SaveYourself.ca •Sensible advice for aches, pains & injuries
 

Articles Index

Hundreds of articles about the science of pain and injury, manual therapies like massage and chiropractic, sports and exercise, and much more

This is the main directory for content on SaveYourself.ca — a wiki-like collection of 230 steadily evolving articles and e-books, plus 317 blog posts (about 555,000 words in all, plus lots more in the nooks and crannies). Browse and sort, or click the gear Show or hide controls for the article list for more options. Popular articles are highlighted by default. Other starting places: a simpler categorized index, a Reading Guide for Patients and another for Professionals, the big Pain & Injury Survival Tips page, and the Microblog page for news and updates only.


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blogAudio article no. 7+   new   Aug 27, 14Aug '14 55
blogThe fate of medicine without reductionism+   new   Aug 27, 14Aug '14 65
blogNow basically rather “edited”   new   Aug 26, 14Aug '14 190
blog“Positive”   new   Aug 26, 14Aug '14 275
Why “Science”-Based Instead of “Evidence”-Based?   The rationale for making medicine more science-based updated   Aug 26, 14Aug '14 2,400 •••
The Power of Barking   updated   Aug 23, 14Aug '14 600 ••
Confirmation Bias+

Confirmation bias explains a lot about human nature. Most people know it best as “selective hearing” or “selective memory” — hearing and remembering only what you want to hear (see also “pareidolia”). Confirmation bias is a whole lot more: a dazzling array of devious and largely unconscious mental tactics and thinking glitches that lead people to confirm their beliefs and pet theories. We not only tend to ignore, deny and overlook anything that contradicts our point of view, but we also invariably notice, inflate and or even fabricate anything that supports it.

Confirmation bias is one of the main reasons that The Truth is so slippery, and both amateurs and experts alike are prone to significant thinking errors. There are people who consider it part of their job description to eliminate confirmation bias from their thinking — the best scientists and journalists, for instance — but it’s really difficult. Everyone has confirmation bias: it’s just how minds (don’t) work!

  Confirmation bias is the human habit of twisting our perceptions and thoughts to confirm what we want to believe
updated   Aug 23, 14Aug '14 800 ••
The “Impress Me” Test   Controversial therapies are usually fighting over scraps of “positive” evidence that damns them with faint praise updated   Aug 23, 14Aug '14 1,600 •••
blogTesting magic   new   Aug 21, 14Aug '14 180
Why So “Negative”?+I criticize many poor ideas in health care, so I often seem “negative,” especially to people who truly believe in treatments I debunk. But defending patients from false hope and fraud is a Good Thing, I also report on many effective treatments, and I have fun taking my subject seriously. Not so negative after all!   Answering accusations of negativity, and my reasons and methods for debunking bad treatment options for pain and injury. updated   Aug 21, 14Aug '14 5,000 ••••
A Better Hot Bath   Tips for getting the most out of the oldest form of therapy updated   Aug 21, 14Aug '14 2,750 •••
blogVibram gets vague   new   Aug 20, 14Aug '14 220
blogI’m not holding my breath   new   Aug 20, 14Aug '14 170
blogThe chemistry of the burn+   new   Aug 19, 14Aug '14 130
blogPeak musculoskeletal anatomy+   new   Aug 19, 14Aug '14 100
blogClassic anatomy videos still going strong   new   Aug 4, 14Aug '14 325 ••
blogJust exercise those thighs!   new   Aug 4, 14Aug '14 190
blogIt doesn’t go to my head!+   new   Aug 1, 14Aug '14 100
blogIs there hope?+   new   Jul 31, 14Jul '14 130
blogFree speech+   new   Jul 31, 14Jul '14 25
blog2nd edition of patellofemoral pain e-book, co-authored with Tony Ingram   new   Jul 29, 14Jul '14 850 ••
blogNeck pain updates+   new   Jul 24, 14Jul '14 30
blogExplaining away treatment successes   new   Jul 24, 14Jul '14 325 ••
blogMark my words: a new e-book feature   new   Jul 22, 14Jul '14 275
blogDownward dog needs more dog+   new   Jul 22, 14Jul '14 30
The Tyranny of Yoga and Meditation!   Do you really need to try them? How much do they matter for recovery from conditions like low back pain? updated   Jul 17, 14Jul '14 1,900 •••
Poisoned by Massage+

Massage is not a detoxification treatment in any sense, contrary to a popular belief. Ironically, it’s the opposite: post-massage soreness and malaise (PMSM) is probably caused by mild rhabdomyolysis (“rhabdo”). True rhabdo is a medical emergency in which the kidneys are poisoned by myoglobin from muscle crush injuries. But many physical and metabolic stresses cause milder rhabdo-like states — even just intense exercise can do it, and probably massage as well. This is substantiated by a case study of acute rhabdomyolsis caused by intense massage (see Lai), by many well-documented cases of exertional or “white collar” rhabdo, and by the strong similarity between PMSM and ordinary exercise soreness. A rhabdo cocktail of waste metabolites and by-products of tissue damage is probably why we feel a bit cruddy after biological stresses and traumas — even massage, sometimes. And you can’t “flush” the rhabdo away with massage or by drinking a little extra water. PMSM is just an unavoidable mild side effect of strong massage.

  Rather than being “detoxifying,” massage may cause a modestly toxic situation in the body
updated   Jul 16, 14Jul '14 4,500 ••••
What Could Go Wrong With Massage?   Rare but real adverse effects of massage therapy, especially “deep” massage updated   Jul 16, 14Jul '14 1,800 •••
blogThe weirdness of pain+   new   Jul 15, 14Jul '14 130
blogToo many choices+   new   Jul 15, 14Jul '14 100
Save Yourself from Tennis Elbow!   Not just for tennis players, straight-talking advice on healing from this common tendinitis (lateral epicondylitis) updated   Jul 12, 14Jul '14 3,250 ••••
Digital Motion X-Ray+

Digital motion X-ray (DMX) is an X-ray video: many X-ray images strung together to make a movie. The output is impressive. In theory, it can reveal serious problems that somehow eluded diagnosis otherwise. In practice, this unregulated and banned-in-Canada technology is primarily sold to neck pain patients by chiropractors, often for evidence in personal injury lawsuits, and is completely eschewed in medicine because of concern about radiation exposure. DMX undoubtedly has some potential to show important things, but is it worth an increased risk of cancer to diagnose conditions that, mostly, can and should be diagnosed any other way? It’s not completely out of the question, but you should get multiple medical opinions and think hard before resorting to this exotic diagnostic method.

  What’s the risk from the radiation exposure? Is the diagnostic potential worth it?
updated   Jul 11, 14Jul '14 1,000 •••
blogAn epic fail for pre-run stretching+   new   Jul 9, 14Jul '14 130
blogWonder Core!+   new   Jul 7, 14Jul '14 15
blogSpeaking of needles…+   new   Jul 7, 14Jul '14 30
blogWhat’s the point?+   new   Jul 7, 14Jul '14 140
blogTreat the animal, not the radiograph   new   Jul 3, 14Jul '14 160
blogIt’s about time+   new   Jul 2, 14Jul '14 65
blogWhy fascia matters medically (get ready to cringe)   new   Jul 1, 14Jul '14 425 ••
Does Spinal Manipulative Therapy (SMT) Work?+

The idea of “adjusting” the spine refers to many different manual therapies that wiggle, pop and otherwise manipulate spinal joints. The correct umbrella term for these treatments is “spinal manipulative therapy” or SMT. Expert opinions on SMT range widely, with some prominent medical scientists expressing strong concern and skepticism. Its provenance in chiropractic subluxation theory is dubious, its benefits are minor at best, and yet there are serious risks, even including paralysis and death in the case of SMT for the joints of the neck.

Despite all the controversy, there has been little high quality scientific research to determine whether or not SMT is safe and really works. Major science reviews have either been thoroughly discouraging. Thus, SMT fails the “impress me” test — it can’t possibly be working any miracles.

And yet spinal joint popping in particular is something that people crave, and most clinicians believe that some forms of SMT can be helpful to some of their patients, some of the time. There seems to be almost no doubt that there is something of therapeutic interest going on in SMT, at least some of the time.

