Craig Liebenson - Academia.edu (original) (raw)
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Papers by Craig Liebenson
Journal of Bodywork and Movement Therapies, 2000
Journal of Bodywork and Movement Therapies, 2000
Journal of Bodywork and Movement Therapies, 2003
Palpation is not very reliable. Yet, mankind has always relied on palpation as is borne out by la... more Palpation is not very reliable. Yet, mankind has always relied on palpation as is borne out by language (not only English): if you have understood something you have grasped it, if you have solved a problem you have worked it out (with your hands). In a field where even the best assessment tools can provide a specific diagnosis only 15 percent of the time, to lobby for the exclusion of a safe, inexpensive assessment tool believed to be valuable by experts in manual medicine, is highly illogical (Bigos et al. 1994, Waddell et al. 1996). Our entire array of evaluative procedures have low predictive validity. For example, we still lack the ability to identify subgroups of low-back pain patients who would respond to specific therapeutic interventions. From this we can only conclude that our science is in its infancy. The question about palpation’s reliability should not be turned against palpation, but should be turned towards asking how to develop reliable, responsive, and valid instruments? The difficulty of establishing palpation of joints reliability may, in fact, point to the conclusion that our ability to measure the parameters involved in motion palpation is insufficient. The Nobel prizewinning microbiologist Rene Dubos said ‘the measurable drives out the useful.’ To abandon a tool because it is hard to measure does not make much sense when we are in a field where over 85 percent of our patients are labeled as having a ‘nonspecific disorder’(Bigos et al. 1994, Erhard & Delitto 1994). If we were able to identify, specifically, what was wrong with most back pain patients with non-palpation tools and thereby determine the most appropriate treatment, then it would be foolish to hold onto techniques with questionable reliability and validity. However, in our field, we are just beginning to crawl. While we strive to establish proof as our goal for creating a ‘best practice’ scenario, we are a long way from being able to reasonably justify throwing away such a safe, low cost, although admittedly difficult to measure, technique as palpation of joint, muscle or soft tissue motion and stiffness.
Journal of Bodywork and Movement Therapies, 2003
Journal of Bodywork and Movement Therapies, 2000
Journal of Bodywork and Movement Therapies, 2003
This paper discusses the role of activity modification advice regarding safe squatting methods fo... more This paper discusses the role of activity modification advice regarding safe squatting methods for low back and knee pain patients. Safe squats for the back involve maintaining mild lumbar lordosis and should not be performed early in the morning or after prolonged sitting. Safe squats for the knees avoid excessive anterior patello-femoral shear and knee valgosity.
Journal of Bodywork and Movement Therapies, 2003
Journal of Bodywork and Movement Therapies, 2007
Abdominal wall training is a key to preventing recurrent lower back pain and enhancing athletic p... more Abdominal wall training is a key to preventing recurrent lower back pain and enhancing athletic performance. Traditional exercises such as sit-ups have been replaced with safer alternatives such as the dying bug. The emphasis is on spine stability, form, endurance, and proper breathing. To borrow a page from Pilates, the quality of the movement (e.g. coordination) is more important than the quantity (sets/repetitions/weight). For each exercise perform 8-12 slow repetitions on each side. This type of training should be performed twice a day. Marching dying bug on foam roll Begin with your arms stretching upwards to the ceiling holding a medicine ball (Figure 1a). Keep your lower front ribs pressed down while breathing normally (Figure 1b). March by raising one foot at a time (Figure 1c). Dying bug with twist Assume the basic dying bug position with a medium size medicine ball in your hands.
Dynamic Chiropractic, Dec 17, 2007
Journal of Bodywork and Movement Therapies, Jul 1, 2018
Journal of Bodywork and Movement Therapies, Apr 1, 2018
Journal of Bodywork and Movement Therapies, Jul 1, 2017
Journal of Bodywork and Movement Therapies, 2018
Journal of Bodywork and Movement Therapies, 2019
Journal of bodywork and movement therapies, 2017
Dynamic Chiropractic, Apr 23, 2001
Journal of bodywork and movement therapies, 2014
Journal of Manipulative and Physiological Therapeutics, 2000
Journal of Bodywork and Movement Therapies, 2012
This paper discusses a number of common myths in the musculoskeletal pain management and rehabili... more This paper discusses a number of common myths in the musculoskeletal pain management and rehabilitation/athletic development fields. The origins or rationale for these beliefs are reviewed. New scientific evidence disputing or refuting the myth is then presented followed by and explanation and evidence for an updated perspective.
