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 232 steadily evolving articles and e-books, plus 338 blog posts (about 575,000 words in all, plus much more in the nooks and crannies, especially the bibliography). Other starting places: Reading Guide for Patients and another for Professionals, or the big Pain & Injury Survival Tips page.

TIPS

Type topics of interest in the search field above the list. Keywords are suggested as you type. Choosing a keyword from the popup list is just like typing it. Or you can continue to type anything at all. The keywords show you what kind of content is available.

Example: To find featured and controversial articles about back pain, type “featu” and then press enter to complete the “featured” keyword. The list now only contains featured articles. Then type “contr” and choose the “controversial” keyword. The list now contains articles that are featured or controversial, but those that match both sort to the top.

Sort the table by clicking on the column headings. Make the table more detailed by adding subtitles.

You can also use an “old-fashioned” Google Site search at very top of the page.

  TAGS

Tag (keyword) suggestions as you type show show you what kind of content is available. Start typing knee pain and you’ll see that there are many items about knee pain. There are many other subject matter tags for all kinds of painful problems, like back pain, more for treatments like massage or chiropractic, plus dozens of other kinds of tags. Try typing size to pick a size tag, to favour articles of that size. Searching for featured articles is a good way of finding the best. Some other useful tags:

  • tags for specific areas: leg, head, knee, etc.
  • tags for the feel of a post: fun, debunkery, deep for mind blowing items, or pro for more advanced content
  • tags for different types or sizes of items are handy: search for little blog posts, or large tutorials, or excerpts from my books
 
REJOICE, fibromyalgia sufferers! Your nightmare is over!   new   Oct 30, 14Oct '14 300
The state of medicine+   new   Oct 30, 14Oct '14 100
Between offices+   new   Oct 28, 14Oct '14 80
Diabolically difficult   new   Oct 28, 14Oct '14 210
Statistical Significance Abuse+Many study results are called “statistically 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   Oct 28, 14Oct '14 3,250
A Systems Perspective on Chronic Pain   new   Oct 23, 14Oct '14 450
Save Yourself from Neck Pain!+

Who hasn’t had a crick in the neck? This tutorial isn’t the last word on this surprisingly complex subject, but it is a detailed, sensible and scientific survey of what makes a neck crick tick — and your treatment options. Ideal for any frustrated patient with a jammed cervical spine, it’s also helpful for many a therapist not really sure how to treat this quirky phenomenon. Ships with a free bonus, SaveYourself.ca’s valuable trigger point tutorial!

  All your treatment and self-help options for a crick in the neck explained and reviewed
updated   Oct 22, 14Oct '14 54,000
1.83 metres under   new   Oct 15, 14Oct '14 190
Not so FAST   new   Oct 14, 14Oct '14 350
197, 198, 199… 200!+   new   Oct 14, 14Oct '14 55
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 updated   Oct 14, 14Oct '14 4,250
I’m not an expert+   new   Oct 10, 14Oct '14 110
Best mini-testimonial ever+   new   Oct 9, 14Oct '14 55
FMS: Back to the drawing board?   new   Oct 9, 14Oct '14 475
Still not so ancient after all   new   Sep 30, 14Sep '14 250
The smell could almost be heard+   new   Sep 30, 14Sep '14 35
Does Acupuncture Work for Pain?   A review of modern acupuncture evidence and myths, particularly with regards to treating low back pain and other common pain problems updated   Sep 25, 14Sep '14 6,500
Salamander head+   new   Sep 24, 14Sep '14 1
Save Yourself from Shin Splints!+

Do you know why your shins hurt? Shin splints are often not what they seem. With several possible underlying problems, patients often end up barking up the wrong tree. There are four very different types of shin pain. This tutorial breaks it down for you and goes through all the treatment options and recent science. About 20 times more information about shin splints in one place than you can get anywhere else. Ships with a free copy of SaveYourself.ca’s trigger point tutorial!

  Causes and treatment options for shin splints explained and discussed in great detail, especially shin pain caused by myofascial trigger points, compartment syndrome, medial tibial stress syndrome, and stress fracture
updated   Sep 23, 14Sep '14 22,000
Save Yourself from Plantar Fasciitis!+

Plantar fasciitis is a stubborn pain in the arch of the foot. Yet scientists have proven that certain treatments are effective for most patients — so why don’t more professionals recommend them? Much of the science is new, and old myths die hard. This tutorial debunks the myths and reviews of all the common treatment options. Incredibly detailed, 74 sections in all, and thoroughly referenced.

  Plantar fasciitis explained and discussed in great detail, including every possible treatment option, and all supported by recent scientific research
updated   Sep 23, 14Sep '14 37,000
Save Yourself from Patellofemoral Pain Syndrome!+

PFPS is a common kneecap pain problem — and yet almost universally misunderstood. Patients are often given exactly the wrong advice. There is no miracle cure for patellar pain, but this tutorial is much more detailed than anything else you can find, weighing in at 40,000 words. Both patients and pros can greatly improve their understanding of the options — and maybe that is a kind of miracle. Inspired by the work of surgeon Scott Dye and firmly grounded in readable analysis of the science.

  Patellofemoral pain syndrome (aka runner’s knee) explained and discussed in great detail, including every imaginable self-treatment option and all the available scientific evidence
updated   Sep 23, 14Sep '14 65,000
Save Yourself from IT Band Syndrome!+

ITBS is an infamously stubborn lateral knee pain common in runners. Therapy hasn’t been working? You’re not alone. This exhaustively researched tutorial shows that most medical “facts” about the condition are wrong — supported by 142 footnotes analyzing as much of the science as you can stand. Cures cannot be guaranteed, but this tutorial offers both patients and pros 25 detailed treatment options and more insights than you can find anywhere else, as well as a free bonus: SaveYourself.ca’s valuable trigger point tutorial.

