Lots of people say lots of stupid things (what a way to start an article, eh?). Unfortunately, that includes health professionals.

                I’ve written extensively about the stupid things that personal trainers do and say.

                In an effort to tick everyone off, I’m going to look outside of my industry, and explain the stupid things that other health professionals (both conventional and alternative medical professionals) say. As well as why they’re stupid.

Original source: here.

                Man, I’m going to get some hate mail from this. Oh well. Such is life.

“You Feel Tight”

                One thing that massage therapists, chiropractors and osteopaths often say is “you’re tight.” The implication is that the tightness is the reason for your pain. The implication is also that you have limited range of motion.

                Those implications are false.

                First of all, on the “tightness = pain” claim, one study decided to examine that. The researchers decided to use a machine to help them find tight spots in the subjects’ upper trapezius (upper back/shoulders). They found a few tight spots, and they didn’t correlate very well with pain. At all. What actually happened (ironically) that the spots that weren’t tight experienced more pain when pushed than the spots that were tight. And even then, it wasn’t a strong relationship.

                Furthermore, you think that when a manual therapist is touching you, there’s a lot of validity behind that. Well, there isn’t.

                In one systematic review, researchers looked at how much do manual practitioners agree with each other. The answer was very little. Ten manual practitioners could touch a patient’s lower back, and they all have strong opinions on what they’re feeling. But they’re 10 different opinions. For a test to have validity and reliability, it should be that regardless of who’s performing the test, the result will be the same. Unfortunately, just touching a person and feeling the texture of the muscle has very little agreement between practitioners on what they’re feeing.

                So hopefully we’ve broken down that myth – that the subjective feeling of tightness is the cause of pain. And by making a muscle less tight (in that therapist’s opinion – because often, 2 therapists don’t agree on what they’re feeling), you’re going to reduce the pain.

                The second part of that myth is that the subjective feeling of tightness correlates with range of motion.

                I’ve assessed the joint range of motion of thousands of people. Many of them complain of tightness. And yet, their subjective feelings of tightness correlate very poorly with objective range of motion testing. Very poorly.

                In their attempt to get rid of the sensation of tightness, they stretch, and stretch and stretch. And stretch some more.

                And the feeling of tightness goes away for a few minutes, and comes back. So they keep on stretching. But it never goes away permanently.

                So why do they feel tight when objectively speaking, they aren’t? Often muscles feel tight when their neighbouring muscles aren’t doing the job. For instance, one of the most common complaints I hear are tight hamstrings, and a tight lower back. Yet, when I test it, the hamstring and lower back have normal range of motion.

                But the glutes are weak. So the hamstrings and the lower back have to work overtime to compensate for lazy glutes (now that’s what you call – literally – a lazy bum!).

                Once the glutes are strengthened, the sensation of tightness in both the hamstrings and lower back goes away. Without any stretching.

                In conclusion, what does it mean when a manual therapist calls you tight? Very little. It has no relationship to either pain or range of motion. It’s just artifact. Noise.

                Unless someone is testing your range of motion, they can’t make the claim of “your muscles are tight.” Of course, if range of motion testing reveals deficient flexibility, then and only then can you legitimately make the claim of “you’re tight.”

“You Feel Strong/Weak”

                This is another one from the sayings of largely massage therapists.

                They touch your muscle. Your muscle feels hard or soft (in their opinion). Based on that, they make the claim that you’re either strong or weak.

                Neither claim can be made.

                What is the definition of strength? The ability to produce force. Have they put a load on a muscle, and asked that muscle to overcome that load/force? Nope. They just tested texture. And texture means very little.

                A strong muscle that is relaxed will feel soft. That doesn’t mean it’s not strong. It just means it’s relaxed.

                A weak muscle that is tense will feel hard. But that doesn’t mean that it’s strong.

                So let’s get rid of the association of muscle texture to muscle strength. There’s no relationship.

Massage Improves Circulation

                This is a nice, scientific-sounding term. Frequently, RMTs lie to themselves (and their patients), and patients usually don’t know any better, because they don’t have a background in physiology.

