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A lot of dead horses are getting beaten in alternative medicine: pointlessly studying silly treatments like homeopathy and reiki over and over again, as if it’s going to tell us something we don’t already know. This point has been made ad infinitum on Science-Based Medicine since its founding in 2009, but this week Drs. Novella and Gorski make the case against testing “whether magic works” in a high-impact journal, Trends in Molecular Medicine:
[Trials] of highly improbable modalities continue to be funded and performed, not because of any compelling scientific rationale or prescientific evidence but rather because they are popular. Indeed, another key argument used by proponents of…clinical trials is that they should be carried out because these treatments are used by a lot of people…. These trials degrade the scientific basis of medicine by treating modalities where the basis rests in prescientific thinking as though they were well-supported science- and evidence-based modalities, while clinical investigators labor under a seemingly reasonable delusion that negative RCT results will lead to the abandonment of CAM and IM modalities that fail to perform above placebo in RCTs. Unfortunately, this abandonment never seems to occur.
The SaveYourself.ca home page has a featured content carousel: little teasers for popular articles that slide past. I’ve been meaning to do this for ages.
All the known forces depend on virtual particles to carry them (hence carrier particle) across space. For the electromagnetic force, the carrier particles are virtual photons. Electromagnetic radiation also is carried by photons. There has to be a physical means to to get from here to there. A proposed new form of energy, a form of energy that interacts strongly with matter (of which human tissue is an instance), would require such a carrier particle. Reorganizing particle physics to include a new energy and its accompanying particle presumes that something that should have been obvious was overlooked in all the particle experiments analyzed over the years. I wouldn’t hold my breath.
I’m glad Keith wrote this article — and I don’t think anyone could possibly be better qualified for it — because I still just can’t bring myself to bother delving into “energy massage” myself. It’s just too silly! So this is (still) all I have to say about it.
Recently, post-lawsuit, they changed the text to be even more vague (which is saying something):
The typical human foot is an anatomical marvel of evolution with 26 bones, 33 joints, 20 muscles and hundreds of sensory receptors, tendons and ligaments. Like the rest of the body, to keep our feet healthy, they need to be stimulated and exercised. Vibram FiveFingers® footwear is different than any other footwear on the planet. Not only does it bring you closer to your environment, it also delivers a number of positive health benefits—by leveraging all of the body’s natural biomechanics, so you can move as nature intended.
Uh huh. So basically the same stuff — but now too vague to get busted for. I’ve updated my barefoot running article.
I get a lot of my exercise science news via Alex Hutchinson of Sweat Science. For instance, this interesting item about “the burn” of intense effort — what exactly causes it? Which molecules? According to Pollak et al, it’s protons, lactate, and ATP — and only in concert. “There was essentially no response whatsoever to the individual metabolites,” explains Alex, “so the receptors apparently respond only to the synergistic combination of all three.”
Surprisingly, this fairly unsurprising result is brand new information: the paper’s authors call it “the first demonstration in humans that metabolites normally produced by exercise act in combination to activate sensory neurons that signal sensations of fatigue and muscle pain.”
Hi, I’m back. The last couple weeks were consumed by an anatomy exam (and then some “special projects” I will remain deliberately mysterious about). The exam seemed easy except for a few questions with diagrams that looked like they’d been scribbled on the back of an envelope with a crayon and then photocopied 12 times. “Label this.” Okaaaay…
I originally intended to be an efficient underachiever, and accept much less than an A for the course, but … turns out I get sucked into anatomy. I really went for it! And I’ve now probably achieved peak musculoskeletal anatomy knowledge — I’ll never have it more down than this.
I’ll leave off the blogging and social media for a couple weeks here while I wrap up an advanced anatomy course, one of three remaining courses I need to complete a Bachelor of Health Sciences in my so-called spare time. But before I go, a quick review of a terrific anatomy resource I’ve been using: Acland’s Video Atlas of Humany Anatomy.
The secret to the quality of the videos is Dr. Robert Acland’s relentlessly deft and mild-mannered narration, paired with extremely effective rotating views of skilled dissections (example). There may be higher tech presentations of dissection video available today, but this one is standing the test of time just swimmingly.
Last week I announced a major new edition of the patellofemoral pain book, with new co-author Tony Ingram. Here’s an example of the kind of evidence Tony presented me, to persuade me that the new edition had to be more positive about exercise. This is just one of many studies cited in the book…
“Effects of physical therapist-guided quadriceps-strengthening exercises for the treatment of patellofemoral pain syndrome: a systematic review”
Do quadriceps strengthening exercises help with patellofemoral pain? This 2014 systematic literature review set out to summarize the evidence, sorting through the junk to find 7 of the highest quality studies published at the time.
The conclusion was strongly in favor of quadriceps strengthening being effective for decreasing pain and improving function in patients with PFPS. Effects sizes were mostly “large” — clinically significant as well as statistically significant (a rare combination). Considering the decent methodological quality of the studies included, it seems the total evidence suggests quad strengthening works for PFPS. Of course, this doesn’t mean it will work for everyone — but it should for many, or most.
Note that this study also found that pretty much any form of quadricep strengthing is effective, with no superiority found in weight bearing vs non-weight bearing or vastus medialis specific training. Just exercise those thighs!
I’ve always had trouble remembering the name of the “cephalic” vein, because the name seems wrong. What does it have to do with the head? It doesn’t go to my head! I finally went looking for an explanation and found one quickly on Wikipedia: “Ordinarily the term cephalic refers to anatomy of the head. When Persian physician Ibn Sīnā's Canon was translated into medieval Latin, cephalic was mistakenly chosen to render the Arabic term al-kífal, meaning ‘outer’.”
Phew, I feel much better knowing that! (It’s also probably to stick in my mind much more better now.) And now I wonder how many other anatomical terms are based on mistranslations…
One of the top five questions I am asked by email, about any condition, is simply Is there hope? The answer is nearly always the same…
Yes, there’s hope. There’s never a guarantee, but there’s always hope, and recovery from most kinds of severe chronic pain is not only possible but fairly common. Unless you have a known serious aggravating factor — a major trauma, for instance — there is almost never any reason to fear that recovery from any chronic pain problem is impossible. For the same reason that pain can be absurdly persistent and out of proportion to any clear cause — because it is so brain-tuned — it also never loses the potential to finally shift and evaporate.
This thought was added to my Pain is Weird article, and probably should be in several other articles as well.