  All your treatment options for Iliotibial Band Syndrome reviewed in great detail, with clear explanations of recent scientific research supporting every key point
updated   Sep 23, 14Sep '14 51,000
Phantom scratching is like pain   new   Sep 22, 14Sep '14 160
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
updated   Sep 20, 14Sep '14 1,500
The “Impress Me” Test   Controversial therapies are usually fighting over scraps of “positive” evidence that damns them with faint praise updated   Sep 20, 14Sep '14 1,800
Pain is Weird+Modern pain science shows that pain is a volatile, complex sensation that is often strongly distorted by the brain, not just a symptom, and maybe worse than anything else that’s actually wrong with us. So can we think pain away? Probably not, but we do have some “neurological leverage” of great value — but it requires a good, modern understanding of how pain actually works.   Pain science exposes a volatile, misleading sensation that is often more than just a symptom, and sometimes worse than whatever started it updated   Sep 20, 14Sep '14 7,500
Does Chiropractic Work?   An introduction to chiropractic controversies like aggressive billing, spinal adjustment as a panacea, treating kids, neck manipulation risks, and more updated   Sep 20, 14Sep '14 6,000
Baby steps remix   new   Sep 17, 14Sep '14 210
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 vitalistic medicine in North America. Most practitioners are massage therapists and, oddly, nurses. Many years ago I believed in it, but eventually I decided it was based only on wishful thinking, laughably naive references to quantum physics, and wide-eyed exaggeration of ordinary social interaction effects. 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, 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 — a placebo, in short. And placebo is nowhere near as “powerful” as people believe, and there are all kinds of ethical and practical problems with cluttering up the interaction with magical interpretations of what’s going on.

  No touch included! Auras don’t exist and can’t be felt, let alone massaged for medical benefit
updated   Sep 16, 14Sep '14 950
Prism Podcast   new   Sep 15, 14Sep '14 160
Ancient wisdom+   new   Sep 14, 14Sep '14 85
Blood therapy, anyone?+   new   Sep 11, 14Sep '14 130
Baby steps+   new   Sep 11, 14Sep '14 40
Studying the Studies   Tips and musings about how to understand and wite about pain and musculoskeletal health science updated   Sep 11, 14Sep '14 2,200
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.

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 much lower, because they have vastly more experience with much sicker people (see Chiropractor, Naturopath Training Way Less Than Doctors).

  Alternative medicine often diagnoses overconfidently, overlooking or underestimating serious symptoms
updated   Sep 11, 14Sep '14 475
Does Platelet-Rich Plasma Injection Work?+

Platelet-rich plasma (PRP) injections bathe troubled cells in a concentrated mixture of platelets from your own blood. Platelets are involved in clotting and wound healing, and so the more-is-better hope is that they’ll stimulate healing “naturally” — regenerative medicine, supposedly. Unfortunately, the hype and costs are high, there could be risks above and beyond the basic risks of any injection, and the science so far is completely discouraging — three major evidence reviews have ruled it “ineffective.” Although it’s plausible and interesting in theory, this stuff just can’t beat placebos in fair tests.

  An interesting treatment idea for arthritis, tendinopathy, muscle strain and more
new   Sep 10, 14Sep '14 1,800
Chiropractor, Naturopath Training Way 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.

  Medical training is much longer and better than anything chiropractors or naturopaths normally get.
updated   Sep 9, 14Sep '14 600
Medical Errors in Perspective+

Alternative medicine practitioners often point accusingly to medical error rates with the implication that their services are much safer. That’s probably true … in the sense that walking is much safer than driving. But if your profession had to treat huge numbers of people with dire injuries and illnesses, it would also have scary error rates.

Bad things do 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 unethical 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
updated   Sep 9, 14Sep '14 750
Toxins, Schmoxins!+

The idea of “toxins” is usually used as a tactic to scare people into buying some kind of de-toxifying snake oil. Obviously there are dangerous substances; the problem is with the kind of people who toss the idea around, the reasons they do it (fear, profit, ignorance), and because toxin claims are usually so vague that they are literally meaningless, except as a marketing message. Indeed, “detoxification” may be the single most common marketing buzzword in alternative health care.

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).

  The idea of “toxins” is used to scare people into buying snake oil
updated   Sep 9, 14Sep '14 600
Collateral and Re-Injury Prevention   Don’t underestimate the importance of prevention … even after you’ve already been injured! updated   Sep 9, 14Sep '14 1,200
Six Ways To Prevent Sports Injuries   Get warm, co-ordinated, relaxed, smart and mobilized! updated   Sep 9, 14Sep '14 800
Applied Kinesiology is Bunk+

Applied kinesiology (AK) muscle testing is a pseudoscientific method of diagnosis used by many chiropractors and naturopaths, and denounced as an absurd parlour trick by everyone else. (AK has no relationship to kinesiology, the legitimate study of human movement.) Practitioners believe that changes in muscle strength, reacting to substances placed in the aura and probing questions, reveal the sensitivities and needs of the patient. This is about as scientific as a ouija board. There is almost no real AK research, of course: no real scientist would bother.

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. It fools practitioners just as readily as it fools patients: most are deluded true believers, not scam artists.

  The skeptical position on applied kinesiology, a bizarre alternative medicine method of diagnosis
updated   Sep 7, 14Sep '14 650
Phantom limb scratching+   new   Sep 6, 14Sep '14 25
Leaky old canoes+   new   Sep 6, 14Sep '14 65
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.

  Masking symptoms,” especially with medications, is often maligned. But sometimes symptoms need masking!
updated   Sep 6, 14Sep '14 750
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 some kind 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. Some 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.”

  Is there any such thing?
updated   Sep 6, 14Sep '14 1,300
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, with important consequences for free speech, and great personal significance (I was being legally bullied for similar reasons at the same time).

Singh criticized the British Chiropractic Association for endorsing spinal adjustment for children, famously calling it “bogus.” The BCA sued, exploiting Britain’s nasty libel laws, and the case got off to a rough start for free speech. Singh persisted until the case became a public relations disaster for the BCA, and they withdrew.

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.”

  The most famous case of legal bullying science, which catalysed a campaign to reform British libel law
updated   Sep 6, 14Sep '14 650
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 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. In 2002, Freedman et al wrote: “It is ... reasonable to conclude that medical school preparation in musculoskeletal medicine is inadequate.” In 2005 in Journal of Bone and Joint Surgery, Matzkin et al concluded that “training in musculoskeletal medicine is inadequate in both medical school and non-orthopaedic residency training programs.” In 2006, Stockard et al found that 82% of medical graduates “failed to demonstrate basic competency in musculoskeletal medicine.”