  Adjustment, manipulation, and popping of the spinal joints and the subluxation theory of disease, back pain and neck pain
updated   Jul 1, 14Jul '14 12,000 •••••
blogMore painful audio+   new   Jun 30, 14Jun '14 100
blogShot by the witch+   new   Jun 30, 14Jun '14 55
blogA million page views+   new   Jun 29, 14Jun '14 50
blogEscape!+   new   Jun 26, 14Jun '14 100
blogGone studyin’+   new   Jun 24, 14Jun '14 1
blogMy worst pain ever+   new   Jun 18, 14Jun '14 80
blogCruciate repair non-crucial+   new   Jun 18, 14Jun '14 100
blogThe DOs and DO NOTs of running your first marathon+   new   Jun 18, 14Jun '14 20
blogTrue story+   new   Jun 18, 14Jun '14 40
blogFoot strikes vary widely in elite runners+   new   Jun 11, 14Jun '14 95
blogAre you a narcissist?   new   Jun 10, 14Jun '14 150
blogSoldiers and single moms+   new   Jun 10, 14Jun '14 130
blogA vote for tolerance+   new   Jun 10, 14Jun '14 75
blogMy pro-science bias+   new   Jun 7, 14Jun '14 25
blogThe back is still important in back pain+   new   Jun 7, 14Jun '14 130
blogDo you need a calf-stretching gadget?+   new   May 29, 14May '14 80
blogPlasticity versus tolerance: they got more flexible, but how, dammit, HOW?!   new   May 28, 14May '14 180
blogFor whatever it’s worth+   new   May 28, 14May '14 110
blogThe Better Movement Book+   new   May 26, 14May '14 100
blogAmericans Struggle to Stand Up+   new   May 22, 14May '14 55
blogNo real evidence that parachutes work+   new   May 21, 14May '14 120
blogSociety for Science-Based Medicine+   new   May 21, 14May '14 30
blogThe “integrated medicine” straw-man+   new   May 21, 14May '14 80
Statistical Significance Abuse+Many study results are called “stastically significant,” giving unwary readers the impression of good news. But it’s misleading: statistical significance means only that the measured effect of a treatment is probably real (not a fluke). It says nothing about how large the effect is. Many small effect sizes are reported only as “statistically significant” — it’s a nearly standard way for biased researchers to make it found like they found something more important than they did.   A lot of research makes scientific evidence seem more “significant” than it is updated   May 18, 14May '14 2,300 •••
Pseudo-quackery in Chronic Pain Care+Not all quackery is obvious — not even to skeptics. Subtler snake oil is actually a more serious problem in musculoskeletal health care, because it’s harder to spot and much more common, but probably generates just as much false hope and wasted time, energy, money, and even harm.   A field with a large gray zone between overt quackery and evidence-based care for chronic pain and injury rehabilitation updated   May 18, 14May '14 2,500 •••
Water Fever and the Fear of Chronic Dehydration   Do we really need eight glasses of water per day? updated   May 16, 14May '14 2,500 •••
blogHyperaesthesia of the shins+   new   May 15, 14May '14 95
blogPractitioners of “placebo enhancement”   new   May 15, 14May '14 220
blogKill pain, kill performance+   new   May 15, 14May '14 55
Therapy Babble   Hyperbolic, messy, pseudoscientific theories about therapy are all too common updated   May 15, 14May '14 3,250 ••••
Icing for Injuries, Tendinitis, and Inflammation   Become a cryotherapy master updated   May 15, 14May '14 4,250 ••••
blogVibram spanked+   new   May 9, 14May '14 120
blogThe Cassidy paper+   new   May 7, 14May '14 140
blogPain without a name   new   May 6, 14May '14 200
What Happened To My Barber?   Either atlantoaxial instability or vertebrobasilar insufficiency causes severe dizziness and vomiting after massage therapy, with lessons for health care consumers updated   May 5, 14May '14 2,750 •••
blogSmall study proves showers work+   new   May 1, 14May '14 45
blogPlacebo Paradox 2: The Mechanism+   new   May 1, 14May '14 120
blogSatisfaction is not efficacy+   new   May 1, 14May '14 110
blogSo much “power”!+   new   Apr 30, 14Apr '14 110
blogSpine wrangling+   new   Apr 29, 14Apr '14 75
blogInflatable back support?   new   Apr 29, 14Apr '14 160
blogIt’s no Game of Thrones, but…+   new   Apr 25, 14Apr '14 25
blogConsider the source+   new   Apr 23, 14Apr '14 95
blogThe two-legged dog and biomechanics   new   Apr 17, 14Apr '14 160
blogThe Salamander’s Law of Bad Therapy+   new   Apr 17, 14Apr '14 10
blogStretch for torn muscles   new   Apr 15, 14Apr '14 180
blogNo Heartbleed here+   new   Apr 12, 14Apr '14 35
blogNew book+   new   Apr 10, 14Apr '14 90
blogCompression socks with tape   new   Apr 10, 14Apr '14 250
blogTwo books edited, six to go+   new   Apr 9, 14Apr '14 140
blogSo…what does work, Mister Smartypants?+   new   Apr 9, 14Apr '14 100
blogVandal massage   new   Apr 3, 14Apr '14 300
blogBarefoot resource+   new   Apr 2, 14Apr '14 45
blogOh, stretching! Can you do anything right?+   new   Apr 2, 14Apr '14 100
blogNew anecdote disclaimer   new   Apr 2, 14Apr '14 210
blogNeck Pain, Submerged!+   new   Apr 1, 14Apr '14 20
blogFinancially motivated ignorance   new   Apr 1, 14Apr '14 150
blogCalf size variability+   new   Mar 27, 14Mar '14 60
blogAudiobooks project cancelled   new   Mar 27, 14Mar '14 170
blogThe marble hand+   new   Mar 27, 14Mar '14 65
blogThe greatest hits of back pain science   new   Mar 26, 14Mar '14 170
blogA lot of science is junky   new   Mar 26, 14Mar '14 190
blogFollow-up on the baby’s broken neck story+   new   Mar 25, 14Mar '14 80
blogWhat “Big Ortho” doesn’t want you to know!+   new   Mar 25, 14Mar '14 100
blogLove letters from librarians+   new   Mar 25, 14Mar '14 30
blogGoodbye PDF, hello lifetime access   new   Mar 20, 14Mar '14 250
blogWhen books don’t heal+   new   Mar 20, 14Mar '14 140
blogHe’s trying to shoot me, all right…+   new   Mar 20, 14Mar '14 35
blogThe meaning of heel spurs   new   Mar 19, 14Mar '14 210
blogA good friend advances medical science+   new   Mar 19, 14Mar '14 80
blogSay release again   new   Mar 19, 14Mar '14 180
Does Massage Therapy Work?   A review of the science of massage therapy … such as it is updated   Mar 19, 14Mar '14 13,000 •••••
blogNew massage for fibromyalgia study   new   Mar 18, 14Mar '14 600 ••
blogKwitcherbichen+   new   Mar 18, 14Mar '14 10
blogBack to work and blogging   new   Mar 18, 14Mar '14 190
blogMany (unnannounced) updates and upgrades     Feb 10, 14Feb '14 180
Trigger Point Doubts+

People routinely experience muscle pain and acutely sensitive spots in muscle tissue — “muscle knots.” They can be surprisingly severe, and massaging them often seems to help quite a bit. What’s going on? The dominant theory is that a trigger point is a patch of tightly contracted muscle, an isolated spasm affecting just a small patch of muscle tissue. Unfortunately, after a few decades it’s still just a theory, and trigger point science is a bit half-baked and somewhat controversial. It’s not even clear that there is really a problem in the meat at all; it could be a sensory “disturbance,” for instance. Meanwhile, people keep hurting, and there is little doubt that there is an important, almost epidemic phenomenon here in need of explaining and treating. Massage — especially self-massage — remains a safe, cheap way of trying to deal with it, and there is some evidence that it can provide some meaningful relief (e.g. Furlan 2008) is probably the best example). That’s why I have a large tutorial devoted to how to self-treat “trigger points” — whatever they really are. But it’s very important to keep in mind that they are not well understood.

  Is there really such a thing as a muscle “knot”?
  Jan 19, 14Jan '14 9,000 ••••
Psoas, So What?+The iliopsoas muscle (“illy-oh so-ass”) is a two-in-one hip flexing pair, mostly only palpable through the guts. Its clinical importance is often curiously exaggerated, but sometimes it does need a massage.   Massage therapy for the psoas major and iliacus (iliopsoas) muscles is not that big a deal   Jan 16, 14Jan '14 1,300 •••
Dance of the Sarcomeres   A mental picture of muscle knot physiology helps to explain four familiar features of muscle pain   Jan 16, 14Jan '14 2,750 •••
Stiff, Tight Muscles and Limited Range of Motion   Is your range actually limited, or do you just feel that way?   Jan 9, 14Jan '14 1,300 •••
blogA brief public appearance     Jan 6, 14Jan '14 250
Morning Back Pain   An uncomfortable daily mystery for many people   Jan 6, 14Jan '14 2,200 •••
Does Chiropractic Work?   An introduction to chiropractic controversies like aggressive billing, spinal adjustment as a panacea, treating kids, neck manipulation risks, and more   Jan 5, 14Jan '14 5,000 ••••
Healer Syndrome+“Healer syndrome” is a common delusion of grandeur in alternative medicine, especially massage therapy, naturopathy and chiropractic, where many afflicted professional like to be known as “healers” with allegedly unusual curative powers, vaguely defined and pseudoscientific, and often based on the exaggerated importance of a single idea. Such lack of humility is tragically common. Healer syndrome has reached its most extreme in some of the founders of methods of therapy, “modality empires.”   Therapists who think they are God’s gift to therapy   Jan 1, 14Jan '14 1,200 •••
Why Does Pain Hurt So Much?+How an evolutionary wrong turn led to a biological glitch that condemned the animal kingdom — you included — to much louder, longer pain.   How an evolutionary wrong turn led to a biological glitch that condemned the animal kingdom — you included — to much louder, longer pain   Dec 28, 13Dec '13 5,000 ••••
Proprioception, the True Sixth Sense   The vital and strange sensation of position, movement, and effort   Dec 24, 13Dec '13 700 ••
The Art of Rest   The finer points of resting for injury & pain rehabilitation (hint: it’s a bit trickier than you might think)   Dec 14, 13Dec '13 4,250 ••••
Can Supplements Help Arthritis and Other Aches and Pains?   Debunkery and analysis of supplements and food-like medicines (nutraceuticals), especially glucosamine, chondroitin, and creatine, mostly as they relate to pain   Dec 12, 13Dec '13 5,500 ••••
Tissue Provocation Therapies+

"There are two “laws” of tissue adaptation, one each for hard and soft tissue. Wolff’s law is that bone will change and strengthen in response to loading. This was first noticed by Julius Wolff in the 19th Century, who got the naming rights. It was greatly refined in the mid 20th century by Dr. Harold Frost, an American surgeon who studied bone biology, and published scientific papers more often than I change my socks. The full details of how bone responds to stress are described in his Mechanostat model. The corollary in soft tissue is the obscure and much less developed Davis’ law. (No one even seems to know who Davis was.)

Although there’s no question soft tissue does adapt to stress, the responses of muscles, tendons, and ligaments are much more complex and less well understood. Many treatments are based on the idea of forcing adaptation or “toughening up” tissues by stressing the tissues. It has always been a reasonable idea, but the devil is in the details: what constitutes the “right” amount and kind of stress is difficult to know, and the results of such therapies have generally been highly inconsistent.

