rck=UFpDZkw4dlpWZkdyN1dlckFhWDNZbUFyUlZGRFdraFh1bjJ2MUIrVkFLdnA3Z0xwRk1NcVdhaUNOQmRoQzE0OS9GbW1waGFlSlczUVkwV01pam9jN2c9PQ&gclid=Cj0KEQiA99qnBRDnrYCkt4ClzZABEiQAvqPaLAeI0IDLoCnJKjcFoDOEPjMQsare9ApmpO8Y1MYAZQAaArRe8P8HAQ)
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Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.
And you're an orthopaedic surgeon?
I've read thousands of medico legal reports dealing with everything from minor soft tissue injuries through to catastrophic injury and I can never recall a case where the suggested treatment was 'spinal manipulation' (other than the equivalent of TEETH).
Osteopathy is 'alternative medicine'. What do you call alternative medicine that works? 'medicine'.
Hardly the gold standard, but http://en.wikipedia.org/wiki/Osteopathy (http://en.wikipedia.org/wiki/Osteopathy) I wonder why mainstream 'big pharama' isn't diverting research funding from reiki to show how effective this 'medicine' is :blink:
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Medico legal reports may not be representative of the average person with back pain, spinal manipulation is part of the NICE guidelines on the conservative treatment of lower back pain and has an important place in the treatment of non specific lower back pain. A spinal surgeon or doctor may offer pain killers, injections or the knife, give me manipulaton or even reiki any day as long as it helps.
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To the original poster -
Yes you can get his sort of thing done, I had this sort of functional analysis done post spine surgery last year. I was lucky enough to stumble upon a well-trained and very experienced personal trainer working as part of a team in a local sports injury clinic. Among a long list of quals and experience in various training disciplines she is a NASM Certified Personal Trainer who specialists in Functional Movement / Functional Training and Corrective Exercises.
I recommend hunting down someone along those lines - a Certified Personal Trainer with quals/experience in functional movement analysis and corrective exercises. It's probably worth asking around the universities and sports teams - I've been told that good people with the above qualification are relatively thin on the ground, but don't know how true that is. In my experience of seeing physios/osteos, chiros and others, the person I'm now seeing is by far the most effective at keeping me healthy. When something acute is niggling then the physios/chiros etc. are more relevant.
It's worth complimenting any analysis with getting a good sports massage therapist on board to iron out any identified tightness that you can't self-treat. Again I got lucky through a word of mouth recommendation and found a very knowledgeable sports massage therapist. Not a whale-song practitioner who gives you a soothing rub and some peppermint oil.
Of course none of this comes cheap! I accept the cost as part of wanting to stay in good shape/ingrain good habits to keep me healthy for as long as possible.
All this assumes that you buy into the current popular theory which says imperfect movement patterns, weakness in the kinetic chain and muscle imbalances contribute to injury - it isn't cut and dried and opposing theories claim that there exist people with terrible movement mechanics who never get injured. But I get a lot from it.
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Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.
And you're an orthopaedic surgeon?
Your (self)love of the serious professions is laudable but an orthopedic surgeon is someone you go to see when all else has failed. Effectively you've reached the point of admitting the body's self-healing mechanisms are a lost cause and it requires someone applying deliberate trauma to heal you.
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One reason we don't do all-over health checks is that it would results in endless unnecessary treatment.
If you have endless time and money, your plan sounds like a good one. Assuming the unnecessary treatment isn't harmful.
If you're lucky, ignorance, the placebo effect and the odd benefit will outweigh the harms and you'll move on.
If you're unlucky you'll get conned into becoming dependent on expensive treatments by a well-meaning practitioner of one of the above arts, who will in fact be exacerbating the problem. And getting paid well for the service.
None of the above negativity seemed sufficiently strong.
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Are you aware of mobilityWOD and the associated book "Becoming a Supple Leopard" by Kelly Starrett?
It basically covers whole body movement, flexibility, mobility etc. and shows you ways how to address them on your own.
I know there is a bit of controversy regarding a lot of the material out of the Crossfit corner, but if you don't take everything for face value but use your own head too, there is some really good stuff in there which might be able to help you.
Do you mind summarising, as mobilityWOD seems to be a bit of buzzword atm?
+1 for Becoming a Supple Leopard, got it on my shelf. Great book and especially good for people into weights
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Do you mind summarising, as mobilityWOD seems to be a bit of buzzword atm?
Sorry, didn't see that at first.
Hm, I'm not sure what exactly you'd like to hear. I suggest you go to youtube and check out some mobilityWod / mWod episodes from Kelly Starrett and give some of the exercises or mobility drills a try.
