Recent Research Articles


September 2018

An exercise and education program before knee and hip surgery
leads to better outcomes for patients

Osteoarthritis (OA) is a condition in which cartilage that normally protects the ends of bones gradually wears away, leading to pain and disability. It can occur in just about any joint, but is most common in the knees and hips. Although non-surgical treatment is recommended first for this condition, many patients go on to have surgery when their condition does not improve, and the number of individuals having surgery is rapidly increasing. Before surgery, a rehabilitation program - or "prehabilitation" - led by a physical therapist may be used to educate patients and improve their chances of a successful outcome, but research to support this type of program is limited.  With this in mind, researchers decided to review 35 high-quality studies to evaluate the effectiveness of prehabilitation. Results showed that the prehabilitation programs led to a number of improvements in patient outcomes following surgery, particularly in pain and function.  Participating in such a program before having knee or hip surgery may therefore be a smart way to experience better results and a quicker return to normalcy after the procedure.

Bracing and balance training both reduce the
risk for ankle sprains in athletes

Ankle sprains are some of the most common injuries in sports, especially those that require quick direction changes, cutting movements and rapid acceleration and deceleration. After a first ankle sprain, between 35-73% of patients report ongoing symptoms, and the risk of having another sprain is about 70%. This is why measures are needed to reduce the risk for a first ankle sprain, and two ideas proposed for this goal are bracing and balance training. Unfortunately, studies evaluating these interventions are lacking, which led researchers to conduct a powerful pair of studies called a systematic review and meta-analysis. Results showed that both balance training and bracing were effective for reducing the risk and the incidence of ankle sprains in athletes, but it was unclear if either intervention alone or a combination of the two was better. Athletes who are concerned with their risk for ankle sprains are therefore encouraged to see a physical therapist for a balance training program or fitting for a brace to keep their ankle sprain risk as low as possible.

High-quality review finds that exercise
is one of the best ways to prevent falls in older adults

Falls are one of the biggest problems faced by older adults, as about 36% of individuals over age 65 will experience a fall every year. This is why it's so important to identify methods that are effective for preventing falls in older persons. There are many prevention methods available, but it's not clear which ones are best, so researchers performed a high-quality review of numerous studies to answer this question. Overall, findings showed that the most effective intervention for reducing the risk of and number of falls in the elderly population was exercise. Other interventions like dietary and home-based modifications, vision assessments, orthotics and supplements may also be helpful, but older adults at risk for falling are encouraged to visit a physical therapist for an exercise treatment program.

August 2018

Five years after an ACL tear, patients who had surgery experience
similar outcomes as those treated non-operatively

ACL tears are extremely common in sports that involve lots of cutting movements, and after a tear occurs, patients must decide between having surgery and rehabilitating the injury through a course of physical therapy. Many choose surgery and go into the procedure expecting to eventually return to their prior level of activity, but a large proportion of patients end up being unable to meet these goals. To get a better sense of how long-term outcomes compare between patients treated surgically and non-surgically, a study was conducted on 105 athletes over five years. At the five-year follow-up, patients in both groups experienced positive outcomes, and the results between the two groups were found to be very similar. Researchers concluded that the results suggested surgery is not mandatory for all individuals with ACL tears, and that positive results are still very possible with non-surgical treatment like physical therapy, too.

Improvements from a physical therapy program
for knee pain are maintained by patients for three years

Patellofemoral pain syndrome, or runner's knee, is a condition particularly common in active individuals that causes a dull ache behind or around the kneecap. The initial treatment is usually conservative (non-surgical) and may consist of a physical therapy program with various exercises that target the quadriceps muscles in the front of the thigh. While many studies have shown that this type of treatment is effective in the short term, long-term results are not as clearly understood. For this reason, researchers conducted a follow-up study to investigate if improvements from a one-month physical therapy program in patients with patellofemoral pain syndrome were maintained three years later. Overall, results were positive, as all patients reported an improvement in knee pain scores and 82% of them were able to fully resume their sport of choice.

Many patients with no shoulder pain have MRI findings that show a tear

The labrum is a piece of cartilage attached to the rim of the shoulder that secures the shoulder socket and keeps the ball of the joint in place during movement. This structure can tear either from injury or because of the aging process, and the resulting labral tear may or may not cause symptoms. These tears are difficult to diagnose, and the methods used for evaluation - like physical exams - and MRIs are not very consistent at identifying the injury. In fact, it's possible that many patients are told they have a labral tear and then go on to have surgery, even though the tear itself may not be responsible for their pain. To investigate this matter, a study was conducted on middle-aged individuals with no shoulder pain, and the results showed that labral tears were in fact quite common. The first radiologist interpreted 38 (72%) of the MRIs as containing a labral tear, while the second radiologist found labral tears in 29 patients (55%). This shows why patients should carefully process the results of their MRI and understand what they mean before giving any consideration to surgery.

July 2018

Six weeks of physical therapy leads to several improvements
for athletes with a dislocated shoulder

The shoulder is the most frequently dislocated joint in the body, and shoulder dislocations are common in sports like rugby, football and hockey. Unfortunately, after the first injury, the shoulder tends to become unstable, which increases the chances of another dislocation occurring. This is why it’s so important to prevent these injuries from occurring in the first place and rehabilitate them properly when they do occur. Physical therapy that focuses on strengthening the shoulder is one of the best ways to accomplish this, but it’s not clear which exercises are most effective to accomplishing these goals. A study was therefore conducted on the use of elastic bands and other strengthening exercises to improve strength in patients with a first-time shoulder dislocation, and the results were promising. After the six-week exercise program, patients experienced considerable improvements in strength and flexibility of more than 90%, and the values between the injured and uninjured shoulders were extremely similar in the final measurements. These findings suggest that a physical therapy rehabilitation program that includes elastic resistance bands and weight machines can be effective for improving strength and flexibility in patients who dislocate their shoulder.

For patients with long-term shoulder pain, general mindset
can have a significant impact on their level of pain and disability

When shoulder pain lasts for more than three months, it’s referred to as chronic shoulder pain. Unfortunately, patients who have pain for this long often do not have positive outcomes, and about 60% of them continue to deal with symptoms one year after first noticing it. Current treatments like physical therapy generally help patients in the initial stages of shoulder pain, but are less effective when it progresses into the chronic phase after several months. This may be due to psychological factors like depression, anxiety and fear of pain, which may actually impact how a patient perceives their pain. To better understand the connection between these factors and chronic shoulder pain, a review of 27 studies was conducted, and the results clearly showed that patients’ attitudes and perceptions had a significant impact on their levels of pain and disability. This means that in some cases, there is more to the experience of pain than actual damage to the body. Psychological factors can also play a significant part, and it’s therefore important to consider and possibly address these factors when treating chronic shoulder pain.

Pitching on consecutive days in youth softball leads to pain and weakness
that can be addressed with pitch counts and physical therapy

Fast-pitch softball is one of the most popular and fastest growing sports among young females, but unlike baseball, studies on the mechanics of the windmill pitch and its impact on the body are lacking. The number of injuries in fast-pitch softball is very high and it’s been suggested that it may place a similar amount of stress on the shoulder as baseball, but the details surrounding these injuries are poorly documented. There are also no pitching limitations in fast-pitch softball, which means that some softball pitchers can pitch multiple games in a single day, up to three days in a row. With this in mind, researchers performed a study to investigate the effects of windmill pitching consecutive days on strength, fatigue and pain. It was found that in general, pitchers had a significant increase in shoulder pain and fatigue and a decrease in their strength, and the more days in a row they pitched, the greater these changes were. These types of changes can lead to shoulder damage and increase the risk for injury in young softball players if they continue to pitch on consecutive days without regulations. It is therefore recommended that pitch count limits be implemented in softball similar to those used in baseball to address this potential problem and reduce the likelihood of injury in these athletes.

June 2018

Adding a hands-on treatment to a physical therapy program leads to even better results for patients with neck pain

Neck pain is one of the most common health problems in the world, as up to 71% of the population will experience it at least once. While most people improve within a few weeks, some go on to develop chronic neck pain, which is essentially a long-term form of the condition that does not respond to normal treatments. This shows why it’s important to treat neck pain early and avoid long-term complications. Physical therapy is commonly used to address chronic neck pain patients and it often includes manual therapy, in which the physical therapist mobilizes to the neck muscles to alleviate pain. But despite the popularity of manual therapy, evidence is lacking to support its effectiveness, which led to researchers to conduct a study on the topic.

Results: physical therapy in general was effective for helping patients with chronic neck pain improve, but adding manual therapy led to even better overall outcomes for patients.

Neck stretching and strengthening exercises guided by a physical therapist
lead to less neck pain and related anxiety in patients

Neck pain is currently the fourth leading cause of disability in the U.S., and its prevalence is also high throughout the rest of the world. Unfortunately, many individuals with chronic neck pain—meaning it has lasted for more than three months—deal with symptoms of anxiety and depression in addition to their physical symptoms. For this reason, it’s important to develop treatments that are found to improve patients’ emotional wellbeing as well as their physical issues. One possible way to accomplish this is through a physical therapy program that involves a variety of exercises for the neck and surrounding muscles. Therefore, a study was conducted to evaluate whether a series of neck exercises and a home-exercise program was effective for reducing neck pain and anxiety and/or depression levels.

Results: combining physical therapist-led exercises that targeted certain neck muscles and a home-based exercise program reduced patients’ chronic neck pain while also alleviating some of their anxiety and depression related to this pain.

Patients who receive opioids before neck surgery
take longer to return to work than those who do not

When non-surgical methods like physical therapy fail to bring about improvements in patients with neck pain, surgery may be recommended to address their issue. For people receiving workers’ compensation, surgery can pose a serious problem, since it means more time away from work without a guarantee of a successful recovery. The use of opioids can complicate this issue even more, since these individuals already have worse surgery outcomes and because opioids are associated with extended disability and higher costs. It is therefore important to determine if opioid usage before neck surgery has any impact on the amount of time needed to return to work, and a study was conducted to investigate just this.

Results: using opioids before neck surgery had a negative effect on returning to work, days absent from work afterwards and several other factors.

May 2018

Exercises that strengthen the neck and shoulders
are found to reduce neck pain in office workers

Studies have suggested that up to 63% of office workers are affected by neck pain, and between 34-49% of these workers report a new episode of neck pain each year. This poses a serious problem in the workplace, as those who are unable to return to work within a few months are at a high risk for developing disability and possibly being incapable of working in the long term. It is therefore important to develop interventions to alleviate office workers’ neck pain and reduce the burden of this condition on the workplace. For this reason, a powerful pair of studies was conducted to determine if any workplace interventions are actually capable of reducing neck pain in office workers. Results were generally supportive of workplace-based interventions, and the programs that included strengthening exercises for the neck and shoulder muscles were most effective in the office workers who had neck pain. In addition, it was found that the longer these office workers participated in the exercise intervention, the greater the reduction in their neck pain. Business owners and policymakers should therefore consider incorporating one of these types of programs into their workplace to address the growing problem of neck pain in that environment.

Older patients treated with physical therapy prior to hip surgery
experience better outcomes than those who do not

Hip fractures are the most common fractures in older adults, and their frequency is growing as a result of an aging population. Rehabilitation methods like physical therapy are recommended after hip fractures to prevent the loss of patients’ independence, but many patients also require surgery if their condition is severe enough. Occasionally, surgery for these patients needs to be delayed, which can lead to complications that will have a negative impact on their outcomes. One possible solution is to provide physical therapy before surgery (preoperative physical therapy) but research on this topic is limited. For this reason, a study was conducted to determine the effect of preoperative physical therapy on older adults who have hip surgery. Results indicated that the patients who did undergo physical therapy experienced a number of benefits and better outcomes compared to those who did not. In particular, these patients became significantly more independent in their daily lives and were also discharged from the hospital at a faster rate compared to those who did not receive the therapy. Preoperative physical therapy is therefore recommended for older patients preparing for hip surgery to increase their chances of having a successful outcome.

Guidelines recommend non-surgical treatments like exercise
instead of surgery for meniscus tears

The meniscus is a crescent-shaped piece of cartilage located between the thighbone and shinbone, and it stabilizes the knee joint and absorbs shock. Damage to the meniscus often leads to a lesion and eventually a tear of this structure, and many patients have surgery to address it. New research, however, is questioning if surgery is best for individuals over the age of 40 with meniscus tears. Instead, non-surgical treatments like physical therapy and exercise may be a smarter and safer approach. With this in mind, researchers performed a review of the available literature on the topic to investigate meniscus tears and determine the best methods for diagnosing and treating these injuries. The review identified moderate evidence that there were no differences between patients who were treated with physical compared to those who had meniscus surgery. Surgery also did not lead to any added benefits when combined with these exercises. Patients who experience a meniscus tear are therefore encouraged to see a physical therapist first and attempt a comprehensive exercise program before considering surgery for their injury.

April 2018

Surgery and physical therapy lead to
very similar outcomes for patients with painful hip condition

Hip impingement is a condition in which extra bone grows along one or both bones of the hip joint. This causes the bones to rub against each other during movement and results in painful symptoms in the hip and groin area. Conservative (non-surgical) interventions like physical therapy may be recommended as the first line of treatment for this condition, but some patients have hip surgery either right away or if conservative treatment fails. The rate of hip surgery has been growing at a rapid rate in the U.S., but it’s not clear which treatment is most effective for these patients. For this reason, a powerful study was conducted that compared physical therapy to surgery for hip impingement in the long term. Results showed that after two years, physical therapy and surgery led to very similar outcomes. There were no significant differences between the groups in overall hip function, and the physical therapy group actually reported significantly better scores than the surgery group in their ability to perform daily activities. These findings suggest that patients with hip impingement are likely to experience similar outcomes from physical therapy and surgery, and the reduced cost and lower risk of complications should make physical therapy a much more desirable option.

Opioids are found to be no better than non-opioid medications for relieving pain

As the opioid epidemic continues to burden the country, questions are now being asked about whether these drugs should be prescribed to patients with chronic pain. Current guidelines now discourage their use in favor of other, safer alternatives, but studies are still lacking that evaluate the long-term effects of opioids on pain and other measures. For this reason, a powerful study was conducted to compare opioid therapy to non-opioid therapy for patients with back, knee or hip pain over one year. Overall, results showed that patients who received opioids improved to a very similar extent compared to those who received non-opioids. In addition, the non-opioid group actually experienced less pain intensity than the opioid group, as well as significantly fewer negative symptoms related to their medications. This is considered a landmark trial that has clearly shown patients can do just as well—if not better—with non-opioid pain medications, and these results should only continue to sway doctors away from prescribing these dangerous drugs and towards safer alternatives like physical therapy instead.

Getting enough sleep, having a healthy diet and strength training
can all reduce the risk for injury in younger athletes

Childhood and early adolescence are crucial times of rapid development, and establishing healthy habits during this time will increase the chances of maintaining these behaviors later in life and developing optimal physical literacy. Physical literacy is the ability, confidence and desire to be physically active for life, which can in turn improve health and fitness, and reduce the risk for injuries. Recently, researchers have become more interested in what factors can improve physical literacy and reduce injury risk in children and adolescents, and two recent studies investigated this topic from different angles. The first was based on a questionnaire to determine if certain habits were associated with a risk for injury. Results showed that younger athletes who got enough sleep each night and maintained a healthy diet had a lower risk for sustaining a new injury. The other study evaluated the possible benefits of resistance training, which is a type of strength training, on injury risk. Results showed that resistance training was effective for reducing injury risk, and was associated with improved sports performance and better physical literacy. Based on the findings of these two studies, it appears that the most effective ways to reduce the risk for injury in children and adolescents are by getting enough sleep, maintaining a healthy diet and participating in resistance training.

Patients who receive opioids before neck surgery take longer to return to work than those who do not

When non-surgical methods like physical therapy fail to bring about improvements in patients with neck pain, surgery may be recommended to address their issue. For people receiving workers’ compensation, surgery can pose a serious problem, since it means more time away from work without a guarantee of a successful recovery. The use of opioids can complicate this issue even more, since these individuals already have worse surgery outcomes and because opioids are associated with extended disability and higher costs. It is therefore important to determine if opioid usage before neck surgery has any impact on the amount of time needed to return to work, and a study was conducted to investigate just this. Results: using opioids before neck surgery had a negative effect on returning to work, days absent from work afterwards and several other factors.

March 2018

Prevention program reduces the number
of ankle sprains in the athletic population

Ankle sprains are by far the most common injuries in athletes, especially those who participate in sports with lots of jumping, changing direction and/or pivoting. After an athlete experiences one ankle sprain, the risk for experiencing additional sprains in the future increases significantly. One way to address this problem is by reducing the risk for the first ankle sprain with strategies like proprioceptive training. Proprioception allows one to know where their body is in space, by taking in sensory input from the outside world and integrating it into specific movements. A prime example of proprioceptive training for the ankle is balance exercise, which can enhance the body's ability to adapt to a changing environment and protect it from injury. To investigate if this type of training could be effective, researchers conducted a review, and the results showed that proprioceptive training did reduce the risk for ankle sprains. In particular, individuals who completed the training had a 35% reduced risk for an ankle sprain compared to those who did not. Based on these findings, if you are interested in reducing your risk for an ankle sprain, consider seeing a physical therapist to receive an appropriate proprioceptive training program.

Personalized rehabilitation program decreases
the risk for another hamstring injury in soccer players

Strains of the hamstrings, a group of three muscles in the back of the thigh, are the most common injuries in soccer. On top of this, about one-third of players who experience a first hamstring strain will go on to have another hamstring injury soon after returning to play. In some cases this is because players do not take enough time to fully heal, which is why it's important to ensure that rehabilitation programs are as effective as possible. One way to accomplish this is by following an algorithm that consists of a specific set of steps for treatment, and a powerful study was conducted to evaluate the effectiveness of this type of treatment algorithm. Results showed that over six months, the soccer players who followed the treatment algorithm experienced substantially fewer hamstring strain injuries than those who did not, especially in the early period when most of these injuries occur. Individuals who are dealing with a hamstring strain should therefore consider seeing a physical therapist for a rehab program of this nature to increase their chances of returning to sports appropriately with a lower risk for future hamstring injury.

Hands-on treatment administered by a
physical therapist is beneficial for heel pain

Plantar fasciitis, or plantar heel pain, is a common condition that about 10% of the population will experience at least once in their lives. It occurs when a strong piece of tissue on the bottom of the foot—the plantar fascia—becomes inflamed or damaged, which leads to a stabbing pain in the heel. Manual therapy is a hands-on intervention frequently administered to patients with plantar heel pain by physical therapists, but there is only weak evidence available to support its effectiveness. Therefore, a study was conducted to review all the available research on manual therapy for plantar heel pain and to determine if it is beneficial for these patients. The results were generally supportive of manual therapy, with one type in particular - soft-tissue mobilization - being found to be more effective than other treatments and placebo. The quality of the included studies was rated as moderate-to-high, which shows that these findings are reliable and can guide physical therapists treating these patients.

February 2018

Low back pain patients who receive physical therapy
less likely to be prescribed opioids

Low back pain is one of the most common and expensive healthcare conditions, it can be more expensive for some patients than others depending on how it's treated. Education and physical therapy are both frequently recommended for these patients, which have been found to improve outcomes and reduce costs overall. In particular, seeing a physical therapist early is associated with less use of health care and lower patient costs, but only 7-20% of patients actually do this. There are many factors that influence these patients' decision, and understanding them can help to better ensure they are getting the right care. For this reason, a study was conducted to investigate these factors and how physical therapy affected the use of other treatments like opioids. Results showed that patients were less likely to participate in physical therapy if they were given multiple orders in addition to the referral to see a physical therapist, or if they had a history of opioid abuse. In addition, receiving a physical therapy consult was associated with a reduction in opioid prescriptions, and participation in physical therapy reduced these odds even more. We believe that physical therapy should be seen as an alternative to opioids for managing pain, and this study offers additional support to this concept.

Patients that access physical therapy directly spend less
and have a shorter duration of treatment than those who are referred

Neck and back pain are among the most common conditions that cause pain, and both are associated with high costs of treatment. Part of this may be due to the fact that many patients are not receiving appropriate treatment soon enough, and one way to address this is with direct access, which allows individuals to directly consult a physical therapist without a physician’s referral. Unfortunately, studies on the impact of direct access are limited, which prompted researches to conduct a trial to investigate this. Results showed that most patients with back or neck pain chose the traditional medical route of seeing a doctor first over direct access, but regardless of how they accessed physical therapy, the majority completed treatment and experienced significant improvements in disability and pain. Patients who accessed physical therapy directly also had fewer treatment sessions, days in care and lower overall costs than those who did not. This is why we encourage all individuals living with pain to see us directly for an evaluation and treatment program instead of going to your doctor.

Adding hip strengthening exercises to knee strengthening exercises
leads to the greatest benefits for patients with knee pain

Patellofemoral pain syndrome, or runner's knee, is a painful condition that’s very prevalent in physically active individuals like runners. Physical therapy is commonly recommended for these patients, and treatment typically includes various strengthening exercises as well as other interventions. Exercises to strengthen muscles that support the injured knee are most common, but some physical therapists also recommend exercises to strengthen muscles surrounding the hip. Research to support the effectiveness of these exercises, however, is lacking, which led a team of investigators to perform a large-scale review and analysis. From this, they were able to find evidence that both hip and knee strengthening exercises were effective for patients with runner's knee. In addition, the studies revealed that combining hip- and knee-strengthening exercises resulted in a greater decrease in pain and improvement in activity compared to knee strengthening alone. With these findings, physical therapists may be more likely to include both hip- and knee-strengthening exercises into your treatment program for runner's knee.

