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SaveYourself.ca is now a successful project. It’s going so well it’s almost alarming: it has gotten tough to juggle all the demands of a fast-growing publishing business. You can read more about that on my personal blog, Writerly (PaulIngraham.com). Here’s a snippet from Uh oh, success!
Many people who start small businesses want them to stay small, usually so we can (mostly) keep wearing the hat that defines us (butcher, baker, e-book maker). We’re more interested in whatever our business is about than we are in running a business. Fast growth — too many customers, too much “paper”-work, too many phones ringing — can make that vision recede in the distance like a mirage.
This blog will now fall mostly silent for a spell, while I work harder than ever on new content, avoiding the distraction of blogging about the subject matter as I go. I need to buckle down and do some serious work:
major updating and polishing of the books
finishing the audio versions (finally!)
purging some scruffy old content
major investments in publishing technology and efficiency (my favourite part, actually)
And so on, and much more. Stay tuned for a revival of this blog and a lot of good stuff in 2014. The salamander’s best is yet to come!
Sometimes when researchers sum up by saying “more study needed,” what they really mean is “the evidence hasn’t gone our way yet, so let’s keep doing shabby science until it tells us what we want to hear.” This meta-analysis of kineso taping for sports injuries in New Zealand’s Sports Medicine journal doesn’t really have much good news to report, but it manages to come off as pro-taping and cautiously optimistic anyway:
In conclusion, there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries. KT may have a small beneficial role in improving strength, range of motion…. The amount of case study and anecdotal support for KT warrants well designed experimental research, particularly pertaining to sporting injuries, so that practitioners can be confident that KT is beneficial for their athletes.
This formal response in the British Journal of Sports Medicine, by Drs. Steve Kamper and Nicholas Henschke, just seethes with irritation.
Despite the title of the review, the authors do not report a meta-analysis of the included studies. … The review has several flaws, the most serious of which is selective reporting of outcomes. As only positive (significant) results are reported it is not possible to assess the entirety of the evidence for effectiveness of kinesio taping. In addition, while the authors report to have followed the methodological guidelines of the Cochrane Collaboration this does not appear to be the case. … Clinicians should look to other sources of information…
More study of taping is needed, but not “so that practitioners can be confident” — it should be done because we need to find out if practitioners should be confident. And the limited evidence so far is discouraging, not encouraging, and to the extent that there are a few scraps of positive evidence, it’s a classic case of damning with faint praise.
“Kinesio taping for sports injuries”
Science-Based Medicine posts off and on for years now, often sharing a laugh or commiserating about some of the tragic subject matter (like today’s post, Faith Healing: Religious Freedom vs. Child Protection). She’s an amazing writer and person:
When Harriet Hall graduated from medical school in 1970 and entered the Air Force, she was in a distinct minority. As the second woman ever to do an Air Force internship, she had to fight for acceptance. Even a patient’s 3 year old daughter proclaimed, “Oh, Daddy! That’s not a doctor, that’s a lady.” She was refused a residency, paid less than her male counterparts, couldn’t live on base, and couldn’t claim her husband as a dependent because he wasn’t a wife. After six years as a general medical officer in Franco’s Spain, she became a family practice specialist and a flight surgeon, doing everything from delivering babies to flying a B-52. She earned her pilot’s license despite being told “Women aren’t supposed to fly,” and eventually retired from the Air Force as a full colonel. She is witness to an era when society was beginning to accept women in traditionally male jobs but didn’t entirely like the idea yet. A somewhat warped sense of humor kept her afloat, and it spices the stories she tells about her own experiences and the patients and colleagues she encountered.
Jason Silvernail, PT, regarding a plea to help defeat legislation to make dry needling of trigger points the exclusive domain of acupuncturists:
This is the kind of pointless turf war foolishness that the licensure system encourages. Remember it has nothing to do with evidence and everything to do with lobbying and economic protectionism.
Definitely. It’s important context that acupuncturists are struggling to preserve their reputation as the evidence piles up and overflows: acupuncture can’t beat a placebo. This is a blatant attempt to lay exclusive claim to a superficially similar treatment method that has the appearance of being more evidence based, because it is currently practiced by many physical therapists and doctors. Unfortunately and ironically, it isn’t based on much evidence — at best, it’s only more plausible. Acupuncture isn’t even worth testing any more — it’s all over — whereas dry needling still needs to be properly tested. Nowhere in this legal battle can you find anything of clear value to fight over: it’s a tug-of-war over scraps.
Nevertheless, I have no trouble picking a side …
Do our bones influence our minds? “Who thinks of the bone as being an endocrine organ? You think of the adrenal gland, you think of the pituitary, you don’t think of bone.” But apparently you should.
The data is now overwhelmingly negative. DoctorDoubter:
I will say what surgeons seem reluctant to say: “I am sorry, but for this condition, surgery is unlikely to provide any benefit over the non-operative alternatives.”
And that’s why I link to him.
Mea culpa: that knee ligament “discovery” I linked to yesterday? Not so much discovered as “looked at more careful like.” Studied, classified. Perfectly worthwhile research, but over-hyped by the media reporting about it. It was definitely hyperbole to describe it as a discovery. It’s been known of for at least a century, and a paper last year reported finding it in every knee they looked at. I didn’t look more carefully at the story because it was just a minor interesting thing (and anatomy really is never done), but it’s amazing what even a tiny little bit of hype will do. Hat tip to Tony Ingram of BBoy Science for raising my awareness.
Two knee surgeons at University Hospitals Leuven have discovered a previously unknown ligament in the human knee. This ligament appears to play an important role in patients with anterior cruciate ligament (ACL) tears.”
And perhaps iliotibial band syndrome? I don’t see any obvious relevance to ITBS — this new ligament is a little low for that — but I’ll be mulling it over. Regardless, it’s a fun discovery. Contrary to what people assume, “basic” anatomy is still a work in progress.
If you’re trying to build muscle size, how many weight-lifting sets should you do? One set? Two sets? (Red set, blue set?) More? James Krieger’s 2010 paper in Journal of Strength & Conditioning Research is the best review of the evidence to date. While it can’t conclusively settle the issue until there’s more data, it does strongly suggest that “more is better,” and yet at the same time it reaffirms that “less is fine.” Single sets will get the job done, which is ideal if your goal is bang-for-buck. (If you want to be “hyooge,” though, definitely go with more sets. It’s all about goals.)
Alas, there wasn’t that much data to review, just 8 studies, and only 2 of those included higher numbers of sets. That’s not a lot to work with. But the results are consistent with the more complete data about strength (see Krieger’s 2009 review), and strength and muscle size do tend to go together. Both citations are now included in my article about strength training bang-for-buck, see:
The SaveYourself.ca “microblog” was introduced in March of 2013, a minimalistic format optimized for bite-sized posts and announcements. This week it got its first big upgrade: small as they are, posts now have their own dedicated pages (instead of just living in a big list). For instance, see the last post, “Dissing dyskinesis.” Or — random example — the very popular “Good news about running.”
There could be a little strangeness with the RSS feed at first, probably duplicates of recents posts, but it will be fine going forward.