The Egoscue Method

[Guest guest]

Khasin asked:

<What is your opinion about this " revolutionary approach " :

Pete Egoscue's book is unusual in that it is not written by a medical

authority. Pete Egoscue is a sports injury consultant, and he seems to be

exceedingly knowledgeable about the function of the muscle groups. He has

developed low-impact exercises to " reset " your muscle groups and realign your

bones. These exercises are deceptively simple, but can take all you have to

complete. They are preventative medicin at its best. Pete Egoscue's book is

unusual in that it is not written by a medical authority. " Pain Free " by

Pete Egoscue with Gittines.>

*** The above comments sound like the came from some of the advertising copy

on Egoscue's books and method, but that, in fact, is virtually the sum total

of what is available to " substantiate " the Egoscue method - very thin in

research backing, but very copious in anecdotes, testimonials (from golfers

in particular) and claims. In that respect, it is little different from

other methods claiming to achieve the same as Egoscue. In fact, if you carry

out a Medline and other academic searches, you will find little or nothing on

the Egoscue claims.

Earlier today, I submitted a post on " How to Spot Quackery " - well a good

portion of that letter applies to this topic. In stating this I wish to

point out that applying the term " quackery " to any therapy does not

necessarily mean that it enjoys no success at all - if that were the case,

all quackery would die a very rapid death. No, what that term really means

is that this sort of therapy is very deficient in any form of theoretical or

practical explanation and works in some cases for reasons that most likely

have nothing to do with the hypothesized or claimed modus operandi.

I have no doubt that Egoscue works in a substantial number of cases, as do

many other forms of therapy or self-management, but the likelihood that it

works for reasons propounded by Egoscue are dubious. As I stated in my

earlier letter on quackery, " The occurrence of the placebo effect ensures

that almost all " revolutionary "

or " space-age " methods, no matter how unproven or apparently outrageous, will

enjoy just enough success to ensure that many therapists or self-appointed

experts will stay in business.... " and:

" Comparative studies in this field, especially using double-blind methods,

are so notoriously difficult to devise and conduct that the odds are that

you will get away with almost any non-invasive therapy that is fairly

harmless for long enough to become a rather wealthy person - provided that

you are well-marketed - yes, that is the key, not the method itself, but how

it is packaged, presented and sold. Naturally, a smattering of

impressive-sounding medical or scientific jargon and guru-speak can work

wonders in captivating the masses! "

It is also likely that some of the exercises and methods used by Egoscue and

borrowed from a wide variety of different sources do offer a degree of relief

and it is well know that small, though discernible, changes in state can

produce powerful non-linear results, i.e. changes that are way out of

proportion to the stimuli involved. Those changes can also significantly

enhance the placebo effect, so that you may be winning in two respects.

Now the Egoscue-converted no doubt will say, " So, what is wrong with that? -

that is exactly what we noticed - that is why we use Egoscue! " . The point is

that specific Egoscue methods per se may have little to do with the change of

state - many other methods could have provided a suitable stimulus and

effected comparable improvements, as is very much the case with ,

Feldenkrais, Bobath, Maitland, McKenzie, Rolf, " Active Release " , " Trigger

Point Release " and many other well-known therapies.

There is no proof, other than the subjective testimonials of happy users,

that Egoscue is comparable to or better than any other method of treatment.

The fact that some people who " tried everything " before revelling in their

first improvements with Egoscue (or any other method) is scientifically and

practically irrelevant, because that sort of occurrence is rife with most

medical interventions. It is well know what works with one patient does not

necessarily work with another.

Let us now examine some of the web information on the " Egoscue Method " :

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<The Egoscue Method of Health Through Motion by Pete Egoscue with

Gittines

Are you one of the walking wounded? Do you suffer from chronic pain in the

hip, shoulder, back, neck? Do you have rounded shoulders, uneven legs, sore

feet, a duck walk? The Egoscue Method will teach you how your muscles and

joints should line up and function and how your postural habits can cause

pain in your day-to-day activities or sports. The long " Self-Diagnosis "

chapter at the heart of the book uses many pictures and self-tests to help

you analyze your functional " Condition " which is determined by the tilt of

your pelvis and the alignment of your shoulder, hip and knee joints. From

there you follow various combinations of twenty-two stretches and exercises

that will help to realign your body. You'll feel as if you're having a

private session with Pete as he encourages you to listen to the pain messages

that your body is sending and to take responsibility for returning your body

to its proper alignment.>

*** So, here we have yet another guru claiming to know exactly " how your

muscles and joints should line up and function and how your postural habits

can cause pain in your day-to-day activities or sports " , despite the fact

that there is no universal postural and movement standard to which humans

must conform in order to avoid physical deterioration and pain.

There is considerable latitude for deviations from " ideal " or optimal

postures and there is no definitive proof that slight deviations

automatically result in pathology and pain In fact, a good deal of

deterioration and disease in the body is NOT associated with pain and,

conversely, a lot of pain is associated with no obvious physiological or

mechanical malfunction. Pain also can have great deal to do with

psychosocial factors and cannot always be regarded as a reliable indicator of

bodily function.