  Can healing be forced? The laws of tissue adapation & therapies like Prolotherapy & Graston Technique.
  Dec 11, 13Dec '13 2,300 •••
Is Diagnosis for Pain Problems Reliable?   Reliability science shows that health professionals can’t agree on many popular theories about why you’re in pain   Dec 11, 13Dec '13 1,400 •••
Neck Pain, Submerged!   The story of my curious experiment with dunking severe chronic neck pain   Dec 3, 13Dec '13 3,750 ••••
blogUh oh, success!     Nov 21, 13Nov '13 210
blogA tale of two taping papers     Nov 20, 13Nov '13 300
blogMemoirs of a female flight surgeon     Nov 19, 13Nov '13 230
blogA tug-of-war over scraps     Nov 19, 13Nov '13 170
blogDo our bones influence our minds?+     Nov 19, 13Nov '13 35
blogKnee arthroscopy does not work+     Nov 13, 13Nov '13 40
blogNot so new+     Nov 7, 13Nov '13 110
blogNew ligament+     Nov 6, 13Nov '13 80
blogHow many sets is enough?     Nov 5, 13Nov '13 170
blogMicroblog changes+     Nov 1, 13Nov '13 85
The Great Ice vs. Heat Confusion Debacle   A quick guide that explains when to ice, when to heat, when not to, and why   Oct 24, 13Oct '13 650 ••
blogDissing dyskinesis     Oct 22, 13Oct '13 240
blogYou too can learn to feel a hair!+     Oct 21, 13Oct '13 130
blogIt’s not medical+     Oct 21, 13Oct '13 35
blogLike getting blood from a bone     Oct 21, 13Oct '13 375 ••
Fatigue-induced muscle rippling+

Muscle fibres do not normally contract all at once, as most people imagine. Instead they are organized into groups called “motor units,” one per motor nerve. Rather than firing all at once, the groups alternate their contractions, like pistons. At any given time, countless motor units are in different phases of contraction and relaxation. The units are so small and the switching system is so fast that their coordinated action seems to be completely smooth to us.

There is an interesting exception, though: if you get tired enough that a lot of motor units start failing to contract, the switching system fails because there aren’t enough motor units available for smooth contraction. This is why muscles start to ripple and quiver with very intense exertions.

This phenomenon has no official name that I know of. It is sometimes called “fasciculation,” and I used to do that myself, but it’s an error: that’s just the smartypants word for an involuntary contraction, a twitch or spasm. This rippling business happens in a resting muscle as well a contracting one.

 
  Oct 17, 13Oct '13 180
blogReflexology “science”     Oct 4, 13Oct '13 190
blogTherapy dominated by obsolete ideas+     Oct 3, 13Oct '13 120
blogHow to run really, really far+     Oct 2, 13Oct '13 120
The Functional Movement Screen (FMS)+The Functional Movement Screen (FMS) is a set of seven physical tests of coordination and strength, especially “core” strength, invented in 1997 and now in widespread use around the world. It was originally proposed as a trouble-detection system, which is baked into the name: it’s a “screen.” Its use in the wild seems to over-reach this stated purpose.   The benefits of the popular screening system for athletes might be over-sold by some professionals   Oct 2, 13Oct '13 3,000 ••••
blogSaveYourself faster!+     Oct 1, 13Oct '13 110
blogTight hamstrings, back pain, and movement     Sep 24, 13Sep '13 190
blogPain’s complexity+     Sep 24, 13Sep '13 80
blogBad biomarkers, good knee news     Sep 20, 13Sep '13 275
blogWhat’s a runner gotta do?+     Sep 20, 13Sep '13 55
blogTouch-testing the world+     Sep 19, 13Sep '13 130
blogPerformance enhancement+     Sep 19, 13Sep '13 130
blogThe prodigy problem     Sep 17, 13Sep '13 170
blogHow to dismiss science you don’t like+     Sep 16, 13Sep '13 60
blogNot good enough, Pilates+     Sep 12, 13Sep '13 140
blogEducated guesses+     Sep 11, 13Sep '13 60
blogWhat people really look like+     Sep 10, 13Sep '13 120
blogPain vs. brain: a follow-up     Sep 5, 13Sep '13 300
blogWeights as good as a run?+     Sep 5, 13Sep '13 90
blogPain vs. 1600 pounds     Sep 4, 13Sep '13 180
blog“Just” a half hour+     Sep 3, 13Sep '13 30
blogNeedless needles?     Aug 29, 13Aug '13 160
blogBecause fascia     Aug 29, 13Aug '13 210
blogBiomechanicomplicated     Aug 29, 13Aug '13 200
blogMobilizing cat+     Aug 27, 13Aug '13 55
blogDoes [favourite massage method] work?     Aug 27, 13Aug '13 230
The Pricing of SaveYourself.ca e-Books   A candid discussion about my prices and how I present them to new visitors   Aug 26, 13Aug '13 950 ••
Why Massage Therapy?   An attempt to explain the magic of touch therapy, and why I decided to become an Registered Massage Therapist   Aug 26, 13Aug '13 3,250 ••••
blogEnhanced placebos     Aug 22, 13Aug '13 170
blogNever give up+     Aug 22, 13Aug '13 60
blogIs science your enemy?+     Aug 22, 13Aug '13 80
blogWonky knees     Aug 20, 13Aug '13 200
blogHappy traffic stats, ScienceBasedMedicine.org news     Aug 20, 13Aug '13 375 ••
Ten Trillion Cells Walked Into a Bar   A humourous and unusual perspective on how, exactly, a person is even able to stand up, let alone walk into a bar   Aug 20, 13Aug '13 2,300 •••
blogHooray for thorough massage!     Aug 15, 13Aug '13 250
blogWhy are non-USD prices for my e-books so much higher than the going exchange rate?     Aug 15, 13Aug '13 220
blogWhen to worry about back pain     Aug 14, 13Aug '13 220
blogGood screening news     Jul 31, 13Jul '13 150
blogShould I run recklessly?+     Jul 30, 13Jul '13 120
blogCritical what?+     Jul 30, 13Jul '13 120
blogYoga for neck pain+     Jul 25, 13Jul '13 60
blogThe placebo paradox+     Jul 25, 13Jul '13 90
blogMore pain = more pain     Jul 23, 13Jul '13 170
blogSelf-improvement through pain+     Jul 23, 13Jul '13 140
blogIntelligent rabbit massage     Jul 22, 13Jul '13 150
Healing by Growing Up   Pain relief through the pursuit of emotional intelligence, life balance, and peacefulness   Jul 20, 13Jul '13 2,000 •••
blogWhy so negative?+     Jul 19, 13Jul '13 110
blogNoise, noise, noise!+     Jul 18, 13Jul '13 80
blogRisk vs benefit     Jul 17, 13Jul '13 50
blog“Disc” pain+     Jul 16, 13Jul '13 60
blogAllTrials is going well+     Jul 16, 13Jul '13 80
blogTerrible and wonderful+     Jul 16, 13Jul '13 65
blogGood news about running+     Jul 9, 13Jul '13 85
blogDramatic acupuncture harm+     Jul 5, 13Jul '13 15
blogPainful neck = weak breathing+     Jul 5, 13Jul '13 65
blogLess is more than enough     Jul 3, 13Jul '13 150
blogI’m officially more important now     Jul 2, 13Jul '13 375 ••
blogWhy is back pain still a huge problem?+     Jul 2, 13Jul '13 140
blogDerpish stupidity+     Jul 2, 13Jul '13 100
The Mind Game In Low Back Pain   How back pain is powered by fear and loathing, and greatly helped by rational confidence   Jul 1, 13Jul '13 1,000 •••
Do You Believe in Qi?   How to embrace a central concept of Eastern mysticism without being a flake   Jul 1, 13Jul '13 800 ••
blogHoly spinal adjustment, Batman!+     Jun 29, 13Jun '13 70
blogKnee surgery denounced by surgeons     Jun 26, 13Jun '13 200
blogUnderstatement+     Jun 25, 13Jun '13 40
blogCat pets baby+     Jun 25, 13Jun '13 25
Spinal Nerve Roots Do Not Hook Up to Organs!+Are the little bundles of nerves that exit your spine the wellspring of all visceral vitality? Will your organs wilt like neglected house plants if those nerve roots are slightly impinged? No: cut a nerve root completely, and you’ll certainly paralyze something, but not an organ, because organs simply don’t depend on spinal nerve roots. And yet this is what many chiropractors believe, and would like their customers to believe, after a century of contradictory evidence.   One of the key “selling points” for chiropractic care is the anatomically impossible premise that your spinal nerve roots are important to your general health   Jun 21, 13Jun '13 2,400 •••
blogRunning still good for you     Jun 13, 13Jun '13 170
blogScience isn’t broken     Jun 8, 13Jun '13 210
blogApplied “Kinesiology”+     Jun 7, 13Jun '13 80
blogResearch tip+     Jun 5, 13Jun '13 20
blogFailed healing+     Jun 4, 13Jun '13 140
blogNow hear this: 5 new audio articles+     Jun 4, 13Jun '13 120
blogActual touch not included+     Jun 4, 13Jun '13 120
blogGood questions about orthotics     Jun 4, 13Jun '13 160
blogRippling muscles!+     Jun 4, 13Jun '13 15
Therapeutic Touch is Silly+

Therapeutic touch (TT) is hands-off aura massage, actual touch not included, and it is the most common form of energy or chi medicine. Many years ago I believed in it, but that’s true of Santa Claus too; eventually I decided it was nonsense based only on wishful thinking, laughably naive references to quantum physics, and wide-eyed exaggeration of ordinary social interaction effects. Most practitioners are massage therapists and, oddly, nurses. TT is a culturally neutral subset of Japanese reiki, which has been successfully exported around the world. (Reiki practitioners have the infamously obnoxious holier-than-thou habit of calling themselves “masters.” •eyeroll•)

Auras do not exist and cannot be felt, let alone manipulated therapeutically. Just as dousers and psychics have never passed a controlled test, TT practitioners cannot not detect a person by feeling their aura (see Rosa et al), which makes them look ridiculous.

