Archive for November, 2010

Corrective Exercise 18

Thursday, November 18th, 2010

My One Day at the 7th Interdisiplinary Congress on Low Back and Pelvic Pain

Wednesday, November 17th, 2010

What an opportunity for those of us in Southern California to have the 7th Interdisciplinary Congress on Low Back and Pelvic Pain come to Los Angeles. This is an incredibly influential gathering of top experts from all over the world and is only held every 3 years. Unfortunately, I was limited to attending just one day due to other obligations, but I’m glad I did.

I hit the road from San Diego at 5:30 a.m. Thursday morning to be there for the morning sessions that began at 8:00 a.m. Thursday was the day that I really wanted to be there because of the presenters speaking that day. In particular, I wanted to see Robert Schleip from Germany and Leon Chaitow from the UK. Dr. Schleip heads up the Fascia Research Project from the University of Ulm. And Dr. Chaitow is the author of many books on manual medicine and the editor of The Journal of Movement Therapy.

This was a line-up of “heavy hitters’ in the world of myofascia and exactly why I coordinated my schedule to be there on this day. The afternoon ran two parallel sessions in which I jumped back and forth between rooms to hear the speakers on topics that were of more interest to me.

The line-up for the morning sessions looked like this:

Siegfried Mense: The thoracolumbar fascia as a source of low back pain

Robert Schleip: Tearing and micro injuries of lumbar fasciae as potential pain generators

Helene Langevin: Ultrasound imaging of connective tissue pathology associated with chronic low back pain

Jean Claude Guimberteau: Journey under the skin to the muscles, lumbar fasciae and structural architectures

Jay Shah: Ultrasound techniques reveal objective abnormalities of myofascial trigger points and surrounding connective tissue

Leon Chaitow: Fascia directed therapies for the treatment of low back pain: review and new directions
(There were too many afternoon sessions to list here)

It was an honor to be there and listen to the latest research. I was thoroughly impressed at the level of knowledge that the faculty had on their subject matter and their dedication to research. At the same time, I felt myself being a bit disappointed in the limitations of the very same research.

Most of the researchers made it a point to clarify the insight derived from their study was limited to a very specific (and small) area of the body and at a very specific moment in time. While a few others implied very broad applications to similarly limited studies. And others openly wondered about the possible applications and inferences from the study without attempting to make the study something it was not.

Over the years I have read and continue to read a significant amount of research papers and have been involved in several studies. Although my knowledge of statistics is very limited, my understanding of experimental design and application of findings is reasonably solid. So when I hear the findings of a study presented without any “qualifiers” by the very researchers themselves, I find it intriguing if not alarming.

A platform such as this Congress is the perfect opportunity for a researcher to speak to other researchers and clinicians about the limitations and possible applications of the research. Most research is not given this opportunity. Instead, it is read through a scientific journal without the opportunity for further clarification.

The research into the human organism continues to be pieces of the puzzle and not the solution to the puzzle itself. And when therapists, trainers, coaches read reviews of the research or abstracts and not the research itself, there tends to be huge misinterpretations and misapplications. And if the person reading the research does not understand experimental design or only makes conclusion from their paradigms or philosophies, we’ve got problems.

I would have loved to have had some time to ask questions of the researchers. I did get a chance to speak briefly with Dr. Paul Marshall of Australia after his talk. He was one of the researchers who, in my opinion drew some very broad conclusions from his research. Talking with him I found out that his study looked at isometric, concentric and eccentric contractions. Yet he only presented on the isometric contractions because there was too much data too analyze from the concentric and eccentric contractions.

In an effort to get his paper published, there is no surprise he used the data that was more accessible. But he did not even mention during his presentation that he had data from the other contractions. Nor did he communicate that the findings may have been different when movement was involved. Common senses and other studies would suggest that the findings would be different.

My take-home from the conference was confirmation of a belief that I already had: Proceed with caution when citing research. I love what these researches have done and thank them for their contribution. Let us all keep things in perspective.

The next World Congress is in Dubai. I don’t think I’ll be dropping in for just one day if I go there.