Research Documents Strong Children Are More Likely To Become Fit Adults
weight-training-fitness-kids-adults

In America we face a energy crisis where the CDC reports 1 in 3 adults and shockingly 1 in 5 kids are obese. The imbalance between caloric intake and caloric expenditure has literally tipped the scales and created an growing obesity problem. In Colorado we have seen our blue state (low levels of obesity) turn pink due to an increase in obesity especially among children. Aerobic and resistance training has been found to be both both safe and effective in children and teenagers leading to improvements in mental, emotional, and physical health. A recent review of the medical literature documents the impact of childhood and adolescent fitness on their transition to adulthood.

In the journal Sports Medicine Garcia-Hermoso and colleagues analyzed the available research to determine the association between muscular fitness in childhood and future health (2019). Authors included 30 studies on a total of 21,686 participants between 3 and 18 years old. As expected they reported a significant, moderate to large effect between baseline muscular fitness and future body mass index, fat mass, metabolic blood levels, and cardiovascular status as adults. In short, fit children and adolescents became fit adults. Embracing the American College of Sports Medicine’s Exercise is Medicine campaign, especially in children, may help our country regain the energy balance they need to live their best life.

How Does Needle Depth Impact Treatment Effects From Dry Needling?
dry-needling-depth-treatment-effect

Dry needling is a treatment provided by Physical Therapists to relieve a patient’s muscular pain and associated symptoms. This intervention can be performed in both extremity and spinal regions within the body. Current research continues to investigate the mechanisms behind its’ effectiveness, as well as, the most appropriate patient populations and diagnoses for its’ utilization. In addition, authors are trying to determine which parameters of the treatment such as needle placement, needle number, duration of treatment, utilization of electrical stimulation and needle depth may be modified for optimal treatment effects.

Griswold and colleagues reviewed the available evidence behind needle interventions for spinal pain to determine if depth of needle placement influences treatment effects (JMMT. 2019). Authors included 12 studies in the systematic review and 10 studies in the meta analysis. They reported both superficial and deep dry needling improved pain but significantly better outcomes on pain where found for utilization of deep dry needling. In addition, there was a greater effect when needles were placed in the area of pain compared to a distal site on the body.

Contact the experts at MEND to learn more on how dry needling can improve your current symptoms

Does Treatment Of Trigger Points Improve Outcomes For Patients With Rotator Cuff Injury?
rotator-cuff-treatment-trigger-point

Rotator cuff injuries span the spectrum from acute strains to chronic tendon pain (tendinopathy) and rotator cuff tears. Physical Therapy remains the gold standard, first line treatment for all rotator cuff injuries due to its’ cost and clinical effectiveness treating these disorders. A Physical Therapy first strategy has been reinforced by recent research demonstrating equivalent outcomes between surgery and Physical Therapy for patients with rotator cuff tears. Strength training exercises remain the most important intervention for patients due to their ability to reduce pain, heal injured tissues, and restore lost function. A recent study examined the effectiveness of adding trigger point treatments to an established Physical Therapy exercise program.

Akbaba and colleagues randomized patients with rotator cuff tears to one of two groups (J Back Musculoskelet Rehabil. 2019). Both groups received the same Physical Therapy strengthening program completed twice a week for 6 weeks, but one group also received manual soft tissue treatment of their shoulder’s trigger points. Authors assessed each patient’s pain, range of motion, function, and mental health outcomes initially and upon completion of the 6 weeks. Both groups improved pain, range of motion, function, and mental health but the addition of trigger point treatments did not improve clinical outcomes in patients with rotator cuff tears. This study highlights exercise remains the most important treatment in patients with rotator cuff injury and soft tissue interventions add little to the overall recovery of patients.