  Most doctors are unqualified to care for many common pain and injury problems. Especially the stubborn ones
updated   Sep 6, 14Sep '14 550
Save Yourself from Muscle Strain!+

Got a muscle strain? Maybe … and maybe not. Probably 75% of so-called muscle strains are actually something else. Doctors routinely diagnose muscle strain incorrectly. The muscle strain tutorial is guaranteed to sort it out … and it is just about only the source of information that does. For the majority of readers who’ve been misdiagnosed, the muscle strain tutorial ships with a free bonus tutorial about the problem they most likely do have — myofascial trigger points.

  Muscle strain (pulled muscle) and muscle pain explained and discussed in great detail, plus every imaginable treatment option
updated   Sep 5, 14Sep '14 17,000
A Historical Perspective On Aches and Pains   We are living in a golden age of musculoskeletal health care … sorta updated   Sep 4, 14Sep '14 700
Audio article no. 7+   new   Aug 27, 14Aug '14 55
The fate of medicine without reductionism+   new   Aug 27, 14Aug '14 65
Now basically rather “edited”   new   Aug 26, 14Aug '14 190
“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
‘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
updated   Aug 25, 14Aug '14 850
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
Testing 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
Vibram gets vague   new   Aug 20, 14Aug '14 220
I’m not holding my breath   new   Aug 20, 14Aug '14 170
Does barefoot running prevent injuries?   A dive into the science so far of barefoot or minimalist “natural” running updated   Aug 20, 14Aug '14 5,000
The chemistry of the burn+   new   Aug 19, 14Aug '14 130
Peak musculoskeletal anatomy+   new   Aug 19, 14Aug '14 100
The Trouble with Chairs   Back pain and worse hazards of sitting in chairs way too much updated   Aug 18, 14Aug '14 5,500
The Runner’s Knee Diagnostic Stand-Off   How to tell the difference between the two most common kinds of runner’s knee: IT band syndrome versus patellofemoral pain updated   Aug 15, 14Aug '14 1,000
Delayed Onset Muscle Soreness (DOMS)   The biological mysteries of “muscle fever,” nature’s little tax on exercise updated   Aug 6, 14Aug '14 6,500
Classic anatomy videos still going strong   new   Aug 4, 14Aug '14 325
Just exercise those thighs!   new   Aug 4, 14Aug '14 190
It doesn’t go to my head!+   new   Aug 1, 14Aug '14 100
Is there hope?+   new   Jul 31, 14Jul '14 130
Free speech+   new   Jul 31, 14Jul '14 25
2nd edition of patellofemoral pain e-book, co-authored with Tony Ingram   new   Jul 29, 14Jul '14 850
Save Yourself from Low Back Pain!+

There are thousands of low back pain books — what’s special about this one? The problem is that 90% of doctors and therapists assume that back pain is structural, in spite of mountains of scientific evidence showing … exactly the opposite. Only a few medical experts understand this, and fewer still are writing for patients and therapists. Supported by 326 footnotes, this tutorial is the most credible and clarifying low back pain information you can find. Ships with a free copy of SaveYourself.ca’s trigger point tutorial!

  Low back pain myths debunked and all your treatment options reviewed
updated   Jul 25, 14Jul '14 91,000
No Comment   Why I have never allowed public comments on SaveYourself.ca like most blogs, and never will updated   Jul 25, 14Jul '14 1,100
Neck pain updates+   new   Jul 24, 14Jul '14 30
Explaining away treatment successes   new   Jul 24, 14Jul '14 325
Mark my words: a new e-book feature   new   Jul 22, 14Jul '14 275
Downward 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
Too many choices+   new   Jul 15, 14Jul '14 100
The weirdness of pain+   new   Jul 15, 14Jul '14 130
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
An epic fail for pre-run stretching+   new   Jul 9, 14Jul '14 130
Your Back Is Not Out of Alignment+

“Structuralism” is the excessive focus in the physical therapies on crookedness or “mechanical” problems in the body — what I call the biomechanical bogeymen. It is the source of much bogus diagnosis — things like tilted pelvises, short legs, abnormal spinal curvatures, or “misaligned” anything — and the cause of much therapeutic barking up the wrong tree. Such factors are much less important than many people still believe.

Structuralism has been challenged by many medical researchers and experts like Dr. Lorimer Moseley Moseley, Dr. Scott Dye (knee surgeon); or back experts Drs. Richard Deyo, John Sarno, and Nickolai Bogduk; soft tissue pain experts like the late Dr. Janet Travell, Drs. David Simons and Seigfried Mense (see Muscle Pain), or Dr. Chann Gunn, and on and on.

Many key scientific studies over the years have undermined major structuralist assumptions, like Finan’s finding that knee pain correlates more with pain sensitivity than arthritis; Grundy’s conclusion in Lancet that short leg length differences don’t correlate with back pain; or Grob’s findings that abnormal neck curvatures do not predict neck pain; or Moseley’s finding that a placebo for knee osteoarthritis is just as good as real surgery; or numerous MRI studies showing terrible correlation between structural problems and back pain (see Boden, Jensen, Weishaupt, Stadnik, Borenstein); or the astonishing finding by Haig that even narrowing of the spinal canal does not necessarily cause stenotic back pain; or the clear evidence that even dislocation of the upper cervical spine is often asymptomatic (Swinkels); and so on (and on and on).

  Debunking the obsession with alignment, posture, and other biomechanical bogeymen as major causes of pain
updated   Jul 9, 14Jul '14 12,000
Quite a Stretch+Stretching just doesn’t have the effects that most people hope it does. Plentiful recent stretching research has shown that it doesn’t warm you up, prevent soreness or injury, enhance peformance, or physically change muscles. Although it can boost flexibility, the value of this is unclear, and no other measurable and significant benefit to stretching has ever been proven. Regardless of efficacy, stretching is inefficient, “proper” technique is controversial at best, and many key muscles are actually biomechanically impossible to stretch — like most of the quadriceps group (which runners never believe without diagrams). If there’s any hope for stretching, it might be a therapeutic effect on muscle “knots” (myofascial trigger points), but even that theory is full of problems.   Stretching science shows that a stretching habit isn’t doing much of what people hope updated   Jul 9, 14Jul '14 12,000
Save Yourself from Trigger Points & Myofascial Pain Syndrome+

Myofascial trigger points — muscle knots — are increasingly recognized by all health professionals as the cause of most of the world’s aches and pains. This detailed tutorial focuses on advanced troubleshooting for patients who have failed to get relief from basic tactics, but it’s also ideal for starting beginners on the right foot, and for pros who need to stay current. 193 sections grounded in the famous texts of Drs. Travell & Simons, as well as more recent science, this constantly updated tutorial is also offered as a free bonus (2-for-1) with the low back, neck, muscle strain, or iliotibial pain tutorials.