If you then have any specific questions, I'm happy to help, I just wouldn't know how to summarize the entire topic better than quickly giving it a try yourself :)
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Sloper, if the entire population of the planet was divided into 10 equally-sized deciles and ranked in order of 'most likely' to 'least likely' to give useful advice on musculoskeletal issues and manipulation, you'd fall somewhere within the second-to-bottom decile alongside 'the bloke I recently stood next to in the pub' and 'my dad', but just above 'Gordon Brown' and 'Norman Lamont'.
And you're an orthopaedic surgeon?
Your (self)love of the serious professions is laudable but an orthopedic surgeon is someone you go to see when all else has failed. Effectively you've reached the point of admitting the body's self-healing mechanisms are a lost cause and it requires someone applying deliberate trauma to heal you.
Of course the body heals itself, of that there is no doubt.
The point is that as an intervention osteopathy has little / no evidential base as a means of 'cure'. There was a RCDBT trial of acupuncture where medics in white coats inserted needles in random places and this was found to be just as effective as acupuncture conducted by a 'master'.
To put it simply osteopathy is based myth and magic rather than science and medicine.
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One reason we don't do all-over health checks is that it would results in endless unnecessary treatment.
If you have endless time and money, your plan sounds like a good one. Assuming the unnecessary treatment isn't harmful.
None of the above negativity seemed sufficiently strong.
I thought this was the argument for not having a full body scan / health checkup where your blood etc is tested but good posture is not a matter of opinion as far as I know. I thought that we are pretty sure how all the joints, muscles etc should work and the basic range of movement joints should allow.
I'm not looking for someone to diagnose me with an illness, I am looking for someone to say "fix your posture by doing this, try this exercise to restore full ROM to your ankle, use these exercises to fix the imbalance in the front of your shoulder" etc
I didn't think that any of this was hokum...
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Just throwing this out there, but could it be a good idea to get some climbing coaching, but also explain the the coach your concerns and needs? (S)He will be able to identify any climbing related strength and flexibility deficiencies and, in addition, you'll get some movement skills and tactics thrown in for free!
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Sloper - you're arguing the wrong point - a 'cure' for what? We're talking about the theory that muscle imbalances, a weak kinetic chain and 'poor' posture may contribute to injury and whether it's worth having these things checked out by somebody qualified/experienced in the currently popular theories doing the sports medicine/personal training rounds. I.e. the issue is one of prevention of or rehabilitation from injury. There's a saying about that..
I'm not advocating osteopathy (I've never seen one and doubt I ever will) - I get the impression the original poster wasn't either but was just asking who to see.
You're doing a grand job of proving my characterisation of you - as a fuckwit with little useful advice on this subject - as spot on.
To quote my neurosurgeon - expensive as fuck private harley street - Sloper you'd definitely approve of him:
'''Whatever system you use [of core/kinetic chain strengthening] developing your core muscle strength is perhaps the most important element of rehabilitation and back pain prevention''
mctrials - it's worth reading up on the subject because there are plenty of people who disagree with the muscle imbalance theory. A little knowledge and a questioning attitude helps prevent you believing anything a 'practioner' tells you. Here are a couple to start with:
http://www.bboyscience.com/outdated-pain-theories-part-3/ (http://www.bboyscience.com/outdated-pain-theories-part-3/)
https://www.painscience.com/articles/posture.php (https://www.painscience.com/articles/posture.php)
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The OP posited the question as to whether he should seek a once over from an osteopath and my advice is no, I regard them as taking money from the deluded with no proper evidential base for their 'treatments'.
A good physio however is well worth the outlay.
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The OP said 'osteo / physio', you just chose to focus on the one you consider to be a quack while ignoring the other.
And in reply to your ''evidential base'':
To once more quote the consultant neurosurgeon - your idea of the gold standard guy, this time on evidence based medicine:
Whilst you may well gain benefit from sessions with a professional physiotherapist, or other manipulative therapist (osteopath, chiropractor (his words)) it is essential that you develop your own programme. The aim is to maintain the range of movements in your spine - of the discs and of the multiple joints. ... Stretching of the hamstrings and the rest of the body will then reduce the amount of movement required of the spine. This is very important and often neglected. Your physiotherapist may have taught you specific movements. However, the simplest programme and one which may be adequete is as follows:
..
[goes on to explain a very simple 'touch your toes and sideways/backwards bends]
..
Is this ''evidence based medicine''? No, and virtually no back pain treatments are, in the sense of the definitions fashionable today. But I was taught these stretches by my predecessor Mr John O'Connell when I was appointed consultant at St. Bartholomews in 1990. He had been the first surgeon to perform discetomy in Britain and I still encounter patients he saw in the 1950s who tell me they ''have been doing the stretches ever since and have been perfect''. This is evidence enough for me. Sadly he is no longer with us but I would have much enjoyed witnessing one of the modern zealots of evidence based medicine suggesting to Mr O'Connell that he didn't have any!