January 2018

Several physical therapy treatments reduce pain and disability
in patients with common lower back condition

Low back pain (LBP) continues to represent one of the biggest health problems in the world, as 70-85% of the population will experience it at some point in their lives. About 90% of LBP patients have a good prognosis, but the other 10% will go on to experience chronic, or long-term pain and disability. Sacroiliac joint dysfunction (SIJD) is a condition in which the joint that connects the lowest part of the back to the pelvis does not move properly, and it is a common cause of back pain that occurs in up to 30% of LBP patients. There are several treatments available for this disorder, such as physical therapy, which can include a variety of interventions. Although physical therapy is often used to treat SIJD, research is lacking and it’s not completely clear just how effective it is for the condition. This uncertainty led researchers to conduct a powerful pair of studies called a systematic review and meta-analysis. Results showed that three different physical therapy interventions were in fact beneficial for reducing pain and disability, and for restoring normal symmetry of the pelvis in patients with SIJD. These researchers then went on to recommend that anyone affected by SIJD should strongly consider seeing a physical therapist for a comprehensive treatment program to address their pain and disability.

Strength training should be recommended to older adults
in a similar way to medications

Resistance training is a term used to describe any type of exercise that causes muscles to contract a resistance force like weights, resistance bands or body weight. These exercises are used to increase strength, tone, mass and/or endurance, but can also bring about other benefits, and research has shown that increased muscle strength and mass can actually help predict longevity and mortality. This means that stronger individuals are likely to live longer lives with less risk for disease, and regular resistance training is therefore recommended for older adults due to the main health risks associated with aging. To explore the importance of this concept, a “mini-review” was conducted, and researchers concluded that resistance training could and should follow a simplistic approach in the elderly population. Doing so appears to be sufficient to bring about health benefits and will likely increase the chances of older adults following these programs. The researchers even go so far as to say that medical professionals should recommend this type of training to older adults just like medications due to the many improvements it can bring about, and physical therapists in particular can be key to introducing resistance training to their older patients.

The majority of Americans would prefer to manage their pain
with drug-free options like physical therapy instead of opioids

The opioid epidemic in the U.S. has been consistently exploding to devastating proportions, with more than 33,000 Americans having died from an opioid overdose in 2015. As this problem has been continuing to worsen, Americans are becoming more aware of the dangers associated with opioid abuse, and recent survey statistics showed that Americans consider opioids to be the most serious ongoing local drug problem. To develop a clearer idea of Americans’ opinions regarding opioid use and how to best manage painful conditions, a large-scale poll was conducted. More than 6,000 Americans responded to the poll, and results showed that most people are aware of the dangers associated with opioids, and are very much interested in ways to manage their pain. In particular, it appears that most patients in pain believe that physical therapy is a very safe treatment option, and 86% considered it to be effective for reducing their pain levels. This is reassuring news, since it can be taken as a sign that a growing number of people are becoming aware of the risks associated with opioids and are looking to other means to address their pain instead.


September 2017

Recent study shows that opioids do not provide relief for long-term pain

Opioids are powerful pain-relieving medications that have been around for a long while, but the “opioid epidemic” really started developing in the late ‘80s and early ‘90s. Around this time, doctors thought that opioids could be used safely and effectively to treat long-lasting pain, but it led to opioids being overprescribed on a massive scale. Since the epidemic started, at least 300,000 people have died of opioid overdoses, and more than 30,000 Americans are expected to die of overdoses this year alone. To further investigate the dangers of opioids, a powerful study was conducted on patients with low back pain or arthritis of the hip or knee. These patients were given either opioids or some other combination of non-opioid drugs and monitored regularly over one year. Afterwards, patients treated with non-opioids actually experienced better outcomes than those treated with opioids. In particular, there was no difference in pain-related function between the two groups, but the non-opioid group reported less pain intensity than the opioid group. Patients in the opioid group also experienced significantly more adverse symptoms related to their medication than the non-opioid group. This shows that opioids should not be the treatment of choice for painful disorders.

Hands-on physical therapy and surgery lead to similar outcomes for patients with carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a condition that leads to numbness/tingling, pain and loss of motor control. Treatment may be either surgical or non-surgical, and although surgery is most common, there is a great deal of debate regarding its effectiveness. Physical therapy is a non-surgical treatment that is also used frequently, but there is limited evidence to support some of its techniques. In manual therapy, the therapist performs a series of manipulations and mobilizations to various regions in order to bring about tissue changes that will reduce pain. Unfortunately, manual therapy has not been directly compared to surgery for treating CTS, so a study was conducted to investigate this. Results showed that patients in both groups experienced similar improvements, and the manual therapy group actually did better than the surgery group at certain time points. Considering that these outcomes are similar, manual therapy is strongly recommended, since surgery is a more expensive treatment with a greater risk for side effects and complications.

Substituting doctors with physical therapists may lead to similar outcomes for patients with painful disorders

Musculoskeletal disorders are painful conditions that affect the muscles and/or bones. They are the second largest cause of disability in the world, and most patients who have them go to their primary care doctor first for treatment. Although these doctors can provide initial treatment, it becomes difficult to treat patients in the long term if they have complicated problems. One possible solution is to manage patients who have musculoskeletal disorders with physical therapists instead of doctors. This substitution could skip a step in the treatment process and allow doctors to focus on other patients instead. Although this idea has been proposed, there is not much research on the topic, which prompted some researchers to conduct a study. A total of 14 studies were analyzed to determine the value of this substitution, and on the whole, their findings were supportive of physical therapy. Specifically, five studies suggested that there was no significant difference in outcomes of patients being treated with either doctors or physical therapists, while eight suggested that patients were equally or more satisfied with consulting a physical therapist than a doctor. Although more research is needed on this topic, these results suggest that a change in the treatment of these patients may be possible.

August 2017

Combining hands-on therapy with other physical therapy techniques
is beneficial for patients with knee condition

Patellofemoral pain syndrome (PFPS), or runner’s knee, is a condition in which the cartilage in front of the kneecap (patella) becomes damaged, usually from a single injury or gradually over the course of time. This causes knee pain and other symptoms that tend to get worse during activities that repeatedly bend the knee like squatting or jumping. Manual therapy is one type of physical therapy intervention in which the therapist applies massage and manipulation techniques to the injured area to alleviate symptoms. Combining manual therapy with other physical therapy treatments may therefore be beneficial for patients with PFPS, and to investigate this, a powerful study called a systematic review was conducted. Overall, results showed that combining manual therapy with various physical therapy techniques reduced pain and improved the function of patients with PFPS. In addition, all five studies were rated as having an acceptable quality level, with scores of 3/5 or 4/5. Based on these findings, it appears that combining manual therapy and physical therapy techniques such as strengthening exercises can lead to various improvements in these patients.

Hands-on therapy found to be effective for office workers with shoulder pain

Approximately 90% of white-collar workers use computers for more than four hours per day. Over time, sitting and working at a computer can lead to a dysfunction of muscle stability and other disorders of the region, which may result in shoulder and neck pain, as well as a decreased threshold for pain. One of the main reasons for shoulder pain is hyperactivity of an upper back muscle called the upper trapezius, which results in decreased control of two other muscles and instability. To treat this muscle instability, several physical therapy interventions may be used, including manual therapy. Manual therapy may therefore be helpful for office workers with shoulder pain, and to evaluate this possibility, a study was conducted. Results showed that participants who underwent manual therapy experienced greater improvements than those who did not, and individuals currently dealing with this type of pain should therefore seek out the services of a physical therapist for appropriate treatment.

Helping patients understand what is causing their low back pain
may allow them to break free of a cycle and reduce pain levels

Low back pain (LBP) is a very common condition that will affect up to 80% of the population at some point in their lives. For most people who develop LBP, the pain will generally subside within three months or less. But for about 10% of patients, LBP will become a chronic, or long-term condition. Chronic LBP is much more difficult to treat than other cases of LBP, since there is no actual damage to the body causing the pain in the majority of these patients. Many of these patients also wind up entering a vicious cycle in which they are fearful of moving, which can lead to less movement and make their pain worse. One way to help patients break free of this cycle is to help them better understand how their fears and beliefs are contributing to their pain, and to instruct them on how to change their overall mindset. To explore this concept, a team of physical therapists created a commentary article. The suggested approach to helping patients with chronic LBP better understand their condition is based on the common-sense model (CSM). A CSM approach to assessing and treating pain-related fear involves five stages, each of which focus on motivation, reflecting and communicating about their condition. Following this CSM can better equip patients to make sense of their chronic LBP and break the vicious cycle that’s holding them back. More research is needed to evaluate this type of approach, but patients should be aware of its possible benefits and ask their physical therapist more about the importance of understanding the causes of their pain.

July 2017

Hand-delivered therapy reduces pain and
stiffness in patients with knee arthritis

Joints are where two bones come together, and a protective layer called articular cartilage surrounds the end of each joint. This cartilage cushions your bones and protects them from rubbing against one another, but when it diminishes, a condition called osteoarthritis develops. Osteoarthritis can occur in any joint in the body, but is most common in the knees and hips. Manual therapy is a frequently-used treatment for knee osteoarthritis in which a physical therapist applies various movements and manipulations to the knee to reduce pain and other symptoms. Although manual therapy is commonly used for knee osteoarthritis, it's not completely clear how effective it is. For this reason, a powerful review of 14 appropriate studies on the topic was conducted. Results showed that manual therapy significantly reduced pain, alleviated stiffness and improved physical function in patients with knee osteoarthritis. These positive effects occurred with less than four weeks of treatment, but treatment lasting longer led to even greater benefits. This suggests that manual therapy may be a beneficial treatment for patients dealing with knee osteoarthritis.

Patients treated early for neck and back pain in the emergency room
experience better outcomes than those who wait

Many emergency departments have a finite number of resources available, which forces them to prioritize the treatment of patients based on their condition. Injuries like neck and back pain account for a significant portion of the conditions seen in emergency rooms, and having an overflow of these patients can create a long wait list. Patients who fall into this category may either be treated or discharged from the hospital, and some will be referred to physical therapy for additional treatment. Unfortunately, many patients do not receive appropriate care quickly enough due to the overflow and other reasons, but one way to improve this system is to treat these patients with physical therapy as early as possible. To evaluate this type of approach, a study was conducted, and results showed that participants treated with early physical therapy had significantly lower levels of pain and disability compared to those treated with standard care. The median value of pain was 1 and 9% of patients reported disability in the early physical therapy group, while the other group reported a score of 4 for pain and 33.4% were disabled. Patients treated with early physical therapy also reported greater satisfaction with their treatment and had fewer prescriptions for pain-relieving medications than the others group. These findings show that staffing an emergency room with a physical therapist can help patients with neck or back pain recover more quickly, while also freeing up other emergency room doctors to treat other patients.

Spine strengthening exercise and posture training
reduces hyperkyphosis in older adults

Kyphosis is a disorder in which an excessive outward curvature of the spine results in an abnormal rounding of the upper back. Kyphosis generally tends to get worse with age, and once the angle progresses past 40°, it's referred to as hyperkyphosis. Research has shown that strengthening exercises for the back muscles can lead to improvements in patients with hyperkyphosis, but most studies on the topic suffered from some limitations. For this reason, a powerful study called a randomized-controlled trial was conducted. Results showed that patients who followed the physical therapist-led exercise program experienced several significant improvements when compared to patients who only received education. Most importantly, the angle of the curvature of the spine reduced by an average of 3.3° in the treatment group, compared to only 0.3° in the other group. The treatment group also reported better self-image and satisfaction with their appearance after completing treatment. These findings suggest that a treatment program consisting of strengthening exercises for the spine and posture training can lead to physical improvements in patients with hyperkyphosis, which appear to boost their confidence.

June 2017

Exercise-based therapy leads to less pain and better
flexibility in patients with jaw disorder

Temporamindibular joint disorder is an umbrella term used to describe several conditions that involve a dysfunction of the jaw. The most common symptoms of temporamindibular joint disorders are pain and decreased mobility of the jaw, both of which can have a negative impact on a patient's quality of life. Exercise-based therapy that may include aerobic, stretching, balance and strengthening exercises is commonly used to treat these disorders, but the available research on it has produced inconsistent results. Therefore, a powerful pair of studies called a systematic review and meta-analysis was conducted on the topic. Results showed that exercise therapy reduced pain and improved the jaw flexibility of patients with temporamindibular joint disorders, and the greatest improvements in flexibility came from programs that emphasized mobility exercises and a mixed treatment programs. Based on these results, individuals with temporamindibular joint disorders are encouraged to seek out the treatment of a physical therapist for an appropriate treatment program that will help their condition improve.

Hands-on therapy reduces pain and has several other positive effects
for patients with carpal tunnel syndrome

Carpal tunnel syndrome is a condition that results from pressure being placed on a nerve in the wrist, which leads to numbness, weakness, tingling and other symptoms in the hand. Carpal tunnel syndrome affects up to 3.8% of the population, and its symptoms often make it difficult for working individuals to complete their jobs. Effective treatment is therefore needed to address carpal tunnel syndrome, and one available option is manual therapy, a physical therapy intervention in which the therapist performs various manipulations with their hands. Due to the fact that evidence is lacking to support these treatments, a powerful study called a randomized-controlled trial was conducted. Results showed that both physical and manual therapy helped patients experience less pain, greater function and fewer symptoms. Patients in the manual therapy group, however, reported average pain reductions of 290% compared to only 47% in the physical therapy group. These findings support the use of manual therapy for carpal tunnel syndrome, and patients with this condition should therefore seek out the services of a physical therapist to receive this type of treatment and any other appropriate interventions.

Two exercise programs may be effective for
reducing the risk of falls in older men

As individuals grow older, several changes occur that are considered risk factors for falling, such as decreases in balance, control of posture, muscle strength and changes in walking performance. For this reason, prevention strategies are needed to address these risk factors and lower the risk for falls in the elderly community. Two intereventions that are often recommended for these types of exercise programs are aerobic training and resistance exercises, which are used to increase strength. Despite the evidence available on aerobic and resistance exercises, it's not completely clear if combining the two of them is any more effective than each one of them individually, and a study was therefore conducted to evaluate this combination. Results showed that both aerobic and resistance exercises on their own were more effective than no exercise for reducing risk factors for falls such as balance, posture control, mobility and leg strength. However, combining these two interventions was even more effective for reducing these risk factors. Based on these findings, it appears that either an aerobic or resistance exercise program can be effective for reducing the risk of falls in older men, but combining both of them is even more beneficial and may serve an important role in addressing this significant danger.

May 2017

Most guidelines recommend education, physical therapy
and exercise for low back pain

Low back pain is one of the most common of all sources of disability, as more than 80% of people will experience it at least once in their lives. There are many treatments available for LBP, and it may be difficult for some doctors to determine which is the best possible approach for each patient. For this reason, a number of guidelines have been developed that are intended to simplify this process. The only possible downside is that the quality of some of these guidelines is not very high and can lead to recommendations for treatments that are not effective or even harmful. Researchers therefore decided to conduct a review of all the guidelines available for treating low back pain, and the results identified several treatments that were universally supported by all guidelines reviewed. Some of the strongest recommendations included advice and/or education, returning to activities or staying active, and a hands-on form of physical therapy called spinal manipulation. All of these interventions are fundamental components of most physical therapy programs, and individuals with low back pain are therefore urged to see a physical therapist if they are dealing with symptoms to receive the best possible care available.

Referral rates for physical therapy to treat low back pain
have remained low as rates for opioid prescriptions have risen

Low back pain is one of the leading causes of disability and reasons for visiting a doctor throughout the world. On top of this, studies suggest that this problem will only continue to grow in the future as more people become affected by the condition. Physical therapy is an effective treatment for low back pain that is commonly recommended by numerous medical guidelines, but there are many doctors that may still not be referring patients to a physical therapist for one reason or another. This can prevent patients from receiving the care they need and being treated with more dangerous interventions like opioids instead. To get a clearer idea of how many patients are actually being referred to physical therapy for low back pain over the years, a study was conducted. Results showed that about 170 million patients visited a doctor for complaints related to low back pain. Approximately 17.1 million of these patients were referred to physical therapy, which equated to a referral rate of 10.1%. From 1997 to 2010, this referral rate for physical therapy remained stable at this low percentage, while the rate for opioid prescriptions increased in these patients over the same time period. This highlights a major problem in the medical world, as more patients with low back pain are being prescribed opioids while the same number are being referred to physical therapy, a much safer and more effective treatment.

Supervised physical therapy is found to be more effective
than a home exercise program for treating wrist fractures

A distal radius fracture is the technical term for a broken wrist, which is one of the most common of all injuries. These types of injuries account for between 15-20% of all fractures, and they are especially common in older adults over 60 years of age. Treatment for distal radius fractures typically consists of realigning the broken bone and then putting the patient in a wrist cast. Unfortunately, more than 50% of patients continue to have problems with their wrist after this procedure, and physical therapy is commonly recommended after the cast is removed for this reason. Physical therapy can be administered either at a physical therapy clinic or with a home-exercise program, and it’s not completely clear which of the two is more effective. Therefore, a powerful study called a randomized-controlled trial (RCT) was conducted to compare a supervised physical therapy program to a home-exercise program. Results showed that patients in both groups improved in all of the measurements taken, but the participants who followed supervised physical therapy experienced less pain and better wrist function and flexibility than those who followed a home-exercise program. Even more impressively, these improvements lasted for at least six months. Patients with a broken wrist are therefore encouraged to consider seeing a physical therapist for an effective treatment program after their cast is removed.

April 2017

Surgery and hands-on therapy lead to similar long-term outcomes
for patients with carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a painful condition that affects the hands and is particularly common in the workplace, as it accounts for nearly 50% of all work-related injuries. CTS results from a pinched nerve in the wrist, which leads to numbness, tingling and weakness in the affected hand. Conservative (non-surgical) treatment is typically recommended at first for CTS, but if symptoms are severe or the patient doesn't improve, surgery may be advised. Physical therapy is a common conservative treatment for CTS and may consist of manual therapy, in which the therapist performs various mobilizations and manipulations with their hands. Studies comparing the benefits of surgery and manual therapy have produced mixed results, and it's not completely clear which is better for patients. For this reason, a powerful study called a randomized-controlled trial was conducted to determine if manual therapy or surgery was more effective for treating patients with CTS. Results showed that after one month, patients in the manual therapy group experienced significantly greater improvements than those in the surgery group. After six and 12 months, the two groups reported more similar scores, but these findings are still supportive of manual therapy. This is mainly due to the fact that manual therapy is significantly less expensive and comes with far fewer risks than surgery, which makes it the much more attractive option of the two.

Patients who have higher levels of low back pain
get the most benefits from physical therapy

Low back pain is one of the most common painful conditions in existence, as up to 36% of the population will experience it at least once each year. Physical therapy is frequently used to treat low back pain, but it's been found to be more effective in some patients than others. For this reason, one of the main goals of researchers is to identify specific groups of patients that respond to treatment best, which can help medical professionals make better treatment decisions. Therefore, a study was conducted that compared the effects of physical therapy to advice with the goal of determining which patients had the best responses to treatment. Results showed that patients who had higher levels of pain, a higher risk for persistent pain, a longer duration of symptoms and less of an ability to cope with their condition experienced the greatest benefits from physical therapy compared to advice. On the opposite end, results showed that patients who had low back pain that was not very severe responded well to advice alone. Based on these findings, it seems that patients who have the most intense cases of low back pain stand to benefit the most from an individualized physical therapy treatment program.

Most patients with common foot injury don't
seek out physical therapy services

Plantar fasciitis is a very common foot injury, with about one million individuals seeking out treatment for it every year. Patients with plantar fasciitis typically experience a stabbing pain in the bottom of the foot near the heel, which is usually the worst with the first few steps after awakening. Recommended treatments for plantar fasciitis include a variety of stretching and strengthening exercises, bracing and hands-on therapy called manual therapy, which is usually administered by a physical therapist. There is strong evidence showing that physical therapy-based treatments like manual therapy and exercises are effective for this injury, but it's not completely clear if patients are actually taking advantage and seeking out this type of care. For this reason, a study was conducted to investigate how many patients with plantar fasciitis are referred to physical therapy. Of the more than 800,000 patients in the database, only 7.1% were actually evaluated by a physical therapist within 30 days of their diagnosis. Patients who were treated with manual therapy were found to have shorter lengths of care and paid less overall for their care than those who did not. These findings show that although physical therapy is strongly supported by evidence as a beneficial treatment for plantar fasciitis, the vast majority of patients with the injury do not seek out this type of care.

March 2017

Having physical therapy after knee replacement surgery
leads to improvements and speeds recovery

Knee osteoarthritis is a condition in which cartilage that normally protects the knee joint gradually wears away, which goes on to cause pain and disability. Physical therapy is commonly recommended to treat this condition at first, but surgery may be necessary for patients that fail to improve. After surgery, most patients follow a course of physical therapy to bring them back to full strength, which may either begin at home or within a clinic. Since it's not completely clear which of these approaches is more beneficial for patients, a study was conducted to compare them. Results showed that after completing physical therapy, patients improved in their knee range of motion, walking speed and quality of life, regardless of where they started therapy. When compared to one another, there were no major differences found, but the group that received physical therapy in the clinic first completed their treatment about 20 days sooner than those who had home-based therapy first. This study suggests that after surgery, it may be best to start a physical therapy program in a clinic as soon as possible to speed up the recovery process.

