Recently a lively discussion was born on Leon Chaitow's fb page regarding an essay published by Eyal Lederman pretty much refuting the value of manual therapy altogether, except, of course, for his own 'harmonic' version of passive joint mobilization. It also challenged most assumptions about how postural variations might be contributing to back pain, by suggesting that they don't contribute much, if at all.
This got the muscle energy technique, structural integration practitioners and a few chiros knickers all in a twist. Refutations will be published in Leon's April JBMT journal.
Personally, I love when myths are scattered asunder replaced with a more sound scientific understanding. I've also invested many hours practicing meditation techniques based entirely on myths and unproven Asian world views proposing that Enlightenment can be reached in one lifetime. I guess if I'm a true believer in anything it's that here in duality, dichotomies reign.
One thing that bugs me in the bodyworking communities, and I say communities because some schools of practice seem to think their methods are far superior to the good old effleurage, kneading, compression, petrissage of 'Swedish' massage, and therein lies the rub. (Not only am I gonna squeeze all I can get outa these corny metaphors, but I'm gonna be blatant about it.) 'Different strokes for different folks' in this case should be appended to different strokes for different purposes.
The more tools a person has up her sleeves (albeit short ones while working) the better chance she has of pulling just the right one out when conditions call for it, maybe even a rabbit or two might appear. Some of this work does involve the ordinary magic of re-framing, in every sense, since it is the unconscious mind of the client that is doing all the healing, when that is the focus of the work.
It isn't always the focus of my work, thankfully. I'm interested in an ounce of prevention and in supporting the experience of open relaxed states of mind as having value in our all to busy world. I think those foci are valuable enough to stand up for, or lay down depending whether you are the active or receptive component of the mutual meditative experience a good massage can be. But that's a theme for another discussion.
I love learning from what my clients bring me and I also appreciate the serendipity that occurs in that play. Today an e-mail from one of them brought me a new link exploring this topic from a different POV. It emphasizes the importance of muscle endurance for back pain prevention. Discovering that an aspect of strength is a key factor introduces a whole new discussion of this issue, IMO, without necessarily obliterating all the belief systems of structurally oriented manual therapists, though it does poke a big hole in them. This article's studies appear to prove the importance of the specificity of the kind of back strength that prevents low back pain, which I think gets overlooked by many manual therapists. In this case, it appears that back muscle endurance is a key factor in predicting/preventing low back pain incidents.
Sometimes on Rolfing pages it seems to me that folks seem to think if they release the fascial adhesions, some of which are believed to be appearing in meridians in certain circles these days, that the structure will automatically correct and remain so. I've always thought that was a short sighted, or sided, view, if you prefer.
Some of the underlying reason for shortening/tightening of muscles or fascia around a joint or a forward drooping head is more probably a sequelae of weakness or instability in synergistic components of the structural biomechanics of that area. That's discussed well, I think, in the hammie aspect of this SIB link Ron sent me, which refutes, it seems to me, many assumptions of Rolfing/Structural Integration/Anatomy Trains/MET practitioners regarding the importance of, and their role in influencing the anterior/posterior alignment of the ilia.
The other aspect of this article I love is what the studies of ab exercises show regarding specificity as a law of adaptation. If you don't train in planes that target the obliques, they won't be firing....seems obvious, but nice to know that assumption is true. These ab studies also support Eyal Lederman's "Myth of Core Stability" essay (pdf link in green table under books on right) refuting the overemphasis and viral blossoming of myriad diverse 'core training' paradigms as essential for back health in training and bodywork belief systems these days.
In that light Paul Ingraham (who really likes Lederman's essays, not surprisingly) presents a well written expose of the over emphasis of structuralism in the fields of manual therapy. He does not, however, in this piece, propose a workable alternative view, although he espouses trigger point work as a valid manual therapy emphasis elsewhere on his site.
I'm still chewing on the cud of all this and enjoying the flavors that emerge from this mental exercise. I do think, however, that many folks with huge investments in structuralism as the basis of their work had better be prepared to amend their views a bit or be swept aside with those who once were sure the Earth is flat.
That's gonna be hard to do if you're raking in truckloads of coin teaching these methods and their underlying assumptions as CEU seminars to DCs, DOs, physical therapists and bodyworkers worldwide. The assertion that what you're teaching is worth addressing in therapy is not much more substantial than a straw dog argument in rhetorical play could feel like a bit of an earthquake. These essays are the equivalent of techtonic plates shifting. Some true believer acolytes and sychophants in the bodywork community who have invested lots of money, time and tethered their world views and careers to these assumptions are bound to get pissed off. Always happens when sacred cows get sacrificed to sound scientific discovery. Hey, those scientists who proposed the Earth is round and not the center of the universe were pretty unpopular in their communities and considered to be thinking way out on the fringe.
I'm not a big fan of encouraging the blind men to explore the elephant thinking that each has 'the' answer as to what this elephant really is. I'd prefer if we could have the humility to explore and dialogue acknowledging that we're still just feeling out mere parts of a much more interesting and mysterious whole.
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