Author Topic: Physiotherapist using dubious methods ( "Be activated" by Douglas Heel )  (Read 1850 times)

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Offline runner

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Hi guys !

I'm a runner and have Patellofemoral Pain Syndrome ( pain around the kneecap ). I'm now at a physiotherapist who is treating me with methods where my BS-detectors are ringing all the time. ( I know he took courses with http://www.douglasheel.com and http://zhealtheducation.com )

One particular thing he is doing every time :
He makes a strength test in my legs where i push or pull against his arm ( very much like that: )
Then he tells me he is gonna make me stronger and presses for maybe 10 seconds on a spot between my belly button and the rib cage. It really hurts.
He repeats the strength test , this time he tells me I'm stronger ( I'm "winning" against him ). I also can feel a difference. When i ask him what he is doing, he says he is activating my muscles through the lymphsystem , but thats it - he kinda refuses to give further explanations...

 ( when i do the strength-test with my wife without the pressing in the belly we have the same result of being stronger the second time. I guess its just natural to be better a second time, maybe you're just warmed up )

So here is the thing: I'm obviously leaving him but I at least want to tell him or write him something. Does anyone know if there is any kind of clinical evidence for doing that kind of technique ?  if not, does someone have a good way of explaining why this technique is such a nonsense ?
I just need to show him that not all clients are "taking" that sort of stuff and I don't just want to talk about my feelings and the ringing of my bs- detectors as a reason for leaving him.


Any help would be much appreciated !!!

Cheers !
Runner
« Last Edit: February 20, 2017, 06:35:49 PM by runner »

Online daniel1948

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Re: Physiotherapist using dubious methods
« Reply #1 on: February 18, 2017, 08:53:27 AM »
Just off the top of my head I'd say don't bother giving him a reason unless he specifically asks. The chances are he believes that his therapy works, and you'll just get into an argument that he's probably better prepared for, since he does this for a living and can cite multiple lines of fake evidence that you'd have to study to refute, and you still would not convince him.

You could just tell him "I think you are a fraud," but that would accomplish nothing.

You could say, "I don't think your methods are based on real physiology," but again, that would just lead to an argument. I would tell him this only if he insists on a reason why you are leaving. A legitimate health professional would never ask why you are leaving.

So, my advice is, find a different therapist and don't engage with this one.

Just my opinion. And best of luck with your injury. There are (I think) good physical therapists out there. And welcome to the SGU forum.
Daniel
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Offline runner

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Re: Physiotherapist using dubious methods
« Reply #2 on: February 18, 2017, 09:53:24 AM »
Thanks, Daniel !
I very much agree of you with all your points - telling him my opinion would be like pouring a drop of water on a hot stone. I wouldn't be ready for an argument, he wouldn't change his opinion or methods and Douglas Heel and co. keep doing their business.
Its just so... disappointing ! For me its the first time I dove skeptically and critically into medical stuff and found out with what level of quackery some physiotherapists are working and how people like Douglas Heel are making money with their clients. And I also see why its so easy to fall for it as a patient.
So basically I do have a little bit the need to tell him: Hey, I do not agree at all with these things you are doing. I want to do it in a very kind polite way though.
But yeah - in a bigger picture there is probably no point in having discussions with him...

Offline arthwollipot

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Re: Physiotherapist using dubious methods
« Reply #3 on: February 18, 2017, 05:27:19 PM »
This sounds an awful lot like the applied kinesiology trick that power-band sellers use to convince the marks that their product has some merit.



It is, indeed, bunk.

Offline runner

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Re: Physiotherapist using dubious methods ( "Be activated" by Douglas Heel )
« Reply #4 on: February 20, 2017, 07:07:01 PM »
Thats funny - my wife showed me exactly that video when she heard about Douglas Heel.

So, now i "researched" a little more about Douglas Heel and his "Be activated" Technique. First of all, this thing is huge , he is holding his courses all over the world , all the time. Its super expensive. The ( unscientific ) health and sports world is praising him. And I cant find anything critical about him !
Now i kind of think that i found the reason for that. First , I still think he is doing mainly BS - therefore intelligent people might not even bother to care about what that guy is doing ( not to mention to make studies about any of his claims ) . Second , Douglas Heel doesn't care about any scientific evidence - its the opposite, like he shows in this article  about his  seminar on his webpage:

"Too many people get caught up in the mechanism, not the result." – Douglas Heel

One doctor in attendance said he was taught, “if it’s not documented in scientific research, you can’t do it”.

"Stop worrying about being right.  As soon as you think you are right, you stop learning." – Douglas Heel


and especially in this video:https://vimeo.com/130889800





Still, if there is anyone with an opinion or experience with that sort of stuff  - you are very welcome to share it !

« Last Edit: February 20, 2017, 07:10:26 PM by runner »

Offline pavanmehat

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Hello my name is Pavan Mehat and I would like to respond to this comment about Douglas Heel's methods being dubious. Firstly, I would like to state that I am currently a medical student, and that I have competed at Boston University as an NCAA division 1 athlete. I completed my B.Sc in bio-medical engineering summa cum laude, and before starting medical school I earned an M.Sc (thesis based master's) in epidemiology. Further, I have taken Douglas's Heel's course at the behest of one of my former teammates who had ~ 10 stress fractures over a 2 year period. However, after incorporating Douglas Heel's Be Activated Self Activations he has not had a single stress fracture despite maintaining training intensity! However, an anecdote does NOT make science.