I too would enjoy watching you argue with someone like that for your gold-standard evidence-based medicine Sloper.
If something gives long-term relief of symptoms without causing further harm, that's a successful outcome. Whether it fits into an 'accepted' definition is less important.
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I had a good experience seeing an osteopath. She was towards the physio/sports massage end of the osteo spectrum rather than the wellness/baby massage end tho (she had a physio degree as well as studying osteopathy, which i think was key). I saw her once a week for a month during which she did a lot of deep tissue massage and checking of posture and mobility. After that I saw her once every six weeks until i was confident i could self manage. The main benefit for me was having a professional diagnose what was actually wrong, allowing me to take steps to deal with it.
I agree with pete here that the talk of "cure" is inaccurate (for me at least), anyone regularly (as in 3 times a week) climbing or training will develop issues that need addressing before they become serious injuries. I now have the attitude that if i want to climb hard, i need to factor in time for body maintenance.
On the back cracking issue, both my osteo and a physio i have seen at a later date have done this, so it's not just the realm of "quacks". Personally i can't get enough of it.
Also, get on mobilityWOD. You won't regret it.
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To put it simply osteopathy is based myth and magic rather than science and medicine.
Please do not put medicine and science in the same sentence implying they are similar!
From my own experience, the (Well qualified) physio I saw got my diagnosis quite wrong. The (well qualified) Osteo I saw got it right and I am now in the latter stages of recovery...
I didnt see a physio or osteo expecting to be 'cured' by their magic hands etc... but to act more as a project manager for my back pain - to find out what was wrong and suggest what exercises/rest/ice/heat I should have do/have done in order for it to get better..They kept a record of my injury - how I was progressing - and adjusted my program of exercises accordingly. For that I paid £40 a week/two weeks.
That the Osteo cracked my back and neck every trip (and I felt better for a couple of hours after that) I saw as an added bonus...
Both had theories as to why I was in pain. Physio thought the intense pain in my left glute was linked to a late teens broken right shoulder.. (!?!?), Osteo said it was the sciatic nerve being pressed due to herniated discs in my lower back - not helped by bad posture and a rigid upper back...
Maybe I saw a shit physio and a good osteo? TBH I didnt see too much difference in how they operated (as professionals) except they came from slightly different viewpoints. One massaged and stretched (including leaving me with quite some bruising on my back) - the other manipulated and stretched...
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That the Osteo cracked my back and neck every trip (and I felt better for a couple of hours after that) I saw as an added bonus...
The spinal manipulation is what scares me about osteos and chiropractors but then my sister in law is a nurse who loves to spread stories of doom and gloom about the times it goes horribly wrong. After I fell on my head a few years back I had some back and neck manipulation and having a bloke say 'try and relax' followed by a loud crack and a moment of panic while I check I'm not paralyzed didn't really work for me... It never provided anything more than very short term relief for me so I made my excuses and didn't book a repeat as soon as I could.
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That the Osteo cracked my back and neck every trip (and I felt better for a couple of hours after that) I saw as an added bonus...
The spinal manipulation is what scares me about osteos and chiropractors but then my sister in law is a nurse who loves to spread stories of doom and gloom about the times it goes horribly wrong. After I fell on my head a few years back I had some back and neck manipulation and having a bloke say 'try and relax' followed by a loud crack and a moment of panic while I check I'm not paralyzed didn't really work for me... It never provided anything more than very short term relief for me so I made my excuses and didn't book a repeat as soon as I could.
I had uncontrollable giggles when he was cracking my back on the first visit - I don't know why - and I suspect it was and unusual reaction! For my upper back (Thorasic spine - check me..) this does seem to free things up. The stuff on the neck? Meh... You can always ask them to not do it? The stretching/non spine cracking manipulation has been good for me too...
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The OP said 'osteo / physio', you just chose to focus on the one you consider to be a quack while ignoring the other.
And in reply to your ''evidential base'':
To once more quote the consultant neurosurgeon - your idea of the gold standard guy, this time on evidence based medicine:
Whilst you may well gain benefit from sessions with a professional physiotherapist, or other manipulative therapist (osteopath, chiropractor (his words)) it is essential that you develop your own programme. The aim is to maintain the range of movements in your spine - of the discs and of the multiple joints. ... Stretching of the hamstrings and the rest of the body will then reduce the amount of movement required of the spine. This is very important and often neglected. Your physiotherapist may have taught you specific movements. However, the simplest programme and one which may be adequete is as follows:
..
[goes on to explain a very simple 'touch your toes and sideways/backwards bends]
..
