These syndromes are very useful. Well, not in clinical or performance work, since there is almost no data to support these ideas and to my knowledge there never has been. They are useful because they help you see how these outdated ideas get popular in the first place and how that popularity continues despite changes in the science that should make you reject them. I dont blame Professor Janda, he was doing his best with what he had at the time and had what he probably felt was an important clinical insight, that improved his clinical process with patients. Now as practice went on, we found trends in the published literature that should have made us reject these ideas: 1. Trend of poor reliability between clinicians in making these assessments 2. Trend of no correlation between measures of muscle tightness to strength, pain, or any useful construct for treatment 3. Trend of very little published data involving the use of this process to evaluate and manage patients/clients that lead to positive outcomes We also found trends in the foundational science that should have made us reject these ideas: 1. The motor control literature grew toward an emphasis on CNS control and away from stretching or strengthening individual muscles 2. The pain literature moved away from the importance of some of these findings as primary concerns in ongoing pain states 3. The clinical literature has moved away from tightness/weakness of individual muscles as being critical to treatment (cf TrAbd and Multifidus). But this approach has strong memetic appeal. Why? 1. It involves muscles. In our culture strength and fitness is a value, proper posture is a value, and alteration of muscles with stretching and strengthening is also a value. Some of these things are good and are healthy (like fitness) whereas some of these are unhealthiy or unimportant (posture). 2. Its accessible to a wide variety of practitioners. Since it involves muscular assessment, everyone from physicians to personal trainers to physical therapists, chiropractors, athletic trainers, massage therapists and strength coaches could use this approach with their patients or clients. Both clinicians (physicians, physical therapists, chiropractors, athletic trainers) and fitness and service professionals (personal trainers, strength coaches, massage therapists). Those with rigorous academic education at doctoral or postgraduate level (physicians, physical therapists), those with college education (athletic trainers, strength coaches, some trainers) and those with trade school or certification training (personal trainers, massage therapists). Huge numbers of different people in different people could use this. A marketing dream. 3. It provides a simple solution to a complex problem that leverages deeply embedded cultural ideas that are far more powerful than scientific data.So there you go. Thats why these crossed syndrome type things make no sense whatsoever but are not going away any time soon.People will be talking about this brilliant insight for another 50-odd years. I wonder if Janda would [facepalm] if he heard how people were unable to move beyond this idea, and had more fidelity to this particular product/idea than to the process he advocated. Dr. Jason Silvernail, DPT
Posted on: Sun, 21 Dec 2014 12:23:14 +0000
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