PainSci summary of Meltzer 2010?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★☆☆☆2-star ratings are for studies with flaws, bias, and/or conflict of interest; published in lesser journals. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
I would never normally be interested in this paper. In fact, I would never have chosen to read it myself, because I don’t think it’s good enough science. I am spending some time on it only as a gesture of good faith to a critic, who supplied the paper as an example of basic fascia science that matters. It may not have been a good choice for that purpose.
This is a test tube study showing that naked cells handled stress better (fewer signs of harm) if they were treated with, believe it or not, “simulated” myofascial release (MFR). A meaningful, accurate simulation of manual therapy on naked cells is an amusing notion, and it’s clear that what happened to those cells differs dramatically from what would happen in a real living body.
Even if true and reproducible, this data would mainly support the rationale for MFR specifically for post-exercise soreness — something of a dead end for the clinical relevance of MFR, because exercise-induced soreness has little to do with the main claims of MFR, which primarily concern correcting postural asymmetries, eliminating alleged restrictions, and treating chronic pain.
Post-exercise soreness is comparatively trivial, and patients don’t seek therapy for it (it’s usually over before they can get to an appointment). There’s a lot of research showing that exercise-induced soreness is basically invincible anyway. For this property of fascia to be clinically relevant, it would have to imply that MFR might be able to treat chronic pain from other causes … not the transient annoyance of soreness after a game of soccer.
This isn’t a rejection of all possible clinical relevance of the data. My point is that there are so many problems that its relevance is watered down to quite a thin sauce — way too thin.
I do concede that the paper shows some evidence that fibroblasts have interesting and perhaps positive responses to mechanical forces. That is inherently interesting, and probably worth investigating further, but it’s a mighty reach to postulate any clinical relevance to what most therapists do, most of the time, with patient’s fascia.
“Reach” is what the authors do, in spades. They claim to have no conflicts of interest, and they probably don’t, technically. Nevertheless, I suspect their egos are deeply invested in the notion that “fascia is important,” because they seem to be seeking evidence to support their pre-conceptions — typical of research funded by The National Center for Complementary and Alternative Medicine, and a hallmark of junk science.
It’s quite likely that if less biased researchers did this experiment, they would not be able to reproduce these results.
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
In this study we modeled repetitive motion strain (RMS) and myofascial release (MFR) in vitro to investigate possible cellular and molecular mechanisms to potentially explain the immediate clinical outcomes associated with RMS and MFR.
One article on PainScience.com cites Meltzer 2010 as a source:
- PS Does Fascia Matter? — A detailed critical analysis of the clinical relevance of fascia science and fascia properties
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.