Large-scale review shows that exercise therapy is one
of the most effective treatments for ankle sprains

Ankle sprains are the most common injury in athletes and those who are physically active. After spraining an ankle, up to 40% of patients will go on to develop a condition called chronic ankle instability, which increases the chances of another ankle sprain occurring in the future. Many treatments are available to reduce the chances of this condition developing, but there is so much research out there that it is difficult to determine which is most effective. For this reason, a large-scale review was conducted of these studies to summarize them and figure out which treatments are best. Results showed that exercise therapy was capable of reducing pain, swelling and function in patients with ankle sprains, and was helpful for preventing future ankle sprains from occurring.

Older adults with headaches benefit from
a physical therapy treatment program

Headaches are common in all age groups, but they affect people of different ages in unique ways. Secondary headaches, in which the cause of the pain is from something other than the headache itself, and associated neck pain tend to become more common with older age. There are many treatments available for headaches and associated neck pain, but it's not completely clear which is most effective for older adults. Physical therapy is generally considered a safe and effective treatment option, but more research is needed to study how far its benefits go. For this reason, a powerful study was conducted to evaluate the effectiveness of physical therapy for older adults with headaches and associated neck pain. Results showed that participants who received physical therapy improved more significantly than those who underwent a usual course of treatment. In particular, the frequency of their headaches was significantly reduced after 11 weeks, and remained at this level up to nine months later. The intensity and duration of their headaches also decreased after physical therapy.

February 2017

Neck pain has a notable effect on the
lives of women who work in an office

Neck pain is very prevalent in general, but it is especially common in working individuals, where it occurs in 45-63% of the population worldwide. Although so many people deal with this condition in the workplace, it's not clearly known how their pain impacts work performance and which strategies are most effective for treating it. For this reason, a study was conducted to describe the consequences of neck pain on female office workers and explore what strategies are used to manage and cope with the condition. Results showed that out of the 51 female office workers who participated, 82% experienced neck pain in the last 12 months. About 20.7% of participants with neck pain missed work on account of their pain, and 22.4% reduced their work activity because of it. The most common strategies for managing neck pain were prescription or over-the-counter medications (82.5%), physical therapy (64.7%) and visiting their general medical professional (54.9%). These results show that neck pain can certainly impact work performance if they fail to seek out effective treatments like physical therapy to address it.

Research review shows that strengthening exercises are recommended
for addressing instability of the shoulder

Shoulder instability is a condition that occurs when the head of the upper arm bone falls out of the shoulder "socket," and it affects approximately 2% of the general population. Patients with shoulder instability generally experience pain and weakness in the front and back of the shoulder joint, as well as a possible tightening and/or clicking sensation in the back of the shoulder. Several treatments are available to address the condition, but there is a need for clear guidelines to better assist medical professionals making treatment decisions. For this reason, a powerful study called a systematic review was conducted on the topic. Results showed that strengthening exercises for specific areas of the shoulder were most effective for treating shoulder instability by reducing pain and instability, as well as increasing function. Based on these findings, researchers recommend a rehabilitation program that focuses on strengthening and stabilization exercises. Patients dealing with shoulder instability to any degree should therefore view physical therapy that includes these components as a strong option to address their condition and help them improve.

Adding elastic bands to physical therapy program improves several physical
features in older adults and may reduce their risk for falls

Falls remain a major problem in the elderly population, and the risk of falling increases with older age. This is why it's so important to develop strategies that will reduce the risk for falls. Exercise programs are commonly used to address this problem, and elastic bands in particular can be very helpful for the elderly since they are portable, inexpensive and easy to use. For this reason, a study was conducted to determine if elastic bands could improve balance and other physical features in order to lower fall risk in the elderly population. Results showed that participants who used elastic resistance bands reported better overall scores for balance, flexibility, fear of falling and gait ability than those who did not. This shows adding these bands to a physical therapy program may help to reduce the risk and fear of falling in the elderly. Using this type of program can therefore help to build confidence in older adults and may in time lower the overall rate of falls.

January 2017

The addition of strengthening exercises to standard treatment
improves outcomes in patients with shoulder condition

Adhesive capsulitis, or frozen shoulder, is a condition in which tissues that surround the shoulder become inflamed and stiff. Individuals with frozen shoulder experience pain and have difficulty performing most activities that require rotating the shoulder, and the condition can last for up to 18 months or longer. Physical therapy that includes strengthening exercises is commonly recommended to treat frozen shoulder, but no studies have specifically investigated just how effective these of exercises are. Based on this, a powerful study called a randomized-controlled trial was conducted to determine if adding strengthening exercises to a standard physical therapy program would lead to greater benefits in patients with frozen shoulder. The findings showed that patients who were treated with physical therapy and strengthening exercises experienced the most significant improvements overall. In particular, they reported greater decreases in pain and greater increases in flexibility and physical function. This shows that strengthening exercises should be a necessary part of physical therapy, and individuals dealing with frozen shoulder should therefore seek out this type of treatment in order to experience significant benefits.

Strengthening exercises that use resistance are
beneficial for patients with knee arthritis

Osteoarthritis is a painful condition in which cartilage that normally protects the joints gradually wears away, which eventually causes pain and disability when bones begin to rub against one another. Osteoarthritis is very common in the knees, and there are several strategies available to treat it. One option is called resistance exercises, which use some form of resistance - such as body weight, elastic bands or machines - to force muscles to contract. Studies have shown that resistance exercises can be effective for knee osteoarthritis, but there have been some flaws in the research. Therefore, a powerful study called a systematic review was conducted to determine the true value of resistance exercises for knee osteoarthritis, and results showed that it did in fact lead to several significant benefits for patients. In particular, these exercises reduced pain, relieved stiffness and improved overall function, especially if they were performed at a high intensity. Patents with this condition are therefore encouraged to seek out the services of a physical therapist, which typically include these types of exercises.

A physical therapy program following back surgery
significantly helps with recovery

Low back pain is the single leading cause of disability throughout the world, and about 31 million Americans experience it at any given point in time. There are many different conditions that may lead to the development of low back pain, and one of the most common is called degenerative disc disease. Non-surgical treatments like physical therapy are typically recommended for this condition at first, but surgery may be considered if a patient doesn’t improve or gets worse. After surgery, physical therapy is often prescribed to help patients recover properly, but there is a general lack of research that investigates the effects of this type of treatment. For this reason, a study was conducted to evaluate the long-term effectiveness of physical therapy following a surgery. Results showed that patients who received four or more sessions of physical therapy following surgery experienced to the most significant improvements out of three study groups. In particular, these participants showed less disability, reduced pain and better quality of life than the other two groups, and these improvements lasted for 24 months. These findings suggest that at least four sessions of physical therapy after surgery can lead to various improvements for patients that are maintained in the long term.


December 2016

The use of ultrasound as a therapy is found to reduce pain
and improve the function of patients with knee arthritis

Osteoarthritis is a condition in which cartilage that normally protects joints gradually wears away, which causes bones to rub against one another and leads to pain and other symptoms. Osteoarthritis can occur in any joint of the body, but it is most common in the knees and the hips. Physical therapy is commonly recommended to address knee osteoarthritis, and therapeutic ultrasound is one of the many treatments that may be used by a therapist. Therapeutic ultrasound applies sound energy to an injured area through sound waves at different frequencies in order to reduce pain and inflammation. Some studies have shown that ultrasound is effective for treating knee osteoarthritis, but it's not clear to what extent this is true, which led researchers to conduct a in-depth study called a systematic review. To perform the review, researchers identified 10 studies with information on 645 individuals and compared their findings. Results showed that therapeutic ultrasound appears to be beneficial for patients with knee osteoarthritis, as six studies suggested it was more effective than sham ultrasound and no treatment, and three suggested it significantly reduces disability in physical function.

Exercises that strengthen the hip are helpful for patients
with common cause of knee pain

Patellofemoral pain syndrome, commonly referred to as runner's knee, is a broad term used to describe pain that occurs in the front of the knee and around the kneecap. Although many cases of runner's knee improve after patients seek out treatment like physical therapy, about 80% of individuals who develop runner's knee still have pain five years later. One possible reason for this is that people who develop runner's knee have weak muscles around their hips, but this is not a universally held belief. Nonetheless, some treatment programs for runner's knee focus on strengthening the muscles around the hips, and research is needed to evaluate their effectiveness. Therefore, a powerful study called a systematic review was conducted, which collected and reviewed 21 studies on the topic. Most of the studies reviewed showed that the exercises reduced pain and improved hip function for patients with runner's knee. Other analysis found that hip-strengthening exercises reduced the chances of runner's knee developing in the first place as well.

Vast majority of individuals with no symptoms
have signs of bulging disc in neck

Magnetic resonance imaging (MRI) scans are commonly used to capture images of the spine and diagnose many disorders in the region that cannot be detected any other way. Medical professionals like surgeons use these MRIs to make decisions about the most appropriate treatment to prescribe, and sometimes to determine if a patient needs surgery or not. Unfortunately, some doctors suggest surgery even if abnormal MRI findings are the only reason for their decision. Instead, they should only be making this call if other symptoms like back pain are also present in the patient. To develop a clearer understanding of just how many people have abnormal MRI findings of the neck, a study was conducted of individuals with no signs of neck pain. Results showed that of the 1,211 volunteers without any symptoms of neck problems, the vast majority (87.6%) had significant disc bulging on their MRIs. Since bulging discs are so common, medical professionals should only evaluate the findings of patients' MRIs along with the actual symptoms they are experiencing. Patients should also be aware that having a bulging disc - or discs - is usually quite normal and should not be a matter of concern until other symptoms arise.

November 2016

A treatment program that includes specific exercises and hands-on therapy
is helpful for patients with repeated ankle sprains

Ankle sprains are the most common injury in athletes and those who are physically active. In addition to the initial pain and disability that these injuries cause, up to 40% of patients who sprain their ankle once will go on to develop a condition called chronic ankle instability. Those who experience chronic ankle instability deal with continual pain and soreness, and are more likely to sprain their ankle again in the future. Two strategies used by physical therapists for treating these patients are manual therapy and exercise therapy. Both have been found to lead to benefits, but it's not completely clear what effect they have when used together. Therefore, a powerful study called a randomized-controlled trial (RCT) was conducted. Results showed that the combination of manual therapy and exercise therapy led to lower levels of pain, better ankle stability and greater flexibility overall. Patients with chronic ankle instability should therefore seek out these services from a physical therapist to reduce their chance of future ankle sprains.

Prevention program that includes dietary changes
and more physical activity significantly reduces the rate of diabetes

Obesity is a major health crisis in the U.S., as almost two-thirds of Americans are currently overweight or obese, and 300,000 people die every year due to obesity and obesity-related diseases like diabetes. For this reason, several medical organizations have developed specific programs to decrease the rate of obesity and diabetes, but not all programs have been successful. To better guide medical professionals who deal with these types of patients, a paper was released that highlighted the most important characteristics of an effective prevention program. The program consisted of guidance from a lifestyle coach, 24 weeks of a Mediterranean-style diet, at least 150 minutes of moderate-intensity physical activity each week and walking 10,000 steps a day. The prevention program was found to be effective, as there was a 58% reduction in the rate of diabetes in participants compared to groups that received placebo or medications only. Those who are at risk for developing diabetes (prediabetics) should therefore seek out guidance from a medical professional and follow a similar prevention program in order to reduce their risk.

Combining education with physical activity and specific exercises is beneficial for patients with long-term neck pain

Neck pain is a major problem that affects an estimated 30-50% of the population each year. Although most cases of neck pain improve on their own within a reasonable amount of time, for some individuals it becomes a long-term problem, which is called chronic neck pain. There are many treatments available for chronic neck pain, and education and specific exercises for the neck are considered beneficial interventions, but there is a lack of information that evaluates the two treatments being used together. A powerful study called a randomized-controlled trial was therefore conducted, and results showed that patients who received both education and exercises had better muscle function, neck flexibility and pain threshold, as well as improved mood and both mental and physical quality of life.

October 2016

Adding hands-on movements from a physical therapist to stretching exercises is more beneficial for patients with shoulder condition

Adhesive capsulitis, or frozen shoulder, is a condition that causes stiffness and pain in the shoulder joint. It restricts the function and motion of the shoulder, which makes it difficult to perform many activities normally. One of the many treatments available for frozen shoulder is called joint mobilization, in which a physical therapist moves the shoulder in different directions to increase its flexibility and reduce pain. Another is manual stretching exercises, which are stretches that are also performed by a physical therapist for the same purpose. Research has found both of these treatments to be effective for frozen shoulder, but they have not been evaluated when used in combination. Therefore, a study was conducted to investigate this, and it found that the patients who received the combination experienced better outcomes than those who had stretching exercises only. These findings suggest that adding joint mobilizations to manual stretching exercises leads to the best possible outcomes for frozen shoulder, and makes a case for physical therapists including both treatments whenever dealing with these patients.

Seeing a physical therapist early for neck pain is better than waiting

Under the current system, most health care in the U.S. is delivered in a model that allows doctors to receive payment regardless of whether patient improve. It's one of the main reasons healthcare costs are so high, and is part of the problem that needs to be fixed. One possible solution to reduce costs is to recommend early physical therapy for disorders like neck pain, the second most common painful condition behind low back pain. Doing so may save patients money, but it has not been well researched, which prompted a new study. The results showed that patients who received early physical therapy experienced better outcomes with less disability and pain than those who delayed it. This was found to be the case not only in their actual outcomes, but in their value as well, since patients got more out of each dollar they spent with early physical therapy over delayed physical therapy. This topic requires more research, but patients with neck pain are encouraged to seek out physical therapy early rather than waiting in order to receive the greatest possible benefits while saving money.

Surgery is not found to be any more effective than non-surgical treatment for tears of the rotator cuff

The rotator cuff is a network of tendons and muscles in the shoulder that keep it stable and allow it to move in a variety of directions. This region is also a common site for injuries like tears, especially in the athletic population and older adults. Treatment for rotator cuff tears usually consists of either surgery or a non-surgical (conservative) approach like physical therapy; however, there is no clear evidence that shows one treatment is superior to the other. For this reason, a powerful study called a meta-analysis was conducted, which analyzed all available research on the topic to determine which of these treatments should be used. Results showed that after one year, no significant differences were found between patients who had surgery compared to those who had conservative treatment. Individuals with this injury should therefore seek out physical therapy first before even considering surgery, which is a more expensive approach that comes with far greater risks.

September 2016

Getting lots of physical activity significantly reduces the risk for developing several medical conditions

Being physically active on a regular basis is beneficial and has a protective effect against many diseases and health conditions, but it’s not clear how this effect differs based on the amount of physical activity achieved. To investigate this in more detail, a powerful pair of studies called a systematic review and meta-analysis was conducted. The systematic review gathered all of the highest-quality evidence on the topic available, and the meta-analysis compared the findings of these studies to one another to establish a conclusion. Results showed that higher levels of total physical activity were associated with a lower risk for five health conditions studied, but these benefits level off after a certain point. Individuals should therefore strive to achieve an ideal amount of physical activity each week in order to obtain the most benefits, but have a limit so they don’t overwork themselves.

The use of physical therapy improves health and is effective for its cost

The cost of health care is continuing to rise throughout the world, and millions of Americans either don't have insurance or are not satisfied with their plan. One concept that plays a major role in bringing down costs is called cost-effectiveness, which essentially determines how much someone is getting out of a treatment based on how expensive it is. Physical therapy is considered by many to be cost-effective, but studies are lacking that clearly illustrate this. Therefore a powerful study called a systematic review was conducted, and results showed that physical therapy—either on its own or added to usual care—led to improved overall health and was in fact cost-effective. More tha half of the studies reviewed supported physical therapy as a cost-effective treatment, and it should therefore be recommended to any individuals dealing with either short- or long-term pain.

Physical therapists may be an alternative to seeing a doctor first for painful conditions

A large percentage of the population is getting older, and as a result, there will also be an increase in the number of health conditions related to old age. Currently, most individuals with painful conditions like back or knee pain see their general practitioner first for treatment or a referral to another doctor. But with the growth in the population of older adults, there will come a time when general practitioners won't be able to handle this amount of patients. One possible solution is to have patients see a physical therapist for these conditions instead, which can help them get the care they need more quickly. Since evidence is lacking on this type of approach, a study was conducted in which patients were given the option of seeing a physical therapist instead of their general practitioner for a painful condition. Results showed that this approach was safe, effective and less expensive, and also led to complete satisfaction in 70% of patients. Patients may therefore consider making an appointment with a physical therapist rather than their general practitioner the next time they experience a painful condition.

August 2016

Patients who see physical therapists that follow guidelines spend less time and money on treatment

Approximately 84% of the population will go on to experience at least one episode of low back pain at some point in their lifetime. Most of these cases will improve completely in 2-4 weeks, but about 25% of individuals have to deal with long-term pain and other problems. Physical therapists are one of the many different types of medical professionals that treat patients with long-term—or chronic—low back pain, and they are all supposed to follow a set of guidelines in order to provide the best possible care. Unfortunately, only about 30% of physical therapists actually follow these guidelines, and this may have an effect on the outcomes patients experience and how much they spend on treatment. To develop a clearer understanding of how following these guidelines can impact the care patients receive, a powerful study called a systematic review was conducted. The findings showed that when physical therapists gave treatment in line with guidelines, patients needed fewer visits to improve and spent less overall than those who did not. Patients with low back pain should therefore check to see if their physical therapist is following the current clinical practice guidelines for low back pain before making any treatment decisions.

Using desks with a standing capability may increase work productivity

The majority of Americans spend far too much time sitting every day, mainly due to the prevalence of desk jobs. Studies are now continuing to show how dangerous this type of behavior can be, and that it can contribute to health conditions like obesity, heart disease, diabetes and cancer. One method that has been suggested to address this problem is to use desks that can be switched to a standing mode at offices, which will encourage employees to stand more. For this reason, a study was conducted to determine what type of effect having these desks would have on the individuals using them. The results showed that the workers who were using these “stand-capable” desks were more productive than those using the standard seated desks. This study can serve as a precedent and hopefully encourage more businesses to strongly consider using these types of desks in their offices.

Strengthening exercises can be used as an effective alternative to surgery for bunions

Hallux valgus is a deformity of the foot that leads to a growth of bone on the side of the big toe, which is called a bunion. About 64 million Americans have bunions, and they are most common in older females. Surgery is currently the only treatment available to correct bunions, but in about 15% of patients who have surgery, the bunion returns in the future. Instead of surgery, another approach is to have patients perform a variety of strengthening exercises for the muscles in the foot, which can reduce pain and help patients walk more easily. To highlight the importance of this alternative to surgery, a paper was published that explained some of the most effective strengthening exercises for bunions. The paper recommends completing an exercise-training program to increase strength and the ability to produce force with the foot at least once a day, which can be taught to patients by physical therapists.

July 2016

Walking meetings may be a feasible way to increase physical activity in the workplace

Spending most of the day sitting on a regular basis is now well known to lead to various health-related issues. Walking, on the other hand, has a positive impact on overall health, and doing so for as little as 30 minutes a day can reduce the risk for many health conditions. With this in mind, walking meetings have been growing in popularity in recent times. Although this concept has been around for a while, no studies have been performed to investigate its effects on physical activity yet. Therefore, a study was conducted in the workplace setting. Results showed that participants increased the amount of time engaged in physical activity during weeks in which they used walking meetings. The study also showed that walking meetings were feasible and well received by the participants, which should encourage businesses to consider using this type of strategy to improve physical activity levels.

Physical activity reduces the risk for getting 13 different types of cancer

More than 550,000 Americans die each year of some form of cancer, which is the second leading cause of death in the country. In addition to finding better ways to treat and diagnose cancer, many efforts are also ongoing to find ways to prevent it. One factor that may help with prevention efforts is increasing physical activity levels. Physical activity is know to reduce the risk of heart disease, colon, breast and endometrial cancer, and a number of other conditions, but it’s not clear how it affects one’s chances of developing all other cancers. Therefore, a study was conducted to more thoroughly investigate the connection between physical activity and 26 different types of cancer. Results from 12 studies with data on 1.44 million individuals showed that a higher level of physical activity was associated with a lower risk of 13 of the 26 cancers evaluated. This study—the largest of its type ever performed—provides clear evidence that physical activity is not only good for you, but it may also reduce your risk for cancer.

Following a course of exercise leads to similar results compared to surgery for knee injury

The meniscus is a crescent-shaped piece of cartilage between the thighbone and the shinbone, and its job is to stabilize the knee and absorb shock. Damage to the meniscus (meniscal lesion) can occur from an injury or gradual changes over time due to aging. Although most patients with meniscal lesions are told to follow a “wait and see policy” that usually involves physical therapy, those who are in extreme pain or don’t improve may have surgery to address their condition. After surgery, exercise therapy (a form of physical therapy) is often recommended to help patients improve; however, it’s not clear how effective this approach is. Therefore, a powerful study was conducted to determine the effectiveness of exercise therapy for these patients. The results showed that exercise therapy and surgery led to similar results for patients overall. In addition, exercise therapy was found to help patients improve more rapidly after surgery than if they did not receive any treatment. This study shows that exercise therapy can be considered an alternative to surgery for these meniscus lesions, and when surgery is performed, it can also be effective for helping them rehabilitate afterwards.

