Caution! Extreme Views!

Every now and then an article ruffles my feathers. Extreme views and flimsy justifications providing awful advice seem to really get to me. This cartoon, tweeted by @SandyHiltonPT really sums it up;

In the past we've had 'glutes gate' where an article said we should never, ever do sidelying glutes exercises. This resulted in this rant evidence based glutes article. Then we had a similar thing saying runners should never use weights machines. Now we have a one against calf raises (thanks to @Seth0Neill for bringing my attention to it). Once again we have a site claiming an exercise should be avoided, this time Why it's time to abandon calf raises. To be honest I wasn't sure whether to include a link to this article or not. Do I give them more site traffic by linking them? Is it unfair to single them out? So first I commented on the article to give them an opportunity to reply and justify their views. With no response forthcoming I thought it was fair to write this blog and give you the opportunity to make your own conclusions.

This is one of their comments on calf raises,

“I consider it one of the most damaging exercises any athlete can do and entirely unjustifiable from a rehabilitation point of view”

Such an extreme, unbalanced view with big claims but no research evidence offered to support them. When you make bold claims you have to support them with evidence. In this case the author would need to provide evidence that calf raises are 'damaging' and studies showing they are ineffective in rehab. This evidence doesn't exist, in fact there is strong evidence for the opposite – Silbernagel et al. (2007) successfully used calf raises as part of a rehab programme for achilles tendinopathy. I've written a more detailed response in the comments section of the article (linked above).

What frustrates me with articles like these is they help to spread myths and misunderstandings that are really unhelpful to runners. Using provocative terms like 'damaging' will worry runners who include calf raises as part of their rehab programme. The inclusion of some scientific reasoning (although incorrect and misguided) will convince many to believe it.

But this piece isn't really about calf raises, it's about helping you determine what is fact and what is fiction when it comes to articles and advice. Here are a few tips to help you get the most of information you find;
Be cynical – with every site, even this, be a little cynical. Is the site selling you something? Does the advice fit with common sense and the general consensus?

Look for extreme or over-confident views – in sports and in health nearly everything we think we know can be questioned. There are so many grey areas, so little conclusive evidence and so many considerations, how can anyone be supremely confident? Most people involved in sports at a high level or aware of the research will temper their opinions with limitations or provide a balanced view. They rarely, if ever, say 'abandon' something or 'avoid it at all costs'. If they do they will provide strong supporting evidence.

Beware of generic advice and one size fits all solutions – everyone is different, we all have different needs, abilities and goals, no one approach suits all of these. Sites claiming to have an exercise/ treatment/ product that fixes everyone are usually trying to sell you something!

Look for quality evidence – websites in general are not subject to peer review. This means they don't have to provide research evidence to support their claims. However many sites will include references and links to studies to support their views. This is a good sign but look out for 'cherry picking' – when an article selectively includes only the evidence that supports their view and ignores everything else! Research itself also needs to be assessed carefully, this is a topic in its own right!

What about the author? – is the author of the article qualified to make the claims they have? Could they be biased? Do they have an agenda?

It's not just the net – sports magazines, newspapers and people you meet will all have opinions. The same issues apply. It's important to question what you read and hear and consider if advice is right for you regardless of the source.

Closing thoughts: more and more people use the net to find solutions to injuries or ways to improve performance. Sadly the quality of online advice varies considerably. Look out for extreme, unsupported views and have a healthy level of cynicism. It's important to question what people say…

Picture source

Contributed by Tom Goom, The Running Physio


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