The fall of the postural–structural–biomechanical model in manual and physical therapies: Exemplified by lower back pain
Summary and conclusion points
• Postural-Structural-Biomechanical (PSB) asymmetries and imperfections are normal variations—not a pathology.
• Neuromuscular and motor control variations are also normal.
• The body has surplus capacity to tolerate such variation without loss to normal function or development of symptomatic conditions.
• Pathomechanics do not determine symptomatology.
• There is no relationship between the pre-existing PSB factors and back pain.
• Correcting all PSB factors is not clinically attainable and is unlikely to change the future course of a lower back condition.
• This conclusion may well apply to many common musculoskeletal conditions elsewhere in the body
(e.g., neck pain).
Lederman, E. The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. Journal of Bodywork & Movement Therapies. (2011) Apr;15(2):131-8.
Eyal Lederman certainly doesn't hesitate to challenge the status quo as in his previous paper The Myth of Core Stability.
One of the section summary points caught my attention and is something I tend to agree with:
• PSB factors are unlikely to change in the longterm by manual techniques or even exercise, unless rigorously maintained (exercise).
... basically shit's hard and has to be consistent; real training, over and over again. Beyond that, I really have no idea... I guess just try something and test to see if it works.