June 2016

Recent review highlights the importance of exercise to reduce falls in older adults

Falls are a major problem for adults who are 65 and older, since about 35% of individuals in this age group fall each year. Falls are the main cause of injury, disability and death in this older population, and they can lead to many long-term complications. In addition to the physical toll that suffering a fall can have, it can also affect mental wellbeing and reduce quality of life. Although many recommendations are given in an effort to reduce falls, even greater efforts are needed. For this reason, an updated review was performed on all the best available evidence on the topic. Some of the most important recommendations of the review included the following: doctors should ask patients once a year if they have fallen recently, perform an assessment to decide if they are at an increased risk, and prescribe an exercise program that includes exercise and physical therapy to reduce overall fall risk.

Patients with arthritis of the hip or knee seem to benefit from water-based exercise

Osteoarthritis is a condition in which protective cartilage that normally prevents bones from rubbing against one another gradually wears away. It can occur in any joint of the body, but it's most common in the hips and knees. One of the many treatments available for osteoarthritis is called aquatic exercise, in which patients perform a series of exercises while being immersed in water that's between 90-97°F. The warmer water is believed to reduce pain and stiffness, and may offer some benefits over land-based exercise. To evaluate the extent of these benefits, a high-quality study called a Cochrane review was conducted on aquatic exercise for hip and knee osteoarthritis. Results showed that aquatic exercise does in fact lead to less pain, less disability and a better quality of life for patients. Based on this, aquatic exercise should be considered a safe and effective treatment for patients with hip or knee osteoarthritis, and in some cases it may be preferred to land-based exercise if patients get more out of it.

Having physical therapy after hip surgery may lead to better outcomes than normal care

In hip osteoarthritis, cartilage at the end of joints becomes thin to the point that bones eventually start rubbing against one another. This leads to pain, weakness and difficulty walking, which makes normal functioning a major chore. Non-surgical treatments like physical therapy are recommended at first, but many patients that don't improve decide to have surgery instead. After surgery, some of these patients are referred to physical therapy to help them get back to full strength, but for some reason these rates are declining. Therefore, a study called a randomized-controlled trial was conducted to determine if having physical therapy after surgery was more effective than the usual, standard treatment. The findings of this trial were supportive of physical therapy: patients who received it improved significantly more in walking speed and overall daily function than patients who received usual treatment. This study should encourage the use of more physical therapy for patients recovering from surgery in order to help them regain their strength and functioning as efficiently as possible.

May 2016

New guidelines from the CDC are designed to help doctors prescribe opioids more safely

Opioids are natural or synthetic chemicals - such as hydrocodone (Vicodin), oxycodone (OxyContin), methadone and fentanyl - that are used to reduce pain. Today, there is a major problem with the over-prescription, overuse and abuse of these drugs. Part of this is due to the fact that many primary care doctors having difficulty treating patients with chronic (long-term) pain. This highlights the need for more guidance to assist doctors managing patients in chronic pain. Therefore, the Centers for Disease Control and Prevention (CDC) created an updated set of guidelines. This included 12 important recommendations on when and how to prescribe opioids, such as using non-opioid drugs and other treatments first before opioids, establishing treatment goals with patients before starting the use of opioids, prescribing the lowest effective dosage and immediate-release opioids to patients, evaluating the harms of benefits of these prescriptions over time, and arranging appropriate assistance to patients with opioid use disorder.

Having physical therapy before ACL surgery leads to better outcomes for patients

Injuries to the knee account for almost 45% of all sports-related injuries, and the anterior cruciate ligament (ACL) is the most commonly damaged structure of the knee. The main treatment for ACL injuries is a surgical procedure called ACL reconstruction, and before surgery, many patients are prescribed a course of physical therapy to prepare the knee. The goal of treatment is to increase muscle strength and function, and reduce damage to the knee in order to shorten the time of recovery. Although this form of physical therapy is commonly used, there is not much research to support it, and for this reason a large-scale study called a systematic review was conducted. The findings of this review showed that even though there was a range of treatments used, they were found to improve outcomes for patients with ACL injuries overall. Patients preparing for ACL reconstruction should therefore ask their doctor or surgeon about physical therapy before surgery if the treatment is not already offered.

Properly examining the neck can lead to a more accurate diagnosis of headaches

Headaches are extremely common, as about 96% of people will experience at least one of them in their lifetime. Cervicogenic headaches are one type of headache that results from a dysfunction of the neck region of the spine, and they account for about 15-20% of all headaches. One problem with a cervicogenic headache is that many of their signs and symptoms overlap with other types of headaches, and it's difficult to properly diagnose them. For this reason, a powerful study called a systematic review was performed to determine the best physical examination to diagnose cervicogenic headaches. Results showed that the cervical flexion-rotation test was most accurate. This is a test performed by a physical therapist that has patients flex and rotate their neck to see how it moves. By using this test, physical therapists can more accurately diagnose these types of headaches and give patients the proper treatment they need.

April 2016

Athletes who have surgery return to sports at about the same rate as those treated without surgery

Low back pain is a common issue for many competitive athletes that can cause long-term complications if it's not treated properly. Although there are many causes of low back pain, a condition called herniated disc is often responsible in the athletic population. When it comes to treating herniated discs, it's not clear whether using surgery or non-surgical methods are more effective, even though surgery was once considered the norm. For this reason, a powerful pair of studies called a systematic review and meta-analysis was conducted on the topic. The meta-analysis assessed 14 studies with data on both professional and amateur athletes, and results showed that there were no significant differences between athletes treated with surgery and those treated with other approaches. While some athletes returned to their sport quicker after having surgery, others returned quicker following other treatments, and the rates were quite similar. Based on this finding, athletes with a herniated disc should utilize non-surgical treatments like physical therapy first before considering surgery, which is more expensive and carries a greater risk for complications.

Hands-on therapy applied to the upper spine helps reduce headache occurrence

A cervicogenic headache is a headache that's caused by a problem with the bones or other structures within the neck. Cervicogenic headaches account for as many as 20% of all headaches, and they are especially common in patients that have experienced whiplash. One of the more common treatments for cervicogenic headaches is called spinal manipulative therapy, which includes mobilizations and manipulations performed by the hands of a physical therapist. Although some research has evaluated the effects of mobilization and manipulation, no studies have directly compared them in treating cervicogenic headaches. For this reason, a study called a randomized-controlled trial (RCT) was conducted, which randomly assigned 107 patients to two separate treatment groups. Results showed that although both groups experienced improvements, patients who received manipulations had less headache duration, intensity and frequency. The study shows that spinal manipulation can be effective for cervicogenic headaches, and patients who suffer from this condition should therefore consider seeing a physical therapist for appropriate treatment.

Patients with hip fracture found to move better after performing certain exercises

Hip fractures are very common injuries in the elderly population, and they are often severe. Most older individuals that fracture their hip are treated with surgery, but only about 30% of them patients regain the same level of physical function as before. Following surgery, many patients go through rehabilitation that's designed to improve their mobility and function and help them move normally again. One type of rehabilitation commonly used is called structured exercise, but it's not clear if this approach actually improves patient's overall mobility. For this reason, a powerful pair of studies called a systematic review and meta-analysis was conducted, which assessed 13 high-quality studies on the topic. The outcomes showed that structured exercise does in fact help patients improve after surgery for hip fracture, and the most effective programs were those that used resistance—like weights and resistance bands—and took place outside of a hospital. Rehabilitation programs that incorporate these elements should therefore be used for these patients to help them recover as quickly and completely as possible.

March 2016

An exercise program that targets the hip muscles is best for painful knee condition

Patellofemoral pain syndrome (PFPS), or runner's knee, is a very common condition in which the kneecap rubs against the upper leg bone. Runner's knee occurs most frequently in physically active individuals and leads to pain that gets worse from running, squatting or climbing stairs. There are many different approaches for treating runner's knee, and one new approach suggests that strengthening a group of muscles around the hip and pelvis may be one option, but more research is needed on the topic. For this reason, a powerful study pairing called a systematic review and meta-analysis were conducted. Results showed that programs that strengthened these muscles led to reduced pain and improved function for patients, and when these exercises were combined with quadriceps-strengthening exercises for the thighs, results were even better. Patients with runner's knee should therefore consider seeing a physical therapist for an exercise program that involves these types of exercises.

Hands-on physical therapy techniques are more effective than medications for headaches

A tension-type headache is what we think of as a normal, everyday type of headache. They are the most common type of headaches in the world, but the causes that lead to them are not well understood. Although pain medications are typically used to treat tension-type headaches, many doctors also prescribe physical therapy and relaxation therapies; however, there is a general lack of research on its effects, especially one type of physical therapy called manual therapy. In manual therapy, the therapist performs a series of mobilizations and manipulations on the patient with their hands to relieve pain. Therefore, a powerful pairing of studies called a systematic review and meta-analysis was conducted. Results found that manual therapy reduced the frequency, intensity and duration of tension-type headaches more than pain medications, which shows that physical therapy can serve as an alternative treatment to taking pills for headaches.

Surgery and physical therapy lead to very similar results for patients with back condition

Lumbar spinal stenosis (LSS) is a common condition in which the space that surrounds the spinal cord narrows, which can cause pain and weakness in the lower back, buttocks and thighs. Treatment for LSS may be either surgical or conservative (non-surgical), which often includes physical therapy and exercise. Although surgery and physical therapy have been compared in studies before, it’s still not clear which is superior for treating LSS. For this reason, a powerful study called a randomized-controlled trial was conducted that directly compared these two types of treatment for LSS patients. At the end of the study, there were no major differences between patients that had surgery or physical therapy in regards to relieving their symptoms and improving their function, and this was found to be the case for up to two years. Surgery also led to many more complications that physical therapy. This study points out that both treatments lead to very similar results, but surgery is much more costly and causes more complications than physical therapy. Therefore, patients with LSS should carefully weigh their options when deciding which treatment is best for them.

February 2016

Multiple types of physical therapy and exercise are helpful for women recovering from breast cancer surgery

Whiplash is a neck injury that occurs from a forceful, back-and-forth movement of the neck. It often leads to pain and stiffness that can last for a while, and about 50% of patients that have a whiplash injury experience symptoms for more than one year. When it comes to treating these patients, many are told to remain physically active and perform general exercises for their pain, even though research has shown that specific exercises for the neck are more effective. Since this topic has not been investigated in much detail, a study was conducted that compared multiple different approaches for patients with whiplash symptoms. Results showed that neck-specific exercises helped patients improve more than general physical activity, as previous studies have already shown. For this reason, patients dealing with symptoms from a whiplash injury should be treated with these types of exercises from a physical therapist rather than being told to keep to a general exercise regimen.

Specific exercises are better than general physical activity for patients with whiplash

Whiplash is a neck injury that occurs from a forceful, back-and-forth movement of the neck. It often leads to pain and stiffness that can last for a while, and about 50% of patients that have a whiplash injury experience symptoms for more than one year. When it comes to treating these patients, many are told to remain physically active and perform general exercises for their pain, even though research has shown that specific exercises for the neck are more effective. Since this topic has not been investigated in much detail, a study was conducted that compared multiple different approaches for patients with whiplash symptoms. Results showed that neck-specific exercises helped patients improve more than general physical activity, as previous studies have already shown. For this reason, patients dealing with symptoms from a whiplash injury should be treated with these types of exercises from a physical therapist rather than being told to keep to a general exercise regimen.

Adding specific training exercises to education makes it more effective for neck pain

Neck pain is a common disorder that affects about 37% of the population. In some cases, patients deal with pain that does not improve after three months, at which point it's labeled chronic neck pain. Studies have shown that both exercise training for neck muscles and education are effective for chronic neck pain, but it’s not clear how they work when used together. Therefore, a powerful study called a randomized-controlled trial was conducted to compare the effects of both treatments for chronic neck patients. Results showed that the combination of exercise and education was more effective than exercise alone, as patients in this group experienced improved balance and less pain. This suggests that education should be incorporated into any treatment program for neck pain, but it needs to be combined with exercise in order to lead to significant improvements.

January 2016

A combination of therapy, exercise and education is best for neck pain

Chronic neck pain is a common condition in which patients deal with high levels of disability and pain for more than 12 weeks. Some people may also experience psychological issues like depression and anxiety. Though exercise prescribed by a physical therapist is usually effective for this type of neck pain, education may also be needed to help address the psychological issues that patients might be experiencing. To determine just how effective combining exercise and education is, a study was conducted in which patients were treated with education, exercise or both. Results showed that patients in all groups improved, but those who received exercise and education experienced greater improvements overall. This highlights the importance of educating patients in any treatment program for low back pain.

Spreading therapy out over one time may be more beneficial than doing it consecutively

Osteoarthritis, in which protective cartilage surrounding joints gradually wears away, most commonly affects the knees and hips. Manual therapy is a treatment in which a physical therapist performs manipulations and mobilizations with their hands, and it is commonly combined with exercise therapy to treat knee osteoarthritis. In some cases, these treatments are given with "booster sessions," in which patients receive physical therapy every few months after their initial sessions to increase its effectiveness. It is not known how effective this type of approach is for patients with knee osteoarthritis, so a powerful study was conducted to investigate this. Results showed that adding either manual therapy or booster sessions to a regular exercise program can lead to greater improvements for patients with knee osteoarthritis. It may therefore be worth it to consider using booster sessions when prescribing treatment to these patients.

The type of medical professional you see for low back pain may affect recommendations

Low back pain is an issue most people will face at some point in their lives, and when it occurs, each person has a choice of who will treat them. The decision of what type of medical professional to visit first is important and can affect the prognosis, treatments and their costs. To determine just how much this choice can affect the type of care given for low back pain, a study on the topic was conducted. Results showed that when compared to seeing a primary care doctor first, seeing a physiatrist was associated with higher costs and a higher likelihood of having additional tests, injections and surgery. (A physiatrist is a doctor who handles similar conditions to physical therapists, but they only prescribe therapies rather than perform them.) Chiropractors were associated with a longer duration of treatment, while physical therapists were associated with lower costs, shorter duration of treatments and no patients having surgery. Patients should be aware that the decision of what medical professional to see first is their own, but seeing a physiatrist or chiropractor may lead to higher costs and longer treatment than a physical therapist.


December 2015

Injuries related to high heels have increased significantly

About 62% of American women regularly wear shoes with a heel of two inches or greater, which is not recommended because it can be dangerous and lead to various types of injuries. These precautions regarding high heels have been given for some time, but it’s not known if they have affected the rate of injuries, so a study was conducted to investigate this matter. Results showed that over 11 years, the rate of injuries related to high heels increased by about 82%, with the total number of actual injuries nearly doubling. This shows that high heel-related injuries have been on the rise, and that wearing high heels increases the risk for an ankle or foot injury. Those who wear high heels should therefore be aware of these dangers, and make efforts to reduce their risk by avoiding ultra-high heels and wearing their correct size.

Educating patients on low back pain reduces their fears and concerns

Many patients with low back pain experience higher-than-normal stress levels due to their condition. Reassurance is a core aspect of medical practice that is meant to reduce or remove patients’ fears and concerns about their illness, but there are no specific guidelines on how to accomplish this in patients with low back pain. One possible common-sense approach is to better educate patients on their condition and more clearly explain their symptoms, yet somehow evidence is conflicting on this strategy. For this reason, a review of studies was conducted to determine what role education plays on helping patients improve. Results showed that education indeed helped to reassure patients with low back pain about their condition, and even reduced their number of visits to the doctor. This study presents further evidence of the importance of education in helping patients understand their condition and what it entails while working towards improving.

Aggressive physical therapy immediately after surgery is effective for broken wrists

Fractures of the distal radius—the larger of the two bones in the forearm—are very common and usually occur from falling on an outstretched arm. If the fracture is severe enough, surgery may be recommended, which is then followed by rehabilitation. The wrist is usually immobilized for several weeks during this process, but some say this period of waiting is not necessary. For this reason, a study was conducted that compared standard rehab with a more accelerated program, and the results showed that patients who started wrist motion earlier actually reported better mobility and strength than the others. Surgeons are usually extra careful about moving patients’ wrists within the first week after surgery, but this study shows it may be safe and lead to better overall outcomes for those who break their wrist.

November 2015

Performing a preseason screening on young baseball pitchers may help predict injury

Baseball is an extremely popular sport in the U.S., and of the approximately 11.5 million athletes that play, the majority are between the ages of 8-18. Pitchers have the highest risk of injury in all age groups, and are most prone to injuries of the elbow and shoulder. Measures like controlling pitch type and limiting pitch count have been taken in attempts to address this problem, but the rates for injuries in pitchers still remain the same. Shoulder range of motion - the measurement of the pitcher's movement around the shoulder - is considered a risk factor for injury in higher-level baseball, but it hasn't been studied in younger pitchers. For this reason, a study was conducted to see if the same held true for youth and adolescent pitchers, and the results showed that there were in fact differences in certain pitchers that increased their chances of experiencing a shoulder or elbow injury. Monitoring pitchers' shoulder range of motion and making necessary changes over time may therefore be an effective strategy to help reduce the risk for injury in younger pitchers.

Certain factors may influence how long it takes patients to recover from low back pain

Patients with low back pain are usually treated conservatively - without the use of surgery - first before other options are considered. Though many of these patients improve, there is a large amount of variability in the levels of pain and disability they experience after treatment. It's not entirely clear which factors help determine whether or not a patient will improve from treatment, so a study was conducted to learn more about these variables. Results showed that patients who had pain for more than five days and those who had negative beliefs about their low back pain were less likely to recover within 12 weeks of treatment. This suggests that starting treatment as early as possible and addressing misconceptions that some patients have may improve their chances of having a successful outcome.

A manual form of physical therapy more effective than surgery for carpal tunnel syndrome

Carpal tunnel syndrome is a painful disorder that affects up to 11.7% of the U.S. population, and it occurs when a nerve in the wrist is compressed. Treatment for this condition may consist of surgery or may be conservative (non-surgical), but the scientific evidence to support both approaches is conflicting. Manual therapy, in which a physical therapist uses their hands to move and manipulate joints, may be effective for carpal tunnel syndrome; however, it has not been studied well or compared to surgery. For this reason, a powerful study called a randomized-controlled trial was conducted to compare both treatments for carpal tunnel syndrome. After three months, patients who received manual therapy experienced greater relief of symptoms and improved hand function than those who had surgery. After 12 months, these differences were less noticeable, and most patients had a successful outcome. Due to the fact that surgery costs more and can lead to more complications, and since both treatments led to similar results, manual therapy appears to be the better choice for patients with carpal tunnel syndrome.

October 2015

Common type of surgery for knee pain only leads to small benefits and some harms

Arthroscopic knee surgery is a procedure used to treat people with knee pain that has become very common in recent years, especially for middle-aged or older people with knee osteoarthritis. Despite the fact that research has failed to show an added benefit of arthroscopic surgery when combined with other treatments, many surgeons continue to perform the procedure on patients. Since this type of surgery is expensive and its effectiveness is questioned, a powerful review was conducted in which it was compared to other treatments. Results from this systematic review found that arthroscopic surgery led to small improvements in pain, but they only lasted for six months, and no improvements were found for physical function. This study calls into question whether arthroscopic surgery is in fact worth it for knee pain, and suggests that other treatments like physical therapy and lifestyle modifications may be more effective and less expensive.

Comprehensive review shows that exercise is effective for reducing falls in older adults

Falls are still a big problem for older adults, as about 30% of those over the age of 65 will experience a fall at some point. Falls can have serious financial implications and take away from one's abilities and independence, which is why preventing falls is such an important matter. Many programs have therefore been created to reduce the occurrence of falls in the older population, and to evaluate which aspects of these programs are most effective, an umbrella review was conducted. Umbrella reviews are comprehensive reviews on the most high-quality reviews on the topic, and are thus considered to be some of the most powerful types of research in existence. The most prominent finding of this review was that exercise is capable of significantly reducing the rate, risk and odds of falling, with a 13% reduced fall risk and a 61% reduction in the rate of falls. Exercise has long been regarded as an important component of fall prevention, and this powerful review supports this concept even more, and should encourage older adults to exercise more as recommended through a physical therapist.

Manual manipulations are effective for treating jaw disorders

Temporomandibular disorders are a group of any disorders or dysfunctions that affect the temporomandibular joint, which connects your jaw to the side of your head. Treatments for temporomandibular disorders include education, home care, physical therapy and manual techniques, and it's not known which is the most effective. One option is musculoskeletal manual approaches, in which a physical therapist mobilizes and manipulates the jaw, but research to support this approach is lacking. Therefore, a study was conducted, and results showed that these manipulations were effective in reducing pain and increasing range of motion of patients' jaws after being performed. This study suggests that this manual type of approach from physical therapists may be effective for temporomandibular disorders, and patients should consider them as an option if they're experiencing jaw issues.

Treatments used by physical therapists are effective for multiple types of headaches

Most of us experience headaches from time to time, but for others, headaches and migraines are a regular, painstaking occurrence. Most treatments for all types of headaches centers around various types of medications, but non-pharmaceutical recommendations such as physical therapy are also made in certain situations. Unfortunately, there is not much research to support these types of treatments, so a new study pairing was conducted to look into the matter in greater detail. Results showed that different types of physical therapy had positive effects on all types of headaches, and none were associated with negative side effects. Though more research is needed to evaluate other aspects of this topic, patients should be aware of the option of physical therapy to treat their headaches and know that it may be an effective to address their condition without medication.