It is peculiar and pleasant to have someone wave their hands all around you with friendly intentions, but those effects are minor and fleeting and it doesn’t matter what specifically the therapist does, because it’s the interaction that is the active ingredient. (Hence the term “non-specific effects,” a cousin of placebo.) There’s no problem with doing therapy in a way that optimizes non-specific benefits, but it has strict limits. Placebo is nowhere near as “powerful” as people believe (usually for self-serving reasons), and there are all kinds of ethical and practical problems with cluttering up the interaction with interpretations of what’s going on.

 
  Jun 4, 13Jun '13 275
blogResisting postural assessment+     Jun 3, 13Jun '13 15
blogSome gold standard+     Jun 3, 13Jun '13 65
blogObjectivity+     Jun 3, 13Jun '13 80
blogCRPS science “something of a mess”+     May 31, 13May '13 20
blogGood reviews of crappy studies+     May 31, 13May '13 50
blogPlacebo PSA+     May 31, 13May '13 100
blogGood back pain science news     May 30, 13May '13 160
PubMed Research Tip   A simple tip to help clinicians get more useful results from PubMed   May 29, 13May '13 170
Repetitive Strain Injuries Tutorial   Five surprising and important facts about repetitive strain injuries like carpal tunnel syndrome, tendinitis, or iliotibial band syndrome   May 29, 13May '13 11,000 ••••
Orthotics Review   A consumer’s guide to the science and controversies of orthotics, special shoes, and other (allegedly) corrective foot devices   May 29, 13May '13 3,500 ••••
Save Yourself from Tension Headaches!   Simple advice on healing from chronic tension headaches, also known as fibrositic headaches   May 29, 13May '13 1,800 •••
blogA taijiquan spelling bee     May 23, 13May '13 240
blogThe wrong notch+     May 23, 13May '13 40
T’ai Chi Helps Fibromyalgia, but It’s Not “Alternative” Medicine   Despite a high profile boost from the New England Journal of Medicine, it’s still just gentle, elegant, and pleasant exercise   May 23, 13May '13 850 ••
Applied Kinesiology is Bunk+

Applied kinesiology (AK) is a pseudoscientific method of diagnosis and prescription, used by many chiropractors and naturopaths, and denounced as an absurd parlour trick by everyone else. (AK has no relationship to kinesiology, which is the study of human movement.) Practitioners believe that muscle strength fluctuates meaningfully and is a useful diagnostic tool. They test strength while substances are placed on or near patients, or while asking meaningful questions: strength means the body says yes, weakness means no. This is about as scientific as a ouija board.

There is almost no real AK research: no real scientist would bother with it, or get funding for it. It’s like studying the Nigerian email scam to see if it really works. Even NCCAM hasn’t bothered (NCCAM exists to study alternative medicine).

Patients are often impressed by AK, because it exploits potent illusions based on the ideomotor and observer-expectancy or subject-expectancy (power of suggestion) effects. This is why a magician like James Randi knows exactly how to debunk AK (see also a more detailed video debunking). It fools practitioners just as readily as it fools patients: most are deluded true believers, not scam artists.

 
  May 22, 13May '13 275
blogBlood injection treatment bombs a test+     May 21, 13May '13 70
blogThe anti-placebo+     May 21, 13May '13 40
blogProgressive mythology+     May 21, 13May '13 50
You Might Just Be Weird   The clinical significance of normal — and not so normal — anatomical variations   May 21, 13May '13 1,900 •••
blogNo more store trouble, but sheesh+     May 18, 13May '13 100
blogService announcement for customers+     May 17, 13May '13 120
blogPromising new fitness blog+     May 17, 13May '13 10
blogReplication needed+     May 15, 13May '13 65
blogSurprise run+     May 15, 13May '13 110
blogGood pain reading for pros+     May 14, 13May '13 20
blogThe effects of sleep deprivation+     May 14, 13May '13 45
blogThe power of barking+     May 10, 13May '13 25
blogAntibiotics for back pain reality check+     May 10, 13May '13 90
blogI was wrong: muscle is cheap, not expensive     May 10, 13May '13 250
blogAnd then I read my email…+     May 10, 13May '13 65
blogDo I like “SaveYourself.ca”?+     May 10, 13May '13 70
blogTwo tiny quotes+     May 9, 13May '13 65
blogBad icing news?+     May 7, 13May '13 90
blogStrengthening for the not-so-young+     May 4, 13May '13 25
Modality Empires+

“Modality empire” is my own term for an ego-driven proprietary method or mode of manual therapy — a sub-discipline — championed and promoted by a single charismatic entrepreneur. Most of the “emperors” have healer syndrome, lack humility, make big promises, and make their money from unusually expensive therapy, workshops and books. Professionals are sold on the opportunity to purchase credibility in the form of increasing “levels” of certification, but the quality of these certifications is completely unregulated and often dubious. A modality empire is as much a business model as a method of helping people. There is a lot of overlap between modality empires and quackery. Classic examples of modality empires include Ida Rolf’s ROLFING®, John Barne’s myofascial release, and John Upledger’s craniosacral therapy. Sometimes a modality empire is particularly unoriginal, re-packaging old ideas for a new generation of workshop consumers.