Secondly, just because you do not understand something does not mean its quackery. I am very passionate about evidence based medicine, but unfortunately due to limited resources and politics and the allocation of money, the coverage of evidence is quite poor. If you systematically look at what practices in medical systems are evidence based there is VERY little evidence behind a lot of things! I have always been fascinated by research since early on in my undergraduate career; however I learned very quickly that there is so much corruption/poor science, and biases. That does not mean give up on research, but it means that we can't just have a closed mind and reject everything. The American Heart Association just came out and said Coconut oil is bad for you. After recommending trans fats and margarine for the last 20-30 years and just recently making a complete 180 degree turn and pretending that it never happened that they recommend the worse possible fat for your health. It doesn't matter that soy and canola "vegtable" oil companies are on the nutritional advisory board for the AHA.....


But back to your point, I do agree with muscle activation there can be a lot of trickery/tiny changes to get the desired effect. Further, the 'scam' of muscle testing has lead to excellent research surrounding post-activation potentiation in the strength and conditioning world. It has mostly been test in the setting of complex training, which is a maximal effort strength move (aka a squat) followed by a maximal effort explosive movement (vertical jump). It is not clear what rest periods are optimal to elicit are strong response in the explosive movvement after the maximal effort (and muscle testing is thought to be a maximal effort especially when the muscle tests weak eventhough the force is not large) , but either way when you explore the literature the effect is significant, but not a huge one. So even though muscle testing can be suspect to significant distortion, it is still an absolutely essential technique that neurologists,physiatrists and physical therapists will use. Any good health care practitioner worth his salt would not purposefully deceive their patients to get an improvement. However, it is a serious and important confounding variable when conducting muscle tests.

Thirdly they are no specific research studies done on the "Be Activated" system again (which company would gain money off  of people being able to take control of their health vs. not needing their services anymore). However, there is quite a bit of research that further substantiates his work, and if you are interested in it please let me know and I can send you the research papers!

After, I attended his workshop, I felt amazing, but my critical mind was thinking, what is the catch. How is this working? So I was wondering could there just be something else going on. I tried just doing muscle testing, and I would see some benefit (most likely due to Post Activation Potentiation), but it took me much longer and the results were not as good. Further, I started doing muscle test/muscle test/intervention/THEN last muscle test. The jump from the intervention was much greater than when I just tested. The key variable that is not typically taken account when just doing muscle test/intervention/muscle test is time. So changing it up works. Lastly, when athletes self activate there is no muscle testing, and they are dramatic results. For all the great benefits of research, its takes decades before a breakthrough reaches mainstream, as Tim Ferris breaks down so well in his excellent book 4 hour body. Since Professional sports are so results driven, you know that something that high level athletes are using has a high likely hood of being legit since if it was only a silly little parlour trick it would not stick around. Be Activated is something that is used in the NBA/NFL/NHL and elite NCAA division colleges such as Ohio State Football/Oregon State Footbal, and has even trickled its way down to Ivy league schools such as Yale. They must not know what they are doing....

However some of the Be Activated system is based in applied kinesiology, which can be a bit woo woo. There is still a lot of great stuff in AK, and what Douglas has done a marvellous job of is taking information from various modalities (osteopathy, fascia experts, functional anatomy, and neuroscience) making it simple (too many of us, myself included, get so obsessed with the mechanism that we forget to actually execute, for example we are still researching how exercise is beneficial for our health instead of exercising!). However, the focus of the system, is really in understanding how to optimize our breathing (in which they are literally thousands and thousands of research papers the support improving your breathing) and 'resetting your nervous system' (it seems woow woow but explore poly vagal theory and novel treatments for PTSD/TBI and you would realize it is anything but, and then once you have jump started someone out of their compensation patterns amazing things can happen.

For example, my partner at my workshop, had chronic knee pain for about 5 years that was getting progressively worse, he had seen three orthopedic surgeons who told them that HE MUST have knee surgery and afterwards his pain would be gone (there must be lots of research driving their decisions.... and its well documented the placebo effect in surgery in where if you cut someone open and do nothing, and sow them back up they get practically the same result in many cases as patients who had the actual surgery!!!!). After Douglas did some work on him, he was running for the first time since his knee started hurting, and was now able to keep up with his athletes while coaching cross country and remain safe! If you talk to any body who has attended his course things like this are the norm!

An andecdote does not make science, but to just blindly call something bullshit because you do not understand it is something I am against. It takes no courage to just blindly bash things and find the flaws. The world is a complicated and confusing place. There is so much grey, and there is always confounding factors!! However, it is so easy to get caught up in complexity. However, the human nervous system has amazing ability to heal (as evidenced by Harvard physician Dr. Herbert Benson in his seminal work "The Relaxation Response").

