PainSci summary of Tumminello 2017?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. ★★★★☆4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. 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.
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,” Paul Lagerman, In Touch, 2018.
- “At the borders of medical reasoning: aetiological and ontological challenges of medically unexplained symptoms,” Thor Eirik Eriksen, Roger Kerry, Stephen Mumford, Svein Anders Noer Lie, and Rani Lill Anjum, Philos Ethics Humanit Med, 2013.
- “Thomas L. DeLorme and the science of progressive resistance exercise,” Janice S Todd, Jason P Shurley, and Terry C Todd, Journal of Strength & Conditioning Research, 2012.
- The End of Physiotherapy (book), by David Nicholls.
These five articles on PainScience.com cite Tumminello 2017 as a source:
- PS Quite a Stretch — Stretching science has shown that this extremely popular form of exercise has almost no measurable benefits
- PS Save Yourself from Shin Splints! — Causes and treatment options for shin splints explained and discussed in great detail, especially shin pain caused by myofascial trigger points, compartment syndrome, medial tibial stress syndrome, and stress fracture
- PS Strength Training Surprises — Why building muscle is easier, better, and more important than you thought, and its vital role in injury rehabilitation
- PS Your Back Is Not Out of Alignment — Debunking the obsession with alignment, posture, and other biomechanical bogeymen as major causes of pain
- PS The Functional Movement Screen (FMS) — The benefits of the popular screening system for athletes might be over-sold by some professionals
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:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- 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.