September 2015

Rehabilitation leads to better overall outcomes than surgery for athletic groin pain

Athletic groin pain, a general term used to describe any long-lasting injury to the groin area, has become more prevalent in recent years and is especially common in athletes who play soccer, Australian rules football and ice hockey. The condition is usually treated either with surgery or rehabilitation like physical therapy and exercises, but the two options have never been directly compared. For this reason, a powerful review was conducted that analyzed the results of 57 studies on the topic to determine if surgery or rehabilitation is more effective for athletic groin pain. Results showed the recovery times for those who underwent rehabilitation were half of those who had surgery, and the two interventions led to similar return-to-play rates. This suggests that rehabilitation has at least a slight advantage over surgery in treating athletic groin pain, and since it costs less and is associated with fewer side effects, researchers recommend it as the best treatment option for this condition.

Training program effective for reducing the rate of ankle sprains in athletes

Ankle sprains are the most common injury in sports, especially those that require lots of jumping, pivoting and/or changing direction. In addition to experiencing pain and disability, athletes that sprain their ankles once are more likely to sustain another sprain in the future, which makes it important to reduce the chances of this occurring. Measures like taping and bracing may be effective, but they have some disadvantages, and it's been suggested that prevention exercise programs are better and avoid these disadvantages. A study followed up on this to determine if specific exercises could reduce the rate of ankle sprains, and results showed that athletes with a history of ankle sprain could benefit substantially from such a program and cut their chances of experiencing another sprain in the future.

Hands-on physical therapy effective for patients with common shoulder condition

Shoulder problems are a fairly common problem, and the most prevalent condition that causes pain is called shoulder impingement syndrome, which usually results from too much overhead activity like playing baseball or tennis. Physical therapy is often recommended as the first line of treatment for shoulder impingement, and it is generally regarded as effective. One type of physical therapy called mobilization with movement has been found to be effective for other conditions, but it has not been well studied for shoulder impingement. This led to the creation of a study in which some patients received mobilization with movement and others received a similar treatment that was not meant to be effective. Results showed that patients receiving the actual treatment improved much more significantly than the others, which suggests that this treatment may be incorporated into future physical therapy programs.

June 2015

Runners with hip pain should be evaluated fully and treated non-surgically

Running is one of the best possible forms of physical activity you can get, but running regularly also comes with a high injury risk, especially for long-distance runners. Hip pain is fairly common in runners, and femoroacetabular impingement (FAI) is one of the many conditions that can cause it. FAI usually leads to pain in the groin and/or deep in the hip that's typically described as a dull ache that gets worse when running on inclined surfaces. But the only way to determine if FAI is actually present is to have a full-scale evaluation by a physical therapist. If FAI is diagnosed, it's important to realize that surgery is not necessary, and the best way to treat it is with strengthening and stretching exercises and education on how to modify their running style to reduce pain and aggravation. That's why it's important to see a physical therapist first for any hip pain you may be having.

Goals of patients with low back pain don't align with those of doctors

Low back pain is one of the most painful common conditions out there, and when it lasts for three months or more, it's classified as chronic. When treating chronic low back pain, medical professionals use a standardized set of outcome measures to determine if their methods are successful or not; however, it's suggested that these measures do not always line up with those of the patients. To investigate this matter in greater detail, a study was conducted on 20 patients with chronic low back pain to determine their opinions and goals of treatment. Results showed that patients' goals varied greatly and were idiosyncratic, meaning many were unique to each patient. When they were compared to the outcome measures used by medical professionals, none were shared in common. These results show patients with chronic low back pain have different views and goals than the medical professionals treating them, and efforts should be made to ensure that the two are more closely aligned.

Aerobic exercise leads to greater improvements than balance training for patients with fibromyalgia

Fibromyalgia is a long-lasting condition in which patients typically experience pain, fatigue, disrupted sleep and issues with thinking clearly. Patients with fibromyalgia are usually treated with aerobic exercise and strength training, which have been found to lead to significant improvements for them; however, some fibromyalgia patients also have problems with balance, and balance training is recommended for them as well. A powerful study was therefore conducted to compare aerobic exercise to balance training for treating fibromyalgia patients, and results showed that both programs led to positive effects, but the aerobic exercise group experienced greater overall benefits. While this study does show that aerobic exercise may be superior, it also highlights that balance training is in fact an effective intervention for these patients, and that it may serve an important role in reducing falls for those with fibromyalgia.

Two types of hands-on physical therapy found to be effective for neck pain

Mechanical neck pain means that the source of the pain is from within the spine or the structures that surround it, and it's one of the most common types of neck pain out there. One of the more common forms of treatment for mechanical neck pain is manual therapy, in which a physical therapist applies pressure directly with their hands to manipulate or mobilize joints. Evidence supports manual therapy to the neck (cervical) or middle of the spine (thoracic) to treat this type of neck pain, but there may be some side effects of this treatment, so a powerful study called a randomized-controlled trial was conducted to investigate this matter in greater detail. Results indicated that one session of two different types of manual therapy to the thoracic spine led to improvements for patients with mechanical neck pain, though one was associated with more side effects. Based on this, it appears that just one session of manual therapy can be an effective strategy for managing patients with mechanical neck pain.

Strength training more effective than balance exercises for improving stability in elderly

Falls remain one of the most important concerns for older adults. Poor balance, weak muscles and declining abilities all increase the risk for a fall, and experiencing one can lead to long-term disability and dependency. It's for this reason that many fall-prevention programs are offered for the elderly community, which typically consist of strength and balance training. Though many programs include strength training, few studies have evaluated its effects exclusively, which led to the creation of a powerful study that evaluated its specific impact on older adults. When compared with a traditional balance exercise program, a strength-training program was found to lead to greater improvements for participants, which may translate to a greater impact on reducing fall risk. Though improving balance is essential and should not be overlooked, this study suggests that incorporating strength training may be another important component of these fall-prevention programs that should also be considered.

Comprehensive exercise program more effective than strengthening exercises alone for women with knee pain

Patellofemoral pain is a general term used to describe pain at the front of the knee, and it's regarded as one of the most prevalent knee disorders among athletes. Females have a higher risk for developing this type of pain, and weakness of the muscles around the hip is a risk factor that increases the likelihood of it developing. For this reason, physical therapy that focuses on strengthening these muscles is often recommended, but new research suggests that these types of programs should be even more comprehensive with additional components. A study was therefore conducted that compared standard training to a more comprehensive training program for patients with this condition, and results showed that the comprehensive program led to greater benefits in strength, physical function and pain after three months. It's believed that the verbal feedback provided by the therapist and the progression of exercises in the comprehensive program helped lead to more significant improvements, and researchers believe that implementing this type of program will be more beneficial for patients with patellofemoral pain.

May 2015

Acetaminophen not found to be very effective for low back pain or osteoarthritis

Low back pain and osteoarthritis of the hip and knee are two of the leading causes of disability. Treatments vary widely for these conditions, but in many instances, doctors recommend that patients take pain-relieving drugs like acetaminophen. Guidelines generally support these recommendations, but some evidence has emerged recently that has started controversy regarding the safety of acetaminophen and if it should be so routinely recommended. This led to a comprehensive study called a systematic review, which evaluated all literature on the topic. The review found high-quality evidence that acetaminophen had a significant but small effect on hip or knee osteoarthritis, but it also found high-quality evidence that it was not effective for low back pain and that it increased the risk of having abnormal results on a liver function test by nearly fourfold. This does not necessarily mean that acetaminophen should not be taken, but that it should be done so in moderation and also supplemented by physical therapy to address these conditions.

Aquatic exercise leads to various improvements for men with type 2 diabetes

Type 2 diabetes is a common disorder in which the pancreas doesn't make enough insulin or the body can't use insulin well enough, which can cause many physical problems. Due to the fact that it's associated with being overweight or obese and lack of physical activity, exercise is regarded as the treatment of choice for these patients, and has been found to lead to many benefits. It's possible that aquatic exercise - which is performed underwater - may be ideal for some type 2 diabetics since it's easier on joints, and a study was conducted to investigate this matter. Results showed that patients experienced a number of both physical and emotional improvements after the aquatic exercise program, including decreased blood glucose values, increased ability to breathe, reduced blood pressure and better quality of life. These findings suggest that an aquatic exercise program seems to be safe and effective for men with type 2 diabetes, and it should be strongly considered for these patients, especially if their condition makes it difficult to exercise on land.

Low back pain patients who get imaging tests more likely to have additional treatments

Low back pain is one of the most common and expensive conditions in existence. Part of the reason for the high cost is that many patients with low back pain are instructed to have imaging tests like MRIs, even though many times they are unnecessary. Seeing a physical therapist right away is an alternative to these tests, but there is little research that compares the two directly, so a study was conducted to do just that. Results showed that patients who were ordered to have imaging tests within the first six weeks after seeing a primary care doctor were much more likely to have surgery, injections, see a specialist or visit an emergency room within one year than those that didn't. This study shows that imaging tests can lead to unnecessary and expensive interventions that may not even create a better outcome, while physical therapy has been proven to improve low back pain at a much lower cost.

April 2015

Adding acupuncture-like dry needling to a physical therapy program may help reduce headache symptoms

Headaches are very prevalent in the general population, as they account for about 40% of all neurological (nervous system-related) complaints. Of the more than 100 different types of headaches, the most common are called tension-type headaches, in which a tightening sensation occurs across the forehead or the sides or back of the head. There are a number of different treatments available for tension-type and cervicogenic headaches (another common type), but an emerging technique called dry needling may hold some promise. Dry needling is fairly similar to acupuncture in that a thin needle is inserted into muscles in order to "reset" them, which is believed to reduce pain and increase function as a result, and it's possible that combining it with physical therapy can lead to even better results. This has not yet been clearly proven, so a study was conducted that evaluated the effects of dry needling combined with physical therapy. Results showed that the dry needling was in fact effective at reducing headache symptoms, but evidence was lacking on their combined use. This suggests that dry needling may be a useful tool for physical therapists to add to their repertoire, but more evidence is still needed to confirm this.

Non-surgical treatment just as effective as surgery for patients with shoulder fractures

Fractures of the proximal humerus, the top of the upper arm bone that connects to the shoulder, are particularly common in adults over the age of 65 who have osteoporosis. These types of fractures can be treated with surgery or conservatively (non-surgically), and though the rates for surgery are increasing, there's no hard evidence that it's a more effective treatment. To evaluate which treatment was more effective, a study was conducted in which 250 patients with shoulder fractures were either given one of two types of surgery or partook in a rehabilitation program led by a physical therapist. Results showed that there were no significant differences between all three groups for up to three years, which suggests that both types of surgery and rehabilitation led to very similar results, and that surgery may not be necessary in many cases.

Patients with knee osteoarthritis can improve with non-surgical treatment regardless of imaging tests results

Knee osteoarthritis is a condition in which protective cartilage gradually wears away over time, leading to bones rubbing against one another and resulting in pain. Doctors can often tell how much the knee osteoarthritis has progressed and how severe it is based on a patient's symptoms, but in some cases, they order imaging tests like MRIs and CT scans. Some believe that using these tests will help predict how well a patient will respond to non-surgical treatment, but there's not enough evidence to support this theory, and a study was conducted to investigate it. Based on questionnaires of more than 1,400 patients with knee osteoarthritis, no association was found between the severity of each patient's condition on imaging tests and their pain levels after treatment. These results suggest that patients are just as likely to improve with non-surgical treatment regardless of what their imaging tests show, and means that these tests are often unnecessary and expensive steps that interfere with treatment getting started.

March 2015

List of key messages for osteoarthritis patients highlights importance of exercise, weight loss and education

Hip and knee osteoarthritis (OA) are conditions in which cartilage in the joint gradually wears away, eventually leading to long-term pain and disability. OA can negatively impact patients' lives, and rising obesity rates and an aging population make it likely that more people will suffer from it in the future. Strategies that allow patients to self-manage their OA can significantly improve outcomes; however, there are some barriers to this approach and guidelines may not be clear enough for patients. Therefore, a study was conducted to compile a list of essential messages for patients with hip or knee OA in plain language that's clear and easy to follow.

Patients with heel pain for shorter duration respond better to physical therapy

Plantar heel pain (PHP) is an umbrella term that includes plantar fasciitis and any other conditions that cause pain in the heel or the plantar fascia, a thick band of tissue that supports the arch of the foot. PHP is the most prevalent foot condition treated by podiatrists and physical therapists. Though many patients are able to improve with conservative (non-surgical) treatment like physical therapy, up to 50% of them continue to have symptoms afterwards, and for 30%, it's a recurring issue. One explanation is that certain characteristics of patients like age, weight or duration of PHP could make them more or less likely to respond well to treatment, but no evidence exists to support this. Therefore, a study was conducted to investigate these factors and determine if they play a part in each patient's response to physical therapy.

Patients with painful conditions have poorer physical fitness and do less vigorous exercise than others

The health benefits of regular physical activity and good physical fitness seem to be countless. Some of these include better respiration, increased strength and a reduced chance of developing diseases and other painful conditions. Data from hospitals shows that some patients with certain conditions are less physically active than healthy people. But for patients with various musculoskeletal conditions—which consists of nearly any type of pain or disability in bones, muscles or joints—who are receiving physical therapy, it's not known if the same is true. Therefore, a study was performed to compare the levels of physical activity and physical fitness between patients with various long-term musculoskeletal conditions receiving physical therapy and a random selection of other people.

February 2015

Many patients found to have back conditions despite lack of symptoms

Low back pain (LBP) affects about 80% of the population at some point, and it's associated with major economic consequences. Advanced imaging tests like magnetic resonance imaging (MRI) and computed tomography (CT) scans are becoming increasingly common in to evaluate these patients. These tests often reveal back disorders such as disc degeneration (a condition in which discs in the spine begin to wear away) that are interpreted to be the cause of the pain. This may lead to surgical procedures and other treatments that may not be necessary and sometimes fail to alleviate symptoms. The fact that some people can have abnormal findings on tests without having LBP symptoms helps to explain this. But to get a better idea of just how many people fall into this category, a powerful systematic review was conducted on all relevant literature on the topic.

A physical activity program reduces mobility issues in older adults

The life expectancy for older adults has been continuing to increase, and those 65 or older are now the fastest growing portion of the population. As this age group keeps growing, it's important to help preserve their ability to live independently and function well. Mobility, the ability to walk without assistance, is a major component of functioning independently, and those with low mobility often experience a lower quality of life. Physical activity is believed to prevent or delay the onset of disability issues with mobility, but no studies have tested this over a long period. Therefore, a powerful study called a randomized-controlled trial (RCT) was conducted to evaluate the long-term effects of a physical activity program on the mobility of older adults.

Education saves patients money and improves their opinions following back surgery

Lumbar radiculopathy (LR) is a condition that results from a compressed (squeezed) spinal nerve that leads to pain, numbness or weakness in the arms or legs. Non-surgical treatment is typically used as the first line of treatment, but when this fails or symptoms worsen, back surgery may be recommended. Though most surgeries are successful, 10-40% of patients continue to experience pain and disability. For this reason, rehabilitation is often prescribed after surgery, but its effects vary. Neuroscience education (NE), which helps patients understand the recovery process, may be added and has had positive effects on low back pain patients; however, it hasn't been evaluated on patients after surgery. Therefore, a study was conducted to determine the effects of NE on patients after having surgery for LR.

January 2015

More use of physical therapy linked with less back pain in older adults

Back pain is a prevalent condition in the entire population, as 80% of people will experience it at least once. It's particularly common in older adults, as up to 33% of individuals over the age of 65 experience it regularly, which limits their abilities and reduces quality of life. As the U.S. population continues to age, the number of cases of back pain and need for effective treatment will both continue to grow. Physical therapy is commonly used to address these physical limitations in older adults, but its overall impact on pain and function is unknown. For this reason, a study was conducted to investigate the association between the type and amount of physical therapy on disability and pain in older adults with back pain over one year.

Physical therapy produces similar improvements but costs less than injections for shoulder pain

Shoulder impingement syndrome (SIS) is a general term used to describe numerous conditions that cause shoulder pain. SIS typically prevents patients from performing overhead activities like throwing and lifting, and may cause further complications if not treated properly. Two popular conservative (non-surgical) treatment options are steroid injections and manual physical therapy (MPT), in which therapists use their hands to manipulate joints and muscles. Although both are commonly used, there is some inconsistency regarding their overall effects, and the two treatments have never been directly compared. In response, a powerful study called a randomized-controlled trial (RCT) was conducted to compare their effectiveness on SIS over one year.

Non-surgical treatment recommended for patients with common knee pain

Anterior knee pain, which occurs at the front and center of the knee, is one of the most common knee complaints in physically active people. Its cause is still unclear, but is believed to be the result of numerous factors. Non-surgical treatment is typically recommended for anterior knee pain and should be given for at least three months before other considerations are made. In attempts to guide physical therapists treating this condition, a comprehensive guide was created.


December 2014

Poor sleep quality could make it more difficult to improve for patients with neck pain

Patients with neck pain often experience sleep issues as well, and the relationship between the two conditions may work both ways, as lack of sleep could worsen neck pain. While a connection seems to exist between them, no cause-and-effect association has yet been proven, which led to a study on people with neck pain. The results - which were taken from questionnaires given over three months - suggested that the poorer the sleep quality, the worse the neck pain was for patients. This could mean that improving sleep habits may have a positive effect on reducing neck pain, and may therefore be an important area of interest for future treatments.

Exercise therapy found to be effective for patients with painful knee condition

Patellofemoral pain syndrome (PFPS) is a condition that involves pain in the front and center of the knee that usually comes about from running, climbing/descending stairs or sitting for too long in physically active individuals. Non-surgical, or conservative, treatment such as exercise therapy is often recommended for these patients, but the most effective approach has not yet been defined. For this reason, a study was conducted to determine the effects of an exercise therapy program on patients with PFPS. Results showed that patients experienced improvements in both pain and functional abilities in both the short- and long-term, meaning exercise therapy can be an effective treatment that should be used on PFPS patients.

Balance-training program leads to various improvements for older adults with osteoporosis

Falls and injuries that may result from them are one of the leading causes of disability for older adults, and with age, the risk for experiencing a fall increases as balance and other functional abilities begin to decrease. Osteoporosis, in which bones become fragile and more likely to break, is also common in older adults and can increase the risk of falling even more. To address these at-risk older adults, a study was conducted in which a balance-training program was used to determine its impact. Results showed that the program led to a number of benefits, including faster walking speed, better balance and physical function, and a more positive beliefs regarding fall risk.

November 2014

Physical therapy leads to health benefits 12 years after back surgery

Most people - 80% of the population—will become familiar with low back pain at some point in their lives. Though most cases will resolve themselves on their own, some will get worse and the pain may even spread to the legs. When this happens, a surgery called lumbar discectomy is sometimes recommended, but it often leads to further pain and physical impairments afterwards. Physical therapy is considered a standard treatment option to help these patients, but its long-term effects have not been evaluated. This led to a 12-year follow-up on an original study, and the results indicated that physical therapy helped create both short- and long-term benefits for patients after surgery.

Training program reduces pain and improves function for long-lasting ankle issues

About 23,000 ankle injuries occur every day in the U.S., many of which are the result of participation in sports. The majority of these injuries will improve with some rest and conservative (non-surgical) interventions like physical therapy, but about 34% of patients will continue to experience pain and other complications related to their ankle. These patients require additional care, but it's not clear what the best course of action is for them. Based on this, a review was conducted, and the outcomes indicated that both a training program and manual therapy improved function and reduced pain for these patients. Physical therapists offer both of these treatment options and their use should therefore be strongly considered by patients with recurring ankle issues.

Targeted exercise program helpful for patients with long-lasting low back pain

Low back pain is one of the most common conditions in existence, as 80% of the population will experience it at least once in their lifetime. In about 7-10% of these cases, the pain does not go away - as it does in most other cases—and then becomes chronic. Patients with chronic low back pain have difficulty performing many daily activities and are therefore in need of additional treatments, one of which is the CORE exercise program. This program consists of a series of exercises that can be performed at home, but its effects on chronic low back pain are not known. To test out CORE, a study was conducted, and it was determined that it improved patients' condition and reduced their pain. The CORE program therefore requires more investigation to understand the specifics of its benefits.

October 2014

Aquatic exercise leads to numerous benefits for those with painful conditions

Musculoskeletal conditions affect the bones, joints and muscles, and are among the leading causes of long-lasting (chronic) pain in the healthcare industry. Various treatments are available, but managing these conditions can be difficult for a number of reasons. Aquatic exercise, which is performed underwater, may be effective for musculoskeletal conditions, but the evidence to support it varies. For this reason, a large review of relevant literature was performed on the topic to determine the effectiveness of aquatic exercise. The review found it to be as effective as land-based exercise and with some advantages of its own, which means patients should be able to make their own decision when it comes to treatment options for their chronic pain.

An exercise and education program improves patients' quality of life after back surgery

When back pain is too severe and does not respond to other treatments, surgery may be recommended. Many patients continue to experience pain and disability after surgery that may affect their quality of life, and further treatment is needed for them. Physical therapy and exercise have been suggested as a possible intervention in this situation, but evidence to support this combination is lacking. Based on this, a powerful study was conducted, and it found that a 12-week strength and endurance program was effective for these patients and helped them return to normalcy following their back surgery.