  A tradition of ego-driven treatment methods in manual therapy
  May 3, 13May '13 1,400 •••
blogIncurable shitty ankle+     May 2, 13May '13 60
blogJedi pain tricks!     May 1, 13May '13 190
blogGoodbye supplement confusion+     Apr 23, 13Apr '13 120
blogAffectionate or creepy?+     Apr 22, 13Apr '13 20
blogBeeeep     Apr 19, 13Apr '13 160
blogWe hates the DRMses, my preciousss+     Apr 19, 13Apr '13 80
blogPain changes how pain works+     Apr 17, 13Apr '13 55
blogModality empires     Apr 17, 13Apr '13 170
blogX-Ray video+     Apr 15, 13Apr '13 75
Toxic Muscle Knots   Research suggests that muscle knots (myofascial trigger points) may be quagmires of toxic, irritating molecules.   Apr 11, 13Apr '13 950 ••
blogNot what they seem+     Apr 10, 13Apr '13 95
blogHomo sapiens: not as wimpy you thought     Apr 8, 13Apr '13 275
blogMeanwhile, backstage+     Apr 8, 13Apr '13 75
blogI dare ya+     Apr 8, 13Apr '13 30
What can a runner with knee pain do at the gym?   Some gym training options and considerations for runners (and others) with overuse injuries of the knee   Apr 6, 13Apr '13 2,100 •••
blogTissue pathology does not explain chronic pain+     Apr 5, 13Apr '13 35
blogDisc, schmisc+     Apr 4, 13Apr '13 110
blogUnicorn horn velvet!+     Apr 3, 13Apr '13 45
blog1-Minute fibromyalgia video+     Apr 2, 13Apr '13 55
blogSeven amusing alternatives to evidence-based medicine     Apr 1, 13Apr '13 180
blogElectric baths     Mar 28, 13Mar '13 170
blogSpinal infection?     Mar 26, 13Mar '13 220
blogUpdated Tissue Provocation Therapies+     Mar 22, 13Mar '13 130
blogTesting Treatments+     Mar 22, 13Mar '13 50
blogA boast post+     Mar 20, 13Mar '13 25
blogClinical Decision-Making+     Mar 20, 13Mar '13 20
blogStretching for trigger points+     Mar 18, 13Mar '13 15
blogMore than placebo, less than medicine+     Mar 18, 13Mar '13 70
blogTopical NSAID risks much lower than oral     Mar 15, 13Mar '13 180
blogImpruvism.com podcast+     Mar 15, 13Mar '13 10
blogOne of my favourite history of medicine stories+     Mar 14, 13Mar '13 130
blog“Negative”+     Mar 13, 13Mar '13 65
blogRevenge of the Woo+     Mar 13, 13Mar '13 60
blogTissue state is just chemistry     Mar 13, 13Mar '13 150
blogPelvic tilt+     Mar 12, 13Mar '13 140
blogInteresting but not awfully important epiphenoma+     Mar 11, 13Mar '13 20
blogAn unfortunate trivialization+     Mar 11, 13Mar '13 50
blogTwo especially nice reader comments+     Mar 11, 13Mar '13 120
blogIntroducing the microblog     Mar 8, 13Mar '13 200
blogSeriously, funny salt+     Mar 8, 13Mar '13 75
blogBig fascia update+     Mar 1, 13Mar '13 45
blogDissection-perspective+     Feb 27, 13Feb '13 20
blogGlucosaminimal+     Feb 26, 13Feb '13 25
blogPosture is a hit!+     Feb 26, 13Feb '13 20
blogSexy mental fitness+     Feb 26, 13Feb '13 85
Stretching for Trigger Points   Is trigger point release a good reason to stretch?   Feb 25, 13Feb '13 1,700 •••
blogPerplexed+     Feb 19, 13Feb '13 55
Thixotropy is Nifty, but It’s Not Therapy+Thixotropy is the property of some gels or fluids that are normally thick (viscous), but thin when they are stressed. In the human body, the synovial fluid that lubricates most joints is thixotropic, as is the gelatinous “ground substance,” which is part of all connective tissues such as tendons and ligaments. (Fun fact: semen is also thixotropic.) Thixotropy is one of the reasons that we loosen up a little as we move around, just like engine oil warming up. However, thixotropic effect is not a therapeutic effect, and does not explain “releases” in massage or fascial therapy: it is too minor, slow, and temporary, and connective tissue is too tough.   A curious property of connective tissue is often claimed as a therapy   Feb 19, 13Feb '13 750 ••
blogStretching good for the heart+     Feb 16, 13Feb '13 25
blogGood massage news+     Feb 16, 13Feb '13 15
Help for Anxiety   Anxiety doesn’t respond to logic and reason, so what does it respond to?   Feb 14, 13Feb '13 2,500 •••
SSRI Antidepressants Are Not Medicine   Frightening side effects, cover-ups on the record, and no reason to believe they do what they are supposed to   Feb 14, 13Feb '13 3,000 ••••
blogBig boner+     Feb 13, 13Feb '13 130
blogMorgan Schmorgan+     Feb 12, 13Feb '13 10
blog1,001 followers+     Feb 12, 13Feb '13 10
blogPosture reactions+     Feb 11, 13Feb '13 75
blogPosturology+     Feb 11, 13Feb '13 120
blogTypos+     Feb 9, 13Feb '13 10
blogNew massage myth+     Feb 8, 13Feb '13 15
blogAffective massage therapy+     Feb 8, 13Feb '13 25
blogCleaner, sparklier+     Feb 8, 13Feb '13 15
blogTwo Audiobooks Now Available     Feb 4, 13Feb '13 250
blogUnstable? Unreliable+     Feb 4, 13Feb '13 110
blogDiagnostic reliability+     Feb 4, 13Feb '13 7
blogComic back cracking+     Feb 4, 13Feb '13 25
blogHope springs eternal+     Feb 3, 13Feb '13 20
blogI don’t know if you gots it+     Feb 3, 13Feb '13 25
blogKind customer feedback+     Feb 2, 13Feb '13 15
blogBarefoot understatement+     Feb 2, 13Feb '13 25
blogA common problem+     Jan 31, 13Jan '13 20
blogUltrasound update+     Jan 28, 13Jan '13 30
blogMany people believe+     Jan 28, 13Jan '13 45
blogKinesio tape+     Jan 24, 13Jan '13 40
blogI can relate+     Jan 22, 13Jan '13 15
blogCreatine-induced insomnia     Jan 19, 13Jan '13 250
blogNow that’s ankle flexion+     Jan 19, 13Jan '13 20
blogCrappy acupuncture reviews+     Jan 18, 13Jan '13 35
blogPainless dislocated … neck?+     Jan 18, 13Jan '13 20
blogExploding head syndrome+     Jan 18, 13Jan '13 15
blogChange how it feels+     Jan 14, 13Jan '13 10
blogSensory clutter+     Jan 13, 13Jan '13 25
blogKnee lube jobs+     Jan 12, 13Jan '13 30
blogHonest fan mail+     Jan 12, 13Jan '13 15
blogHealing speed+     Jan 12, 13Jan '13 35
blogAllTrials.net+     Jan 10, 13Jan '13 90
blogMinute Medical School     Jan 8, 13Jan '13 190
blogI Ain’t Just Book Smart!+     Jan 7, 13Jan '13 30
blogThis will sting a little bit+     Jan 6, 13Jan '13 25
blogStretching doesn’t help contracture+     Dec 31, 12Dec '12 10
blogBlogging the process+     Dec 31, 12Dec '12 85
blogAnecdata+     Dec 28, 12Dec '12 6
blogBrains control pain… not minds+     Dec 26, 12Dec '12 15
blogA few thoughts on the limits of self-care     Dec 26, 12Dec '12 240
Should You Get A Lube Job for Your Arthritic Knee?   Reviewing the science of injecting artificial synovial fluid   Dec 18, 12Dec '12 700 ••
blogI’m sorry, Creatine, I misjudged you+     Dec 10, 12Dec '12 20
blogReston was not anaesthetized by acupuncture     Dec 8, 12Dec '12 160
blogFeel safe & good+     Dec 6, 12Dec '12 20
blogEBM appearances+     Dec 6, 12Dec '12 20
blogPlacebo surgeries+     Dec 5, 12Dec '12 30
blogHow important is sleep?+     Dec 4, 12Dec '12 20
blogPNF stretching+     Dec 3, 12Dec '12 130
blogSBM’s about page+     Dec 3, 12Dec '12 40
Deep Friction Massage Therapy for Tendonitis   A guide to a simple self-massage technique sometimes helpful in treating common tendonitis injuries like tennis elbow or Achilles tendonitis   Nov 9, 12Nov '12 2,400 •••
Unconventional Ergonomics   Five creative ergonomics tips you don’t hear as much about as the usual stuff   Nov 3, 12Nov '12 1,100 •••
Should You Drink Water After Massage?   Only if you’re thirsty! Hydration and massage are not detoxification treatments   Nov 2, 12Nov '12 4,000 ••••
Natural Imperfection   Evolution doesn’t care if you have back pain … just as long as you can breed   Nov 1, 12Nov '12 4,000 ••••
Don’t Stretch Your IT Band!   Despite the popularity of Iliotibial Band stretching as a treatment for IT band syndrome, there is no scientific or anatomical reason to believe that any kind of IT band stretch is even possible, let alone an effective treatment — so, what does work?   Oct 27, 12Oct '12 2,300 •••
(Almost) Never Use Ice on Low Back Pain!   An important exception to conventional wisdom about icing and heating   Oct 27, 12Oct '12 3,500 ••••
Massage Therapy for Shin Splints   Perfect Spot No. 3, in the tibialis anterior muscle of the shin   Oct 27, 12Oct '12 1,500 •••
Insomnia Until it Hurts   The role of sleep deprivation in muscle pain and other kinds of chronic pain   Oct 26, 12Oct '12 2,750 •••
Massage Therapy for Upper Back Pain   Perfect Area No. 11, the erector spinae muscle group of the upper back   Oct 26, 12Oct '12 1,000 •••
Massage Therapy for Tired Feet (and Plantar Fasciitis!)   Perfect Spot No. 10, in the arch muscles of the foot   Oct 25, 12Oct '12 1,000 •••
blogPoisoning humour+     Oct 21, 12Oct '12 15
blogThe unkillable lactic acid myth+     Oct 21, 12Oct '12 90
blogSurgeon corrects my tone     Oct 21, 12Oct '12 170
blogRadiological imagining+     Oct 21, 12Oct '12 20
Plantar Fascia Thickening   Science confirms a connection between plantar fasciitis and a surprisingly thick tissue in the arch of the foot   Oct 8, 12Oct '12 275
Contrast Hydrotherapy   Exercising tissues with quick temperature changes for injury recovery, especially repetitive strain injuries   Oct 8, 12Oct '12 2,500 •••
Massage Therapy for Your Quads   Perfect Spot No. 8, another one for runners, the distal vastus lateralis of the quadriceps group   Oct 2, 12Oct '12 1,500 •••
Facts First+

This sentiment is heard all too often in alternative medicine: “We need some science to prove how treatment modality X works!” No! No no no! That is bass-ackwards. It’s a terrible inspiration for doing science, guaranteed to dial confirmation bias up to 11.

The premise that treatment X “works” is invariably based only on clinical experience, which proves nothing and cannot be trusted. Treatment efficacy must be actually tested and proven rigorously first. We need find out if an idea actually produces measurable medical results and then — if it works, if it actually helps people enough to be measurable — then and only then do we proceed to try to illuminate the mechanism. Stated even more briefly: we cannot study how a treatment works if we haven’t figured out if it works.

“It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts.” — Sherlock Holmes (in Doyle’s 1892 A Scandal in Bohemia)

 
  Sep 19, 12Sep '12 190
Electromagnetic Sensitivity Absurdity+

Electrosensitivity is an alleged allergy to electromagnetic fields and radiation. It is the basis for paranoia particularly about the health effects of wi-fi networks, power lines, and cell phones — fears that top the charts of human irrationality. There’s little doubt that the afflicted are suffering from something, but it is either an unrelated medical condition or psychosomatic. Electrosensitivity, like (non-celiac) gluten sensitivity, has been thoroughly debunked.

A massage therapist I know described a client who not only refused an electric heating pad, but didn’t even want to to be close to it unplugged. This isn’t a garden variety silly belief — it’s a logical meltdown. If people could actually be so sensitive to electromagnetic fields that they could be hexed by a heating pad’s vibes (let alone an unplugged one), none of them would last a day anywhere in the modern world. It would be an electrosensitive holocaust. They’d vanish in a poof of oversensitive smoke, moths flying into a bonfire.

 
  Jul 26, 12Jul '12 180
Chiropractor, Naturopath Training Much Less Than Doctors+

Many alternative health care practitioners, especially chiropractors, claim that they are as well trained as physicians. This is false. Doctor’s academic training is routinely longer, and — more importantly — most of their serious learning occurs during extensive on-the-job training, where they are thrust into demanding clinical environments and supervised for years as they deal with a great variety of clinical situations and many extremely sick and hurt patients. That hands-on phase of their training is where all doctors will tell you that they became professionals — and there is nothing like it in any non-medical health care training.

 
  Jul 26, 12Jul '12 110
Toxins, Schmoxins!+

The idea of “toxins” is usually used as a tactic to scare people into buying de-toxifying snake oil of one sort or another. It’s not that there’s no such thing as a toxin — obviously there are toxic substances in the environment. The problem is the kind of people who toss the idea around, the reasons they do it (profit), and the total lack of any specific claim or scientific knowledge or evidence to support it. It is so vague that it’s literally meaningless, except as a marketing message. Indeed, “detoxification” may be the single most common marketing buzzword in alternative health care, and yet exactly which toxins we’re talking about, or exactly how they are disposed of, is never explained by anyone selling a product that supposedly detoxifies — because they don’t know.

The body deals with undesirable molecules in many ways. It eliminates some and recycles others; some are trapped in a safe place; and quite a few can’t be safely handled at all (metals). Most alleged “detox” treatments are focussed on stimulating an excretion pathway, like sweating in a sauna. But it’s not like sweating is broken and the sauna is fixing it! The only truly “detoxifying” treatments help the body eliminate or disarm molecules the body cannot process on its own. A stomach pump for someone with alcohol poisoning is literally “detoxifying.” So are chelation for heavy metals, and antivenoms.

