Archive for February, 2013

A lot of bad advice out there…

A silly video

I ran across a video the other day and thought I’d write a post about it because it gives a good example of just how much bad advice there is out there among “certified” physical therapists and so on.

Before I start, I want to say that I know (and have used) some excellent PTs, and I certainly do not want to say that everyone in the field is a quack or anything like that. There are definitely some good people out there, and if you have access to a really competent PT, he or she can often work miracles. But on the other side of the coin, just having a certification (of any sort) doesn’t necessarily make you competent in your job. And a lot of people get fooled by labcoats.

Personally speaking, I’ve received enough bad advice from “body professionals” over the years that nowadays when I have to see one I always try to assume that they know what they’re talking about…but I also always ask some pointed questions, just to make sure. I hope that this blog post will make you think about things a little, and encourage you not to blindly accept what you’re hearing the next time you go in for some “body work”.

I’m not going to link the video here, but you can find it on YouTube. Just go to the YouTube site and type in /watch?v=pn6i-_dTX0g after the www.youtube.com part of the URL. The video’s less than two minutes long, but if you don’t want to watch the whole thing I’ll give a brief summary below.

Strengthening a tendon

The video shows a PT who tells you how to “strengthen” an apparently healthy woman’s achilles tendon by using a stretch band. The woman is sitting on a therapy bed and takes the band, loops it around her foot, and then proceeds to exercise the foot against the band by pointing and relaxing her toes.

All this is fine, and the PT makes sure to cover some good points about getting in a full range of motion and so on. The problem is that the band only provides about five or ten pounds of resistance, and the woman in the video who uses the band has got to weigh at least a hundred and twenty.

This may not seem relevant, but think about it for a second. If she weighs 120lbs, that means that every step she takes she is putting 120lbs of pressure on her achilles tendon. How is a band with ten pounds of resistance going to strengthen a tendon when that tendon has far more stress put on it just when the woman walks? (We won’t even talk about how much more than 120lbs each step really is because of acceleration/deceleration forces.) If you can bench press 200lbs without any problem at all, you’re not going to develop more strength by working out with 20lbs.

What’s the point?

So what’s the point of using a very weak stretch-band for this? Basically, unless the woman was injured and spent so much time off her feet that her achilles tendons atrophied to the point that they can no longer support any weight (which would mean that she couldn’t even stand up), there is none. Maybe a polio victim would qualify, but exercising an achilles tendon in any realistic scenario will involve using a decent amount of weight, one that equals a significant percentage of the exerciser’s bodyweight.

Yes, if the woman was injured or is recovering from surgery it makes sense to monitor her level of pain and start out using a lighter weight. But not this light. Using a weak band like that reminds me of the housewives who walk into gyms, start using the one- and two-pound dumbbells, and then wonder why their bodies don’t change. It’s not hard to understand when you realize that the average bag of groceries weighs more than the “workout” weights! They’re not using enough resistance to have any effect on the muscles.

One other point about the video is that the PT says that the stretch band provides “constant resistance” so long as the hands holding the other end of the band remain stable, but this isn’t really true. If you stretch a rubber band out, there is going to be more and more resistance the further you stretch it (until it breaks, anyway). The resistance at the beginning is light, and gets progressively heavier the more you pull.

Admittedly, this is pretty minor. The range of motion that a foot has isn’t very great, and so there won’t be a lot of difference in resistance between the beginning and the end of the motion. But it’s disturbing that a trained and certified PT would say something like this in the first place, when a simple, “Be sure to keep your hands in the same place” would be fine. I think that a lot of times people in positions of authority like doctors and physical therapists have a need to justify what they’re saying to their patients, and sometimes this can lead to a little trouble.

Think for yourself!

In any case, please, if you have a problem with your achilles tendon, plantar fascia or anything else, don’t just blindly trust what someone in a labcoat tells you. Use your common sense and try to think critically about what’s being said.

Author: Alex Nordach