Is this ''evidence based medicine''? No, and virtually no back pain treatments are, in the sense of the definitions fashionable today. But I was taught these stretches by my predecessor Mr John O'Connell when I was appointed consultant at St. Bartholomews in 1990. He had been the first surgeon to perform discetomy in Britain and I still encounter patients he saw in the 1950s who tell me they ''have been doing the stretches ever since and have been perfect''. This is evidence enough for me. Sadly he is no longer with us but I would have much enjoyed witnessing one of the modern zealots of evidence based medicine suggesting to Mr O'Connell that he didn't have any!
I too would enjoy watching you argue with someone like that for your gold-standard evidence-based medicine Sloper.
If something gives long-term relief of symptoms without causing further harm, that's a successful outcome. Whether it fits into an 'accepted' definition is less important.
You'd also probably expereince similar benefit from a blow job by a pretty girl, winning £10k on the lottery & etc but that doesn't mean they're 'curing' the cause of the sym,ptoms: there's a reasons why the acronym TEETH (tried everything else, try homeopathy) is widely recognised, it's a way of the doctor getting someone out of their surgery / off their list etc
there's a difference between physiotherapy which is well recognised and has a very strong evidence base and a form of Victorian hokum with good PR
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I'm not clear what you're arguing against anymore - I'm not convinced you know what you're arguing against either.
If in doubt quote homeopathy, that'll distract from the point that you know approximately twat-all about what you're talking about.
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Sorry your half an hour is up.
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Aww.. I was enjoying your consultation. What was that smell of bullshit all about - aromatherapy?
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:wank: response.
If you believe in osteopathy then fine, but trying to dignify it with anything more than dogma and credo is very poor.
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Is that icon supposed to be demonstrating a corrective exercise of yours?
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I've had my back cracked a few times by an osteo and thought it was great.
Something that everyone is forgetting is old age, still young at 28 but your now past your best and its all downhill from here.
Keep meaning to give accupuncute a try one day to see if it helps with my back but too busy these days, I just MTFU and get on with it
;D
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but trying to dignify it with anything more than dogma and credo is very poor.
That's just not correct.
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Honestly.
When Sloper and Sam agree on something, alarm bells should start ringing.
A little digging.
Make up your own minds.
I'll stick to proven medicine , ta very much 'n all.
Matt out.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905885/
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Chiropractors get most of the bad press in that article...
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Chiropractors get most of the bad press in that article...
Ok.
One more.
Fundamentally they are similar in practice and treatment modality (manipulation). They differ, philosophically, in the expected outcomes of treatment.
An Osteopath might expect to treat pneumonia with chest massage, for example.
The Chiropractic method would expect the same result from spinal manipulation.
It is clear that there is little evidence base for either method.
There is a strong evidence base for Physiotherapy.
The later is also strictly regulated and subject to continuing and rigorous research and development.
The others?
Not so much.
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One of the common forms of treatment done by Physios is Ultra sound. There is not a lot of evidence to say this has any effect.
I would rather go with the opinion of our trusts back health advisor/expert who is of the opinion that Physios should stop messing about with their machines and actually start using hands on treatment.
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The neck cracking thing just makes me think of that tough guy in a movie. You know the guy who can kill you with a flick of your head.
People have suffered strokes due to incorrect manipulations (google for info). I'm not letting no one Steven Seagal my neck.
Pain relief is addictive and as chiro/osteo doesn't fix a problem it only alleviates it. It is a pretty good business model for repeat business don't you think.
Got a problem then address the source which will require work/pain/effort/sacrifice or take the Chuck Norris option.
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One of the common forms of treatment done by Physios is Ultra sound. There is not a lot of evidence to say this has any effect.
I would rather go with the opinion of our trusts back health advisor/expert who is of the opinion that Physios should stop messing about with their machines and actually start using hands on treatment.
Most physios. I know stopped using ultrasound more than 20 years ago. There is evidence of small effects in animal models but trials in real people with muscle, tendon or ligament injuries suggest it does not matter if the machine emits ultrasound if the lights turn on. Use of ultrasound would be an indication to me of someone not keeping up-to-date with their practice or was consciously looking for a placebo effect.
Most health checks are worthless for the customer. They may well work well as income generation for the practitioner.
I can see how, theoretically, non-ideal movement could be a predisposing factor to injury, especially in people doing highly repetitive activities like runners or musicians. It's probably less important in climbers since our movement is so varied and it's certainly a small part of a big picture.
Who you choose to do your check is up to you. Physiotherapy courses require the highest academic qualifications to entry of all the movement-analysts you could choose and are pretty good about keeping clear of pseudoscience but, like any other profession, not all Physios. are equally good. Personal recommendation goes a long way.
Sloper, don't confuse manipulation mechanism (poorly understood, often misrepresented) with effect (small-moderate effect size in spinal pain, which makes it one of the better interventions on offer). It is a NICE recommended intervention.
Basically, what Pete said.