  A guide to the science of muscle pain, with reviews of every possible self-treatment and therapy option, even for the most difficult cases
updated   Jul 8, 14Jul '14 122,500
Wonder Core!+   new   Jul 7, 14Jul '14 15
Speaking of needles…+   new   Jul 7, 14Jul '14 30
What’s the point?+   new   Jul 7, 14Jul '14 140
Treat the animal, not the radiograph   new   Jul 3, 14Jul '14 160
It’s about time+   new   Jul 2, 14Jul '14 65
Why 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
More painful audio+   new   Jun 30, 14Jun '14 100
Shot by the witch+   new   Jun 30, 14Jun '14 55
A million page views+   new   Jun 29, 14Jun '14 50
Escape!+   new   Jun 26, 14Jun '14 100
My worst pain ever+   new   Jun 18, 14Jun '14 80
Cruciate repair non-crucial+   new   Jun 18, 14Jun '14 100
The DOs and DO NOTs of running your first marathon+   new   Jun 18, 14Jun '14 20
True story+   new   Jun 18, 14Jun '14 40
Thumbs Up for the Scientific 7-Minute Workout   new   Jun 11, 14Jun '14 450
Foot strikes vary widely in elite runners+   new   Jun 11, 14Jun '14 95
Are you a narcissist?   new   Jun 10, 14Jun '14 150
Soldiers and single moms+   new   Jun 10, 14Jun '14 130
A vote for tolerance+   new   Jun 10, 14Jun '14 75
My pro-science bias+   new   Jun 7, 14Jun '14 25
The back is still important in back pain+   new   Jun 7, 14Jun '14 130
Doubting doubts   new   Jun 6, 14Jun '14 250
Do you need a calf-stretching gadget?+   new   May 29, 14May '14 80
Plasticity versus tolerance: they got more flexible, but how, dammit, HOW?!   new   May 28, 14May '14 180
For whatever it’s worth+   new   May 28, 14May '14 110
The Better Movement Book+   new   May 26, 14May '14 100
Pain & Injury Survival Tips   Dozens of ideas for evidence-based rehabilitation and self-treatment for common pain problems and injuries updated   May 25, 14May '14 9,500
Americans Struggle to Stand Up+   new   May 22, 14May '14 55
No real evidence that parachutes work+   new   May 21, 14May '14 120
Society for Science-Based Medicine+   new   May 21, 14May '14 30
The “integrated medicine” straw-man+   new   May 21, 14May '14 80
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
Hyperaesthesia of the shins+   new   May 15, 14May '14 95
Practitioners of “placebo enhancement”   new   May 15, 14May '14 220
Kill pain, kill performance+   new   May 15, 14May '14 55
Placebo Power Hype+Placebo is fascinating, but its “power” isn’t all it’s cracked up to be: the power of belief is strictly limited and accounts for only some of what we think of as “the” placebo effect. There are no mentally-mediated healing miracles. But there is an awful lot of ideologically motivated hype about placebo!   The placebo effect is fascinating, but its “power” isn’t all it’s cracked up to be updated   May 15, 14May '14 2,750
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
Vibram spanked+   new   May 9, 14May '14 120
The Cassidy paper+   new   May 7, 14May '14 140
Pain 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
Small study proves showers work+     May 1, 14May '14 45
Placebo Paradox 2: The Mechanism+     May 1, 14May '14 120
Satisfaction is not efficacy+     May 1, 14May '14 110
So much “power”!+     Apr 30, 14Apr '14 110
Spine wrangling+     Apr 29, 14Apr '14 75
Inflatable back support?     Apr 29, 14Apr '14 160
It’s no Game of Thrones, but…+     Apr 25, 14Apr '14 25
Consider the source+     Apr 23, 14Apr '14 95
The two-legged dog and biomechanics     Apr 17, 14Apr '14 160
The Salamander’s Law of Bad Therapy+     Apr 17, 14Apr '14 10
Stretch for torn muscles     Apr 15, 14Apr '14 180
No Heartbleed here+     Apr 12, 14Apr '14 35
New book+     Apr 10, 14Apr '14 90
Compression socks with tape     Apr 10, 14Apr '14 250
Two books edited, six to go+     Apr 9, 14Apr '14 140
So…what does work, Mister Smartypants?+     Apr 9, 14Apr '14 100
Vandal massage     Apr 3, 14Apr '14 300
Barefoot resource+     Apr 2, 14Apr '14 45
Oh, stretching! Can you do anything right?+     Apr 2, 14Apr '14 100
New anecdote disclaimer     Apr 2, 14Apr '14 210
Neck Pain, Submerged!+     Apr 1, 14Apr '14 20
Financially motivated ignorance     Apr 1, 14Apr '14 150
Calf size variability+     Mar 27, 14Mar '14 60
Audiobooks project cancelled     Mar 27, 14Mar '14 170
The marble hand+     Mar 27, 14Mar '14 65
The greatest hits of back pain science     Mar 26, 14Mar '14 170
A lot of science is junky     Mar 26, 14Mar '14 190
Follow-up on the baby’s broken neck story+     Mar 25, 14Mar '14 80
What “Big Ortho” doesn’t want you to know!+     Mar 25, 14Mar '14 100
Love letters from librarians+     Mar 25, 14Mar '14 30
Goodbye PDF, hello lifetime access     Mar 20, 14Mar '14 250
When books don’t heal+     Mar 20, 14Mar '14 140
He’s trying to shoot me, all right…+     Mar 20, 14Mar '14 35
The meaning of heel spurs     Mar 19, 14Mar '14 210
A good friend advances medical science+     Mar 19, 14Mar '14 80
Say release again     Mar 19, 14Mar '14 180
Does Massage Therapy Work?   A review of the science of massage therapy … such as it is   Mar 19, 14Mar '14 13,000
New massage for fibromyalgia study     Mar 18, 14Mar '14 600
Kwitcherbichen+     Mar 18, 14Mar '14 10
Back to work and blogging     Mar 18, 14Mar '14 190
Many (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
A 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 Therapeutic Ultrasound Work?+