Click Here to learn more about how Physical Therapy can improve your shoulder symptoms

How Does My Running Cadence Impact Forces In My Legs?
running-cadence-injury-forces

Cadence, or the amount of steps taken each minute, is a common and effective running assessment. This assessment can be done in both healthy and injured runners, but its’ modification is most impactful in the latter group. In our Boulder Physical Therapy practice, we routinely utilize running gait retraining to reduce abnormal forces in the lower quarter. While most runners self select between 160-180 steps per minute (up to 200 in elite runners) this rate can be altered to change force distribution across injured and healthy tissues. For example, a faster cadence (shorter stride) may be utilized to reduce knee pain from arthritis and a slower cadence (longer stride) can take pressure off a healing achilles tendon. Recent evidence has shown self selected cadence to be unrelated to load rate in a healthy runner, but cadence remains a valuable assessment in the injured runner.

A recent research article examined the relationship between cadence, loading rates, and a runner’s leg length (Tenforde et al. JOSPT. 2019). Authors performed a cross sectional study of both healthy (N=40) and injured (N=42) runners who utilized a rear foot strike pattern. All runners underwent a structural assessment and biomechanical analysis while running. As expected authors reported an inverse relationship between a runner’s leg length and their cadence rate, but leg length only explained a small relationship indicating others factors are at play. Injury status did not influence the association between leg length and cadence. Surprisingly, no relationship was found between cadence and vertical loading rates when normalized to a runner’s leg length.

This research adds to our understanding on cadence rate, loading rates, and injury status. Based off the current research, cadence remains one variable which may be altered to reduce ground forces among injured runners.

Rupture Of Knee Tendon After PRP Treatment
PRP-injection-risk-injury

Platelet Rich Plasma (PRP) is becoming a popular treatment for muscle strains, arthritis/cartilage injuries, and tendinopathies, but the evidence behind its’ use is limited. Specifically there is a lack of large human trials with randomization to both placebo injections and alternative treatments. Consistent with alternative treatments PRP’s clinical utilization is outpacing the evidence leaving many more questions than answers. To date there is insufficient research to advocate for injections into injured tendons and in some cases (corticosteroid) authors have argued the risks outweigh the benefits. A recent research article highlights a risk of PRP.

A case report published in the Clinical Journal of Sports Medicine highlights a risk on the utilization of PRP for sports injuries (Redler et al. 2018). Authors describe a single patient with a degenerative patellar tendinopathy treated with a series of 4 PRP injections. Upon subsequent surgical examination authors reported a complete rupture in the patellar tendon with significant degeneration is the surrounding tendon. Although the results of this report must be taken in consideration due to its’ methodology, including a single patient, the authors state this report questions both the effectiveness and safety of using this injection in patients with severe tendinopathy.

Impact Of Walking On Chronic Low Back Pain
walking-exercise-chronic-pain-low back pain

Low back pain remains the most common musculoskeletal diagnosis seen by primary care providers including Physical Therapists. While the majority of cases of low back pain are not serious in nature symptoms tend to be recurrent and can become chronic (> 3 months) if left untreated. As low back pain progresses from acute to chronic in nature changes in the both the peripheral and central nervous systems can occur leading to increased symptoms and loss of function. Patients with signs and symptoms consistent with nervous system changes are often prescribed pain science education and graded exercise to improve their symptoms and most importantly participation in life, work, and recreational activities. A recent review of the research examines the impact of walking vs. general exercise on patients with chronic low back pain.

Vanti and colleagues reviewed the available research on the effects of walking alone compared to exercise, as well as, the impact of the addition of walking to other forms of exercise (Disabil Rehabil. 2019). They reviewed 5 randomized controlled trials on the topic and make recommendations based off this evidence. In general, most forms of exercise including walking, showed a positive effect on a patient’s low back pain, fear of activity, and disability. Authors noted walking was not superior to other forms of exercise, but may be more easily implemented because of its’ ease of implementation compared to other forms of exercise. This study confirms prior research advocating for increasing the activity levels of patients with chronic back pain.

Click Here to learn more about the benefits of exercise for your symptoms