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One of the common forms of treatment done by Physios is Ultra sound. There is not a lot of evidence to say this has any effect.
I would rather go with the opinion of our trusts back health advisor/expert who is of the opinion that Physios should stop messing about with their machines and actually start using hands on treatment.
Hear hear.
After I had the big accident, I had maybe three physio sessions a day for the best part of six months (various body parts) and apart from the odd private session I paid for myself - the NHS basically rebuilt me to a point were I could work again.
After 10 months or so, the insurance claim against the other fella started to be processed and I had access to the world of insurance funded private physios. This was great for getting detailed scans of various other body parts the NHS hadn't focused on but I don't remember once, any of these physios actually getting properly physical - straight to the ultrasound machine and the bill is in the post. One actually looked at the scans of my knee, turned on the machine and set to without even touching my knee. Never went back there, he may well have been a decent physio but I had no confidence in him after that.
Only my little anecdote, it seemed to me that certain physios were too quick to press the button on the miracle machine.
As I wasn't working much at the time, I tried googling ultrasound but there wasn't masses of stuff about it and I became convinced that the best use for it would be in the creation of a targeted near use raybeam gun for the assassination of Presidents - turn it up and hit them straight in the heart, with no one any the wiser as they fall to the floor dead. Assumed heart attack until much later and you'd be well away by then...
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Chiropractors get most of the bad press in that article...
Ok.
One more.
Fundamentally they are similar in practice and treatment modality (manipulation). They differ, philosophically, in the expected outcomes of treatment.
An Osteopath might expect to treat pneumonia with chest massage, for example.
The Chiropractic method would expect the same result from spinal manipulation.
It is clear that there is little evidence base for either method.
There is a strong evidence base for Physiotherapy.
The later is also strictly regulated and subject to continuing and rigorous research and development.
The others?
Not so much.
Matt I get your skepticism and it's something I share. However, if you believe physiotherapy is one side of some well-defined imaginary 'quackery line in the sand' and the chrio/osteo sits on the other side, then I think you're either misinformed or unhelpfully dogmatic (i.e. Sloper). From what I can tell - and disregarding what the 'xyz' practioners may believe are the mechanisms behind the effect of the manipulation, the manipultive therapies all float around in the same nebulous area of knowledge and practice. Chrio/osteo/physiotherapy all have crossover in the area of manipulation and alignment. The most effective physiotherpaists in my experience are MACP qualified ones. This is all about musculoskeletal manipulation and how the body's neuromuscular system reacts to manipulation.
Very little of any form of preventative sports medicine is 100% proven to be effective.
The whole concept of alignment and imbalance is open to question - therefore physiotherapy could be said to be onboard an unproven bandwagon.
If you disagree with the beliefs behind why one form of 'xyz' manipulation works then I share your skepticism - I've encountered some totally whack beliefs among various physio/chiros.
Getting back to the OP's point - The person I get most benefit from for keeping my body healthy and in good shape and general all over fitness is someone who shows me exercises for keeping the kinetic chain toned up and strong, and who keeps me on track ensuring I perform the exercises with good form - i.e. good alignment (the unproven part of the concept). TRX and various other simple body-weight exercises for range of movement, strength and mobilty. It isn't rocket science but I never used to do any of it.
When I've been overdoing the climbing/training I see a good sports massage therapist to give the muscles a treat.
And the principle 'do no further harm' sits in context - it doesn't apply to surgery. 'Do less harm than good' is more accurate.
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There is a strong evidence base for Physiotherapy
No there isn't, except for chest physio and possibly for stroke rehab
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When I've been overdoing the climbing/training I see a good sports massage therapist to give the muscles a treat.
Feels great. Probably worth the money just for that. Very little evidence of any physical benefit. :shrug:
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Spoken like a true armchair philosopher/critic who's read some studies, like this one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/ (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/)
Which show no measurable benefit.
Imagine trying to live a life in strict accordance to a rule that states 'you must only adopt practices and beliefs that are proven beyond all doubt by scientific studies to be beneficial'. You'd be paralysed by indecision before you finished breakfast. In fact, breakfast would be an impossible choice of conflicting data. Don't you dare think about approaching the fingerboard - just lie on the bed and don't move, that way you won't risk breaking the rule.
Back on planet earth... People who regularly put a high load on their bodies find masage to be 'benefical'. without getting the force measurement apparatus; the range of movement measurments; the metabolite markers measured and various other parameters tested out both pre and post massage, the definition of 'beneficial' is quite unscientific and instinctive. Like much of life :shrug:
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An Osteopath might expect to treat pneumonia with chest massage, for example.