I cover the specific idea of “flushing” toxins in Should You Drink Water After Massage? (Massage is wonderful for all kinds of reasons — it doesn’t need the support of the idea that it detoxifies.) For more general consumer advocacy and education about toxins, see “Detoxification” Schemes and Scams (from QuackWatch.org).

 
  Jul 26, 12Jul '12 275
blogBad Science Watch     Jul 12, 12Jul '12 170
You’re Really Tight   The three most common words in massage therapy are pointless   Jul 4, 12Jul '12 1,600 •••
Masking Symptoms Is Under-Rated+

“Masking symptoms,” especially with medications, is often maligned because it doesn’t “aid healing” or “treat the root cause.” But masking symptoms can be a perfectly good idea, and it should not be eschewed just because it doesn’t have a real healing effect … because there are very few real healing effects! Maybe none. There are few or no known ways to actually improve on the biological process of healing. We can’t tell the body, “Hey, heal better, will ya?”

“Healing” is mainly about removing impediments to natural recovery, such as continued overuse and excessive stress. It’s not dictated by some mythical power to speed healing, but by a strong understanding of the nature of the problem and what pisses it off and slows recovery. The most idiotically simple example is that bad sprains need to be immobilized for a while, just like a fracture — and maybe that seems “obvious,” but it was actually common practice for decades to recommend excessive early mobilization.

Here’s a classic, trickier example: patellofemoral pain is often misdiagnosed and “treated” with strength training that tends to stress the knee even more, and yet it often works to simply avoid sitting with bent knees, because that position is more biomechanically “intense” than most patients realize. Removing that sneaky knee stress isn’t “healing,” per se, but it’s sure important!

Focus on facilitating natural recovery, and don’t knock a little “symptom relief” along the way.

 
  Jul 2, 12Jul '12 250
Massage Therapy for Shoulder Pain   Perfect Spot No. 14, The Most Predictable Unsuspected Cause of Shoulder Pain   Jun 25, 12Jun '12 1,500 •••
What’s a Claim?+

A claim is any unverified assertion. But not all claims are created equal. In health care and health science, “claim” implies a more self-serving assertion. If a claim could be used as a bullet-point in a sales pitch, it’s more claim-y. If it makes you (or your profession) look better, it’s more claim-y. And the more claim-y it is, the more it needs to be backed up.

This special case of the word claim comes from the thorny ethical challenges with selling care to sick, hurt people. All claims need critical appraisal and verification, but it’s just not as ethically critical if it has no claim-stink. Sagan’s idea that “extraordinary claims require extraordinary evidence” is not just about alien abductions and lake monsters. It’s also, in spirit, about more mundane but self-serving and profitable claims — a more common ethical hazard than truly extraordinary claims.

 
  Jun 21, 12Jun '12 150
Spinal Subluxation+

There can certainly be something wrong with your spinal joints — there are a few possibilities — but “subluxation” and spinal joints being “out” are not defined clearly enough to be useful, and are probably quite misleading.

“Subluxation” is mainly a chiropractic idea of spinal joint dysfunction, with many shades of meaning — too many — depending on who is talking about it. However, it is inextricably entangled with the idea of a spinal joint being “out” of place, and it is this sense of the word that needs some debunking. Chiropractors attribute great importance to subluxation. Most believe that subluxations cause neck and back pain, and — significantly — many also believe that they cause a wide variety of other health problems and so they “use spinal manipulation to treat visceral disease” (Homola). Subluxation theory has been both popular and controversial for many decades now, and it has never achieved medical respectability. Many experts, including quite a few chiropractors, actually deny that spinal subluxations exist in any meaningful sense.

It’s problematic that spinal manipulative therapy — the umbrella term for all kinds of spinal joint “adjustment” — is so often based on such a confusing and controversial concept. Subluxation has too much baggage to be a useful term. Let’s use more modern and specific terminology, and get away from the idea of spinal joints being “out.”

 
  Jun 21, 12Jun '12 240
Simon Singh Story and British Libel Reform+

Simon Lehna Singh’s story is now the most famous example of legal bullying of a science writer for commenting on controversial health care. It has had important consequences for free speech, and great significance to me because I was being legally bullied for similar reasons at the same time.

Simon Singh criticized the British Chiropractic Association for endorsing spinal adjustment for children with conditions like asthma and ear infections, calling it bogus and pointing out the lack of evidence. The BCA sued, exploiting Britain’s nasty libel laws, which bizarrely require defendants to prove themselves innocent at fantastic expense. The case got off to a rough start for free speech with a ruling that Singh could not rely on his only realistic hope, the “fair comment” defence. Nevertheless, Simon appealed and the case became a public relations disaster for the BCA. On April 1, 2010, Simon Singh won his appeal, and the BCA withdrew its lawsuit.

The case catalysed a major on-going campaign to reform British libel law and put an end to the phenomenon of “libel tourism” — corporations suing their critics around the world in Britain, exploiting crazy laws that favour them there. A science writer should be able to comment on genuine concerns on an important public health issue (such as correct treatment for children) without the threat and expense of British High Court libel claims. The cost of an opinion about a controversial health care issue should not be ruinous. In the words of Frank Frizelle: “Let’s hear your evidence, not your legal muscle.”

 
  Jun 21, 12Jun '12 275
Missing Serious Symptoms+

One of the most common and serious basic problems with alternative medicine is that ominous signs and symptoms of serious disease are often overlooked, misinterpreted, and minimized by many overconfident and under-trained “professionals.” Naturopaths, chiropractors, acupuncturists and massage therapists often have a haughty disdain for “mainstream” medicine. I have been constantly exposed to that attitude for many years now — it is much too common.

Of course doctors often also overlook problems — nobody’s perfect (see Medical Errors in Perspective). However, the chances of a doctor missing a scary diagnosis are generally far lower, and particularly so because they have vastly more experience with much sicker people (see Chiropractor, Naturopath Training Much Less Than Doctors).

 
  Jun 21, 12Jun '12 120
Medical Blind Spot for Aches and Pains+

Doctors lack the skills and knowledge to treat most common aches, pains and injury problem, especially stubborn cases, and even the best are poor substitutes for physical therapists. Many doctors are well aware of this, but some are alarmingly oblivious. Dr. Jonathon Tomlinson, an instructor at St. Leonards Hospital in Hoxton, explains that “undergraduate training is focused on hospital orthopedics (broken bones and anything else that’s amenable to surgery) or rheumatology (nasty inflammatory diseases) which comprise a minority of the aches/pains/strains and injuries that people actually suffer from.”

Medical researchers have done many studies showing that most doctors do not understand aches and pains or heed expert recommendations. A good recent example is a paper in the Archives of Internal Medicine showing that family doctors frequently ignore guidelines for the care of low back pain — see Williams et al.

More generally, the Journal of Bone and Joint Surgery, and the Journal of the American Osteopathic Association, have both published papers recently showing that physicians simply do not have an adequate understanding of musculoskeletal medicine. In 2002, Freedman et al felt that “It is ... reasonable to conclude that medical school preparation in musculoskeletal medicine is inadequate.” Then again in 2005 in JBJS, Matzkin et al concluded that “training in musculoskeletal medicine is inadequate in both medical school and non-orthopaedic residency training programs.” Most recently, in 2006, Stockard et al found that 82% of medical graduates “failed to demonstrate basic competency in musculoskeletal medicine.”

 
  Jun 21, 12Jun '12 275
Medical Errors in Perspective+

Alternative medicine practitioners often point accusingly to medical error rates, with the implication that chiropractic, naturopathy and other alternative care is much safer. That’s probably true … in the sense that walking is much safer than driving. But if you routinely had to treat huge numbers of people with life-threatening injuries and dire illness, your profession would have scary error rates, too.

There is no question that bad things happen in hospitals, and stats about iatrogenic (doctor-generated) medical errors can seem alarming. However, to simply state that medicine kills and hurts people is misleading fear-mongering. Cars kill and hurt people too, and for pretty much the same reason: sure it’s risky, but the benefits are worth the risk, and huge numbers of people are willing to take that chance.

Medical systems deal with vastly greater numbers of much more serious cases than any chiropractor or naturopath, and many of them are no-win, rarely-win, or sometimes-lose situations with the highest stakes, terrible suffering and death. We should be cautious about criticizing that from the outside. Try working in a hospital for a while, try to be perfect, try to never have anything go wrong that matters!

  Medical error rates should not be used to spread fear, uncertainty and doubt
  Jun 21, 12Jun '12 475 ••
Homeopathy Schmomeopathy+

Homeopathy is a 200-year-old medical philosophy that has been thoroughly debunked, and survives today thanks to wishful thinking, ignorance, and because it is too useless to be very dangerous. It is the flagship in the alternative medicine fleet: the most profitable, absurd, and snakey of all snake oils.

Most people have no idea just how strange homeopathy is. The deal-breaker for many consumers is the discovery that it’s not just an “herbal” or “natural” remedy, but a “magical” one, based on a principle that reeks of flaky physics and old-timey snake oil flamboyance—much farther out in left field than herbs. Some people, of course, are quite happy citing quantum physics to explain alternative medicine, but you really have to be a card-carrying new age sort to go there. For most people, that crosses a line.

But they have to find out first! Fortunately, doctors, scientists and skeptics are unanimously and harshly critical of homeopathy, and have published many good quality critical reviews. For instance, see my own article about homeopathic arnica — the most popular of all homeopathic products, intended to treat inflammatory pain.