Ultrasound therapy is the use of sound waves to treat musculoskeletal problems, especially inflammation (tendinitis, bursitis). It has been a popular therapy for decades, its use so widespread that it almost defines physical therapy. Unfortunately, although mainstream, it is not as scientific a treatment as most people assume. It has been generally undermined or damned with faint praise by one scientific review after another for more than a decade now. Between 1995 and 2008, what little science has been done on the subject was reviewed in ten papers I considered to be worthwhile (see Gam, Windt, Brosseau, Robertson, Welch, Baker, Buchbinder, Ho, Ho, Jamtvedt). Eight of those were unambiguously negative, some of them strongly so. Authors had almost nothing good to say about ultrasound. Conclusions like this one (from Windt et al) are the rule: “As yet, there seems to be little evidence to support the use of ultrasound therapy in the treatment of musculoskeletal disorders.” Some modern variants of ultrasound are expensive, hyped, and totally unproven for any or many conditions.

  Many concerns about the widespread usage of therapeutic ultrasound, especially extracorporeal shockwave therapy (ESWT)
  Jan 1, 14Jan '14 3,000
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
Does Fascia Matter?+

Fascia is widely regarded as an exciting scientific frontier, with well-attended fascia conferences featuring “rock star” gurus in the world of massage and manual therapy. The main idea is that fascia — tough connective tissue wrapping around all muscles and organs — can get tight and restrictive, and needs to be “released” by pulling on it artfully. Unfortunately, although fascia science may be inherently interesting as biology, and fascial compartment syndrome is certainly a real and scary medical problem, no subtle property of fascia has yet been shown to be clinically relevant. No fascial pathology seems to be a factor in any common painful problem, and no method of fascial manipulation is known to “fix” fascia or even change it.

I have challenged fascia fans to cite clinically relevant fascia science, with no result years now. This article reviews three key candidates: well-known studies about fascia’s toughness, its contractility, and its fibroblasts. None confirm any clinical relevance of fascia, and one actually undermines it, showing that fascia is too tough to “release.” I also discuss the irrelevance of piezoelectricity, thixotropic effect, and contradict Gil Hedley’s popular fascial “fuzz” theory of stiffness. The article criticizes fascia excitement from a scientific perspective.

  A detailed critical analysis of the clinical relevance of fascia science and fascia properties
  Dec 11, 13Dec '13 13,000
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
Save Yourself from Insomnia!   Serious tips from a veteran of the insomnia wars   Dec 11, 13Dec '13 6,000
The View from Somewhere+

Readers often prevail upon me to be “objective,” but it’s an over-rated virtue. I am often criticized for a lack of it — always by somone who disagrees with me. And sometimes I am praised for my neutrality — always by someone who agrees with me. But I am not impartial on any of the controversial questions in my field, I’ve never met anyone who is, and I don’t aspire to it.

Objectivity and balance are highly over-rated as journalistic virtues. They are mostly a pretentious delusion, and you should actually beware of those who claim to have them. See Jay Rosen on “the view from nowhere.” And Dan Rather said it well: “I don’t like the word ‘balance’ as applied to journalistic work, because to me, that carries with it at least a connotation that, if you run 15 words about the Republican Party, then you’ve got to run 15 words about the Democratic Party. That’s balance. But I think “fairness” is the word I prefer” (interviewed by Hedrick Smith on PBS, 1996).

Instead of expecting balance, look for someone with a View from Somewhere — from someone who isn’t afraid to disclose and own a bias. That is my goal. Not only will I fail to achieve the ideal of “objectivity,” I assume that my biases are inevitable, constantly egregious, and utterly human. We are all bias machines. We can only keep a bemused eye on this frailty, do some damage control, and try to avoid being emphatic or overconfident about much of anything other than the rise of the sun, death, taxes, and the absurd fallibility of confidence itself. The ideal is not be unbiased, but to be biased with integrity.

 
  Dec 7, 13Dec '13 275
Neck Pain, Submerged!   The story of my curious experiment with dunking severe chronic neck pain   Dec 3, 13Dec '13 3,750
Uh oh, success!     Nov 21, 13Nov '13 210
Kinesio Taping Review+

Most therapeutic taping is either practical (stabilizing a sprained ankle), or aims to tinker with more subtle biomechanics. Taping has gotten a lot hotter in the last few years with prominent new products and branding, and lots of hype and claims about therapeutic effects, prevention, and performance enhancement. New materials that may achieve different and possibly superior benefits, but probably not much. It doesn’t work biomechanically, as many professionals assume. It’s more likely that the odd sensations change function and reduce pain, but that kind of effect tends to be minimal, and hard to predict and control.