                So let’s break this one down.

                What is circulation? It just means the amount of blood flowing. Massage doesn’t increase the amount of blood you have. Your hydration status has more to do with that.

                But I don’t think that lots of people believe that massage creates more blood. So what’s up with the claim that massage increases circulation?

                Since there’s a fixed amount of blood in the body if there’s more blood flowing somewhere, it means there’s less blood flowing somewhere else. So if the skin covering a muscle turns red after a massage therapist massaged that muscle, there’s more blood going to that muscle – and less blood elsewhere. That’s not a good or a bad thing. That’s just how the body works.

                Circulation is really about pushing blood around the body. What pushes blood around? Certainly not a massage therapist’s hands. Those hands certainly push, but it’s not the blood they’re pushing. They’re pushing muscles, skin and fascia – not blood. The heart pushes blood.

                You want to improve circulation? Put greater demands on the heart. Go for a walk. Go for a jog. That increases circulation a lot more than lying on a table, while your heart is resting.

Massage Squeezes Out the Toxins

                Some massage therapists are fond of making claims about massage squeezing out toxins. They often do it out of ignorance, or lack of education about toxins.

                The whole world of detoxification is incredibly complex.

                First of all, when you press a massage therapist on which toxins they’re talking about, one of two things will happen:

  • They’ll look like a deer in the headlights, because someone asked them to explain something they don’t know, and are just regurgitating something they heard from someone else… who also didn’t know what they’re talking about.
  • They’ll tell you it clears lactic acid.

Massage doesn’t clear out lactic acid. The body clears it out just fine by itself. Within about 1 minute of finishing exercise, about 50-80% of the lactic acid you produced during exercise is gone. Within about 1 hour, 100% of the lactic acid you produced during exercise is gone.

As for toxins, there are so many different ones. Which one(s) are we talking about?

  • Heavy metals?
  • Xenoestrogens?
  • Plastics?
  • Mold?
  • Something else?

Furthermore, different toxins are stored in different tissues.

  • Mercury tends to go for the brain and thyroid
  • Lead goes for bones
  • Cadmium is stored in the kidneys and liver
  • Arsenic is stored in the hair and nails
  • Plastics are stored in body fat

Notice how none of these toxins are stored in skin and muscle – which is what massage really goes after?

So no, massage therapy does not do anything with toxins. There are 5 organs of detoxication (kidney, liver, skin, lungs, and intestines). Massage works on none of those (just because they’re touching the skin doesn’t mean that they’re getting rid of toxins through the skin. You have to sweat to do that).

                Man, after picking on especially RMTs for the last 1200ish words, I came out guns blazing. I’m not dumping on massage as a profession. It has great benefits – just not the ones busted previously. The greatest benefit of massage – it feels good – doesn’t need justification.

                Plus, there’s plenty of massage therapists who don’t make these claims, like Shon Hsu, Jason Ferreira, and my own RMT, James Alberto.

Subluxation

                This one used to be a darling in the world of chiropractic. The theory went “you have nerves coming out of your spine, to every part of the body.” The only reason for illness is that your spine is not aligned properly. By aligning your spine, we can get rid of all that ails you, including cancer, the common cold, flu, ADHD, autism, etc.

                And while yes, nerves do go out from the spine to the periphery, the claim that different problems are due to spinal misalignment has been thoroughly discredited.

                In fact, the nail is so deep in the coffin that the official stance of the College of Chiropractors of different provinces and states (that’s the governing body of chiropractors) does away with subluxation theory.

                The majority of chiropractors, especially the ones that I refer my clients to (like Drs. David Song and Matt McGrath) don’t promote this disproven theory. But lots of old school chiropractors still do.

Conventional Wisdom for Osteoporosis

                So far, I’ve been picking on alternative medicine. But because I like to have enemies everywhere, let me pick on traditional medicine for a bit.

