Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Wednesday, December 14, 2005

Please Release Me, Let Me Go (MFR)

One of the forms of quackery that even some PTs have adopted is Myofascial Release (MFR). Fortunately as a student I was suspicious and didn't buy into it. Later I took a CE course and became totally convinced it was off the wall. Below is a humorous commentary on the subject from Bob Shutes, PT:

Please Release Me, Let Me Go

There I was, sitting quietly in class, so eager for knowledge, so ready to learn. Like a true scout, I was also willing to give my body to science. Luckily for me, that’s how I missed falling headlong into professional dementia. And to think it all happened in an accredited continuing education class I had paid good money to attend! Little did I know that I was going to take part in a myofascial release ceremony that was woven into the lymphedema course I had signed up for.

The lymphedema training seemed well enough supported by my memories of anatomy and physiology but what really intrigued me were the MFR rituals that were performed in class. That’s when innocent minds began crashing all over the room and I was thankful to be safely supine on a plinth while it happened. I began to wonder if therapists actually get paid for this and how in the world the profession reconciles this kind of “treatment” with our quest for “evidence based practice.” Maybe we should consider doing away with the DPT altogether and openly declare our intent to become shamans, witch-doctors and goofballs instead.

The initiation ceremony began with yours truly supine on a plinth in the middle of the room. With an absolutely straight face my course presenter began holding her palms a few inches above my torso. After a few hushed moments she intoned that she was beginning to feel some warmth over my right shoulder! This was taken to be a pretty neat clinical observation by just about everyone present. As for me I couldn’t resist the temptation to remark in a stage whisper, “I am a mammal!” Wasn’t that ever presented in our lecture halls? “Yes class, today we want to review some interesting characteristics about the patients we treat. They are warm-blooded creatures known as mammals and you will feel warmth when you place your hands near them. In the event that you do not feel any warmth you can assume your patient is either a reptile or is dead. In either case you should stop treatment until you have consulted with the referring physician to verify species and life.” Suddenly I knew I was going to have more fun than anyone else in the room.

Once my warmth had been verified it was time to begin “unwinding” my right upper extremity which (unbeknownst to me) had apparently gotten pretty wound up. My instructor began applying vigorous manual traction to my right arm and then began to slowly and magically circumduct it, all the while telling the class (and I’m not kidding here) “I am not moving his arm! It’s moving all by itself!”

With mouths rounded in slack-jawed wonder, my classmates were transfixed. Suddenly I realized that we had all descended into a “Far Side” moment and I found myself wishing that Gary Larson were there to capture the event. Temptation came my way and once again I could not resist it. When a classmate asked if my arm was really moving all by itself I said “No, not at all, she’s pulling it around pretty hard.” Not to be dismayed by my remark the instructor confidently told me “No I’m not! It just feels that way to you.” And then to the group “I’m not doing anything at all. It wants to unwind all by itself!” All I could do was grin and think, ”Please! Release my old fascia or you’re going to pull my arm off!”

Later during a failed attempt to unwind my arm during lab my partner said “Am I doing something wrong? It’s not moving like it did for the instructor.” When I replied that, “You have to pull it around like she did in order for it to move that way.” my dear lab partner said, “But she said she wasn’t moving it at all!” I tried to let her down easy. “Did you really believe that? She was putting so much traction on my arm she almost pulled me off the plinth!” If it wasn’t so sad the whole silly affair might have been even more humorous than it was. I had a little fun, but I couldn’t help but feel disheartened at the epidemic of gullibility in the room. If contemporary PT practice embraces the MFR theory and techniques I experienced I can’t help but think we are in deep trouble as a profession.

There’s an old fable that goes something like this…” One year in a certain kingdom the harvest came in poisoned with mold and all who ate it lost their minds. Because there was nothing else to eat, the king said, ‘We have to eat this grain or we’ll all die but let there be a few among us who at least remember that we are crazy.” I for one, think we must be nuts if this kind of nonsense can pass itself off as a legitimate part of the physical therapy profession. Is it just me or are we all quacking up?

Bob Shutes PT

(Used by permission.)


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