"Voodoo" Physical Therapy

Stretching, strengthening, hot packs, cold packs, taping, therapeutic massage -- these things are essential after an injury, right?

Well, according to an article in the NY Times, maybe not always. The article raises the question of whether a number of common modalities of physical therapy do any good at all.

Treat Me, but No Tricks Please

A representative quote:

"There is a growing body of evidence that supports what physical therapists do, but there is a lot of voodoo out there, too... You can waste a lot of time and money on things that aren’t very helpful."

The article goes on to point out how little actual research supports the efficacy of various treatment approaches, including ice, heat, ultrasound, stretching, massage, taping, and so on. This is not to say that these treatments don't work, or don't work for some ailments, or don't work for some people, but there are apparently very few studies to prove what does and doesn't hasten recovery.

Not being a researcher myself, my conclusions about various forms of physical therapy are strongly biased and colored by my own experiences. That's alright when I'm making decisions only for myself, but it sure would be nice to have hard evidence that certain forms of physical therapy work reliably when I tell someone else to stretch (or not to stretch), ice (or not ice), etc.

As usual with these kinds of articles, the focus is on the general population, not on professional, elite, or even serious athletes. It would be very interesting to get the perspective of someone whose job depends on keeping full-time athletes healthy and able to compete.

I also wonder whether most serious runners already have a pretty good sense of what is helpful and what is irrelevant. It would be interesting to get the perspective of runners who have learned how to avoid the physical therapist by incorporating strengthening, stretching, rolling, etc. into their own routines.

Still, I keep coming back to the lack of data, and it makes me wonder if some day we'll be looking back and saying "remember when athletes were always treated with such-and-such? How crazy was that?"