Osteo == bones, what sort of weird causal pathway posits that manipulating the bones around the lungs will have any effect on bacterial/viral infections within the lung tissue (the underlying cause of pneumonia which is swelling of the lungs due to infection)? A Cochrane Review (http://goo.gl/J3FYnz) concluded it is not efficacious.
I've nothing against proven holistic approaches to healthcare whereby nutrition, sleep, activity, posture etc are looked at in conjunction to understand the underlying causes of chronic problems but if thats what "Osteopathy" is (all problems have their aetiology in the musculoskeletal system and manipulating it will cure it) then its not very scientific.
It might have some utility in treating musculoskeletal problems.
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Spoken like a true armchair philosopher/critic who's read some studies, like this one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/ (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/)
Which show no measurable benefit.
Imagine trying to live a life in strict accordance to a rule that states 'you must only adopt practices and beliefs that are proven beyond all doubt by scientific studies to be beneficial'. You'd be paralysed by indecision before you finished breakfast. In fact, breakfast would be an impossible choice of conflicting data. Don't you dare think about approaching the fingerboard - just lie on the bed and don't move, that way you won't risk breaking the rule.
Back on planet earth... People who regularly put a high load on their bodies find masage to be 'benefical'. without getting the force measurement apparatus; the range of movement measurments; the metabolite markers measured and various other parameters tested out both pre and post massage, the definition of 'beneficial' is quite unscientific and instinctive. Like much of life :shrug:
That's a whole heap of shit. I'm not suggesting that everything we do must be backed by DBRCT, proven in the LHC etc, what I am saying is that paying good £££££ for something that has very limited provenance but very real risks isn't a great idea.
The idea thast 'manipulation' isn't well understood is as tru as the idea that magic isn't well understood either.
Plenty of things, like acupuncture 'work' as placebo and placebo is not wholly understood but we at least recognise that it is the placebo that works rather than the placing of needles in a particular spot that works.
Of course a good massage feels good, who'd dispute that? Do you pefrom better when you feel good? Of course you do. None of this is however relevant.
Personally I see the 'alternative' medicine brigade as being charlatans who dupe the gullible and this ranges from the almost amusing (Hopi ear candles) to the criminal selling of quack cures for serious illnesses. Clearly you think osteopathy is in a special class, so do you want to buy come Accapi clothes?
In respect of the study you cite, I seem to remember it being bad practice to conclude that 'more studies are needed' source Dr Goldacre B.
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Spoken like a true armchair philosopher/critic who's read some studies, like this one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/ (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/)
Which show no measurable benefit.
Imagine trying to live a life in strict accordance to a rule that states 'you must only adopt practices and beliefs that are proven beyond all doubt by scientific studies to be beneficial'. You'd be paralysed by indecision before you finished breakfast. In fact, breakfast would be an impossible choice of conflicting data. Don't you dare think about approaching the fingerboard - just lie on the bed and don't move, that way you won't risk breaking the rule.
Back on planet earth... People who regularly put a high load on their bodies find masage to be 'benefical'. without getting the force measurement apparatus; the range of movement measurments; the metabolite markers measured and various other parameters tested out both pre and post massage, the definition of 'beneficial' is quite unscientific and instinctive. Like much of life :shrug:
Someone has some rage I see!? I fucking love sports massage and would have it every week if I could afford it. There was no sarcasm in my above post, merely observation.
One important issue here is that you seem to be conflating two conditions:
1) The condition in which something has not been subjected to rigorous peer-reviewed studies
2) The condition in which something has been subjected to rigorous peer-reviewed studies and has not been found to be beneficial
It's an important distinction. The third condition worth mentioning here is much more certain and much rarer, since conclusive disproof is extremely difficult.
3) The condition in which something has been subjected to rigorous peer-reviewed studies and has been found to not be beneficial
And if, for some reason, my love of sports massage hasn't dispelled your pejorative accusations of being an armchair philosopher, bear in mind that while I find the debate over the efficacy of breakfast intriguing, I eat a large breakfast every day without remorse. If I try to do, well, anything really without having had breakfast, I get head-rushes, feel faint, weak and grumpy. I can just about manage a lie-in without breakfast, but even this can only last so long. If we go out for brunch, I tend to eat something beforehand since I'll otherwise be sullen, grumpy and poor company by the time I get fed. As I say, in this case it seems that pragmatic approach is the correct on.
That's not to say, of course, that I wouldn't in fact benefit from a radical change of diet including a reduction or removal of breakfast. It may be that doing so would, in the long run, cause my body to adapt and adjust to the new diet and improve my overall health (I could do with losing a stone). In fact, if there was strong and unequivocal evidence in this direction, I might well give it a go.
Also, I should probably say I've been helped substantially by sports physiotherapists. Full body check-ups are still a bad idea.
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I'm genuinely baffled how it comes across that I have 'the rage'? I don't. I'm answering your point that you think there's very little evidence of any physical benefit from sports massage.