  A quick analysis of that colourful therapy tape that was so popular at the Olympics. Does it help?
  Nov 21, 13Nov '13 1,900
A tale of two taping papers     Nov 20, 13Nov '13 300
Memoirs of a female flight surgeon     Nov 19, 13Nov '13 230
A tug-of-war over scraps     Nov 19, 13Nov '13 170
Do our bones influence our minds?+     Nov 19, 13Nov '13 35
Knee arthroscopy does not work+     Nov 13, 13Nov '13 40
Not so new+     Nov 7, 13Nov '13 110
New ligament+     Nov 6, 13Nov '13 80
How many sets is enough?     Nov 5, 13Nov '13 170
Strength Training Frequency   Less is more than enough: go to the gym less frequently but still gain strength fast enough for anyone but a bodybuilder   Nov 5, 13Nov '13 7,500
Microblog 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
Dissing dyskinesis     Oct 22, 13Oct '13 240
You too can learn to feel a hair!+     Oct 21, 13Oct '13 130
It’s not medical+     Oct 21, 13Oct '13 35
Like getting blood from a bone     Oct 21, 13Oct '13 375
Palpatory Pareidolia   Sensory illusions, wishful thinking, and palpation pretension in massage and other touchy health care   Oct 18, 13Oct '13 2,500
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
Reflexology “science”     Oct 4, 13Oct '13 190
Therapy dominated by obsolete ideas+     Oct 3, 13Oct '13 120
How 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
SaveYourself faster!+     Oct 1, 13Oct '13 110
Tight hamstrings, back pain, and movement     Sep 24, 13Sep '13 190
Pain’s complexity+     Sep 24, 13Sep '13 80
Bad biomarkers, good knee news     Sep 20, 13Sep '13 275
What’s a runner gotta do?+     Sep 20, 13Sep '13 55
Touch-testing the world+     Sep 19, 13Sep '13 130
Performance enhancement+     Sep 19, 13Sep '13 130
The prodigy problem     Sep 17, 13Sep '13 170
How to dismiss science you don’t like+     Sep 16, 13Sep '13 60
Not good enough, Pilates+     Sep 12, 13Sep '13 140
Educated guesses+     Sep 11, 13Sep '13 60
What people really look like+     Sep 10, 13Sep '13 120
Pain vs. brain: a follow-up     Sep 5, 13Sep '13 300
Weights as good as a run?+     Sep 5, 13Sep '13 90
Pain vs. 1600 pounds     Sep 4, 13Sep '13 180
“Just” a half hour+     Sep 3, 13Sep '13 30
Needless needles?     Aug 29, 13Aug '13 160
Because fascia     Aug 29, 13Aug '13 210
Biomechanicomplicated     Aug 29, 13Aug '13 200
Mobilizing cat+     Aug 27, 13Aug '13 55
Does [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
Enhanced placebos     Aug 22, 13Aug '13 170
Never give up+     Aug 22, 13Aug '13 60
Is science your enemy?+     Aug 22, 13Aug '13 80
Wonky knees     Aug 20, 13Aug '13 200
Happy 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
Hooray for thorough massage!     Aug 15, 13Aug '13 250
Why are non-USD prices for my e-books so much higher than the going exchange rate?     Aug 15, 13Aug '13 220
When to worry about back pain     Aug 14, 13Aug '13 220
The Bark and the Bite of Low Back Pain   When should you worry about low back pain, and when you shouldn’t you?   Aug 13, 13Aug '13 2,300
Good screening news     Jul 31, 13Jul '13 150
Should I run recklessly?+     Jul 30, 13Jul '13 120
Critical what?+     Jul 30, 13Jul '13 120
Yoga for neck pain+     Jul 25, 13Jul '13 60
The placebo paradox+     Jul 25, 13Jul '13 90
More pain = more pain     Jul 23, 13Jul '13 170
Self-improvement through pain+     Jul 23, 13Jul '13 140
Intelligent 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
Why so negative?+     Jul 19, 13Jul '13 110
Noise, noise, noise!+     Jul 18, 13Jul '13 80
Risk vs benefit     Jul 17, 13Jul '13 50
“Disc” pain+     Jul 16, 13Jul '13 60
AllTrials is going well+     Jul 16, 13Jul '13 80
Terrible and wonderful+     Jul 16, 13Jul '13 65
Massage Therapy for Bruxism, Jaw Clenching, and TMJ Syndrome   Perfect Spot No. 7, the masseter muscle of the jaw   Jul 11, 13Jul '13 2,300
Good news about running+     Jul 9, 13Jul '13 85
Dramatic acupuncture harm+     Jul 5, 13Jul '13 15
Painful neck = weak breathing+     Jul 5, 13Jul '13 65
Less is more than enough     Jul 3, 13Jul '13 150
I’m officially more important now     Jul 2, 13Jul '13 375
Why is back pain still a huge problem?+     Jul 2, 13Jul '13 140
Derpish 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
Holy spinal adjustment, Batman!+     Jun 29, 13Jun '13 70
Knee surgery denounced by surgeons     Jun 26, 13Jun '13 200
Understatement+     Jun 25, 13Jun '13 40
Cat 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
Running still good for you     Jun 13, 13Jun '13 170
Science isn’t broken     Jun 8, 13Jun '13 210
Applied “Kinesiology”+     Jun 7, 13Jun '13 80
Research tip+     Jun 5, 13Jun '13 20
Now hear this: 5 new audio articles+     Jun 4, 13Jun '13 120
Actual touch not included+     Jun 4, 13Jun '13 120
Good questions about orthotics     Jun 4, 13Jun '13 160
Failed healing+     Jun 4, 13Jun '13 140
Resisting postural assessment+     Jun 3, 13Jun '13 15
Some gold standard+     Jun 3, 13Jun '13 65
Objectivity+     Jun 3, 13Jun '13 80
CRPS science “something of a mess”+     May 31, 13May '13 20
Good reviews of crappy studies+     May 31, 13May '13 50
Placebo PSA+     May 31, 13May '13 100
Good back pain science news     May 30, 13May '13 160
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
Does Posture Correction Matter?+Posture matters a little, but not a lot. Most “poor posture” is just bad ergonomics, a different problem. Postures that do harm and have easy fixes are rare; many postures are the result of long-term adaptations and nearly impossible to change. Many people do seem to be vulnerable to postural strain, but they have a problem with vulnerability, not posture. If your main issue is unexplained or stubborn aches and pains, working on posture is not the best way to spend your time: just get more exercise generally, especially tasks that require coordination, and anything you enjoy (inspiration, not discipline). “Advanced” methods taught by posture gurus are generally speculative and over-priced.   Posture correction strategies and exercises … and some reasons not to care or bother   May 29, 13May '13 13,000
A taijiquan spelling bee     May 23, 13May '13 240
The 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
Blood injection treatment bombs a test+     May 21, 13May '13 70
The anti-placebo+     May 21, 13May '13 40
Progressive 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
No more store trouble, but sheesh+     May 18, 13May '13 100
Service announcement for customers+     May 17, 13May '13 120
Promising new fitness blog+     May 17, 13May '13 10
Replication needed+     May 15, 13May '13 65
Surprise run+     May 15, 13May '13 110
Good pain reading for pros+     May 14, 13May '13 20
The effects of sleep deprivation+     May 14, 13May '13 45
The power of barking+     May 10, 13May '13 25
Antibiotics for back pain reality check+     May 10, 13May '13 90
I was wrong: muscle is cheap, not expensive     May 10, 13May '13 250
And then I read my email…+     May 10, 13May '13 65
Do I like “SaveYourself.ca”?+     May 10, 13May '13 70
Two tiny quotes+     May 9, 13May '13 65
Bad icing news?+     May 7, 13May '13 90
Strengthening for the not-so-young+     May 4, 13May '13 25
Incurable shitty ankle+     May 2, 13May '13 60
Jedi pain tricks!     May 1, 13May '13 190
Goodbye supplement confusion+     Apr 23, 13Apr '13 120
Affectionate or creepy?+     Apr 22, 13Apr '13 20
Beeeep     Apr 19, 13Apr '13 160
We hates the DRMses, my preciousss+     Apr 19, 13Apr '13 80
Pain changes how pain works+     Apr 17, 13Apr '13 55
Modality empires     Apr 17, 13Apr '13 170
Pain Changes How Pain Works+Pain itself can change how pain works, so that patients with pain actually become more sensitive and gets more pain with less provocation.   Pain itself can change how pain works, resulting in more pain with less provocation (sensitization)   Apr 16, 13Apr '13 2,500
X-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