Non-surgical treatments better than surgical management of painful elbow condition

The olecranon bursa is a fluid-filled sac in the elbow that helps to cushion bones and tissues, preventing them from rubbing against each other. Normally flat, when it becomes inflamed through trauma or anything else, more fluid will accumulate. This condition is called olecranon bursitis. Unfortunately, no standard approach has yet been defined to treat this condition, and each doctor cares for it differently. In attempts to better establish what treatments are best, a high-quality systematic review was performed. The outcomes of the review showed that non-surgical treatment for olecranon bursitis was more effective and led to fewer complications than surgical options, and recommended a non-surgical approach based on these results.

September 2014

Performing structured exercises before surgery may lead to certain benefits afterwards

Following many types of surgeries, some patients may experience diminished physical abilities and reduced quality of life as a result, which may extend their recovery process. One possible solution to this problem is called prehabilitation, in which physical therapy and exercises that target specific muscles are employed before surgery to help patients recover quicker afterwards. Some evidence supports this strategy, but the quality is lacking, which led to a systematic review on all available literature. Findings from this review revealed a fair amount of literature in support of prehabilitation, but it was not of the highest quality and this calls for additional research to evaluate this intervention in greater detail to be more certain of the effects of prehabilitation.

Looking into common injuries to mature athletes' shoulders and their treatments

The shoulder, the most mobile joint in the human body, is particularly activated in overhead sports like baseball, tennis and swimming. For this reason, older athletes who have been active in these types of sports for a long time often experience an increased risk of certain injuries like rotator cuff tears, osteoarthritis and frozen shoulder. Proper treatment for each of these injuries is essential, and this is usually dependent on the age and activity level of the athlete. Surgery has been found to be effective for older athletes with rotator cuff tears or severe osteoarthritis, while the same has not yet been confirmed for younger athletes. For frozen shoulder, physical therapy is effective and should be the first line of treatment before surgery is considered.

Obesity and reduced physical activity are risk factors for low back pain

Obesity and low back pain are two common conditions that both negatively impact health and quality of life in their own ways. Though there is some evidence that obesity leads to low back pain, it has not yet been consistently proven, and the relationship between the two is not completely clear. For this reason, a study was conducted on a large sample of people to help better understand this potential association. Results showed that being overweight and not getting enough physical activity were defined as risk factors for low back pain, and when combined, the risk for developing it was even higher.

August 2014

Physical therapy with exercises that use a rubber bar effective for treating golfer's elbow

Medial epicondylitis, or golfer's elbow, is a painful condition that results from a golf swing or any other similar activity that aggravates the forearm muscles. Physical therapy is often recommended as an effective treatment for golfer's elbow, and one of its components is eccentric exercises, which can be seen as the opposite motion of conventional exercises. These exercises have been proven effective for a number of other conditions, but research has not yet supported them for golfer's elbow, which spurred the need for a study. Results from the study showed that patients improved significantly and experienced a decrease in disability as a result of eccentric exercises, which can be integrated into a rehab program for anyone with this condition.

Muscle strengthening exercises lead to various improvements in women with knee osteoarthritis

Approximately 20% of the global population suffers from osteoarthritis (OA), and for some reason, women are more affected by it than men. The wearing away of cartilage in knee OA can lead to muscle weakness and poor hip performance, making normal physical functioning very difficult. Therefore, it's possible that progressive resistance exercises - in which a weight load gradually increases - may address these weaknesses and improve overall function in these patients. The effect of these exercises was tested out with a study on women with knee OA, and it was found that they led to significant improvements in pain, function and strength, and they may therefore be a worthwhile strategy for these patients.

Surgery not necessarily better than non-surgical treatment for LBP

Low back pain (LBP) is one of the most common disorders and leading causes of disability in the world, as up to 80% of all people will experience it at some point in their lives. Non-surgical, or conservative treatment, is often the best course of treatment for LBP, but in some extreme cases that don't improve, a surgery called lumbar fusion may be ordered. The research on lumbar fusion for LBP is conflicting, though, and based on this, a powerful systematic review was performed using all available literature on the topic. Outcomes of the review found only a minor advantage of lumbar fusion over conservative management of LBP, and researchers suggested that patients give both options equal consideration when making treatment decisions for these cases of LBP.

July 2014

Specific guidelines highlight importance of different exercises for chronic neck pain

Chronic neck pain, meaning it's persisted for three months or more without improving, is a common condition that about 14% of Americans currently have. Physical therapy and exercise are often prescribed as effective treatments for chronic neck pain, but specific guidelines as to the time and duration of these treatments is not well defined. Therefore, a powerful review of literature called a meta-analyses was performed to better establish guidelines for treatment. Results showed that exercises should be performed in sessions of 30-45 minutes, three times a week for 12 weeks, and that variation in exercise type was the most important component for an effective program.

Non-surgical treatment may be just as effective as surgery for common shoulder pain

Shoulder impingement syndrome is an extremely common source of shoulder pain that usually results from too much overhead movement in sports like tennis and baseball. When the condition becomes severe and doesn't respond well to other treatments, surgery may be recommended, but there is no strong evidence to support this approach over physical therapy. Based on this uncertainty, a powerful review of all available literature on the topic was conducted to determine if surgery is worth it. The review found no significant benefits of surgery over physical therapy, and instructed patients with shoulder impingement to consider this when making treatment decisions.

Thigh-strengthening exercises found to be helpful for patients with knee OA

Patients with knee osteoarthritis (OA), in which the protective cartilage surrounding the joints wears away, often experience pain, stiffness and decreased strength in the thigh muscle, or quadriceps. As a result, it's believed that strengthening the quadriceps can actually treat knee OA and reduce pain, but this has not yet been confirmed with evidence. To test out this theory, a high-quality study called a randomized-controlled trial was conducted on patients with knee OA using isometrics, a basic type of exercise that can easily be performed at home. The results showed that patients who followed the exercises experienced reductions in knee pain and improvements in knee function, and these exercises can be effective way to improve the status of patients with knee OA.

May 2014

Physical therapists offer better management strategies for low back pain than family practitioners

Low back pain (LBP) is one of the most common causes of pain in the U.S., and it has a reputation for regularly leading to absenteeism and long-term disability in the military. In most of these cases, LBP has historically been treated by family practice physicians, but research has shown that early access to physical therapy may be more beneficial. A study therefore compared the treatment strategies of physical therapists to physicians for treating LBP patients in the military. Results showed that physical therapists were more likely to prescribe the proper drug treatments and were more in-tune with the motivation levels and desires of patients than physicians. Based on the one-on-one, personal nature of physical therapy, it appears patients may be more likely to experience positive outcomes from these effective management strategies.

Physical therapy reduces the likelihood of surgery for lumbar spinal stenosis patients

Lumbar spinal stenosis (LSS) is considered one of the leading causes of low back pain, and it is particularly common in older adults. Physical therapy is often prescribed to treat LSS, but it's not clear how effective it is for reducing the likelihood of surgery. For this reason a study was conducted on LSS patients, some of which received physical therapy and others that did not. Results showed that patients treated with physical therapy within the first six weeks of their diagnosis experienced significant improvements and were less likely to have surgery. Read the full article for more details of this study.

How to properly navigate and understand health news

Access to information has never been easier, but when it comes to health-related data, that can also prove to be dangerous if you don't understand what you're reading. While many health news sites are legitimate, some may fail to provide all details of a story, which may lead to a false impression of findings. Therefore, as a reader of any health-related content, you should always be aware of these pitfalls and ask certain questions (e.g., was the study performed on humans; how many people were included in the study; were there any conflicts of interest or limitations) to ensure you're getting the whole story. Read on for more information about how you can safely and efficiently navigate the world of health news.

April 2014

Moderate or vigorous physical activity in leisure time may lead to less low back pain and disability

Low back pain (LBP) has long been one of the most bothersome and prevalent conditions in the general population. Physical therapy is an effective treatment option for LBP that leads to some improvements, but they are usually only moderate, and few cases of LBP are completely cured. A new strategy for combating LBP has been to identify factors that might lead to its development, and then create recommendations based on them. A recent study looked into physical activity during leisure time, which is considered one of these factors. Researchers found that those who spent their leisure time engaged in moderate-to-vigorous physical activity had significantly less pain and disability than those who spent much of their time sitting. Therefore, since it's healthy and it may also alleviate LBP, regular physical activity is strongly recommended.

Physical therapy proven to play a key role in stroke rehabilitation

About 795,000 people experience a stroke each year in the U.S., and that figure is only expected to rise as our aging population grows. The main goal of stroke recovery is usually focused on regaining the ability to perform activities of daily living (ADLs) like dressing and eating independently. Physical therapy is often recommended as an effective treatment to help accomplish these goals, but some of the guidelines regarding the best form of physical therapy are outdated and in need of new research. For this reason, a review was conducted to better understand the details of stroke rehabilitation. Results showed that physical therapy can still be considered effective for treating stroke patients, and that training patients to perform specific tasks with high amounts of repetition is the most beneficial approach to rehab.

A basic exercise program can help prevent low back in office workers

For the majority of people with office jobs, a great deal of the day is spent sitting. As a result of the lack of mobility that comes with sitting for prolonged periods, joints can stiffen up and conditions like low back pain (LBP) may arise. Fortunately, there are ways to reduce the likelihood of painful conditions, and one of the best ways is by participating in a stretching exercise program designed by physical therapists for office workers. A recent study evaluated the effectiveness of such a program and found that it reduced the number of episodes of LBP in the office by a significant amount. Therefore, it appears one of these basic and inexpensive programs could be a beneficial strategy to prevent LBP in the workplace.

February 2014

Manual therapy leads to various improvements for patients with fibromyalgia syndrome

Fibromyalgia syndrome, or FMS, is a painful condition that is more prevalent in women than men and usually leads to other symptoms such as fatigue and sleep disturbances. Manual therapies like massage and manipulations performed by a physical therapist are often recommended for FMS and are known to be effective for treating women with the condition, but evidence is lacking regarding its effectiveness for men. A study therefore set out to compare the outcomes of these treatments for both sexes. Though some important differences were found that need to be considered in revising current treatments, manual therapy was effective for treating both women and men with FMS, and should be encouraged as a useful tool for physical therapists treating patients with this condition.

Exercise, education among most strongly recommended interventions for osteoarthritis

One of the leading issues in the healthcare industry is osteoarthritis (OA), a condition that results from the wearing away of cartilage in the joints and usually affects the hips or knees. Unfortunately, rates for OA are only increasing and it’s expected to double in prevalence by 2020, which means better strategies are needed to treat it. In an attempt to define which guidelines are most highly recommended for OA, a review was conducted using numerous studies that presented guidelines for treatment. While a number of these guidelines were found to be somewhat common, various forms of exercise and education were considered the most widely supported of all interventions. As a result, these types of treatments as administered by a physical therapist should be the most highly recommended for managing OA.

Reaction to standing for prolonged period can predict development of low back pain

Up to 80% of Americans will experience at least one episode of low back pain (LBP) at some point in their life. While there are many factors that can influence the likelihood of this occurring, having a job that involves long periods of standing may be one of the stronger predictors. To get a better sense of just how strong a predictor it is, a study evaluated patients after standing for two hours. Those who experienced pain during that time ended up being more likely to experience an episode of LBP over the next three years. The study also found that these patients were less likely to develop LBP if they underwent an intervention program from a physical therapist. For these reasons, people with jobs that involve prolonged standing can seriously benefit from an exercise program that will lower their chances of experiencing LBP in the future.

January 2014

Listening to music lowers the level of pain experienced during physical therapy

One of the most difficult parts of receiving physical therapy for patients is the pain that comes with it. Though it's necessary in order to make physical therapy effective, this pain may turn some patients away and cause them to lose interest in treatment. To test out a simple solution, one study had some patients listen to music through iPods during treatment sessions. They found that patients reported significantly less pain while listening to music compared to without it, which means music may be an inexpensive way to help patients cope with the pain experienced during physical therapy.

Exercise program reduces occurrence of neck pain for office workers

Office workers who spend most of their day sitting in a chair put extra strain on the neck that can be dangerous, and as many as 69% of these people will experience some form of neck pain every year. One option to help those who sit in a chair for extended periods of time is a prevention program, which uses stretching exercises and endurance training to improve the necks of these workers. To test this out, one study evaluated the effectiveness of this type of program and found it significantly reduced the occurrence of neck pain in office workers, meaning it could be a great way to help the many people who fall into this category avoid neck problems.

Direct access found to have numerous advantages over referred physical therapy

As many as 54 million Americans experience problems with their muscles or bones every year, and one of the most popular and effective ways to treat these conditions is through physical therapy. To receive treatment from a physical therapist, patients can either be referred by a physician or go directly to a physical therapy practice, which is called direct access. Unfortunately, many people don’t realize they have this second option and wait for a referral from a physician instead. To point out the benefits of direct access, a study reviewed all the literature comparing the two options and found that patients who used direct access experienced better outcomes, lower costs, fewer visits and less average pain after discharge from treatment over physician referral. For these reasons, anyone looking for treatment from a physical therapist should be conscious of their options and know the many benefits that direct access provides over referral from a physician.


September 2013

Exercise and weight loss of great benefit for overweight patients with hip osteoarthritis

Osteoarthritis (OA) remains the most common joint disorder in the world. Usually affecting weight-bearing joints like the hip and knees, it leads to significant disability, and its rate of occurrence is only expected to grow. With older age and being overweight considered the two leading risk factors for OA, managing the condition is usually done by helping patients lose weight, which has proven to be effective for knee OA. Attempting to extend these strategies to hip OA, for which evidence is lacking, it was found that physical function improved while pain scores decreased for a group with hip OA who participated in an eight-month exercise and weight-loss program.

Positive patient expectations lead to greater benefits from neck pain treatment

When it comes to treatment of a patient’s condition and the likelihood that they'll have a positive outcome, there is no simple science to predict exactly how things will turn out, as every case is different and many factors affect each individual. One factor that should always be kept in all patients' minds is attitude, as a positive perception about the outcome of treatment has been shown to have a significant impact on the actual end result. To further evaluate this concept, a study asked patients how they felt about treatment for neck pain and what they expected to come out of it. Results showed that the majority of patients had favorable outlooks, which led to more positive results, and the better they felt about a specific treatment, the more effective those treatments turned out to be.

A comprehensive rehabilitation approach to low back pain for golfers

Golf is a popular recreational sport among older adults, and as the 65-and-older population ages, so will the prevalence of golf in that demographic. Unfortunately, with this spike in popularity will also come an increased risk of injury, as golf can put certain strains on the body and lead to a variety of issues, most commonly low back pain. For those concerned, there are a number of strategies for both preventing and managing low back pain, and a few slight modifications to golf swing and improving core strength can go a long way in reducing your likelihood of suffering from any golf-related pain.

August 2013

Low back pain further exacerbates depression symptoms

Depression and low back pain independently account for some of the most common clinical conditions in the U.S., with depression ranking 11th and low back pain fifth for yearly physician visits. When experienced together, the effects are likely to be even worse, as both conditions negatively impact one another. One study evaluated the prevalence of the two conditions together and found that many patients with depression also suffer from low back pain. As a result, it's strongly recommended that low back pain and depression be treated together with conservative care management, which uses a strategy that focuses on both conditions collectively to achieve better outcomes.

Non-surgical treatment just as effective as surgery for chronic low back pain

Lumbar fusion, a surgical procedure that causes two spinal bones (vertebrae) to grow together, is one of the most common types of back surgery and is often used to treat low back pain. Despite the fact that it's used so frequently, there is no evidence that shows lumbar fusion is any better than avoiding surgery and treating back pain with other interventions like physical therapy instead. To compare these two options head-to-head, a massive review called a meta-analysis was performed between lumbar fusion and non-surgical (or conservative) treatment for low back pain. Results from the analysis did not find surgery to yield any greater improvements than conservative treatment, which should in effect cause patients to evaluate their options wisely when considering surgery.

Physical therapy significantly improves musculoskeletal disorders for dentists

As a result of the physical requirements and repetitive motions of being a dentist, many in the profession (roughly 70%) suffer from musculoskeletal problems such as low back, neck and shoulder pain. Though a number of treatment options exist for musculoskeletal disorders, physical therapy is widely considered to be one of the most effective, often leading to notable improvements. To evaluate the effects of physical therapy on dentists with musculoskeletal pain, a study was conducted and found dentist' conditions improved significantly and they missed fewer days of work as a result of the intervention. Dentists who experience similar issues should therefore regard physical therapy as a reliable option to reduce pain in their lives and profession.

July 2013

Arthritis, back pain biggest burdens on quality of life for older adults

Coping with pain from a variety of causes is an unfortunate part of the aging process, and it generally tends to get worse the older we get. While it's impossible to eradicate all types of pain, there are many ways to treat it, and that comes from first understanding the source of pain. From a massive survey distributed to Medicare subscribers, it was made clear that arthritis and back pain are the two leading causes of pain for older adults, and these conditions both have a major negative effect on overall quality of life. By better targeting these conditions, physicians should strive to help the elderly live with less pain and more enjoyment in their lives.

More time spent with therapist leads to greater patient satisfaction following hip replacement

Following a hip replacement, or total hip arthroplasty (THA), patients are usually sent to a physical therapist to help bring back their strength and range of motion. Though most reports of this rehabilitation process are positive, there is no clear evidence of how satisfied patients are with their long-term progress. To get a better sense of this, a survey was given out to patients asking them how satisfied they were with their outcomes from therapy after surgery. Most patients (76%) were satisfied with their physical therapy experience and their overall improvement. For those who were not satisfied, it appeared they either didn't spend enough time, have long enough sessions or didn't have sufficient one-on-one time with their physical therapist.

Stretching before sleep shown to reduce the incidence of nocturnal leg cramps

Leg cramps, which are painful and involuntary muscle contractions, can occur regularly during the night and be a major disturbance on sleep for those who experience them. The specific cause of these cramps is not known, but it's very possible that not getting enough physical activity and habitually stretching leg muscles may lead to them. To test a theory that stretching the calves and hamstrings before going to sleep could reduce the cramps, physical therapists instructed one group of patients to stretch and another group not to before sleep. After six weeks, the group that stretched reported a much better improvement, with fewer and less severe leg cramps than the non-stretching group.


July 2012

Do you suffer from migraines? Try exercising more, and you may be doing yourself two favors

Migraines, which are severe headaches associated with a throbbing in one region of the head, can make one nearly useless while experiencing an episode. If you happen to experience migraines, even on a seldom basis, then you know how debilitating they can be on your life at those times. To combat these problems, the most popular treatments are a drug called topiramate, and relaxation therapy for those who prefer not to take medication on a regular basis. Some doctors are also instructing migraine patients to increase their regular physical activity, but evidence to support this treatment is lacking, until now. According to a new study, increased exercise and physical therapy was shown to be associated with a similar decrease in migraine episodes compared to patients taking topiramate and with a greater decrease for those engaged in relaxation therapy. Read on for more details about how exercise may reduce migraines while also improving your overall health.

Research shows patients with low back pain should see physical therapists early, even if physicians tell them to wait

Low back pain is easily one of the most common and problematic ailments for the worldwide population, and what makes matters worse is the fact that there's no simple or commonly-agreed upon solution. Most patients see a physician first, and from there, may try medications, injections or physical therapy (PT), and in severe cases, are sent to surgery. While research and many medical professionals support PT, a number of physicians generally don't recommend it at all or tell patients to delay going. In an attempt to get the facts out there for low back pain patients and physicians who aren't supportive of PT, a massive study was conducted. Results showed that only a small number of patients (7%) actually went to PT, and the ones who went earlier improved more than the ones that went later on. Read on to see why going to PT early could be your best bet if you have low back pain.

Cell phones may serve a purpose in the medical research field, too

If you're reading this, chances are likely you own a cell phone and at least know how to use text messaging (also called SMS), if you don't actually use it regularly. Chances may also be that you view it primarily as a means for communicating with friends and family, and probably don't see it as a tool to be used for anything important in the medical field. Well, it turns out that conception can very likely change soon, as medical researchers are attempting to start utilizing cell phones to collect data in a much cheaper and more efficient manner, for both patients and researchers. To test if this could indeed be a possible alternative for collecting data to traditional in-person or phone interviews, researchers surveyed a population and found that (unsurprisingly) most people use cell phones and SMS, and many of those followed through with texting researchers. This could mean a new shift in the way studies are conducted and a more productive use for cell phones in the future.


October 2011

No downsides found in skipping the physician referral and seeing a physical therapist on your own accord

For most people who go to a physical therapist for treatment, the process usually entails an initial visit to a physician, who will review the patient's condition and refer them to a physical therapist if they see fit. While this is often the standard protocol, some suggest that the referral from the physician is unnecessary and more costly, and that patients can instead use what's called "direct access" in certain cases and refer themselves to a physical therapist. Opponents cite potential backlashes from this system, and in select states, as well as under certain insurance policies, it's not allowed; however, a study that compared a group of patients who were self-referred with a group that was physician-referred found no significant differences between groups when assessing cost and overall improvement of patients. These findings suggest that physician referrals may oftentimes not be required, and that patients can instead take matters into their own hands and refer themselves whenever possible.