Also, I should probably say I've been helped substantially by sports physiotherapists.
For Sloper's benefit, can you define more accurately how you benefitted? Do you have some scientific evidence? No - well, you may as well have gone for one of Sloper's aforementioned blow jobs or a winning lottery ticket, for the same effect, going with Sloper's tone of argument.
Calorie restriciton will give you years of extra healthy life btw. Or then again it might not.
Slopes- I'm baffled how you keep saying balls like: 'Clearly you think osteopathy is in a special class, so do you want to buy come Accapi clothes?' and expect anyone to take you seriously. I think only you could misconstrue what I'm saying to that extent.
Full body check-ups are still a bad idea.
Do you actually understand what sort of check the O.P. is suggesting? It wasn't a full body check in many people's understanding of the term.
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Spoken like a true armchair philosopher/critic who's read some studies, like this one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/ (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953308/)
Which show no measurable benefit.
Imagine trying to live a life in strict accordance to a rule that states 'you must only adopt practices and beliefs that are proven beyond all doubt by scientific studies to be beneficial'. You'd be paralysed by indecision before you finished breakfast. In fact, breakfast would be an impossible choice of conflicting data. Don't you dare think about approaching the fingerboard - just lie on the bed and don't move, that way you won't risk breaking the rule.
Back on planet earth... People who regularly put a high load on their bodies find masage to be 'benefical'. without getting the force measurement apparatus; the range of movement measurments; the metabolite markers measured and various other parameters tested out both pre and post massage, the definition of 'beneficial' is quite unscientific and instinctive. Like much of life :shrug:
Someone has some rage I see!? I fucking love sports massage and would have it every week if I could afford it. There was no sarcasm in my above post, merely observation.
One important issue here is that you seem to be conflating two conditions:
1) The condition in which something has not been subjected to rigorous peer-reviewed studies
2) The condition in which something has been subjected to rigorous peer-reviewed studies and has not been found to be beneficial
It's an important distinction. The third condition worth mentioning here is much more certain and much rarer, since conclusive disproof is extremely difficult.
3) The condition in which something has been subjected to rigorous peer-reviewed studies and has been found to not be beneficial
And if, for some reason, my love of sports massage hasn't dispelled your pejorative accusations of being an armchair philosopher, bear in mind that while I find the debate over the efficacy of breakfast intriguing, I eat a large breakfast every day without remorse. If I try to do, well, anything really without having had breakfast, I get head-rushes, feel faint, weak and grumpy. I can just about manage a lie-in without breakfast, but even this can only last so long. If we go out for brunch, I tend to eat something beforehand since I'll otherwise be sullen, grumpy and poor company by the time I get fed. As I say, in this case it seems that pragmatic approach is the correct on.
That's not to say, of course, that I wouldn't in fact benefit from a radical change of diet including a reduction or removal of breakfast. It may be that doing so would, in the long run, cause my body to adapt and adjust to the new diet and improve my overall health (I could do with losing a stone). In fact, if there was strong and unequivocal evidence in this direction, I might well give it a go.
Also, I should probably say I've been helped substantially by sports physiotherapists. Full body check-ups are still a bad idea.
Are you me today?
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Pete, I merely pointed out a potentially risky practice, common to both Osteopathy and Chiropractic, namely spinal manipulation or the so called "cracking" of the neck and back.
Tom pointed out that the cited report primarily referred to Chiropractic modalities, to which I replied by noting the similarities in modality compared to the philosophical approach behind them.
(This does not include "cracking" or manipulating other joints or limbs, which I suspect are highly unlikely to cause a stroke or paralysis.)
Both of those issues I, personally, treat with the greatest suspicion.
I find no reason to treat massage in the same light, nor posture exercise or analysis.
If I wanted to further criticise Osteopathy and Chiropractic, I might point out their origins as the unfounded fantasies of two (competing) 19th century laymen, who rode the wave of pseudo science to prominence in that era; became discredited and dropped from medical practice and have recently begun a resurgence, that appears somewhat faddish.
Remember they claim, at the council level, to be able to treat everything from a bad back to Cancer.
I didn't want to get caught into the discussion in detail. Because the manipulation does provide temporary relief of symptoms. Osteopathy is preferable to Chiropractic philosophy, in as much as it slightly less ambitious in it's claims.
If you remove the spinal manipulation and disease curing claims from those methodologies, you end up with physiotherapy.
Practiced by people with less training.
Add that to the potential harm of the manipulation and it seems like something that ought to be much better researched before being allowed to continue.
This has nothing whatsoever to do with massage.
With or without a happy ending.
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Whats your view on Breakfast Matt? ;)
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Whats your view on Breakfast Matt? ;)
With or without coffee/bacon?
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That's not breakfast.