The claims that pictures and self tests based upon visual examination of

one's static posture will reveal what is happening to the body in dynamic

movement are entirely without support.

Let us continue:

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< http://www.egoscue.com/Education/conditions123.html>

As seen in Pete Egoscue's first book, The Egoscue Method of Health through

Motion, people can generally be placed into 1 of 3 postures. Click one of the

following " Conditions " that you fit into based on your posture.

CONDITION 1:

Posture:

Both hips (pelvis) tilted forward (often accompanied by sagging gut)

Kneecaps angled outward

Feet everted (one or both)

Calf and thigh (gait) muscles lazy and dysfunctional (should be used for

walking)

[Kneecaps " angled outwards " , " lazy " muscles, pelvis and hips casually lumped

together, etc - indeed!! Quite an impressive array of " symptoms " ! MCS]

Body's Reaction:

Slumping and tense shoulders

Upper back and neck muscles stressed

Increased arch of spine at low back

Stiff and sore knees and ankles

CONDITION 2:

Posture:

Head angled off to one side

Shoulder drooped forward and down

Upper torso rotation

Forward hip rotation (right or left side) and/or hip elevation

Back of hand showing and may be hanging lower than the other hand

One foot in front of the other with standing

Body's Reaction:

Excessive strain on knees, hips and shoulders (one side of body more than the

other)

Bearing extra weight on one side of body

Inability to bear weight on one side

Strain on back or neck on one side of body more than other

CONDITION 3

Posture:

Head juts forward and can droop down due to gravity pull

Rounding, drooping shoulders

Both hips tilted under as though being pulled down from behind by tremendous

force

Back of hands showing in front of body

Body's Reaction:

Upper back, shoulder and neck pain

Slumping and tense shoulders

Upper back and neck muscles stressed

S-curve of lower back flattened into " C-curve "

Sore feet and ankles

Welcome to the Egoscue Client Image Upload page. This page provides you with

the ability to directly upload your digital images to the Egoscue Online

instructors. In order to use this page you MUST have the following:

- Your email address.

- Digital Pictures of yourself. Ideally you should provide 4 images per the

example, but you may upload any number from 1 to 4.

If you have the above make sure the images are on your system and you know

where they are. Now fill out the form below. To add your images to the form

click on the Browse button below each sample image. This will allow you to

find your image(s) on your computer.

After the form is filled out click on the Send images button. The images and

any comments you have made will then be transferred to the Egoscue facility

where the instructors will be automatically notified. After the transfer is

complete a new web page will be loaded letting you know that everything went

well.>

*** Notice that the entire analysis is based upon one's static standing pose,

which has little or no bearing on what happens to the joints, muscles and

other soft tissues during dynamic tasks. If engineers tested and constructed

buildings and bridges on that basis of static and visual testing, not too

many of those structures would survive even fairly modest earthquakes or wind

loading (I am intentionally using this analogy because of one website which

stated that Egoscue even applies some of the principles of engineering in his

work).

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BOOK REVIEWS

<http://halldiets.com/fitness/233.shtml>

From AudioFile

<Egoscue's theory is that the human body is meant to be in motion; as

lifestyles have become more sedentary, the musculoskeletal system has gone

out of alignment. The cassette is based upon Egoscue's clinical work and his

book of the same title. Egoscue's voice is intermittently flat, fumbling and

condescending. The first tape, which is devoted to an explanation of his

method, is repetitious. The second tape covers the exercises. The tape is

detailed enough to follow, but it would require copious note-taking by the

listener to be of use. Audio is not an appropriate format for this topic......

Synopsis

Endorsed by Mike Ditka, Jack Nicklaus, and others associated with athletics,

Egoscue's revolutionary and highly effective exercise program for maintaining

the body's full range of physical functions includes a series of 22 simple

exercises that stretch, strengthen, and relax the body.

Synopsis

A revolutionary program of stretching and exercises that emphasizes proper

motion to restore the body's natural alignment--resulting in greater energy,

physical well-being, and fewer injuries. Egoscue's method has helped

thousands of people learn how to live healthier, pain-free lives and achieve

complete fitness. Endorsed by the PGA. 2 cassettes........

***Once again, we note that magical standard of " natural alignment " and

exclusive reliance on anecdotes and testimonials. Maybe others have come

across some genuine studies which prove Egoscue claims on the basis of solid

science, so do share them with the rest of us if you have. As far as we can

judge from the existing commentaries, the results have little to do with the

postulated mechanisms and beliefs and, since Egoscue and a host of similar

methods actually produce improvement in certain cohorts of individuals, there

is no doubt that it will be around for a long while.

A definite plus is that many of these methods do no harm, which is in keeping

with the sentiments of the Hippocratic Oath, so we can at least be satisfied

that some people are benefitting, no matter what the " truth " may be. That,

however, does nothing to promote understanding or enhance progress in a

useful synergy of science and art, but that often is no concern to many

people.

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Dr Mel C Siff

Denver, USA

Supertraining/