                Doctors: as soon as a patient is diagnosed with osteoporosis, the patient gets 3 pieces of advice:

  1. Take calcium
  2. Go for a walk
  3. Don’t fall

Those are 3 bad pieces of advice. But it was taught in med schools for so long (and for all I know, still is) that it’s going to take a long time for doctors to stop recommending these, and actually recommend something that works.

Let’s bust these 1-by-1.

Take Calcium

                I spent a good chunk of my osteoporosis book explaining and giving tons of evidence that neither dietary nor supplemental calcium reduce fracture risk (the only measurement that really matters. Bone density is a measurement used to assess fracture risk, but it’s not a perfect measurement).

                Here’s just one example: in one giant meta-analysis, of 170,991 women and 68,606 men, the researchers found no relationship between calcium intake and fracture risk. Whether people consume a lot of calcium or very little calcium doesn’t affect whether or not they’ll fracture a bone. And that’s just one example. I give 4 other examples in my book.

Go For a Walk

                Don’t get me wrong – walking is great and has lots of benefits. But bone strength isn’t one of those benefits.

                In one study, when people with osteoporosis walked, they lost bone density. They just lost it slower than people who didn’t do anything at all. But they still lost bone.

                Why are doctors settling for just slowing down bone loss? Shouldn’t the standard of care be to either maintain already low bone mass, or better yet – to increase bone mass?

                Well, both strength training and jump training increase bone mass. They don’t just maintain. They don’t just slow down the loss. They increase.

                And there’s tons of evidence backing it up. There are two whole chapters in my book going over different studies on strength training and jump training.

Don’t Fall

                I don’t know of more useless advice than “don’t fall.” Um doc… do you think your osteoporotic patients plan to fall? If they could anticipate a fall, couldn’t they prevent it? Falling happens when you don’t expect it. That’s why it’s called “falling” and not “squatting” or “coming down.” It’s not like someone sits there with their calendar, and thinks “Tuesday at 10AM – that’s a good time for a fall. I’ll schedule that in.” Just doesn’t happen.

                Much better advice would be how to improve your balance. I cover that in extensive detail in my video on 3 balance exercises for osteoporosis.

Knee Surgeries (Arthroscopies)

                And now, to barbecue the darling of conventional medicine – surgeries. This is specifically arthroscopic knee surgeries. This is not referring to joint replacements, cardiovascular surgery, brain surgery, etc. Just arthroscopic knee surgeries.

                The verdict about them is not good. At all.

                You hear the word “surgery”, and you think to yourself “this is the heavy artillery. By the time I’m under the surgeon’s knife, it has the highest probability of success compared to everything else I’ve tried.”

                But that’s not the case. When pharmaceuticals, supplements, or even food is tested, it has to be tested against a placebo. Something that has no medicinal properties, but the subject in the study believes it does. This way, you know how much of the effect is due to the “active ingredient”, and how much is it you wanting to get better, so you get better.

                But how do you do a placebo for a surgery? For a very long time, surgery was basically exempt from this standard. The rigor that defines science. Which essentially makes it bad science. Really bad science. You’re cutting up a person, and you’re not even sure how much of the pain relief is due to surgery, and how much is due to placebo.

                So in the early 2000s, research started using sham surgeries as placebos. What’s a sham surgery? The patient is put under, so they’re not conscious. A scar is left in the skin, but the surgeon doesn’t actually open up the joint and tinker around in there. Then, the patient is woken up, told they’ve had the surgery, and goes on their merry way.

                Now real arthroscopic surgeries could be compared to placebos. And the comparison wasn’t favourable at all. One very early study of this found that an arthroscopic knee surgery was no better than placebo. Another study replicated these results. It showed that arthroscopic knee surgery was no better than placebo. Eventually, an entire systematic review came out basically showing that arthroscopic knee surgeries are no better than placebos.

                Once the evidence was overwhelming, even the American Academy of Orthopedic Surgeons changed their stance on arthroscopic knee surgeries. In their clinical guidelines for surgeons, they basically say to manage these issues with exercise, weight loss and painkillers. Radical, I know.

                Now that I’ve made enemies everywhere, I better hide.