was informed of a recent post in The Huffington Post entitled "Stop stretching your hamstrings". This style of article (where we lambast some exercise) has been pretty popular for a number of years and I have certainly contributed my share. This one in particular I could have written 20 years ago when I was pretty strongly against yoga and stretching. I'd go out of my way to find any research that supported my bias.
The point: How are patient's view their pain or injury influences both their behaviours and their sensitivity. Finding ways to change this narrative can be helpful. It might also be relevant the idea of expectancy violation to change pain but I'll stay away from that topic for now.
My good little buddy Adam Meakins wrote another blog post about whether in-session changes in a patient's symptoms are important for long term recovery. As usual he is absolutely wrong (just kidding). He takes the position that they are not important and I am going to give the position on how there are important.
A common physical therapy axiom is to not put strength on dysfunction. The idea behind it can certainly be viewed a number of different ways but I've always interpreted to mean that if someone has pain they just shouldn't ignore it, keep pushing and training hard and they should try to "fix" whatever the underlying cause of the pain is.
Pain is weird - just ask the dude over at painscience.com. But understanding pain helps us explain pain and explain the sensations many people often feel. Understanding pain can both be a desensitizer in its own right and help facilitate behavioural changes that lead to good rehabilitation.
The low back pain literature suggests that a specific intervention (e.g motor control exercises, targeted strengthening etc) are no more effective than general graded activity interventions. Suggesting that treating pain is not really about fixing some sort of impairment that is causing the persisting problem.
Controlled trials of exercise for low back pain often suggest that the type of exercise doesn't matter. And if you love "stability" exercises then these results can really challenge what you think and could even make us expert clinicians feel like we have less "special" knowledge...always challenging to be confronted with this.