Category Archives: Musculoskeletal

Natural Cures for Heel Spurs – the quack is strong in this one.

The whole ‘natural cures’  industry is a scam. Just because something is natural does not make it better. Arsenic is natural. Ionizing radiation is natural. Neither of them are any good for you. Arguing that something is better because it is natural is a logical fallacy.

As for the natural cures for heel spurs in the infographic below. None of them will or can work. Its that simple. It is physiologically implausible and biologically impossible for any of them to work; let alone there being a single shred of evidence showing they work. I never cease to be amazed at those who should know better are so devoid of any critical thinking skills.

 

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Sometimes academics do overthink things

I have to be careful what I say here as I am criticizing my professional colleagues, but …

A while back there was this a couple of studies on proximal changes in those with Achilles tendinopathy. I blogged about one of them here and the other one is here. Both studies found those with Achilles tendinopathy did have change in proximal function such as muscle activity and hip motion. Both studies did lead the author to discuss the role of the proximal structures in Achilles tendinopathy. This lead to responses in social media on how important the hip and core are and that we need to focus the treatment interventions there. This was despite that this is not what the studies showed as correlation is not causation.

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Is forefoot varus related to patellofemoral osteoarthritis?

It is if you believe this study that just appeared in prepublication. However, yet again the editorial and peer review processes let us down as that is not the case at all. The authors and the peer reviewers superficial understanding of the issues have led them to conclusions that are not substantiated and should not have made it to publication.

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JAPMA lets us down again: Shock wave for mortons neuroma

Back in 2009, the Journal of the American Podiatric Medical Association (JAPMA) published this impressively titled study: Extracorporeal Shockwave Therapy for Interdigital Neuroma: A Randomized, Placebo-Controlled, Double-Blind Trial that found:

The treatment group showed a significant difference before and after extracorporeal shockwave therapy (P < .0001). The sham group did not have a significant difference after 12 weeks (P = .1218).

and as such concluded

Conclusions: Extracorporeal shockwave therapy is a possible alternative to surgical excision for Morton’s neuroma

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Plantar Fasciitis Snake Oil

Snake oil is a remedy that is sold for a condition that does not work any better than a placebo. How many remedies that are ‘sold’ for plantar fasciitis don’t work better than a placebo? There is probably a lot.

The biggest problem with plantar fasciitis is that the natural history of it is to generally get better on its own. Just look at the placebo groups in the clinical trials to see how many do get better on their own without treatment. The only reason to treat it is that is hurts and can take a while to get better on its own. The problem with any treatment given, the question is that did the treatment work or was the plantar fasciitis just get better on its own at the same time as the treatment was started. that is why we need to rely on good randomized prospective clinical trial to sort out the treatments that don’t work better than a placebo vs those that do work better than a placebo.

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