 
  Jun 21, 12Jun '12 190
Healing Time+

Healing speed is of great interest, and people often believe that treatment X helped them to heal faster. It’s also a common marketing claim. Unfortunately, most patients aren’t the least bit knowledgeable about what constitutes a normal healing time, and should probably defer to clinicians who have seen hundreds or even thousands of examples — except that they don’t really know either, because they do know that healing time varies wildly depending on countless variables. People often recover faster or slower than expected for reasons no one can ever know. We also seem to recover faster or slower depending on which psychological “goggles” we have on (optimistic, pessimistic, etc).

The bottom line is that the natural variation in healing times tends to obscure the effects of treatments, and simply isn’t actually possible to know if any treatment helped us heal “faster,” because we can never know how long it would have taken without it. You also don’t know what will happen the next time. The only possible way to settle such questions and confirm a faster average recovery time — especially if it’s only a little bit faster — is with carefully designed scientific testing, and quite a bit of it.

  Can healing be hurried? Would we even notice if it was?
  Jun 21, 12Jun '12 1,000 •••
‘Reductionism’ Is Not an Insult+

Alternative medicine practitioners often derisively accuse their critics of being “reductionist.” This is intended to sound wise and knowing, but sneering at reductionism is a transparently convenient way to dismiss rational objections to crank theories and flaky bullshit. It insultingly insinuates a lack of vision and savvy about complex systems (like the body). It’s just an ideological gripe, not a meaningful thought, about people who allegedly can’t see the forest for the trees. (This is quite ironic, coming as it usually does from barely-trained dabblers and dilettantes, people who clearly have not exactly mastered either forest or trees.)

Certainly reductionism can go wrong, like nearly any mental mode, but it’s not an intellectual failing. It’s just one of many thinking and reasoning tools … not an all-consuming obliviousness to “the whole.”

  Reducing complex systems in nature to their components is not a bad thing
  Jun 21, 12Jun '12 900 ••
Typos & Nitpicking Hypocrisy+

Whenever I make criticasms of sloppy writing, I do open myself up to a charge of hypocrazy, because there are certainly scattered errrs on my website , probbly even on this veru page. But it’s a matter of dagree. I only critisize someone’s communiation skills when their writeing problem are signicifant and revelant: when the errors are thick and nasty and thick and nasty, when they arre combimed with style problems like SHOUTING IN CAPS!!!, or abusing “quotion marks”; or just horrible spellung and grammer and sentense structure, and and whn they betray ignoranse of the subjet matter,, like a chiropracor who writes the “veterbra” three times in the same short email and declares “I’m a proffesional”.

(I’m not making that last bit up. I actually got that message.)

Not everyone’s a writer, but writing with many glaring errors is much worse than just lacking a knack — and it exposes a lack of mental rigour and maturity. There is such a thing as a minimum literacy required for one’s ideas to be taken srsly.