I am more than happy to have a discussion or answer any questions you may have.

Lastly, finding "mechanism" for things is extremely difficult. We don't know why the hell a lot of things work. For example in multiple sclerosis it was found by accident that MS patients that had cancer did a lot better. So now chemo can be used in MS, even though we have basically no idea why it works. However, it is transformative for patients. However, we tend to be okay with that because we can use fancy terminologies and make clever theories about why. I am not saying there is anything wrong with it. But the pedantic need to throw everything down because it can't be proven is unfair. It is extremely hard to elucidate a mechanism (it took one of my bio-chem professors who worked under Charles Kreb around 20 years of work to fullly elucidate the Kreb's Cycle). So are we not going to allow MS patients access to chemo because we don't know why it helps if they are willing to take the risk. However, Be Activated does NOT have the slew of negative effect associated with Chemo!


Offline pavanmehat

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I did not share my education history to show off how "intelligent" I am. They are many people much more intelligent than me and I have had the privilege to learn. However, I show it as I would like to think of myself as an intelligent person that cares a great deal about the work Douglas Heel does.

Offline Billzbub

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...But the pedantic need to throw everything down because it can't be proven is unfair...

The mechanism doesn't need to be proven to prove that the treatment works.  If the treatment is as effective as you claim, then blinded, peer reviewed experiments will show that it works.  As you say, it doesn't really have any negative side effects, so use it if you want, but until controlled experiment are done, we simply don't know if the effects are real, placebo-driven, or human bias.  Nobody here will claim that it is definitely woo, but because of the lack of a plausible mechanism, the bar to prove that it is effective is high.

I admit that I am making a ton of assumptions here, like that there are no studies, and that there is no plausible mechanism.  If I'm wrong about those, then please disregard.
Quote from: Steven Novella
gleefully altering one’s beliefs to accommodate new information should be a badge of honor

Offline aloysiuslbc

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Hi guys !

I'm a runner and have Patellofemoral Pain Syndrome ( pain around the kneecap ). I'm now at a physiotherapist who is treating me with methods where my BS-detectors are ringing all the time. ( I know he took courses with http://www.douglasheel.com and http://zhealtheducation.com )

One particular thing he is doing every time :
He makes a strength test in my legs where i push or pull against his arm ( very much like that: )
Then he tells me he is gonna make me stronger and presses for maybe 10 seconds on a spot between my belly button and the rib cage. It really hurts.
He repeats the strength test , this time he tells me I'm stronger ( I'm "winning" against him ). I also can feel a difference. When i ask him what he is doing, he says he is activating my muscles through the lymphsystem , but thats it - he kinda refuses to give further explanations...

 ( when i do the strength-test with my wife without the pressing in the belly we have the same result of being stronger the second time. I guess its just natural to be better a second time, maybe you're just warmed up )

So here is the thing: I'm obviously leaving him but I at least want to tell him or write him something. Does anyone know if there is any kind of clinical evidence for doing that kind of technique ?  if not, does someone have a good way of explaining why this technique is such a nonsense ?
I just need to show him that not all clients are "taking" that sort of stuff and I don't just want to talk about my feelings and the ringing of my bs- detectors as a reason for leaving him.


Any help would be much appreciated !!!

Cheers !
Runner
Hi Runner,

Im a BeActivated practitioner. I did it a year or so, and.. boom! Ever since, i didn't look back of what i have practise as a pilates, PT, soft tissue and biomechanic specialist.

In fact, the theory behind BA, enhance my understand of body movement and adding deeper of whatever i have learn.
It may sound too good to be true. However, just like what you say, there's no negatives effect...

When i took this course, i told the class and doug that im a seeker and skeptic!

I will advise that you have to dig deeper to get more understanding.
In life, that's no right and wrong. I appreciate his work with no doubt.

Contact me: Aloysiuslbc@gmail.com.

I will be happy to share whatever the physiotherapist didnt explained. I cannot speak behalf of him but to share my experience of my journey ever since.

Ps: thanks million, billsbub and pavanmehat for your explanation. Am dyslexic, hard to get my f**king word "in words" out there!

Cheers guys!

Sent from my SM-G610F using Tapatalk


Online daniel1948

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Re: Physiotherapist using dubious methods ( "Be activated" by Douglas Heel )
« Reply #9 on: November 16, 2017, 08:45:44 AM »
I'm not much of a weight lifter, but I incorporate a bit of resistance training along with my cardio (which I'm more serious about).

I believe that I can lift more weight on the second set than on the first. If the above method works, it would be possible to show it by having the subject lift as much weight as he can, then applying the "treatment" and then having him again try to lift as much weight as he can. A control group would do the same thing but without the "treatment."

I'm quite sure that there would be no difference. The very fact that this system requires the unregulated subjective application of force by the practitioner, and relies of the practitioner's judgement and claim that the force increased, is a Big Red Flag.

To paraphrase the tag line from a podcast: There are lots of charlatans out there. And then there's science.
Daniel
----------------
"Anyone who has ever looked into the glazed eyes of a soldier dying on the battlefield will think long and hard before starting a war."
-- Otto von Bismarck