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Page 3, hopefully 15 more to go :popcorn:
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That's not breakfast.
Sadly true at my age.
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Popcorn is an interesting breakfast Dense... sweet or salty? ;)
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you need x2 bodywieght of popcorn :chair:
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Bacon is linked to bowel cancer. Back of a fag packet (deadly things) calculation, I'd attribute greater risk of morbidity (and fewer positve effects, unless you own a pig farm) to bacon than to spinal manipulation.
Food industry .... There's a scene for you
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Order more popcorn Dense...
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Get unsalted Dense. Too much salt is bad for your blood pressure
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Get unsalted Dense. Too much salt is bad for your blood pressure
Sugar is the demon food d'jour.
So just plain popcorn, then.
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Get unsalted Dense. Too much salt is bad for your blood pressure
I think that has been debunked.
:boxing:
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'Being an American' is significantly linked to high blood pressure. I wonder if 'being an argumentative lawyer' (are there any other kinds?) is similarly linked...
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Get unsalted Dense. Too much salt is bad for your blood pressure
I think that has been debunked.
:boxing:
I find it hard to get debunked, in the morning, without the prospect of coffee and bacon...
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Matt
What's the bit about if you take the curing disease bit away from Osteopathy you get Physiotherapy practiced by people with less training. Both are degree level training courses.
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http://www.prospects.ac.uk/osteopath_entry_requirements.htm
http://www.nhscareers.nhs.uk/explore-by-career/allied-health-professions/careers-in-the-allied-health-professions/physiotherapist/entry-and-training/
http://www.ucl.ac.uk/prospective-students/undergraduate/degrees/viking-old-norse-studies-ba
As I said before, take an informed decision and follow your own path.
There are a lot of subjects that can be studied to degree level (including Klingon, I believe).
Physios in the UK are require to be registered as health care professionals and to carry out student time in practice, similar to doctors. Holding the degree does not entitle you to practice (I believe they have to be Chartered to move into private (unsupervised) practice?).
So, if you were to remove the disease curing and spinal manipulation aspects of Osteopathy, the fundamentals of the practice; what is left of the degree?
I don't doubt the effort or study required to achieve the degree and if someone believes in it and finds patients of similar bent, then crack away; I'm not Sloper.
It is, unfortunately, with familiar refrain, that I express my opinion of the practice:
Do you know what they call "alternative" medicine which has been proven to work?
Medicine.
If it shed it's pretension to panacea and focused on demonstrable physical therapies, then it would be another school of Physiotherapy.
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Matts had too much sugared popcorn ;)
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Anyway. I hate breakfast. If someone invented a breakfast pill I could take to stop me feeling hungry, grumpy and light headed before lunchtime I'd love it.
In the morning all I want to do is have a cup of coffee, take a shit and get on with the day...
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Anyway. I hate breakfast. If someone invented a breakfast pill I could take to stop me feeling hungry, grumpy and light headed before lunchtime I'd love it.
Have you considered seeing an Osteopath? - they can cure all sorts including food cravings.
Anyway back on topic. Do you have a burr or blade grinder and what beans?
:tease: :tease:
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Matts had too much sugared popcorn ;)
I know...
But once you allow yourself to be drawn into these discussions, it's strangely hard to leave.
The heart of the issue is that no-one has enough information to conclusively prove or disprove the point, leaving it subject to emotional bias and anecdotal reference.
Still think I'm right.
(Places thumb on nose and wiggles fingers, whilst poking out tounge)
Nur-de-Nur-de-Nur-Nur.
Of course, I remain prepared to make a full 180 on my current position, should appropriate evidence arise.
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It is, unfortunately, with familiar refrain, that I express my opinion of the practice:
Do you know what they call "alternative" medicine which has been proven to work?
Medicine.
If it shed it's pretension to panacea and focused on demonstrable physical therapies, then it would be another school of Physiotherapy.
https://www.youtube.com/watch?v=HhGuXCuDb1U (https://www.youtube.com/watch?v=HhGuXCuDb1U)
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Matts had too much sugared popcorn ;)
I know...
But once you allow yourself to be drawn into these discussions, it's strangely hard to leave.
The heart of the issue is that no-one has enough information to conclusively prove or disprove the point, leaving it subject to emotional bias and anecdotal reference.
Still think I'm right.
(Places thumb on nose and wiggles fingers, whilst poking out tounge)
Nur-de-Nur-de-Nur-Nur.
Of course, I remain prepared to make a full 180 on my current position, should appropriate evidence arise.
Reflexology then?
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sweet or salty? ;)
Sweet and salty is best
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Reflexology then?
Knee jerk?
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Jerk chicken. Now you're talking my kind a therapy...
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Nahh, it's got to be jerk goat, with a cold beer :punk: