Thursday, June 7, 2018

The Thursday Book Review: More on "Crooked"

When I reviewed "Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery," by Cathryn Jakobson Ramin, on Sunday, I left out a few details about the author's recommendations. A friend of mine commented, "It seems like there'a a lot of stuff in the book about how bad all the 'back pain industry' solutions are. But what about other solutions?"

Toward the end of the book, the author writes about remedies for back pain that have worked for many people. Not surprisingly, these don't include personal training in gyms. Surprisingly, they don't include all physical therapy, either. 

In fact, she mentions  physical therapy places with "shake and bake" recommendations. I have personally witnessed this, when I had some PT for a shoulder injury, required by my HMO before they would consider the actual surgery that eventually relieved the pain. The physical therapist flipped through a folder with photocopied pages of photos demonstrating various exercises, chose five of those pages, photocopied them again, then cut out the ones she was going to demonstrate on me, taped them to another sheet of paper, and photocopied that one. She followed that through the series of exercises she had me perform, then gave it to me to take home, along with a wide green rubber band which I was supposed to attach to a doorknob and pull a few times twice a day. That's "shake and bake": minimally educated and trained hokum for the masses.

My friend's experience was slightly different:  He went to a place, again, permitted by his HMO, where the first physical therapist who saw him, an intern, had herself never suffered a sports injury that required PT, and admitted she couldn't relate to the pain my friend was experiencing. When her supervisor took over, it wasn't much better, b/c the supervisor only knew a couple of "facts" about back pain, and, using those "facts," put my friend through some major pain before she believed him when he said, "That doesn't help, and it's making it worse." 

So what does Ms. Ramin recommend? There are knowledgeable and actually trained people who can see what you need to do, and can help you. Even here, all the techniques aren't exactly the same, nor are the models behind them. There's a camp of those with a mechanical or mechanistic model of the body, they figure out how to manipulate it to make it work. And then there's a camp with a more holistic model, who also figure out what will help, and teach you how to help yourself. In both these camps, the trainers are actually educated in body mechanics and techniques, and are required to go through years of training and interning before they're allowed to practice on their own.

Stuart McGill is a practitioner the author mentions approvingly. It's fascinating to see that he recommends what he calls the Big Three, which are essentially yoga poses, and which I know, from watching another friend work through these, really do work to relieve immediate pain and strengthen the back to prevent further pain.

Here are some photos.  And here is Stuart McGill narrating a video of someone demonstrating these exercises.  You can buy books by Dr. McGill, but they're very expensive, and you can probably get all the benefit you need by online reading and videos.

Also, the author recommends, based on her conversations with many specialists on back pain, most (but not all) yoga exercises, but definitely does not recommend Pilates.

She also recommends something called Feldenkrais, which looks like it's available in many metropolitan areas in the U.S.; Rolfing; and the MedX lumbar extension machine, which is harder to find but appears to be beneficial for most back-pain sufferers. 

That's all for now. I hope to receive comments from any and all interested readers. What more do you want me to add? What is helpful here, what is not helpful? 

1 comment:

Jeff Wynn said...


But the links to photos and videos didn't come through.

Does she talk at all about an inversion board?