Not what they seem+     Apr 10, 13Apr '13 95
Homo sapiens: not as wimpy you thought     Apr 8, 13Apr '13 275
Meanwhile, backstage+     Apr 8, 13Apr '13 75
I 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
Tissue pathology does not explain chronic pain+     Apr 5, 13Apr '13 35
Disc, schmisc+     Apr 4, 13Apr '13 110
Unicorn horn velvet!+     Apr 3, 13Apr '13 45
1-Minute fibromyalgia video+     Apr 2, 13Apr '13 55
Seven amusing alternatives to evidence-based medicine     Apr 1, 13Apr '13 180
Voltaren® Gel+Made available in North America only quite recently, Voltaren® Gel is a particularly safe and useful medicine that many people here have still not heard about. It’s a topical anti-inflammatory medication, so it can be applied only where you need it, instead of soaking your entire system with medication, avoiding or minimizing common side effects like indigestion, and some serious safety concerns associated with the oral version of the drug. It’s FDA-approved to treat osteoarthritis in “joints amenable to topical treatment, such as the knees and those of the hands,” but it probably also works for some other painful problems, such as some repetitive strain injuries and back pain. The evidence shows that it “provides clinically meaningful analgesia.” So this product actually works and it gets a pass from skeptics and critics — a rare thing indeed in the world of pain treatments!   A useful rub-on anti-inflammatory medication   Mar 29, 13Mar '13 2,200
Electric baths     Mar 28, 13Mar '13 170
Spinal infection?     Mar 26, 13Mar '13 220
Updated Tissue Provocation Therapies+     Mar 22, 13Mar '13 130
Testing Treatments+     Mar 22, 13Mar '13 50
A boast post+     Mar 20, 13Mar '13 25
Clinical Decision-Making+     Mar 20, 13Mar '13 20
Stretching for trigger points+     Mar 18, 13Mar '13 15
More than placebo, less than medicine+     Mar 18, 13Mar '13 70
Topical NSAID risks much lower than oral     Mar 15, 13Mar '13 180
Impruvism.com podcast+     Mar 15, 13Mar '13 10
One of my favourite history of medicine stories+     Mar 14, 13Mar '13 130
“Negative”+     Mar 13, 13Mar '13 65
Revenge of the Woo+     Mar 13, 13Mar '13 60
Tissue state is just chemistry     Mar 13, 13Mar '13 150
Pelvic tilt+     Mar 12, 13Mar '13 140
Interesting but not awfully important epiphenoma+     Mar 11, 13Mar '13 20
An unfortunate trivialization+     Mar 11, 13Mar '13 50
Two especially nice reader comments+     Mar 11, 13Mar '13 120
Introducing the microblog     Mar 8, 13Mar '13 200
Seriously, funny salt+     Mar 8, 13Mar '13 75
Big fascia update+     Mar 1, 13Mar '13 45
Dissection-perspective+     Feb 27, 13Feb '13 20
Glucosaminimal+     Feb 26, 13Feb '13 25
Posture is a hit!+     Feb 26, 13Feb '13 20
Sexy 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
Perplexed+     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
Stretching good for the heart+     Feb 16, 13Feb '13 25
Good 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
Big boner+     Feb 13, 13Feb '13 130
Morgan Schmorgan+     Feb 12, 13Feb '13 10
1,001 followers+     Feb 12, 13Feb '13 10
Posture reactions+     Feb 11, 13Feb '13 75
Posturology+     Feb 11, 13Feb '13 120
Typos+     Feb 9, 13Feb '13 10
New massage myth+     Feb 8, 13Feb '13 15
Affective massage therapy+     Feb 8, 13Feb '13 25
Cleaner, sparklier+     Feb 8, 13Feb '13 15
Two Audiobooks Now Available     Feb 4, 13Feb '13 250
Unstable? Unreliable+     Feb 4, 13Feb '13 110
Diagnostic reliability+     Feb 4, 13Feb '13 7
Comic back cracking+     Feb 4, 13Feb '13 25
Hope springs eternal+     Feb 3, 13Feb '13 20
I don’t know if you gots it+     Feb 3, 13Feb '13 25
Kind customer feedback+     Feb 2, 13Feb '13 15
Barefoot understatement+     Feb 2, 13Feb '13 25
A common problem+     Jan 31, 13Jan '13 20
Ultrasound update+     Jan 28, 13Jan '13 30
Many people believe+     Jan 28, 13Jan '13 45
Kinesio tape+     Jan 24, 13Jan '13 40
I can relate+     Jan 22, 13Jan '13 15
Creatine-induced insomnia     Jan 19, 13Jan '13 250
Now that’s ankle flexion+     Jan 19, 13Jan '13 20
Crappy acupuncture reviews+     Jan 18, 13Jan '13 35
Painless dislocated … neck?+     Jan 18, 13Jan '13 20
Exploding head syndrome+     Jan 18, 13Jan '13 15
Do Epsom Salts Work?+Epsom salt in your bath is cheap and harmless and it makes bath water feel “silkier,” so there’s no reason to ban it from your life. However, it probably doesn’t do what you hope it’s doing. Although Epsom salt probably does have some physiological effects, it is unknown if there is a therapeutic effect on aches and pains … and somewhat unlikely. Most of the theories you hear are oversimplified and meaningless — for instance, nearly everyone says it is absorbed by osmosis, but that is false and impossible — and the known effects of Epsom salt don’t have much to do with common causes of pain. The heat of a nice bath is probably more therapeutic. The case for the healing powers of Epsom salt is mostly made by people selling the stuff, or recommending it as casually and imprecisely as an old wives’ tale.   There is no good reason to believe that Epsom salt baths aid recovery from muscle pain, soreness or injury   Jan 16, 13Jan '13 8,000
Change how it feels+     Jan 14, 13Jan '13 10
Sensory clutter+     Jan 13, 13Jan '13 25
Knee lube jobs+     Jan 12, 13Jan '13 30
Honest fan mail+     Jan 12, 13Jan '13 15
Healing speed+     Jan 12, 13Jan '13 35
AllTrials.net+     Jan 10, 13Jan '13 90
Minute Medical School     Jan 8, 13Jan '13 190
I Ain’t Just Book Smart!+     Jan 7, 13Jan '13 30
This will sting a little bit+     Jan 6, 13Jan '13 25
Stretching doesn’t help contracture+     Dec 31, 12Dec '12 10
Blogging the process+     Dec 31, 12Dec '12 85
Anecdata+     Dec 28, 12Dec '12 6
Brains control pain… not minds+     Dec 26, 12Dec '12 15
A 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
I’m sorry, Creatine, I misjudged you+     Dec 10, 12Dec '12 20
Reston was not anaesthetized by acupuncture     Dec 8, 12Dec '12 160
Feel safe & good+     Dec 6, 12Dec '12 20
EBM appearances+     Dec 6, 12Dec '12 20
Placebo surgeries+     Dec 5, 12Dec '12 30
How important is sleep?+     Dec 4, 12Dec '12 20
PNF stretching+     Dec 3, 12Dec '12 130
SBM’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
Massage Therapy for Tension Headaches   Perfect Spot No. 1, in the suboccipital muscles of the neck, under the back of the skull.   Oct 28, 12Oct '12 1,500
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+Almost everyone needs to take sleep deprivation more seriously. We are used to thinking of insomnia as a symptom, but it can also be hazardous in itself in many ways. Chronic pain is probably aggravated by insomnia or even mild but chronic sleep deprivation.   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
Poisoning humour+     Oct 21, 12Oct '12 15
The unkillable lactic acid myth+     Oct 21, 12Oct '12 90
Surgeon corrects my tone     Oct 21, 12Oct '12 170
Radiological imagining+     Oct 21, 12Oct '12 20
Basic Self-Massage Tips for Myofascial Trigger Points   Learn how to massage your own trigger points (muscle knots)   Oct 20, 12Oct '12 1,700
When To Worry About Shortness of Breath … and When Not To+Difficulty breathing is a common complaint and a tough diagnostic challenge, and there are some serious causes to be aware of. However, many cases are probably caused by minor and treatable muscle knots, respiratory dysfunction and/or weakness. Relief may be relatively easy for some patients. It’s safe and cheap to experiment with self-massage for muscular trigger points. And, although changing bad habits is always tricky, increasing your respiratory strength is definitely effective and a worthwhile fitness goal in any case.   Two common, minor, and treatable causes of a scary symptom   Oct 12, 12Oct '12 3,000
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
Does Arnica Cream Work for Pain?+

