Eleven articles on PainSci cite Tumminello 2017: 1. Does Posture Matter? 2. Quite a Stretch 3. Complete Guide to Plantar Fasciitis 4. Shin Splints Treatment, The Complete Guide 5. The Complete Guide to Muscle Strains 6. Strength Training for Pain & Injury Rehab 7. Your Back Is Not Out of Alignment 8. Guide to Repetitive Strain Injuries 9. The Functional Movement Screen (FMS) 10. Deep Cervical Flexor Training for Neck Pain 11. What Works for Chronic Pain?
PainSci notes on Tumminello 2017:
Tumminello, Silvernail, and Cormack decisively but gently and diplomatically tip over this most sacred cow of personal training and therapy: corrective exercise, which is based on the idea that there is something in-correct about patients — fragile, weak, or uneven — which can be both identified and fixed by specific, expertly prescribed exercises, mainly strengthening and stretching exercises, the staples of stereotypical physical therapy. The trap is the belief that this “technical” approach is inherently superior to good exercise in general.
The danger here is that many fitness professionals might end up making their training process more about a formalized evaluation procedure and less about good personal training. …In order to spot a physical flaw that needs to be corrected, one must begin by having a reliable measure of whether or not it is actually problematic in the first place.
Spoiler alert: there is no such reliable measure! Corrective exercise is built on wishful thinking. Screening for movement dysfunctions has been failing one fair scientific test after another. The importance of posture has been wildly exaggerated. The importance of anatomical variation has been virtually ignored.
These authors all have excellent credentials and top notch clinical reasoning skills. These are smart guys tackling several thorny sub-topics like postural dysfunction, movement dysfunction, core stability, and — most important of all, I think — the “nocebo concerns” with corrective exercise: “when clients are told such things about themselves from an authority figure (as they might be during some corrective exercise evaluations), that this potentially makes one’s clients less resilient and more prone to injury and pain.”
Translation sans diplomacy: stop #%&^ telling patients they are fragile and weak!
- “Reasoning exercise dosage for people with persistent pain,” Lagerman, In Touch, 2018.
- “At the borders of medical reasoning: aetiological and ontological challenges of medically unexplained symptoms,” Eriksen et al, Philos Ethics Humanit Med, 2013.
- “Thomas L. DeLorme and the science of progressive resistance exercise,” Todd et al, Journal of Strength & Conditioning Research, 2012.
- The End of Physiotherapy (book), by David Nicholls. Amazon.com ❐
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:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.