Most marathon runners are inexperienced and unaware of dangers of not hydrating properly

The popularity of marathon running has skyrocketed in recent history, and what was once an event reserved for the elite competitors throughout the world has come to include all walks of life and a wide variety of skill levels. Due to this process, a large percentage of marathon runners are first-timers, and many are inexperienced in running and the precautions that should be taken while competing in a marathon. To get a clearer sense of this breakdown, surveys were distributed to a large sample of marathon runners to evaluate their perceptions on the race. Unsurprisingly, many of these runners were inexperienced, with only about half having run at least two marathons in the past, but more importantly, the majority of runners displayed a lack of knowledge regarding hydration techniques and how to avoid injuries that arise from improper hydration. This calls for more education on this topic for newcomers to the sport who might not know all the risks involved.

Patients and care providers have different perceptions of pain from exercise and mobilization

For patients with chronic, painful conditions such as neck pain, back pain, or osteoarthritis, there may be instances of pain from either the diagnosis or in the treatment itself. While this is completely normal, helping care providers to diagnose a condition and necessary to make exercise and mobilization techniques effective, some patients may not be aware of this, and instead take it as malicious and fail to comply with their therapy as a result. To get a better impression of how feel about pain experienced during therapy, a series of interviews was conducted with both patients and care providers. Results showed that most patients viewed the pain as a necessary part of therapy, but a select few reacted negatively and were driven away from therapy due to it if their therapist didn't explain it properly. This highlights the importance of communication from care providers, especially physical therapists, when it comes to thoroughly explaining the role and necessity of pain in the treatment of certain conditions.

September 2011

Exercise for elders can lead to improvements in mental health, too

Reaching old age comes with a multitude of associated ailments, particularly in the physical realm with issues like weakening joints and muscles, but also in the mental realm with possible memory loss, depression and anxiety. Getting regular exercise has always been recommended to elders for the plethora of physical benefits it can provide, but in addition to that, it's been suggested that exercise can lead to improvements for the mind as well. To look into this matter in greater detail, a review was conducted that analyzed all available information on the topic, and results supported this notion with a number of significant figures. This led researchers to suggest a minimum of two 45-minute sessions of light-to-moderate intensity exercise each week for those over 65 to help improve mental wellbeing.

Protocols for determining when an injured athlete is ready to return to sports need to be improved

For any injured athlete of any level of competition, the most pressing question following an injury is always, "how long until I can return?" Answering this question and returning an athlete to competition as quickly as possible while also ensuring their safety is a difficult matter for physicians, and evaluating these cases requires consideration of a number of important factors. While there are certain common denominators across the board when it comes to making these decisions, there's also a great amount of variation from one physician to another, which calls for the need of more definitive guidelines to help medical professionals navigate this process. Taking note of this, two physicians highlighted all current guidelines on the topic and pointed out the gaps that need to be improved upon, including in these reviews some useful tests that can gauge an athlete's readiness to return and some vital categorizations that divide athletes into appropriate groupings.

Adding a creatine supplement to a strengthening exercise program can be beneficial for patients with knee osteoarthritis

Osteoarthritis (OA), a result of the wearing away of a protective substance known as articular cartilage, is a prevalent and burdensome condition, and it tends to occur frequently in the knees and in more women than men. Already disabling on its own, those with knee OA who also have weak quadriceps (thigh muscles) are at an additional disadvantage, as it leads to further functional impairments and difficulties in everyday life. On the other hand, a stronger quadriceps could halt the progression of knee OA, which would in turn reduce pain and improve function. For this reason, programs that strengthen the knee have been recommended for OA patients, and one recent development has been supplementing these programs with creatine, a natural organic compound that encourages rapid muscle growth. Based on these components, a study investigated if adding creatine to a strengthening exercise program could lead to additional benefits than the program alone, and results showed the supplement to be extremely helpful in a number of ways.

August 2011

Exercise therapy program can help lift the burden of neck pain for office workers

Following low back pain, the most prevalent musculoskeletal condition in the U.S., neck pain also ranks highly on the list of common, debilitating disorders out there. For those who work in an office and sit at a desk on a regular basis, neck pain occurs even more regularly, with roughly 43-69% of all office workers experiencing pain in the past year. To attempt to curb this trend, measures have been made to reduce neck pain for office workers, and exercise therapy is one intervention growing in popularity. Investigating all available literature on the topic, it was found that muscle strengthening and muscle endurance exercises can help reduce the intensity, duration and discomfort of neck pain. Therefore, instilling a program such as this for office workers suffering from neck pain can relieve employees and improve productivity in the workplace.

Temporarily stopping participation and starting a rehab program effective for young soccer players experiencing back pain

Though soccer doesn't experience the same popularity levels in the U.S. that it does internationally, it's still the most widely played sport in the world, with participation numbers that only continue to grow. Consequently, the rate of injuries sustained by soccer players also continues to increase, especially in the spine. Spondylolysis, which results from a stress fracture to a vertebra, is the most common condition that leads to low back pain (LBP) for soccer players under 18, making it an important disorder for young players. In an effort to determine an effective strategy for dealing with this condition, a study found that temporarily halting participation in sports and beginning a conservative rehab program (free of surgery) was extremely beneficial for young soccer players and greatly facilitated their return to sports.

Attempting to prevent injuries before they occur by using a neuromuscular training program

What if, rather than crossing fingers and hoping for the best, athletes were better equipped to avoid injuries by a training program that teaches their bodies and brains how to react in a situation that might cause injury? Effective use of such a program could significantly reduce the rate of sports-related injuries and save the health-care system huge amounts from the second most common source of injuries behind domestic accidents. Proprioceptive and neuromuscular training programs (PT/NT) are designed to prevent injuries by improving the body's stability and balance, but they're not used universally due to conflicting views on their effectiveness. To clear up this matter, a review was conducted on pertinent literature, which found these types of training exercises to be effective at reducing the rate of a number of injuries in certain sports. Ample consideration should therefore be given to using these programs in sports where they can better prepare athletes in competition and lower their chances of sustaining injury.

July 2011

Regular smokers shown to improve less following back surgery than nonsmokers

The negative impact of being a habitual smoker has never been underplayed, particularly when it comes to lung health and cancer. In addition to those risks, however, smoking can also lead to more complications and slower recovery following certain types of surgery. To determine how great these risks are, a study evaluated the recovery of a number of patients following lumbar spinal surgery, and found smokers to improve less, with more pain and a lower quality of life than nonsmokers, adding more reasons to the laundry list of potential pitfalls of smoking regularly.

The amount of physical activity kids are getting at school and in PE is alarmingly low

It's no longer a mystery that kids in general these days are not getting sufficient amounts of physical activity in their daily lives, which is both a result and a cause of high obesity rates. One component of a child's life that has strong potential to curb these trends is at school, where a good portion of kids' time is spent almost every day, and where programs can encourage kids to become more active regularly. Despite this opportunity, many schools fail to fulfill their part, and consequently, kids are not getting proper doses of exercise. To get a better gauge of just how much physical activity kids are actually getting daily, a study analyzed a large group of elementary students throughout the day and found physical activity rates to be shockingly low, especially during physical education class.

For those going to physical therapy for hip osteoarthritis, certain factors predict a better recovery

Osteoarthritis (OA) is a common condition that becomes more likely to occur with age, and of which there is still no definitive treatment that completely rids patients of pain. One approach to OA that has been garnering attention is to identify certain factors that predict which patients are more likely to respond well to treatments like physical therapy (PT), and taking note of this, a study sought to discover these factors for hip OA. Results from the study identified being aged 58 or younger and suffering from hip OA for one year or less to be amongst five predictive factors that should be used by physical therapists and known by patients to help facilitate recovery from hip OA.

June 2011

Physical therapists need to treat psychosocial factors in addition to physical ones

Most patients enter a physical therapist's office with a physical ailment of some sort, and intend to be treated primarily for that particular ailment. While this is the major concern for physical therapists (PTs) and should remain as such, a recent issue of Physical Therapy magazine stresses the importance of treating the "whole" patient, and the necessity of addressing their psychosocial issues associated with their condition to ensure the best possible outcome. Treating an injury or condition is a process that triggers a number of emotional responses, and, according to the issue, PTs need to keep them in mind and tend to them while treating patients. This sort of shift can mean better overall results and more patient satisfaction, both of which are sought after by all PTs.

Caffeine use can be either beneficial or detrimental, depending on how it's used

Caffeine is far and away the most widely consumed drug in the world, with an estimated 85-95% of Americans using it on a regular basis. While most people drink it for a morning or mid-day pick-me-up in coffee, tea or soda, it can also be used in conjunction with pain medications to increase effectiveness. On the downside, regular caffeine intake can also be detrimental to some when use is stopped after a long period of habitual consumption, possibly leading to withdrawal and headaches. The effects of caffeine such as these and others, on both the positive and negative end of the spectrum, are given sufficient in this review, with the intention of better educating those who use caffeine so regularly.

Knuckle crackers can breathe easily: no associations found to osteoarthritis

When you think about knuckle cracking, whether you do it yourself or not, chances are more than likely that the rumor of it causing arthritis will also pop up in your head in some form or another. Most people are at least aware of this urban legend, but some are uncertain of its validity and if there's any actual medical backing to it. Responding to this prevailing sentiment, a study looked into the relationship between knuckle cracking and hand osteoarthritis in depth, trying to determine if there was in fact any connection. Fortunately for knuckle crackers, no evidence was found of any association between the two, which doesn't guarantee it's safe, but does plenty to dispel the common rumor with great support.

April 2011

Abdominal obesity associated with chronic pain and depression in the elderly

Chronic pain, defined as pain lasting for more than three months, occurs in the elder population more than any other age group, as some figures report more than half of seniors experience chronic pain regularly. Dealing with chronic pain on a regular basis can be an extreme burden and have a negative impact on elders' health-related quality of life (HRQoL), and it unfortunately only gets worse with age. The exact reasons why this pain plagues older people, however, are not clearly defined, leading some researchers to investigate the matter in greater detail. Results showed that greater abdominal obesity and associated osteoarthritis were high indicators of chronic pain and depression based on HRQoL, and that exercise programs catered towards elders should therefore be implemented to address this issue.

Thinking about seeing a chiropractor for your low back pain? Read this report and think again.

The high occurrence rates of low back pain (LBP) and the hindrances it causes on peoples' lives continue to be well documented, and those who suffer from it continue to seek any form of treatment that may be effective in alleviating their pain. One of the most popular interventions Americans use is to see a chiropractor, who will use manipulation and a number of other methods to treat LBP. Yet despite their common usage in the U.S., the evidence of a chiropractor's effectiveness is limited. Looking into this matter further with the intent of drawing more definitive conclusions, a review of available information on the subject actually found no meaningful effects of chiropractic interventions on LBP in the long-term, leading to more questions than answers on the usefulness of chiropractics.

Doing away with the concept of 'diagnosis' could be the key in optimizing treatment for axial neck pain

Axial neck pain, one of the three major types of neck pain, is a musculoskeletal disorder (affecting both the muscles and bones) that's limited to pain in the neck only. Unfortunately, when it comes to diagnosing axial neck pain and determining how to treat it, many spine specialists differ in their approach, using only the types of tests they know will confirm the treatment they wish to recommend. As a result, patients are put through a number of expensive and sometimes unnecessary tests that may or may not even help in better defining their condition. The problems with this system lie primarily in the lack of uniformity of spine clinicians, who continue to do things their own way even if they're not proven to be effective. Many researches believe the flawed system needs to be overhauled entirely, and one possible change that's been gaining some popularity is to nix the term “diagnosis” altogether, and instead use a series of clinical prediction rules that will highlight specific characteristics in patients that will determine which treatments will lead to the best possible outcome for each subject.

March 2011

Balance training program helps reduce the likelihood of repeated ankle injuries

One ankle sprain is usually bad enough for the person who experiences it, but for some, if the proper moves aren't made, it could mean the start of an ongoing and bothersome condition known as chronic ankle instability (CAI). CAI is the tendency towards repeated ankle sprains and recurrent symptoms (pain, weakness, giving way), and occurs in about 40-70% of patients who suffer from an initial lateral ankle sprain. One suggested method to prevent CAI from occurring is by improving balance and proprioception (the sense of your joint's position in your body) after the first ankle sprain. To investigate this theory, a study evaluated the effect of a balance training on study subjects and found it to significantly improve balance and proprioception, meaning such a program has the potential to reduce the occurrence of CAI if administered after the initial injury is sustained.

Insider's perspective from those with low back pain claim it never fully goes away

Low back pain (LBP) continues to affect the lives of millions of Americans on a regular basis, preventing many from engaging in everyday activities and leading a normal lifestyle. Efforts have been made to be better understand LBP and the reason it reoccurs so often, but there is still not a universal system for measuring its recurrence rates. Some measurements take into account time off work and health-care utilization, but questions exist as to if those figures accurately depict the bigger picture of LBP. A group of researchers noted this and thought it would be beneficial to hear from LBP sufferers in an open-forum discussion to get a sense of how it impacts their lives. The overall consensus showed that most with LBP felt it was an ongoing condition that comes and goes in varying degrees, but never fully goes away. Health care use was minimal since participants felt it never actually helped their pain, and work was only missed in extreme situations. These findings suggest that time off work and health-care use aren't effective measurement statistics, and that treatment strategies need to be improved significantly.

Losing weight, engaging in prevention programs among ways to avoid knee osteoarthritis

Osteoarthritis (OA), which is defined by the breakdown of protective articular cartilage in a joint and leads to pain and limitation of movement, is the most common musculoskeletal disease and occurs most frequently in the knee. Though knee OA usually affects athletes involved in high-risk sports, it may also claim the knees of those over the age of 60. In an attempt to reduce its occurrence rates, a review was organized with some helpful tips for athletes and others at risk. Aside from the increasing risk for knee OA that comes as age increases, the review named the three most important risk factors high body mass index (BMI), excessive stress to the knee and previous knee injury. Based on those risk factors, the review suggested weight loss and prevention programs targeted at patients with previous knee injuries as effective strategies to reduce knee OA occurrence. The review also suggested that athletes involved in high-risk sports (soccer, football, basketball) take extra care and educate themselves on how to avoid OA.

February 2011

The approach towards osteoarthritis treatment in the medical world needs to change drastically

Osteoarthritis (OA) is a growing problem on an international scale that is receiving growing recognition for the potential dangers and costs it presents if not dealt with properly, but for some reason there are still no significant improvements in the management of the disease. One of the most important issues with current treatment is that it only seeks to alleviate symptoms and reduce the severity of the disease rather than actually cure it. In a call to action, an article was written that urges medical professionals to come together and establish a definitive model for treating OA that doesn't stop short at mere symptom reduction, but actually focuses on completely eliminating symptoms and halting the progression of the disease. With a new paradigm and unified approach to the disease, OA rates can be reduced significantly and provide millions with safer and healthier lives.

NSNSAIDs proven to be much safer than opioids for older adults with arthritis

Analgesics such as opioids, nonselective non-steroidal anti-inflammatory drugs (NSNSAIDs) and coxibs are popular prescriptions these days for older adults, especially those with arthritis. Yet despite their common usage, the comparative safety of these drugs, particularly opioids, is not well understood. Prescribers of these medications should have access to better information regarding these important safety levels in order to make the best decisions for choosing which drugs to prescribe. In order to rectify this problem, data pertaining to each medication group was compared side-by-side, and opioids were proven to be the most dangerous of the three, while NSNSAIDs were shown to be the safest. Opioid use should therefore be approached with caution and NSNSAIDs should be prescribed more often.

Early physical therapy treatment for low back pain can prevent future complications

Low back pain (LBP) is one of the most common disorders found throughout the world, with about 65-80% of adults experiencing the condition at some point in their lifetime, making it an urgent and pressing matter to address with the best possible treatment. Physical therapy administered early on is regarded by most as the leading treatment method available, but there are some medical professionals who question its effectiveness and choose to treat it by other means. Seeking definitive answers, a study was conducted that compared early PT to a number of other interventions and found it to be effective in reducing the likelihood of receiving costly procedures like injections and surgery later on in the course of LPB.

January 2011

Family history shown to be major predictor of hallux valgus, while high-heeled shoes are deemed safer than believed

Hallux valgus is a chronic condition in which the big toe deviates inward towards the smaller toes, eventually leading to the development of a bump on the side of the foot called a bunion. If the condition isnÕt treated properly and the bunion grows, pain and discomfort will result and lead to disability in every day life. The specific causes of hallux valgus are not known, but many believe improper footwear such as high heels can lead to its occurrence due to excessive pressure on the feet. To test this theory, a study was performed on a population of females in China, and found family history of the condition, and not high heel usage, to be the most indicative predictor of hallux valgus. With this, high heel use should not be encouraged, but those who do wear them should feel secure in knowing they donÕt contribute to the condition.

Ankle sprain prevention program dramatically saves money for health-care system

Acute ankle injuries are far and away the most common musculoskeletal injuries throughout the world, with lateral ankle sprains occurring more often than any other. To combat this issue, a number of preventative intervention programs have emerged as of late, and many of them have proven to be effective in reducing ankle sprain recurrence. The only thing lacking is a full-scale analysis on the cost-effectiveness of such a program on the health-care system. Therefore, researchers tested a particular program and calculated the savings of a reduction in ankle sprains, finding it to beneficial and economically advantageous to those who implement it.

Most patients are incredibly satisfied with musculoskeletal physical therapy

Today, more than ever, health-care providers are concerned with implementing patient-centered care, the goal of which is to provide the highest quality and most cost-effective treatment for every patient. Following this trend, one of the main indicators for evaluating quality care is patient satisfaction, which is doubly important because satisfied patients are also more likely to adhere to treatments and benefit from their health care. With a desire to evaluate patient satisfaction in the physical therapy setting, a team of researchers conducted a review of all available literature on the topic. Results showed that patients are predominantly satisfied with the musculoskeletal physical therapy they were receiving, with an overall satisfaction estimate for all patients of 4.44 out of 5 (with 1 being very dissatisfied and 5 being very satisfied.)


December 2010

Evaluating the effectiveness of exercise therapy for groin pain in athletes

Groin pain is a common ailment for many athletes, particularly those involved in sports like football and soccer, where running and sudden changes in direction make the risk of developing this pain more likely. Diagnosing these injuries is difficult, and treating it is even harder due to the fact that only minimal research exists on treatments that have been proven to be effective. A review of all available literature on the topic was therefore conducted, and it found exercise therapy to be an incredibly helpful intervention, as it led to favorable outcomes in helping athletes return to sport in all research found, with two studies even reporting it significantly reduced symptoms.

How healthcare professionals' word choice affects patients' perceptions on low back pain

Low back pain (LBP) continues to affect countless individuals throughout the globe with distress and discomfort, and remains a major concern of health-care professionals. In addition to the physical aspects that are largely responsible for LBP, there are also some psychosocial factors that can contribute to it and create negative beliefs about the condition. For this reason, the word choice used by physicians to deliver news to patients is of utmost importance, as it can shape patients' views and potentially lead to the condition worsening. A study investigated the role of word choice in a clinical setting and found direct correlations between certain words and inappropriately negative outlooks, which means physicians should be much more cognizant about the manner in which they deliver messages to patients.

Surgical vs. non-surgical treatment for Achilles tendon rupture

The course of treatment for Achilles tendon rupture is one that continues to change on a regular basis, and a general consensus on the best way to approach it is yet to be reached. While re-rupture rates are slightly lower with surgery compared to rehab, the complications and costs associated with surgical intervention are much higher, and some meet it with caution. The recent development of a functional brace that allows movement, however, has given more credence to the possibility of a non-surgical intervention. To determine the effectiveness of this new brace, a study compared it to patients who underwent surgery, and found only minimal differences in re-rupture rates, boosting the stock of rehab over surgery.

November 2010

Knee bracing proven to be ineffective in preventing knee injuries for football players

Knee injuries and football players have a direct and unfortunate relationship, accounting for the most common injuries in the sport and plaguing athletes at all levels of competition. Most knee injuries occur in the medial collateral ligament (MCL) since it's the first ligament to be ruptured upon impact, making it a major matter of concern for health-care professionals and those involved in football. Knee bracing is one method that's been used for MCL and other knee injuries, yet the specific benefits of bracing are yet to be proven. Noting this, a study investigated the use of prophylactic knee braces further and did not find sufficient evidence to recommend them for the prevention of MCL injuries.

Stretching shown to have benefits associated with looseness and soreness, but not in preventing injury

For quite some time, stretching before and after physical activity has been a popular course of action performed by many and underscored with the belief that it reduces the risk of injury while engaged in activity. Surprisingly enough, despite its widespread usage across the gamut, the specific benefits of stretching to prevent injury are not well established, and many studies have shown them to be questionable. To evaluate this matter in greater detail, a powerful study was conducted and found stretching to be effective in increasing the feeling of looseness and reducing some soreness, but debatable in terms of preventing injury.

Understanding possible causes and prevention methods for cramps induced by exercise

Exercise-associated muscle cramps (EAMC) consist of acute pain, stiffness and muscle knotting, and usually occur during or shortly after exercise and last for several days. These types of cramps can be extremely debilitating for athletes and can prevent them from participating at full capacity. Medical professionals believe that by understanding the cause of EAMC, better treatment and prevention methods can be established. Two main schools of thought exist on the subject, one that believes the cramps are due to dehydration imbalances, and another that claims they're a result of deeper-rooted neuromuscular changes. Both theories have some strong points, as well as flaws, and are examined in greater detail here.

