Barrett L. Dorko, P.T.
I've recently been reading a fascinating book about the search for extraterrestrial life. It's called Captured By Aliens and was written by a columnist for the Washington Post, Joel Achenbach. (Simon and Schuster 1999). You might wonder what this might have to do with therapy, but bear with me for a moment.
There is a section of the book devoted to the apparent discovery of some biological material on a meterorite that had originated on Mars. This was a big deal back in 1995, generating a statement from President Clinton, national news reports, and, ultimately, more money for NASA. The discovery gave exobiology (the study of life elsewhere in the universe) a tremendous boost. Up until then it had commonly been called "the science without a subject."
As you might have guessed, after this discovery was announced, a host of scientists in related fields attacked every aspect of their argument. Before long, it could simply not be said with certainty that the meteorite displayed anything special at all. Other scientists effectively refuted every argument in favor of the biological properties of the rock.
There are two things about this situation that I find important. First, life on Mars is generally considered to be a really cool thing to only imagine, much less actually discover. I mean, just consider the number of books about such a thing. And these are books read avidly by the very people attacking the exobiologist's claims. You have to imagine that all of these folks really wanted it to be true, but that this did not interfere with their striving to find the truth, or, at least, the scientist's latest approximation of it.
Secondly (and this is closely related to the first point), the objections to the first scientist's findings rose immediately and loudly from their peers, no matter what the objectors would have preferred to be true. As Achenbach notes: "Their critics could pick out any weak link in their long chain of evidence. In science, if you don't try hard enough to prove yourself wrong, your friends will gleefully take up your slack. Proving the work of others false is virtually a sacred rite."
Now this is where I finally get to the issue of therapy, and, if you know much about my writing, you may guess what is coming next. I notice that my criticism of some of the methods popular in therapy practice is met with a kind of embarrassed silence. When I point out that there is no evidence for some traditional ideas in therapy (using the relevant literature, of course), nobody says anything in defense of them, few agree wholeheartedly in any public forum, and, if I am disagreed with, it takes the form of a personal attack. (Check out the archives of the McKenzie listserv for several examples of that)
When I say that the theory behind so-called "myofascial release" is, well, absurd, given what is known about the properties of connective tissue, two things typically happen; I am chastised for daring to disagree with the founder of the method and/or I am asked to explain its effectiveness if not by the means that I propose are nonsensical. I could say the same about my criticism of McKenzie's theory and method.
Of course, it is not my responsibility to explain why another's method might be effective. I presume that this is their job. When I offer my own explanation and it clashes with the underlying theory of the revered founder, well, we're back to what I feel is the real problem in much of clinical practice today: physical therapy as a clinical discipline shies away from the kind of scrutiny that science has always depended upon in order to not only progress, but to toss out those who haven't done the work necessary to defend their method. It seems "impolite" to say anything negative about another's work, and I believe that this has led quite predictably to methods that make absolutely no sense. Effectiveness is another issue, and one not nearly so easy to measure or determine. (see The Wrong Question)
So now we've got a growing array of "therapies" that will never withstand the examination of a scientist outside the profession. When we talk of myofascial release, "energy" work, magnets. you know of others- we might as well be trying to convince them we've discovered life on Mars.
It won't fly. And it shouldn't.