By Nick Ng
While my Facebook feed was flooded with shares of the Association of Massage Therapy's research finding of massage therapy for various health issues last week, I stumbled upon an interest Tweet from PainScience's Paul Ingraham:
This led me to probe a little deeper into AMT's research summary. Well, a “little deeper” led to a “lot deeper” than I like.
By Nick Ng, BA, CMT
Despite the advances in our understanding of pain in the last sixty years in research, many manual therapists and fitness professionals are still being taught and adopting outdated ideas about pain. However, there is a small and emerging population of therapists and trainers who are gradually learning (and unlearning) about pain science and how to apply research with their patients or clients.
Even with this gradual movement, we see a lot of myths and misconceptions about pain being posted on Facebook, Twitter, Instagram, and LinkedIn. This leads to some major debunking of these myths online that we often see over and over again like it's Groundhog's Day. If you're sick of seeing the same myths and explanations of why they are inaccurate, well, here's a list from five influential manual therapists on social media who are getting tired of seeing the S.O.S. almost everyday.
By Nick Ng
Updated April 13, 2017: Dr. Gary Fryer, corresponding author of the review, shares his thoughts on this topic.
There seems to be more and more systematic reviews and meta-analyses recently shared on social media that examine the effectiveness or efficacy of a treatment with a specific health problem. Last month, someone shared a Cochrane Review on Muscle Energy Technique (MET) on Facebook, which piqued my curiosity to see what it says.
MET is “a system of manual therapy for the treatment of movement impairments the combines the effectiveness, safety, and specificity of reeducation therapies and therapeutic exercise. The therapist localizes and controls the procedures, while the patient provides the corrective forces and energies for the treatment as instructed by the therapist.” (1) It was developed by an osteopath named Fred Mitchell, Sr., about 50 years ago, which was refined by his son, Fred Mitchell, Jr. “MET uses the patient’s own voluntary muscle contraction in a precisely controlled direction against an operator applied counter-force,” the researchers described in the latest Cochrane Review of MET's effectiveness for nonspecific low back pain. (2)
However, the current philosophical underpinnings of MET is quite uncertain.
“This is a difficult question because I don’t think there is any more a common philosophy that underpins the application of MET,” Dr. Gary Frye explained, who is an associate professor at the College of Health and Biomedicine at Victoria University in Melbourne, Australia.
“Like the profession MET arose from — osteopathy — there are widely differing views on the principles of assessment and treatment, and different authors have emphasized different methods of application and uses of MET. The originator of MET, Fred Mitchell Sr., developed MET within a biomechanical framework using particular spinal and pelvic biomechanical models to guide assessment and treatment. My approach to the underlying principles and application of MET is influenced strongly by what appears supportable from modern research evidence.
“I have written and criticised the mechanistic approach commonly advocated in MET texts because I don’t think these principles are valid, and a purely biomechanical approach is out of touch with modern understanding of pain and disability.
“Rather than applying MET based solely on a biomechanical diagnosis, I think it is reasonable to instead consider the likely physiological actions of the technique, such as pain modulation, changes to motor control, reducing fear and gaining confidence in muscle contraction and movement, and apply it with these aims in mind.”
By Nick Ng and Alice Savito
Sometimes we see a post on social media about a new research finding that adds a better understanding of how our body works. And sometimes these findings may (or may not) apply to what we do with our clients or patients. So how do we know if certain research can be applied to what we do or not? The last thing we want to do is to misinterpret the research and fabricate narratives to fit our opinions.