Journal of Bodywork and Movement Therapies, 2002
Journal of Bodywork and Movement Therapies, 2000
Journal of Bodywork and Movement Therapies, 2000
Journal of Bodywork and Movement Therapies, 2003
Palpation is not very reliable. Yet, mankind has always relied on palpation as is borne out by la... more Palpation is not very reliable. Yet, mankind has always relied on palpation as is borne out by language (not only English): if you have understood something you have grasped it, if you have solved a problem you have worked it out (with your hands). In a field where even the best assessment tools can provide a specific diagnosis only 15 percent of the time, to lobby for the exclusion of a safe, inexpensive assessment tool believed to be valuable by experts in manual medicine, is highly illogical (Bigos et al. 1994, Waddell et al. 1996). Our entire array of evaluative procedures have low predictive validity. For example, we still lack the ability to identify subgroups of low-back pain patients who would respond to specific therapeutic interventions. From this we can only conclude that our science is in its infancy. The question about palpation’s reliability should not be turned against palpation, but should be turned towards asking how to develop reliable, responsive, and valid instruments? The difficulty of establishing palpation of joints reliability may, in fact, point to the conclusion that our ability to measure the parameters involved in motion palpation is insufficient. The Nobel prizewinning microbiologist Rene Dubos said ‘the measurable drives out the useful.’ To abandon a tool because it is hard to measure does not make much sense when we are in a field where over 85 percent of our patients are labeled as having a ‘nonspecific disorder’(Bigos et al. 1994, Erhard & Delitto 1994). If we were able to identify, specifically, what was wrong with most back pain patients with non-palpation tools and thereby determine the most appropriate treatment, then it would be foolish to hold onto techniques with questionable reliability and validity. However, in our field, we are just beginning to crawl. While we strive to establish proof as our goal for creating a ‘best practice’ scenario, we are a long way from being able to reasonably justify throwing away such a safe, low cost, although admittedly difficult to measure, technique as palpation of joint, muscle or soft tissue motion and stiffness.
Journal of Bodywork and Movement Therapies, 2003
Journal of Bodywork and Movement Therapies, 2000
Journal of Bodywork and Movement Therapies, 2003
This paper discusses the role of activity modification advice regarding safe squatting methods fo... more This paper discusses the role of activity modification advice regarding safe squatting methods for low back and knee pain patients. Safe squats for the back involve maintaining mild lumbar lordosis and should not be performed early in the morning or after prolonged sitting. Safe squats for the knees avoid excessive anterior patello-femoral shear and knee valgosity.
Journal of Bodywork and Movement Therapies, 2003
Journal of Bodywork and Movement Therapies, 2007
Abdominal wall training is a key to preventing recurrent lower back pain and enhancing athletic p... more Abdominal wall training is a key to preventing recurrent lower back pain and enhancing athletic performance. Traditional exercises such as sit-ups have been replaced with safer alternatives such as the dying bug. The emphasis is on spine stability, form, endurance, and proper breathing. To borrow a page from Pilates, the quality of the movement (e.g. coordination) is more important than the quantity (sets/repetitions/weight). For each exercise perform 8-12 slow repetitions on each side. This type of training should be performed twice a day. Marching dying bug on foam roll Begin with your arms stretching upwards to the ceiling holding a medicine ball (Figure 1a). Keep your lower front ribs pressed down while breathing normally (Figure 1b). March by raising one foot at a time (Figure 1c). Dying bug with twist Assume the basic dying bug position with a medium size medicine ball in your hands.
Dynamic Chiropractic, Dec 17, 2007
Journal of Bodywork and Movement Therapies, Jul 1, 2018
Journal of Bodywork and Movement Therapies, Apr 1, 2018
Journal of Bodywork and Movement Therapies, Jul 1, 2017
Journal of Bodywork and Movement Therapies, 2018
Journal of Bodywork and Movement Therapies, 2019
Journal of bodywork and movement therapies, 2017
Dynamic Chiropractic, Apr 23, 2001
Journal of bodywork and movement therapies, 2014
Journal of Manipulative and Physiological Therapeutics, 2000
Journal of Bodywork and Movement Therapies, 2012
This paper discusses a number of common myths in the musculoskeletal pain management and rehabili... more This paper discusses a number of common myths in the musculoskeletal pain management and rehabilitation/athletic development fields. The origins or rationale for these beliefs are reviewed. New scientific evidence disputing or refuting the myth is then presented followed by and explanation and evidence for an updated perspective.
Journal of Bodywork and Movement Therapies, 2002