Homeopathic (diluted) herbal ointments for inflammatory pain, like muscle pain, joint pain, sports injuries and bruising, are quite popular, but their effectiveness is fairly questioned by many. Known to most customers as “herbal” arnica cream, most contain less than 10 micrograms of arnica per dose — dramatically less that what is needed of most substances to be considered a chemically active ingredient. Homeopathy is based on an exotic interpretation of physics that involves diluting ingredients to the point of completely removing them. Some of the herbal ingredients are less diluted and may be chemically active and more useful.

A few tests of homeopathic pain creams have been mildly encouraging, but mostly old and poor quality ones. In all good quality, modern scientific trials so far, they seem to do no better than placebo. It is possible that a benefit can still be proven, but it is not likely.

  A detailed review of popular homeopathic (diluted) herbal creams like Traumeel, used for muscle pain, joint pain, sports injuries, bruising, and post-surgical inflammation
  Oct 2, 12Oct '12 9,000
The Unstretchables   Eleven major muscles you can’t stretch, no matter how hard you try   Oct 2, 12Oct '12 2,000
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.

Unsurprisingly, many people who believe they can heal with life energy — reiki, acupuncture, and so on — are also active spreading fear, uncertainty, and doubt about artificial energy.

No one with an actual energy allergy 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.

  Electrosensitivity is an imaginary, debunked energy allergy
  Jul 26, 12Jul '12 475
Bad 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
Massage Therapy for Shoulder Pain   Perfect Spot No. 14, The Most Predictable Unsuspected Cause of Shoulder Pain   Jun 25, 12Jun '12 1,500
Health Care Claims Are Special+

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.

  In health care, claims often involve a more self-serving assertion
  Jun 21, 12Jun '12 220
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.

  Homeopathy is not a natural or herbal remedy: it’s a magical idea with no possible basis in reality
  Jun 21, 12Jun '12 750
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
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 Neck Pain, Chest Pain, Arm Pain, and Upper Back Pain   Perfect Spot No. 4, an area of common trigger points in the odd scalene muscle group in the neck   Jun 15, 12Jun '12 2,500
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 Low Back Pain (So Low That It’s Not In the Back)   Perfect Spot No. 12, a common (almost universal) trigger point in the superolateral origin of the gluteus maximus muscle   Jun 9, 12Jun '12 2,100
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 Back Pain, Hip Pain, and Sciatica   Perfect Spot No. 6, an area of common trigger points in the gluteus medius and minimus muscles of the hip   Jun 9, 12Jun '12 1,100
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
How 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
An 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
Bad 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
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 '09 200
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
Back Pain and Trigger Points   Understanding the role of trigger points in back pain   Jun 26, 08Jun '08 325
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
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
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