September 2010

Full-scale evaluation of various treatments for knee osteoarthritis

Osteoarthritis (OA) is an extremely prevalent and hampering condition defined by the breakdown of joint articular cartilage that causes pain and discomfort and occurs in the knee more than any other bodily location. It's estimated that more than 30% of adults over the age of 60 experience functional limitations due to knee OA today, which detracts majorly from their quality of life (QoL) and costs the health care system billions of dollars annually. For this reason and more, it's essential that all available treatments are analyzed for their effectiveness and that physical therapists stay current on how to administer optimal care for the droves who suffer from knee OA. Noting this, a systematic review was created that evaluated various interventions for knee OA with the intention of determining which is most effective and if there are any other variables that need to be considered in constructing a treatment plan for knee OA.

Identifying which pitchers are at risk for injury in minor and major league baseball

Assessing injury risk for professional athletes is an incredibly important duty that has the potential to save sports franchises large sums of money if performed correctly. When it comes to major and minor league pitchers, the task is weighted even greater, since so much rides on pitchers' health as it is, and because they're more likely to sustain injuries than any other players. For this reason, it's essential to attempt to determine which pitchers are more likely to experience a throwing-related injury during the season by indicators they show during the preseason. Therefore, a study was created that sought to define risk factors that could lead to injury, and found weaknesses in particular shoulder muscles to be a likely cause for future injury.

The role of habitual physical activity in overall health for the elderly

It's well understood and recommended that regular moderate-intensity physical activity for the elderly population (aged 65 and older) is one of the most important components of a healthy lifestyle, as it enhances life, prolongs independent living and reduces the risk of numerous chronic health disorders. Despite this widely publicized concept, many elders fail to exercise as regularly as they should, leaving them at a higher risk for health complications. To get a better understanding of exactly what types of physical activity patterns elders should be engaging in, and to evaluate what factors influence whether or not elders exercise regularly, a study was performed in an average-sized town not far from Tokyo, Japan. Gender, physical and mental health, and weather were all shown to be important factors that affect the likelihood of exercise for those in the elderly community.

August 2010

Progressive resistance exercises and glycemic control for type 2 diabetes patients

Diabetes is a metabolic disorder that results from complications with insulin, which creates elevated plasma glucose levels and disturbances in metabolism that lead to further complications. Therefore, in order to manage diabetes, patients try to maintain appropriate plasma glucose levels, which can be done with medication, dietary intervention and exercise. Progressive resistance exercise is one form of exercise that has been suggested to improve glycemic control, but there is minimal research to confirm this theory. To better evaluate the effectiveness of this type of exercise on glycemic control, a systematic review was conducted and found it to be both beneficial and safe for type 2 diabetics compared to aerobic exercise and no exercise at all.

How characteristics of swinging mechanics can lead to low back pain for golfers

Golf is a sport that enjoys wide-ranging popularity on an international scale due to its casual nature and mild intensity level. Despite the fact that golf doesn't require much energy exertion and is fairly safe compared to most other sports, injuries still do occur, with lower back pain (LBP) being the most common complaint for both professional and amateur golfers. Consequently, physical therapists have been investigating which characteristics, if any, in a golf swing could contribute to a more likely chance of a golfer experiencing low back pain and why. One study compared golfers with LBP to those without it, and found a number of indicators that may lead to LBP that can be avoided if addressed properly.

Moderate exercise proven to be safe for fetus in last trimester of pregnancy

Exercise of any sort throughout the course of a pregnancy has long been a debated topic that continues to attract varying viewpoints. Of the greatest concern is the final trimester of a pregnancy, a time vital to the development of fetal lungs and other organs, which leads to questions regarding the effect of exercise on the homeostasis of the maternal-fetal unit. To better understand the connection between moderate exercise and the safety of fetuses in the final trimester of a pregnancy, a study was conducted on pregnant women and found no noticeable effects that were negative to the development of the fetus resulting from exercise.

July 2010

Treating ACL tears with physical therapy can eliminate need for surgery

Tears of the anterior cruciate ligament (ACL) occur often in young athletes who are active in sports, and tend to result in extended absences from performance. Reconstructive surgery is considered the preferred method of treatment for tears, despite the fact that surgery is extremely expensive and there is a lack of evidence confirming its effectiveness, while treatment with rehab alone is rarely seen. To compare the two, a study was conducted and found no significant advantages of going into surgery right away, recommending to begin with rehab and only have surgery in cases where it's unsuccessful.

Many patients with low back pain fail to follow recommendations for improvement

Low back pain (LBP) is an extremely common condition and major source of discomfort that affects a large percentage of people throughout the world at some point in their lives. When not treated correctly, cases of LBP can go on to turn more extreme and pose future problems that could've been avoided if guidelines were followed properly by patients. Noting this, an Australian study surveyed patients with LBP and found that many of those suffering from the condition didn't seek advice, and of those that did, a significant amount didn't actually follow the recommendations given to them. This figure points out much of what's wrong with the overall face of LBP rehab and should be considered in moving forward.

Non-operative treatment for labrum tears proven to be just as effective as surgery

Superior labrum anterior posterior (SLAP) tears, which can be extremely painful and debilitating injuries, occur most frequently in athletes who participate in overhead sports such as baseball, tennis and swimming. Treatment options are typically reserved to surgical intervention or the non-operative route of physical therapy and medication, though research is minimal on the latter. To better establish an understanding of the non-surgical option, a case series was performed and the results showed that treatment without surgery provided outcomes that were very similar to those from surgical intervention, suggesting that surgery is not always necessary.

June 2010

A close look at hyperkyphosis: how it develops, how to manage it

Age-related hyperkyphosis, which is defined by an exaggerated curvature of the thoracic spine, is a common condition in the elderly population that impairs the ability to function properly and increases the risk of falls and fractures. Though it effects somewhere between 20-40% of senior citizens, the natural history of hyperkyphosis is not completely understood, and it's thought to come about from a variety of processes. Fortunately, if hyperkyphosis is identified and treated early in its onset, the chances of recovering from it are much more likely. Take a look at what can cause it and the best ways to treat hyperkyphosis if it occurs.

How hip-strengthening exercises can help reduce knee pain in runners

Patellofemoral pain (PFP) is an extremely common issue encountered by runners in that usually occurs when the kneecap (patella) and thighbone (femur) rub against each other, causing pain in and around the kneecap area. The condition tends to only come about while in the course of running, but can intensify to the point where running becomes nearly impossible. One theory suggests that strengthening the hips will alleviate PFP since stronger hips can mean an improvement in running-form flaws that cause the pain in the first place, and a small trial of collegiate female runners provided outcomes that were favorable in supporting this theory.

Shoulder muscles with pendulum exercises and light activities during rotator cuff rehab

Tears and other injuries to the rotator cuff are seen in a variety of sports and usually occur due to the stress that repetitive throwing motion puts on the shoulder. Some studies claim that 75% of patients who repair large rotator cuff tears will go on to re-tear their rotator cuff in the future, meaning proper rehab is extremely important. One study sought to get a better understanding of activities that could be harmful to a healing shoulder, and found that the commonly prescribed pendulum exercises, when done incorrectly, as well as drinking out of a water bottle, could have a detrimental effect on shoulder rehab and should be performed with caution.

May 2010

Full-scale evaluation of lumbar spinal stenosis surgery for older adults

Spinal stenosis, a condition in which the narrowing of the spinal cord causes nerve pinching and subsequent pain in the buttocks, is the most common indicator for spine surgery in older adults, which itself is extremely prevalent. Despite the popularity of the surgery, however, a general consensus on the best surgical method has yet to be reached, as many surgeons still take their own individualized approach. To investigate these various methods and to clarify which is the best option, a study was conducted that evaluated Medicare trends to determine the optimal surgical style.

The effects of exercise intervention on elite swimmers' posture

Swimmers who compete at a competitive level rotate their shoulders an average of 16,000 times a week, a motion that over time can have serious complications and lead to sidelining injuries. Consequently, some studies show that as many as 47% of collegiate swimmers report pain, or swimmer's shoulder, for three weeks or more at some point in their career. Exercise interventions aimed at strengthening weak muscles and stretching tight ones are believed to alleviate pain and reduce the risk for injury, and to better understand the potential benefits of such an intervention, a study was performed on a group of Division I collegiate swimmers.

Resistance training for young athletes: possible benefits, risks and safety precautions

A new form of exercise that has been experiencing a significant upswing in popularity for young athletes over the past few years has been resistance training, a form of conditioning that uses resistive loads and a variety of exercises to improve strength and overall health. Not quite weightlifting or bodybuilding, which are more focused on increasing muscle size exclusively, resistance training s designed to help young athletes in a number of sports improve their overall performance with a carefully-constructed regimen. Responses to its usefulness and level of necessity have varied, with some deeming it too dangerous for young athletes. On the contrary, though, research has shown it to be a valuable form of conditioning that can be extremely effective if carried out properly and safely.

April 2010

A choice of words: what to use, what to avoid when delivering news to patients

When it comes to hearing news regarding an important, possibly life-altering condition, patients are at an increased level of susceptibility and vulnerability. For this reason, the manner in which news is delivered to patients is of extreme importance, and it can go on to have a major impact on how they come to deal with their diagnosis. Some medical professionals still manage to err in this sensitive process, but this pamphlet should elucidate on the most common mistakes and how to properly deliver these pieces of news.

Differences between running-related injury predictors for male and female novice runners

Running is far and away the most popular form of physical activity throughout the world, primarily due to the fact that just about any able-bodied person in just about any location can do it. With its popularity, however, also comes a high risk of injury, as some studies report numbers as high as 79% of all runners sustaining a running-related injury (RRI) at some point in their career. To evaluate the inherent risks associated with running and to determine the differences in risk factors for male and female novice runners, a randomized control trial was performed with these objectives in mind.

Why obese and overweight young athletes are more likely to sustain injuries

Figures for obesity and overweight in children and adolescents in the U.S. remain some of the highest in the world, and despite major attempts to counter the trend, the numbers don't seem to be getting any smaller. In addition to the general drawbacks of being overweight or obese, experts are now pointing out that there is also an additional risk of injury resulting from excessive weight that must be acknowledged and dealt with. Fortunately, awareness and some minor modifications in both lifestyle and sports participation can help overweight young athletes be less likely to suffer an injury.

March 2010

Vitamin C considered effective in reducing CRPS associated with distal radius fractures

Vitamin C, a water-soluble compound that's found in a wide array of fruits and vegetables, is essential for a number of important bodily functions and is recommended to improve general health. Some physicians also prescribe vitamin C to patients who've recently suffered a wrist fracture to prevent a condition known as complex regional pain syndrome (CRPS), but debate exists as to whether or not it's effective in doing so. To evaluate vitamin C's specific role in preventing CRPS, two randomized control trials were analyzed.

Evidence-based medicine: the importance of understanding varying levels of evidence

With the overwhelming slew of information on the Internet regarding just about any subject imaginable, including medical research and advice, it's difficult for the common man to determine what to believe and what to dismiss. Evidence-based medicine (EBM) uses a system that assigns a number to each medical study according to its strength of evidence, and as a result, makes the process of deciding what to trust as credible much easier.

Common training mistakes for marathon and half marathon runners

Making the decision to participate in a marathon (26.2 miles) or half marathon (13.1 miles) usually means one will be spending a sizable period of time prior to the race involved in a serious training program. For many who follow these programs, however, a number of minor but common mistakes in the course of training or on the day of the race can have negative effects on performance, but can easily be avoided by following these guidelines.

Feburary 2010

How injuries affect adolescent athletes' quality of life

Participation in sports for adolescents remains high, with an estimated 30 million being active in some organized form. Along with it, injuries are common and affect close to half of all young athletes. Aside from the natural impact on physical abilities and functioning, injuries can also have a negative effect on overall quality of life and wellbeing. In order to better understand these secondary implications of injury and the best ways to handle them, a study was performed on a small group of adolescent athletes.

An investigation of physical therapy intervention for adhesive capsulitis (frozen shoulder)

Adhesive capsulitis, also known as frozen shoulder, is a condition defined by pain, stiffness and a reduced range of motion and can have long-term implications if left untreated. The amount of research on nonsurgical treatments such as physical therapy for the disorder is extremely small, prompting a group to conduct an extensive randomized control trial that evaluated the effectiveness of specific therapy interventions. Certain interventions were shown to be beneficial while others proved more likely to impede rehabilitation rather than help it.

Evaluation of osteoporosis risk factors and recommendations for prevention

It's estimated that 1 in 4 women and 1 in 8 men in Canada have osteoporosis, a skeletal condition that occurs as a result of low bone mineral density. Osteoporosis particularly affects those over the age of 65 and has significant implications for those who suffer from it and on the entire health care system due to its prevalence. By understanding who's at risk and by following some simple preventative measures given by the organization Osteoporosis Canada, the rate of osteoporosis can be lowered, saving money and reducing complications for all those affiliated with the condition.

January 2010

Stem cells used in new treatment for damaged cartilage to prevent osteoarthritis

Osteoarthritis, the wearing away of cartilage in a joint, is the most common form of arthritis in the country, and is often caused by weakened or damaged cartilage as a result of injury. Damaged cartilage is usually treated with a procedure known as microfracture, which is only semi-effective and of which the long-term benefits are not known. With a new approach in mind, Dr. Constance Chu of the University of Pittsburgh has been working for the past 20 years on new forms of treatment that use stem cells to regenerate new, improved cartilage.

Hip impingement: recognizing, understanding and treating a common cause of hip pain

Based off the recent progress in diagnosing and treating nonarthritic hip injuries, hip impingement has become increasingly recognized as one of the more common causes of hip pain for athletes, adolescents and adults. Caused by a bone in the hip and the thighbone rubbing against each other, hip impingement can lead to the wearing away of cartilage and eventually osteoarthritis if not treated properly. The debilitating disease can have serious implications for both physical and daily life activities, but physical therapy has been strongly recommended as a method to treat it.

The effect of Pilates on adult fitness characteristics

Pilates have seen a major upswing in popularity in recent years, with more than five million Americans regularly using the exercise system today. The Pilates method, as its formally known, employs a series of resistance exercises performed with various apparatuses and a Pilates mat, and its goal is to improve body composition, flexibility and muscular endurance. Despite its prominence, evidence on the specific benefits of Pilates is scarce. To better analyze the actual effects of Pilates, a small study was performed using a group of physically active adults.


December 2009

The benefits of dealing with obesity in patients with knee osteoarthritis

People who suffer from obesity are at an increased risk of obtaining knee osteoarthritis (OA) due to excessive pressure on joints in the knee, and for obese patients who already have the condition, not doing anything about it can lead to further complications. Increased physical activity and dietary modifications with the purpose of losing weight are therefore considered productive methods to prevent knee OA and lessen the severity of pain in those who have it. To highlight these benefits and prompt physicians to encourage weight-loss treatment programs, a study was conducted and published in The Journal of Musculoskeletal Medicine.

Hip arthroscopy for athletes in the long term: a 10-year follow up

Arthroscopy is a minimally invasive procedure preferred by some for its shorter recovery time and smaller scar, and it has been a popular method to treat sports-related hip problems for years. Despite the popularity of hip arthroscopy, there is a lack of data on the long-term effects of the surgery, spurring a study in which athletes who underwent the procedure were monitored over the course of 10 years to determine its effectiveness or lack thereof.

Obesity accounts for nearly 10% of all medical spending in the United States

Recent research released by the U.S. Center for Disease Control and Prevention (CDC) claims that obesity-related diseases account for 9.1% of all medical spending in the U.S., or about $147 billion annually. With this in mind, the CDC emphasizes the importance of reducing the national obesity rate in order to lower health care costs, and suggests certain ways in which this can be accomplished.

November 2009

Evaluating postconcussive outcomes after return to play in Australian Football

Concussions are prevalent in any sport in which contact is involved, and the rule of thumb usually says the higher the level of contact, the higher the frequency of concussions. One matter of debate amongst physicians is the amount of time that should be spent recovering from a concussion before returning to competition. A study was therefore conducted on players in the Australian Football League (AFL), a sport with one of the highest rates of concussion, to determine the ideal amount of sitting out time following a concussive injury.

How ACL reconstruction and/or meniscectomies can affect NFL players' careers

Two of the most common injuries in football are those related to the meniscus and anterior cruciate ligament (ACL), and as a result, procedures done to repair those areas are extremely prevalent with NFL players. Due to the frequency of these procedures, a study was performed using data from the NFL Scouting Combine to determine how the procedures impact the length and quality of players' careers.

Thrown a curve: a new take on youths, curveballs and overuse injuries

Since the early days of sports medicine, parents and coaches of young pitchers have been under the belief that curveballs are dangerous for developing arms, and should not be thrown at least until the age of 14. Two separate studies investigated the validity of this concept and discovered that fastballs are in fact more stressful on the elbow than curveballs, but a high volume of any pitch will be detrimental to the pitcher's arm despite the type.

What a knee arthroplasty could mean for one's golf game

The popularity of golf in the U.S. is due in part to the fact that its low-impact nature makes it a sport for all ages to participate in, especially elders. Many elders suffering from degenerative arthritis, however, experience problems with their knees during play and go on to have a total knee arthroplasty (TKA) to resolve the issue. In order to better understand the usefulness of TKA on golfers, a study was conducted that evaluated pain and enjoyment levels before and after the procedure.

February 2009

Getting on the ball for diabetes prevention

High rates of diabetes are far from limited to the United States, as the International Diabetes Federation estimates there to currently be 246 million adults worldwide with diabetes, a figure expected to only continue to increase. Mainly due to the paralleled ascension of obesity and overweight, the diabetes problem has reached a global level, and requires dedicated efforts in education, research and development, and forms treatment on grand scale.

Type 2 diabetes patients should be given option of self-monitoring

The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Center for Chronic Conditions surveyed nearly 900 type 2 diabetics to garner a clearer understanding of their perception towards the disease and how best to treat their condition. An updated set of guidelines was subsequently released that emphasized the need for more educational information for diabetics, and recommended diabetics monitor their own glycosylated hemoglobin target barring that it doesn't affect their quality of life.

How high-force eccentric resistance exercise can improve glucose control for diabetics

With the numerous forms of treatment available for diabetics, one of the easiest and cheapest remains basic aerobic exercise. In addition to everyday aerobic exercises like walking, running and biking, a new study found that an eccentric resistance exercise program designed to increase strength and muscle size could also help type 2 diabetics.


December 2008

What studies have more validity and why: The importance of clinical trials

With such an abundance of medical reports being released by the media, it has become a difficult task to determine whether a source or study is trustworthy. Clinical trials, due to a number of powerful factors, are proven to be the most accurate of studies, even when their conclusions contradict popular belief.

Chasing the enigma of female ACL injuries and the gender differences that cause them

A research retreat was held in Greensboro, NC, to further examine why females suffer from ACL injuries easier than males. The group came up with three important themes that need to be aggressively pursued in order to better understand the mysterious disparity.

How menstrual cycle phase and anatomy may have an impact on ACL injuries in females

One major consensus emerging in medical literature is the possibility that the menstrual cycle phase of females affects their vulnerability to ACL injuries. According to a number of studies, females are much more likely to experience an ACL injury in the preovulatory phase of their cycle than the postovulatory phase. Female anatomical makeup is also investigated.

Wrist guards' impact on wrist and elbow injury in snowboarders

An Australian study investigated the effect of wrist guards on both wrist and elbow injuries, as it has been suggested by some that wrist guards can actually lead to elbow injury as a result of redistributing the impact of the force. The study found the claim to be false and the guards to be extremely effective for their purpose.

October 2008

An investigation into damaged menisci in the average middle-aged and elderly reveals a shockingly high number of incidences of damage, many of which occurred in patients who did not have symptoms of injury

Tears to the meniscus, a pair of fibrocartilaginous discs in the knee that provide support and protection, are one of the most common injuries and surgeries to repair this region are recognized as the most common surgery performed by orthopedic surgeons. In addition, many middle aged and elderly persons suffer from damaged menisci without being aware of it. One study investigated the number of people with the injuries and whether MRI usage was effective in diagnosing them.

Evaluating arthroscopic surgery vs. physical therapy for treatment of Osteoarthritis of the knee: the minimally invasive procedure rising in popularity may not be any more effective in rehabilitating OA knee than therapy, but will veritably cost more money and time than the latter

Osteoarthritis of the knee (OA knee) is a condition that can be treated with extensive physical and medical therapy or with arthroscopic surgery in other situations. While arthroscopy has risen in popularity, whether or not it is actually more effective than therapy alone is a matter of debate. An investigation sent nearly 200 eligible patients to both forms of treatment and evaluated which was a more beneficial means of alleviating pain.

Dairy intake, particularly milk and yogurt, is a proven weapon used for combating weight issues and type 2 diabetes due to dietary calcium in all dairy and a number of weight loss properties found in milk

One new dietary method for preventing obesity and type 2 diabetes is based on higher amounts of dairy due to its high concentration of dietary calcium, which is known to burn fat rather than store it. In addition, milk's bioactive peptides provide additional weight loss capabilities, due to their multiform composition with elements that reduce blood pressure, regulate food intake and cause a number of other reactions that contribute to weight loss.

Cod liver oil supplements capable of reducing Non-steroidal anti-inflammatory drugs for patients with rheumatoid arthritis who are forced to limit their usage of NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are essential for patients with rheumatoid arthritis, yet certain people have to limit their usage of NSAIDs due to unwanted gastrointestinal and cardiovascular side effects. A Scottish study found that cod liver oil supplements were able to lower the amount of NSAIDs taken on a regular basis by a significant degree.