blog post #409
Here are some of the thing that have come up in the last week.
I stay current with stretching research. Unfortunately, I have yet to see clear evidence that any stretching method is a clear winner at anything of much importance — no matter how “advanced.” Here’s a perfect example:
Alternately stretching and contracting a muscle is a staple of “advanced” stretching. This is called the contract-relax (CR) method, which is part of a general strategy with the very advanced sounding name of “proprioceptive neuromuscular facilitation” (PNF). However, it’s really nothing fancy: CR just adds contraction. Some readers will sniff at this and say that CR is still not “advanced” stretching, but it is certainly still widely used, taught and touted as being better than humble static stretching. I see trainers using it at the gym all the time. Patients can go for physical therapy pretty much anywhere in the world, and there’s a pretty good chance the therapist will do a whole bunch of CR stretching with them, while charging about a buck a minute.
Guess what? It doesn’t increase flexibility any more than static stretching. Science says so! A well-planned experiment tested whether or not the contraction component of a CR stretch actually makes a difference, and clearly found that it does not (see Azevedo). Researchers compared a normal CR stretch of the hamstring to a modified one without any hamstring contraction (instead, some other “uninvolved, distant” muscle was contracted). The effect of both stretches was the same — “a significant moderate increase in range of motion.” In other words, it didn’t matter if the hamstring was contracted or not — with or without a contraction, the result was the same. This strongly undermines the central claim of CR-PNF stretching, and that’s being charitable. Actually, it kind of eviscerates it.
Is cuboid bone stability “the answer” to all pain? Don’t bet on it! A therapist once seriously told me this—and I’ve been making fun of it ever since, using it as a great symbol for sloppy clinical reasoning and excessive interest in biomechanics. For instance, it comes up in my article about “structuralism.”
I just upgraded this diagram of the cuboid, so I thought I’d share.
First I’ve seen in a while: a key protein identified.
This is a plausible, definite mechanism for lumbar and pelvic pain. Very interesting reading for professionals. For some perspective, see Diane Jacobs’ post about it (the Tarlov cyst section half way through). The nugget:
“a medical myth was born that Tarlov cysts are irrelevant lesions, and it remains widespread today. In fact, radiologists often see Tarlov cysts on MRIs but don’t report them, because they have been taught these cysts are an incidental finding of no medical significance—just as a dermatologist might not report freckles."
My new article Poisoned by Massage had some major implications for another topic: delayed-onset muscle soreness (DOMS). My DOMS article has been updated substantially. It has gotten quite detailed — one update at a time over many years now.
There are also 247 more articles and eight big tutorials on the website, plus dozens more timely updates and “posts.” See the complete categorized index, or get some reading recommendations for patients or professionals.