“a growing number of physio and massage therapists who doubt there is credible evidence that purely mesodermal deformation is responsible for the therapeutic effects we obtain in manual therapy. Instead, they are generally satisfied that it is nervous system interactions that are the driving mechanism for pain relief and therapeutic effects, modulated by biopsychosocial factors. Furthermore, many also claim that manipulation deeper than the ectoderm is unnecessary and possibly not optimal. In that viewpoint, bruising would be considered excess force.”
Another confounding variable when it comes to determining whether a particular therapy is effective or not is the EFC or Expectation Fulfillment Confounder. Which, along with Confirmation Bias, Placebo, Regression to the Mean and other Confounding Variables, makes it next to impossible to determine whether a particular therapy is working through clinical evidence only.
“But hold on! We have to be careful here. Stability wasn’t measured. Just self reports of stability. And we don’t know what the patients were told. If they patients felt that they were unstable, were told that they scored high on self report measures on instability and then were given an exercise program that they were told addresses motor control deficits that contribute to stability with have an Expectation Fulfillment Confounder (EFC). Its not unusual that this subset would respond better because they have been primed to respond better. – Greg Lehman
“Flexibility is overrated, just like good posture. Gymnasts and acrobats need it, the average person doesn’t. Most people need greater power and control throughout their existing range of motion: that’s much more useful for performance and injury prevention.
Another critical concept is that stiffness is a sensation, not a physical property. People think they need to be more flexible because they feel stiff, but that sensation is rarely related to actually limited range of motion. Stiffness is more like a kind of chronic pain, difficult to troubleshoot, much more complicated than range of motion.”
-Paul Ingraham – PainScience.com
To reduce pain, we need to reduce credible evidence of danger & increase credible evidence of safety.
Lorimer Moseley. Explainer: what is pain and what is happening when we feel it? TheConversation.com.