 
  Jun 19, 12Jun '12 190
Massage Therapy for Low Back Pain (Again)   Perfect Spot No. 13, The Most Classic Low Back Pain Trigger Point   Jun 9, 12Jun '12 700 ••
Massage Therapy for Your Pectorals   Perfect Spot No. 9, in the pectoralis major muscle of the chest   Jun 9, 12Jun '12 750 ••
Massage Therapy for Tennis Elbow and Wrist Pain   Perfect Spot No. 5, in the common extensor tendon of the forearm   Jun 9, 12Jun '12 1,300 •••
Massage Therapy for Low Back Pain   Perfect Spot No. 2, in the thoracolumbar corner   Jun 9, 12Jun '12 650 ••
Eccentric Contraction+An eccentric or braking contraction is an interesting but routine type of muscular contraction that seems like a paradox: the muscle is contracting even as it is lengthening! Eccentric contraction is a bit physiologically mysterious, and is known to be harder on muscle, causing more soreness (quadriceps after hiking down a mountain is the classic example).   A weird bit of muscle physiology   Jun 1, 12Jun '12 700 ••
Spinal Fracture Bracing   My wife’s terrible accident, and a whirlwind tour of the science and biomechanics of her spine brace   May 31, 12May '12 1,500 •••
Quackery Red Flags+When choosing treatments, please be wary of Quackery Red Flags: treatments that may be dangerous, dubious, and distracting (costly or time-consuming). No pain treatment is perfect, but does it at least make sense? Is it safe? Cheap? Reasonably convenient?   Beware the 3 D's of quackery: Dubious, Dangerous and Distracting treatments for aches and pains (or anything else)   May 31, 12May '12 1,700 •••
Ioannidis: Making Medical Science Look Bad Since 2005   A famous and excellent scientific paper … with an alarmingly misleading title   May 9, 12May '12 2,400 •••
Water Yoga   6 unusual ways to use a swimming pool for therapeutic exercise   May 7, 12May '12 1,400 •••
The Respiration Connection   How dysfunctional breathing might be a root cause of a variety of common upper body pain problems and injuries   May 2, 12May '12 6,500 ••••
Massage Therapy In British Columbia, Canada+Massage therapy training in British Columbia, Canada, is unusually rigorous compared to most places in the world. When I trained, the requirements included a 3000-hour training program, an internship, and some very challenging certification exams.   Training, credentials and state of the profession of massage therapy in Canada’s west coast province   Apr 30, 12Apr '12 950 ••
Mobilize!   Dynamic joint mobility drills are an alternative to stretching that “massages you with movement”   Apr 30, 12Apr '12 5,500 ••••
Oh, a flow-induced system of mechanotransduction! Of course!   A century-old mystery of bone biology was solved just a little while ago   Apr 11, 12Apr '12 475 ••
Getting On Your Nerves   Can you damage your nerves when self-massaging?   Apr 11, 12Apr '12 600 ••
Buyer (of Therapy) Beware   All other things being equal, always choose the cheapest and most comfortable therapeutic option for your pain problem   Apr 11, 12Apr '12 850 ••
Bogus Citations   11 classic ways to self-servingly screw up references to science, like “the sneaky reach” or “the uncheckable”   Mar 10, 12Mar '12 1,900 •••
Always Running the Same Way   The trouble with running on concrete and asphalt   Mar 8, 12Mar '12 1,800 •••
Progressive Training   How to take “baby steps” to recovery from an injury or pain problem   Feb 18, 12Feb '12 1,900 •••
Massage does not reduce inflammation and promote mitochondria   The making of a new massage myth from a high-tech study of muscle samples after intense exercise   Feb 15, 12Feb '12 4,000 ••••
How Many Muscles?   A (slightly tongue-in-cheek) tally of the body’s many muscles   Jan 27, 12Jan '12 750 ••
blogHow smart is your right foot?+     Dec 22, 11Dec '11 110
Does Craniosacral Therapy Work?   Craniosacral therapists make big promises, but their methods have failed to pass every fair scientific test of efficacy or plausibility   Dec 7, 11Dec '11 1,400 •••
Why Do We Get Sick?   The connections between poor health and the lives we lead   Dec 5, 11Dec '11 2,000 •••
A Stretching Experiment+What happens when you stretch your hamstrings intensely for several minutes a day in a steam room? The results of a thorough, careful personal experiment. Your mileage may vary!   What happens when you stretch your hamstrings intensely for several minutes a day in a steam room?   Nov 30, 11Nov '11 3,750 ••••
Stretch Injury   How I almost ripped my own head off! A cautionary tale about the risks of injury while stretching   Nov 2, 11Nov '11 1,100 •••
Review of the Backnobber II & Knobble II   Plus four other massage tools from the Pressure Positive Company: the Index Knobber, Jacknobber, Orbit Massager and Tiger Tail   Nov 1, 11Nov '11 1,700 •••
We Are Full of Critters   The human body is a colony of ten trillion co-operating cells   Oct 15, 11Oct '11 600 ••
Confused about the location of Iliotibial Band Syndrome?   There is no such thing as “iliotibial band pain” that is not at the knee   Oct 14, 11Oct '11 700 ••
Microbreaking   Prevent low back pain and neck cricks with lots of little breaks   Sep 17, 11Sep '11 1,700 •••
Nerve Pain Is Overdiagnosed   A story about nerve pain that wasn’t really nerve pain.   Aug 26, 11Aug '11 650 ••
The Pressure Question in Massage Therapy   What’s the right amount of pressure to apply to your muscles in massage therapy and self-massage?   Aug 26, 11Aug '11 3,000 ••••
The Power of Avogadro Compels You!   James Randi and Alexa Ray Joel try to poison themselves — one of them deliberately and the other accidentally making homeopathy look 10X sillier than it already did   Aug 17, 11Aug '11 1,800 •••
Massage Therapy Kinda, Sorta Works for Back Pain   It works, but not very well, and “advanced” techniques are no better than relaxation massage   Aug 10, 11Aug '11 4,000 ••••
When exactly do injuries occur in walking and running?   Not when you thought. Biomechanics expert Dr. Casey Kerrigan explains her surprising research results.   Jul 29, 11Jul '11 1,000 •••
The Art of Bioenergetic Breathing   A potent tool for personal growth and transformation   Jun 20, 11Jun '11 2,200 •••
The Not-So-Humble Healer   Cocky theories about the cause of pain are common in massage, chiropractic, and physical therapy   Jun 12, 11Jun '11 2,500 •••
Vitamin D Safety for Pain Patients   Is it still safe and reasonable for chronic pain patients to take higher doses of Vitamin D? And just how high is safe?   May 7, 11May '11 1,500 •••
Strength Training Surprises   Why building muscle is easier, better, and more important than you thought, and its vital role in injury rehabilitation   May 6, 11May '11 4,250 ••••
Chronic Pain and Relationships   People with chronic pain face more than just medical difficulties   Apr 26, 11Apr '11 1,200 •••
Review of John Sarno’s Books about Low Back Pain   Essential reading for low back pain sufferers and most health care professionals   Apr 21, 11Apr '11 1,500 •••
blogAn awesome ebook upgrade     Apr 20, 11Apr '11 325 ••
Civilization Survival Tips   Coping with stress and anxiety in the modern world (without drugs)   Apr 20, 11Apr '11 2,500 •••
Sciatica Tutorial   A basic tutorial about buttock and leg pain   Apr 17, 11Apr '11 4,500 ••••
Alternative to What?   “Alternative” health care professionals need to decide what they are really the alternative to   Jan 14, 11Jan '11 3,500 ••••
Does Hip Strengthening Work for IT Band Syndrome?   Despite its popularity, “weak hips” is a weak theory, and there is no compelling evidence that hip strengthening can treat or prevent running overuse injuries of leg   Dec 29, 10Dec '10 4,250 ••••
blogBad science writer, bad! A major mea culpa   A major mea culpa   Dec 14, 10Dec '10 400 ••
Choose the Therapist, Not the Therapy   When you’re in pain, you want to know “what works,” but what you should look for is an honest therapist of any kind   Dec 9, 10Dec '10 1,100 •••
A Tour of Ideas From Recent Pain Science   Pain science has advanced a great deal in the last fifty years, but most of this information has had seemingly little impact on the way pain is commonly treated   Nov 29, 10Nov '10 1,800 •••
Every little thing a nice therapist does is magic   Loyalty to a physical therapist is often misguided and has little or nothing to do with how well treatment is actually working   Nov 16, 10Nov '10 650 ••
Top Journals for Pain and Injury Science   Medical journals that every physiotherapist, chiropractor, and massage therapist should be paying attention to   Oct 4, 10Oct '10 300 ••
Five Ways To Prevent Sports Injuries   Get warm, co-ordinated, relaxed, smart and mobilized!   Oct 4, 10Oct '10 475 ••
Do Nerve Blocks Work for Neck Pain and Low Back Pain?   Analysis of the science of stopping the pain of facet joint syndrome with nerve blocks, joint injections, and nerve ablation   Oct 1, 10Oct '10 1,900 •••
The Bath Trick for Trigger Point Release   A clever way of combining self-treatment techniques to self-treat your trigger points (muscle knots)   Aug 2, 10Aug '10 600 ••
Tennis Ball Massage for Myofascial Pain Syndrome   Some creative tips on using an ordinary tennis ball and other massage tools to self-treat muscle knots and myofascial trigger points   Aug 2, 10Aug '10 1,100 •••
Heat for Pain   When and how to apply heat for therapy … and when not to!   Jul 12, 10Jul '10 1,700 •••
The Trigger Point Symptom Checker   An interview with creator Jeff Lutz about a unique online visual database of common muscular trigger points (muscle “knots”)   May 26, 10May '10 1,700 •••
Wobble Cushion Technique   Instructions for chair warriors on the best usage of Disc ‘O’ Sit, Balance Fit or Sissel wobble cushions   May 17, 10May '10 1,100 •••
Do you know a good massage therapist in _______?   Three quick ways to find decent medical massage or trigger point therapy in your own area   May 1, 10May '10 800 ••
Hydrotherapy   An introduction to healing with water   Mar 18, 10Mar '10 800 ••
Review of Inside Chiropractic: A Patient’s Guide, a book by Samuel Homola+Homola’s book is an essential guide for anyone who likes a good spine crunch, but is concerned that the chiropractic profession might be imperfect.   Homola’s book the perfect guide if you like spinal adjustment but you’re wary of chiropractic controversies   Jan 2, 10Jan '10 1,500 •••
Body Types and Body Pain   Some speculation about what kind of body types might hurt the most   Nov 12, 09Nov '09 500 ••
Chronic Low Back Pain Is Not So Chronic   The prognosis for chronic low back pain is better than most people realize … especially for Australians in Australia!   Oct 10, 09Oct '09 600 ••
Therapeutic Options for Pain Problems   A guide to therapies and medical professionals for injuries, chronic pain and other musculoskeletal problems   Sep 28, 09Sep '09 180
Three Muscle Knots That Broke The Rules   Three examples of myofascial trigger points that responded to therapeutic methods that don’t normally work   Sep 15, 09Sep '09 700 ••
Battle of the Experts   A guide for patients caught between conflicting diagnoses and prescriptions   Jul 6, 09Jul '09 2,750 •••
The Anatomy of Vitality   What makes life tick? A poetic romp through the substance of vitality   Jun 27, 09Jun '09 2,500 •••
Alternative Medicine Doesn’t Exist   Either health is cared for or it is not cared for, whether we call it “alternative” or “mainstream”   Jun 27, 09Jun '09 900 ••
Trigger Points That Form Fast   Sometimes muscle knots strike with alarming speed and intensity   Jun 12, 09Jun '09 450 ••
Widespread Chronic Pelvic Pain In a Runner With a Surprising Cause   Separation of the pubic symphysis (diastasis symphysis pubis), strangely painless at the site   May 9, 09May '09 550 ••
Safe athletic training tips   Getting into shape without doing damage   Apr 21, 09Apr '09 600 ••
Never, Ever Trust “Common Sense”!   The fallibility of seemingly sensible ideas about physical therapy   Feb 14, 09Feb '09 350 ••
A Recipe for Chronic Neck Pain After Whiplash   Researchers discover some surprising risk factors for chronic neck pain in the aftermath of whiplash   Jan 20, 09Jan '09 750 ••
Into the Fire   Trigger point pain as a major injury complication, and how I finally “miraculously” healed from a serious and stubborn shoulder injury by untying the muscle knots   Nov 28, 08Nov '08 2,400 •••
7 Reasons Older Adults Don’t Stay in Exercise Classes   And 7 reasons they should stick with it: the science and psychology of maintaining an exercise class habit   Nov 12, 08Nov '08 3,000 ••••
Find Good Trigger Point Therapy   The tricky challenge of finding competent treatment for trigger points (muscle knots)   Sep 23, 08Sep '08 2,300 •••
Measuring Progress in Massage Therapy   How do you know whether or not massage therapy is working for you?   Sep 22, 08Sep '08 1,300 •••
Review of The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, a book by Clair Davies and Amber Davies   An important book spreading the word about trigger points, but it misses the mark for tough cases   Jul 6, 08Jul '08 1,000 •••
Knee Pain and Gender   Do women get more knee pain?   Jun 23, 08Jun '08 900 ••
My Very Own Athletic Injuries   A journal of my experiences with injuries acquired while running, cycling and hiking and playing ultimate for fifteen years   Mar 30, 08Mar '08 1,200 •••
9 Surprising Causes of Pain   Trying to understand pain when there is no obvious explanation   Mar 22, 08Mar '08 1,400 •••
Lifting Technique Is Not Important For Your Back   Science surprises with evidence that lifting technique is not an important consideration for low back pain   Feb 6, 08Feb '08 600 ••
Will Therapy Work?   The fool’s errand of trying to guess the effectiveness of a therapeutic approach to a pain problem before you’ve tried it   Jan 26, 08Jan '08 850 ••
The Gentle Art of Pain Acceptance   An important concept in leveraging mind-body connections to deal with chronic pain   Nov 16, 07Nov '07 750 ••
No MRI, Please!   New medical guidelines “strongly” discourage the use of MRI and X-ray in diagnosing low back pain in the early stages   Oct 8, 07Oct '07 600 ••
Muscle Tissue Issues   Three of the most common problems that people have with their muscles   Aug 13, 07Aug '07 600 ••
A Historical Perspective On Aches and Pains   We are living in a golden age of musculoskeletal health care … sorta   Aug 6, 07Aug '07 550 ••
Give Your Muscles What They Want   Resting a “freaked out shoulder” in a sling is actually a fine idea, despite possible medical objections   Jul 15, 07Jul '07 650 ••
Iliotibial band syndrome and patellofemoral pain syndrome aren’t as simple as they seem   Once again, evidence shows that you can’t blame overuse injuries on seemingly obvious structural problems   May 31, 07May '07 600 ••
Apply Occam’s Razor Today!   Use a classic logical tool to clean up a mess of confusing theories about your injury or pain problem   May 21, 07May '07 400 ••
A Delicious Cycle   The better you get, the faster you get get better   Apr 27, 07Apr '07 375 ••
Put your trust in people, not professions   Another appeal to choose the therapist, not the therapy   Mar 10, 07Mar '07 300 ••
Not Much Of A Connection   Many alleged mind-body connections are oversimplified   Mar 8, 07Mar '07 650 ••
Endurance Training for Injury Rehabilitation   What to do when your usual strength training workout isn’t working … or isn’t an option   Nov 30, 06Nov '06 1,200 •••
PF-ROM Exercises   ‘Pain-free range of motion’ or early mobilization exercises can help you heal   Nov 29, 06Nov '06 1,100 •••
Collateral and Re-Injury Prevention   Don’t underestimate the importance of prevention … even after you’ve already been injured!   Nov 27, 06Nov '06 850 ••
An Open and Closed Case   An explanation for a strange duality of muscle sensation observed in massage therapy   Jul 20, 05Jul '05 2,000 •••
A Short Story   Slow growth syndrome, oxandrolone and the pathologization of my height   Mar 28, 05Mar '05 1,900 •••
Extraordinary Claims   A guide to critical thinking, skepticism and smart reading about health care on the web   Aug 28, 04Aug '04 2,500 •••
Ugly Bags of Mostly Water   The chemical composition of human biology   Aug 26, 04Aug '04 1,500 •••
From Atoms to Elvis   A wide-angle look at the foundations of biology   Aug 26, 04Aug '04 500 ••
An Introduction to Biological Literacy   Why you need to know more about your body   Aug 25, 04Aug '04 1,100 •••
Why Massage Makes You Tingle   The physiology of sensation in muscle tissue   Jun 26, 04Jun '04 900 ••
The Still Life   The trouble with a lifestyle of inactivity   Jun 26, 04Jun '04 650 ••
Singing, Breathing, and Scalenes   Connections between singing, breathing and a strange group of muscles   Jun 26, 04Jun '04 1,800 •••