The Myth of Core Stability

[alophysio]

Hi All,

@Neurospast: To be honest, i don't think you are a musician...a wrong note sounds wrong but a note not played sounds ok and most people miss it but it can make the music seem "wrong" or "empty". It is the little things like this that that all add up to distinguish the best orchestras from the good ones. And even if you can't pick the difference, you can hear that there is something different.

In the same way, IMHO 80-90% of patients who end up getting back pain (that is NSLBP pts) have some form of dysfunction. It could be mechanical, chemical or pyschological (which is still chemical i guess with other things ).

I think the reason why it is NSLBP is that there are many structures which may cause the symptoms and again many reasons why the structures are under load (like what gcoe said) and the research is not sensitive enough to tease out the different reasons...and finding enough subjects to do a study on a specific number of patterns is difficult.

In my opinion, you body LOVES choices...if it can only move one way, repetitive strain occurs quickly. Two ways is a dilemma but at least 3 options is good for the body - shares the load around.

@gcoe:

I agree...i think the trouble is that "old" treatment approaches sometimes rely on assumptions which are now informed by research...e.g. Mackenzie treatment is predicated on the the fact that discs have fluid in them (nucleus pulposus) but research has shown that the cervical discs are NOT fluid fluid and in fact split horizontally. So another way of describing the no doubt successful Mackenize approach needs to be undertaken.

What i mean is that no doubt Mackenzie cervical pain patients respond to treatment...it just probably isn't because they are moving the disc in the proposed mechanism...***NB I am NOT Mackenzie trained so i am speaking from general knowledge of Mackenzie, not from training in it***

We have seen people get better for all sorts of conditions...but why? I would wager that a lot of the reasons that are given to the patient are not accurate (including my own) but we are always seeking to fit observations into some form of structure because order and structure and predictability are comforting.

Hence, accurate diagnosis according to your "approach" is key...just make sure your approach is comprehensive...

e.g. I like the model that Diane Lee and LJ Lee propose in their 4th Edition of the Pelvic Girdle - i have repeated it often on this forum. If grew from Panjabi's model...which then evolved to the next model described by Vleeming and Lee which has now evolved again.

I have attached a book chapter explaining it here...it is a heavy read by one that i think explains nicely what i do believe in and a model that best encompasses everything that can occur in the body to cause pain and dysfunction, how to identify it and then treat it.

@beazus, thanks for your kind words...it is exactly the point that i am trying to convey

Cheers!