Research on “sham” surgery shows that the effects of certain orthopedic procedures may be more psychological than physical.

Pain and movement are pretty complicated right? In a sense yes. But in another sense no. Pain and movement are not complicated, they are complex, which is a different animal.

Imagine you are Elon Musk trying to send a rocket ship to the moon. What sort of thinking process, analysis, modeling, research, predictions, and methods of control would help solve this problem? How would that process be different from solving the problem of say, raising a child? 

Why do muscles feel tight? Does that mean they are short? That they can't relax? And what can you do about it?  

Here are some of my thoughts about why muscles feel tight and what to do about it. 

What does the word placebo mean? Does the placebo effect involve actual health benefits or just imagined benefits? Is placebo “mind over body” or “all in your head”? Is it unethical to provide a client with placebo treatments? And what about nocebos? In this article I’ll answer these questions and discuss some fascinating research by Fabrizio Benedetti and colleagues.

We can better understand the complexity of chronic pain, and its relationship to other multi-symptom disorders, by learning something about systems theory. The basic idea is that chronic pain is often driven by dysregulation of a “supersystem” that coordinates defensive responses to injury. The supersystem results from dynamic interaction between different subsystems, most notably the nervous system, immune system, and endocrine system.

The idea that posture causes pain has intuitive appeal, and is advocated by numerous experts. But is it supported by evidence? And should you spend time trying to analyze your own posture and correct deviations from what is considered optimal?

Graded exposure is a key concept in understanding how to reduce pain caused by movement. It's a very common sense idea, and one that most people kind of know at some level, because there is profound truth to it. But it's also an idea that most people will probably fail to put into practice in a systematic way. Here’s a brief discussion of what it is, why it works and how to do it.

In recent years, pain science has become far more widely known, and that is leading to some interesting conversation and also confusion in the fitness, massage and manual therapy communities. Lorimer Moseley and David Butler have been charismatic and influential teachers on this issue. A good example of their work is found in the popular book Explain Pain, which uses neuromatrix theory as a theoretical background. Moseley provides a very accessible and entertaining talk about pain science in this recent DVD video.

Foam rolling is very popular. Athletic trainers use it as a part of the warm-up. Physical therapists use it as part of their treatment strategy, often to improve extensibility of “short” tissues. There is very limited evidence about what benefit, if any, foam rolling confers. But there are a few studies showing it leads to short term increases in range of motion that are not accompanied by strength loss. (This is interesting because stretching interventions tend to show increased range of motion that are associated with a loss of strength and power.)